New quality of life questionnaire for dogs with chronic kidney disease

Abstract

OBJECTIVE: To develop and validate an owner-reported questionnaire designed to measure health-related quality of life (HRQoL) in dogs with chronic kidney disease (CKD). METHODS: This noninterventional study followed best practice guidance for instrument development. Draft items were initially identified through a qualitative literature and social media review. Concept elicitation and cognitive debriefing interviews with owners of dogs with CKD further informed item development and modification. Psychometric properties were then evaluated in a larger sample, alongside 2 global items assessing the dog's HRQoL from the owner's and veterinarian's perspective. Expert veterinarian input was provided throughout. RESULTS: Owners of 11 dogs with CKD were recruited for interviews, and owners of 279 dogs with CKD were recruited for psychometric evaluation. Forty-eight signs and behaviors of CKD were identified from the literature and social media review; an additional 13 concepts were identified in the qualitative interviews. The final questionnaire comprised 13 items assessing observable HRQoL impacts of CKD in dogs and demonstrated reliability and validity in terms of psychometric properties. Factor and item response theory analyses confirmed the questionnaire's unidimensional structure. High internal consistency (Cronbach alpha = 0.89; McDonald omega = 0.89), moderate to good test-retest reliability (≥ 0.73), and strong convergent validity evidence were found. The questionnaire demonstrated the ability to discriminate between early International Renal Interest Society stages and different levels of owner- and veterinarian-reported overall dog HRQoL. CONCLUSIONS: This is the first psychometrically validated questionnaire assessing HRQoL in canine CKD. CLINICAL RELEVANCE: The measure is fit for purpose for use in canine CKD both in clinical trials and veterinary practice.