The new Health-Related Quality of Life in Feline Chronic Kidney Disease Questionnaire demonstrates reliability and validity for use in feline clinical trials

Abstract

Abstract Objective To develop and validate an owner-reported health-related quality-of-life (HRQoL) questionnaire in cats with chronic kidney disease (CKD). Methods This was a noninterventional, international study. Initial draft items were identified through qualitative literature and social media reviews. Concept elicitation and cognitive debriefing interviews were conducted with owners of cats with International Renal Interest Society–staged CKD in the US and United Kingdom to further inform item development. A 2–time point observational study was then conducted in a Greek sample of owners of cats with stable CKD to allow for psychometric analysis. Expert veterinarian input was incorporated throughout. Participants were recruited using purposive convenience sampling. Results Owners of 10 cats participated in interviews, and owners of 208 cats were included in the psychometric evaluation. An initial 20-item questionnaire was debriefed and refined across 2 rounds of interviews, resulting in a 21-item version for psychometric evaluation. The final questionnaire comprised 13 items assessing observable HRQoL impacts of feline CKD. Psychometric analyses confirmed a unidimensional structure, with high internal consistency (Cronbach α coefficient = 0.92; McDonald ω coefficient = 0.93), moderate to good test-retest reliability (≥ 0.72), and strong convergent validity. Questionnaire responses discriminated between early and late International Renal Interest Society stages and varying levels of overall HRQoL as reported by owners and veterinarians. Conclusions This research presents a novel, disease-specific, psychometrically validated questionnaire assessing HRQoL in feline CKD. Clinical Relevance The questionnaire is fit for purpose for use in feline CKD both in clinical trials and veterinary practice.