RSS-Feed abonnieren
DOI: 10.1055/a-2543-7748
Linguistic Validation and Cross-Cultural Adaptation of the Canine Orthopedic Index for the German- and Spanish-speaking Population
Funding This work was supported by AO VET.

Abstract
Objective
The Canine Orthopedic Index (COI) questionnaire was developed to assess chronic pain and functional impairment in dogs with orthopaedic conditions. This study aimed to perform a linguistic validation and cross-cultural adaptation of the COI from the original English version into Universal German and Universal Spanish.
Methods
We employed the Functional Assessment of Chronic Illness Therapy translation methodology, which involves two forward translations, one reconciliation of the two forward translations, a back translation into English, multiple reviews, and cognitive debriefing interviews with a representative sample of dog carers. We followed a universal approach to translation, with translators and study participants from different German- and Spanish-speaking countries.
Results
The two independent forward translations differed by four parts for the German COI and eight parts for the Spanish COI. Comparing the backward translations with the original document identified 10 items or instructions in both translations that required retranslation. Cognitive debriefing interviews with dog carers confirmed that the translated instruments effectively conveyed the same concepts as the original version, leading to no further changes in the Universal German COI and four minor revisions to the Universal Spanish COI.
Conclusion
We provide linguistically validated and culturally adapted versions of the COI suitable for use in all German- and Spanish-speaking countries.
Keywords
observer-reported outcome measures - translation - linguistic validation - canine - orthopaedicAuthors' Contribution
H.R. contributed to the conception of the study, study design, data acquisition, data analysis and interpretation, original draft writing, and reviewing and editing. N.A.R.R. and P.L. contributed to the data acquisition, data analysis and interpretation, and reviewing and editing. C.C. contributed to the original draft writing, and reviewing and editing. P.C. contributed to study design, data analysis and interpretation, as well as reviewing and editing. A.J. contributed to the conception of the study, and study design and reviewed and approved the final manuscript.
Publikationsverlauf
Eingereicht: 14. November 2024
Angenommen: 21. Februar 2025
Artikel online veröffentlicht:
12. Mai 2025
© 2025. Thieme. All rights reserved.
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
-
References
- 1 Clark N, Comerford E. An update on mobility assessment of dogs with musculoskeletal disease. J Small Anim Pract 2023; 64 (10) 599-610
- 2 Anderson KL, Zulch H, O'Neill DG, Meeson RL, Collins LM. Risk factors for canine osteoarthritis and its predisposing arthropathies: a systematic review. Front Vet Sci 2020; 7: 220
- 3 Mele E. Epidemiology of osteoarthritis. Vet Focus 2007; 17: 4-10
- 4 Pantaleon L. Why measuring outcomes is important in health care. J Vet Intern Med 2019; 33 (02) 356-362
- 5 Belshaw Z, Dean R, Asher L. “You can be blind because of loving them so much”: the impact on owners in the United Kingdom of living with a dog with osteoarthritis. BMC Vet Res 2020; 16 (01) 190
- 6 Belshaw Z, Dean R, Asher L. Slower, shorter, sadder: a qualitative study exploring how dog walks change when the canine participant develops osteoarthritis. BMC Vet Res 2020; 16 (01) 85
- 7 Walton MB, Cowderoy E, Lascelles D, Innes JF. Evaluation of construct and criterion validity for the ‘Liverpool Osteoarthritis in Dogs’ (LOAD) clinical metrology instrument and comparison to two other instruments. PLoS One 2013; 8 (03) e58125
- 8 Belshaw Z, Asher L, Dean RS. Systematic review of outcome measures reported in clinical canine osteoarthritis research. Vet Surg 2016; 45 (04) 480-487
- 9 Pinna S, Lambertini C, Grassato L, Romagnoli N. Evidence-based veterinary medicine: a tool for evaluating the healing process after surgical treatment for cranial cruciate ligament rupture in dogs. Front Vet Sci 2019; 6: 65
- 10 Innes JF, Morton MA, Lascelles BDX. Minimal clinically-important differences for the ‘Liverpool Osteoarthritis in Dogs’ (LOAD) and the ‘Canine Orthopedic Index’ (COI) client-reported outcomes measures. PLoS One 2023; 18 (02) e0280912
- 11 Radke H, Joeris A, Chen M. Evidence-based evaluation of owner-reported outcome measures for canine orthopedic care - a COSMIN evaluation of 6 instruments. Vet Surg 2022; 51 (02) 244-253
- 12 Brown DC. The Canine Orthopedic Index. Step 1: Devising the items. Vet Surg 2014; 43 (03) 232-240
- 13 Brown DC. The Canine Orthopedic Index. Step 2: Psychometric testing. Vet Surg 2014; 43 (03) 241-246
- 14 Brown DC. The Canine Orthopedic Index. Step 3: Responsiveness testing. Vet Surg 2014; 43 (03) 247-254
- 15 Andersson A, Bergström A. Adaptation of the Canine Orthopaedic Index to evaluate chronic elbow osteoarthritis in Swedish dogs. Acta Vet Scand 2019; 61 (01) 29
- 16 Engdahl K, Bergström A, Höglund O, Moldal ER, Emanuelson U, Boge GS. Long-term outcome in dogs with cranial cruciate ligament disease evaluated using the canine orthopaedic index. Vet Rec 2023; 193 (12) e3172
- 17 Moore EV, Weeren R, Paek M. Extended long-term radiographic and functional comparison of tibial plateau leveling osteotomy vs tibial tuberosity advancement for cranial cruciate ligament rupture in the dog. Vet Surg 2020; 49 (01) 146-154
- 18 Alves JC, Innes JF. Minimal clinically-important differences for the “Liverpool Osteoarthritis in Dogs” (LOAD) and the “Canine Orthopedic Index” (COI) in dogs with osteoarthritis. PLoS One 2023; 18 (09) e0291881
- 19 Wild D, Grove A, Martin M. et al; ISPOR Task Force for Translation and Cultural Adaptation. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) measures: report of the ISPOR task force for translation and cultural adaptation. Value Health 2005; 8 (02) 94-104
- 20 Eremenco S, Pease S, Mann S, Berry P. PRO Consortium's Process Subcommittee. Patient-Reported Outcome (PRO) Consortium translation process: consensus development of updated best practices. J Patient Rep Outcomes 2017; 2 (01) 12
- 21 McKown S, Acquadro C, Anfray C. et al. Good practices for the translation, cultural adaptation, and linguistic validation of clinician-reported outcome, observer-reported outcome, and performance outcome measures. J Patient Rep Outcomes 2020; 4 (01) 89
- 22 Alves JC. Initial psychometric evaluation of the Portuguese version of the Canine Orthopedic Index. Vet Comp Orthop Traumatol 2023; 36 (05) 236-240
- 23 Alves JCA, Jorge PIF, Dos Santos AMMP. A survey on the orthopedic and functional assessment in a Portuguese population of police working dogs. BMC Vet Res 2022; 18 (01) 116
- 24 Eremenco SL, Cella D, Arnold BJ. A comprehensive method for the translation and cross-cultural validation of health status questionnaires. Eval Health Prof 2005; 28 (02) 212-232
- 25 Bonomi AE, Cella DF, Hahn EA. et al. Multilingual translation of the Functional Assessment of Cancer Therapy (FACT) quality of life measurement system. Qual Life Res 1996; 5 (03) 309-320
- 26 Lent L, Hahn E, Eremenco S, Webster K, Cella D. Using cross-cultural input to adapt the Functional Assessment of Chronic Illness Therapy (FACIT) scales. Acta Oncol 1999; 38 (06) 695-702
- 27 American Veterinary Medical Association. AVMA Pet Ownership and Demographics Sourcebook: 2017–2018 edition. 2018
- 28 Landau RE, Beck A, Glickman LT, Litster A, Widmar NJ, Moore GE. Preparedness of small animal veterinary practices to communicate with Spanish-speaking pet owners with limited proficiency in English. J Am Vet Med Assoc 2016; 248 (06) 690-699
- 29 Landau RE, Beck A, Glickman LT, Litster A, Widmar NJ, Moore GE. Use of veterinary services by Latino dog and cat owners with various degrees of English-language proficiency. J Am Vet Med Assoc 2016; 248 (06) 681-689
- 30 Beatty PC, Willis GB. Research Synthesis: The Practice of Cognitive Interviewing. Public Opin Q 2007; 71: 287-311
- 31 Willis G. Cognitive Interviewing. Thousand Oaks, Ca: Sage Publications; 2005.
- 32 Ryan K, Gannon-Slater N, Culbertson MJ. Improving survey methods with cognitive interviews in small- and medium-scale evaluations. Am J Eval 2012; 33: 414-430
- 33 Willis G. Analysis of the Cognitive Interview in Questionnaire Design. Oxford University Press; 2015
- 34 Webster K, Cella D, Yost K. The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System: properties, applications, and interpretation. Health Qual Life Outcomes 2003; 1: 79
- 35 ITIFDO Publique. IFOP survey: The place of pets within the couple – Vetocanis Annual report, 2022. Vetocanis; 2022