Clinical Metrology Instruments

COAST Development Group’s international consensus guidelines for the treatment of canine osteoarthritis

Summary:

This report describes consensus guidelines and recommendations for the treatment of canine osteoarthritis (OA) according to the “Canine OsteoArthritis Staging Tool excluding radiography” (COASTeR) stage of OA, by the COAST Development Group. The recommendations are based on evidence-based medicine and clinical experience and are proposed with international relevance in mind. The aim is to provide veterinarians with a practical reference to consolidated information and to support the development of patient-specific OA management protocols and informed treatment choices based on the stage of OA.

Conclusion:

Canine osteoarthritis is a complex disease and only animal healthcare professionals with personal knowledge of the patient can optimize care plans to meet the needs of the patient and requirements of the pet caregiver. This proposal for the first international guidelines for the treatment of canine osteoarthritis (OA), according to the COASTeR OA stage, is intended to provide a practical reference to evidence-based recommendations and expert opinion while leaving decision-making and the development of protocols appropriate to each dog’s specific situation, firmly in the hands of the consulting veterinarian. The authors encourage the use of the COAST staging tool and the COAST canine OA treatment guidelines proposal, and welcome feedback to help guide future updates and the optimization of both ([email protected]).

 

Author & Journal:Thibaut Cachon, Ole Frykman, John F. Innes, B. Duncan X. Lascelles, Masahiro Okumura, Pedro Sousa, Francesco Staffieri, Paulo V. Steagall, Bernadette Van Ryssen; Frontiers in Veterinary Science

Assessing Chronic Pain In Dogs

Summary:

“Finding precise, reliable, and accurate measures of chronic pain in animals is a difficult effort. However, much research has gone into developing measurement methods to evaluate chronic pain in dogs (and, more recently, cats); this article reviews the pain scales currently available.”

Conclusion:

Details in linked article reviews the following pain scales: Helsinki Chronic Pain Index, Canine Brief Pain Index, Cincinnati Orthopedic Disability Index, Liverpool Osteoarthritis in Dogs.

Author & Journal:Epstein, Mark E., Today’s Veterinary Practice, 2013

Canine Orthopedic Outcome Measures Program: Where Are We Now?

Summary:

The overall goal of COMP was to advance veterinary orthopedic patient care by providing and supporting mechanisms for all clinicians, researchers, industry partners, and regulatory bodies to produce, assess, and implement the highest evidentiary value data for evaluation of safety and efficacy of diagnostic and therapeutic modalities. At project initiation, we estimated that it would take more than 1 million dollars to recruit key personnel, design appropriate studies, produce data, and create, validate and implement the instruments(s). After 6 years of intensive work in all of these areas, a tremendous amount of progress has been made. This editorial summarizes the COMP’s efforts and results, and suggests a way forward to our ultimate goal of optimal patient-centered, evidence based care in veterinary orthopedics.”

Conclusion:

“The good news is that we now have a number of excellent options for effectively measuring outcomes in clinical and translational studies in dogs. The bad news is that we now have a number of different options to sort through to determine what is optimal for each study. So what should you do?” Click the link for the full article and listed solutions from the author.

Author & Journal:Cook, James L., Veterinary Surgery, 2014

Psychometric testing of the Helsinki chronic pain index by completion of a questionnaire in Finnish by owners of dogs with chronic signs of pain caused by osteoarthritis

Summary:

“To determine the validity, reliability, and sensitivity of a published chronic pain index by completion of a questionnaire in Finnish by owners of dogs with chronic signs of pain caused by osteoarthritis.”

Conclusion:

“The Finnish version of the HCPI provided a valid, reliable, and responsive tool for assessment of response to treatment in dogs with osteoarthritis.”

Author & Journal:Hielm-Björkman, Anna K., et al, American Journal of Veterinary Research, 2009

Evaluation of Construct and Criterion Validity for the ‘Liverpool Osteoarthritis in Dogs’ (LOAD) Clinical Metrology Instrument and Comparison to Two Other Instruments

Summary:

“To test the ‘Liverpool Osteoarthritis in Dogs’ (LOAD) questionnaire for construct and criterion validity, and to similarly test the Helsinki Chronic Pain Index (HCPI) and the Canine Brief Pain Inventory (CBPI).”

Conclusion:

“LOAD is an owner-completed clinical metrology instrument that can be recommended for the measurement of canine osteoarthritis. It is convenient to use, validated and, as demonstrated here for the first time, has a correlation with force-platform data.”

Author & Journal:Walton, Myles Benjamin, et al, PLoS One, 2013

Comparison of Force Plate Gait Analysis and Owner Assessment of Pain Using the Canine Brief Pain Inventory in Dogs with Osteoarthritis

Summary:

Evaluate the relationship between CBPI pain severity (PS) and interference (PI) scores with the vertical forces of FPGA as efficacy measures in canine osteoarthritis.

Conclusion:

In these dogs with hind limb or forelimb osteoarthritis, owner assessment of chronic painusing the CBPI and assessment of lameness using FPGA detected significant improvement in dogs treated with carprofen. The lack of correlation or concordance between the change in owner scores and vertical forces suggests that owners were focused on behaviors other than lameness when making efficacy evaluations in their dogs.

Author & Journal:D.C. Brown, et al, J Vet Intern Med 2013;27:22–30

Face validity of a proposed tool for staging osteoarthritis: Canine OsteoArthritis Staging Tool (COAST).

Summary:

This article outlines the rationale and thought processes behind the construction of this proposed instrument and the ‘item generation’ — determination by expert opinion of what the instrument should contain and look like (face validity). It gives a detailed overview of COAST, and practical details on how it is proposed to be used.

Conclusion:

This report describes a novel instrument developed by an expert panel to facilitate diagnosis of OA through standardized and guided assessment. Ultimately, an effective staging tool like this may help improve pain control and general clinical management of dogs with OA by providing standardized ‘scores’ over time that can be related to treatment efforts. With COAST, the authors are proposing a schematic approach to diagnosing and staging canine OA, utilizing inputs from the pet owner and from the veterinarian consultation and examination.

Author & Journal:Cachon T, Frykman O, Innes JF, et al, Vet J 2018

Validation of a client-based clinical metrology instrument for the evaluation of canine elbow arthritis

Summary:

To validate a disease-specific client-based clinical metrology instrument (questionnaire) for dogs with chronic osteoarthritis of the elbow joint.

Conclusion:

The reliability of Liverpool Osteoarthritis in Dogs (elbow) in the test-retest scenario was good; intraclass correlation coefficient is 0.89, 95 per cent confidence interval 0.75 to 0.95, compared with intraclass correlation coefficient 0.92, 95 per cent confidence interval 0.74 to 0.98, for peak vertical force. Responsiveness testing indicated that the “net” effect size (allowing for placebo effect) for Liverpool Osteoarthritis in Dogs (elbow) was 0.13 compared with (-)0.18 for the force platform. Criterion validity for Liverpool Osteoarthritis in Dogs(elbow) against peak vertical force was poor; Spearman’s rank correlation is -0.24 (P=0.30).

Author & Journal:Hercock, C.A., et al, Journal of Small Animal Practice 50, 266–271