title: Criterion Validation Testing of Clinical Metrology Instruments for Measuring Degenerative Joint Disease Associated Mobility Impairment in Cats.
abstract: BACKGROUND
  Degenerative joint disease and associated pain are common in cats, particularly in older cats. There is a need for treatment options, however evaluation of putative therapies is limited by a lack of suitable, validated outcome measures that can be used in the target population of client owned cats. The objectives of this study were to evaluate low-dose daily meloxicam for the treatment of pain associated with degenerative joint disease in cats, and further validate two clinical metrology instruments, the Feline Musculoskeletal Pain Index (FMPI) and the Client Specific Outcome Measures (CSOM).
  
  
  METHODS
  Sixty-six client owned cats with degenerative joint disease and owner-reported impairments in mobility were screened and enrolled into a double-masked, placebo-controlled, randomized clinical trial. Following a run-in baseline period, cats were given either placebo or meloxicam for 21 days, then in a masked washout, cats were all given placebo for 21 days. Subsequently, cats were given the opposite treatment, placebo or meloxicam, for 21 days. Cats wore activity monitors throughout the study, owners completed clinical metrology instruments following each period.
  
  
  RESULTS
  Activity counts were increased in cats during treatment with daily meloxicam (p<0.0001) compared to baseline. The FMPI results and activity count data offer concurrent validation for the FMPI, though the relationship between baseline activity counts and FMPI scores at baseline was poor (R2=0.034). The CSOM did not show responsiveness for improvement in this study, and the relationship between baseline activity counts and CSOM scores at baseline was similarly poor (R2=0.042).
  
  
  CONCLUSIONS
  Refinements to the FMPI, including abbreviation of the instrument and scoring as percent of possible score are recommended. This study offered further validation of the FMPI as a clinical metrology instrument for use in detecting therapeutic efficacy in cats with degenerative joint disease.
authors.affiliation: Comparative Pain Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America.
authors.forename: Margaret E
authors.initials: ME
authors.lastname: Gruen
authors.affiliation: Department of Statistics, North Carolina State University, Raleigh, North Carolina, United States of America.
authors.forename: Emily H
authors.initials: EH
authors.lastname: Griffith
authors.affiliation: Comparative Pain Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America.
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Thomson
authors.affiliation: Morrisville Cat Hospital, Morrisville, North Carolina, United States of America.
authors.forename: Wendy
authors.initials: W
authors.lastname: Simpson
authors.affiliation: Comparative Pain Research Laboratory, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America; Center for Comparative Medicine and Translational Research, Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States of America; Center for Pain Research and Innovation, University of North Carolina School of Dentistry, Chapel Hill, North Carolina, United States of America.
authors.forename: B Duncan X
authors.initials: BD
authors.lastname: Lascelles
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002371:Cat Diseases / Q000175:diagnosis* / Q000188:drug therapy; D002415:Cats; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D007592:Joint Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000662:veterinary*; D008297:Male; D000077239:Meloxicam; D051346:Mobility Limitation; D009043:Motor Activity; D012720:Severity of Illness Index; D013843:Thiazines / Q000627:therapeutic use; D013844:Thiazoles / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D013843:Thiazines; D013844:Thiazoles; D000077239:Meloxicam