Table 5 Disorder-level score allocation criteria for the seven individual severity metrics contributing to overall severity score. Sub-scores assigned at disorder-level, based on analysis of group data obtained via structured review of electronic health records from 250 affected dogs per disorder during 2013
Disorder-level sub-score category | Severity metric 1: Disorder as reason presented for veterinary care during year | Severity metric 2: Frequency of disorder-related primary care clinic visits during year | Severity metric 3: Chronicity of disorder-related analgesia (including AI) therapy during year | Severity metric 4: Range of other (non-analgesic/AI) therapeutic groups used for disorder treatment/management in year | Severity metric 5: Surgical depth of any disorder-related procedures performed under GA/sedation during year | Severity metric 6: Disorder-related overnight primary-care hospitalisations during year | Severity metric 7: Disorder-related referral during year |
|---|---|---|---|---|---|---|---|
Aims to reflect: | Owner perception of need/urgency of need for veterinary care | Veterinary opinion/owner perceived importance for repeated veterinary visits | Vet/owner perceived need for any pain relief and for how long (i.e. over shorter or longer periods of time) | Clinical indications and perception of extent of veterinary intervention required to manage the disorder | The level/depth of surgical intervention required to manage the disorder appropriately | Vet/owner perceived requirement for veterinary in-patient level care related to the disorder | Vet/owner perceived requirement for referral-level care related to the disorder |
Assigned based on assessment of group data showing: | Evidence for the disorder as a primary or secondary/partial presenting complaint, or an incidental finding | Median number of disorder-related EHR visit entries per case in the year | Proportion of cases prescribed disorder-related analgesic drug therapy, for up to 14 days or longer | Proportion of cases prescribed/sold no, 1–2, or > 2 different non-analgesic/non-AI therapeutic groups related to the disorder | Proportion of cases within different maximum disorder-related surgical intervention categories | Median number of disorder-related overnight primary-care hospitalisations per case during the year | Proportion of cases with evidence for at least one disorder-related referral during the year. |
Sub-score 0 | N/A (At least one disorder-related visit during year required for selection as case) | N/A (At least one disorder-related visit during year required for selection as case) | 0 cases prescribed disorder-related analgesia/AIs during year | 0 cases were sold disorder-related, non-analgesic/AI therapeutic interventions | No procedures: 0 cases underwent disorder-related procedures under GA or sedation | 0 cases with disorder-related overnight hospitalisation at a primary care clinic | 0 cases referred for investigation/management/treatment of the disorder |
Sub-score 1 | Disorder only ever noted as an incidental finding in > 50% of cases | Median 1–2 disorder-related visits per case | < 50% cases prescribed some form of analgesia / AI therapy for the disorder | Under 50% (but > 0%) of cases were sold ANY disorder-related, non-analgesic/AI therapeutic interventions | Few procedures: Under 50% (but > 0%) of cases underwent disorder-related procedures under GA or sedation | At least 1 case with an overnight hospitalisation but median overnight disorder-related hospitalisations per case: 0 | Up to 1% of study cases referred for investigation/management/treatment of the disorder |
Sub-score 2 | > 50% of cases presented with disorder as a partial presenting complaint, at most | Median 3–5 disorder-related visits per case | 50% or more cases prescribed 1–14 consecutive days of analgesia / AI therapy for the disorder | > 50% of cases were sold disorder-related, non-analgesic/AI interventions from 1 or 2 distinct therapeutic groups | Many minor procedures: 50% or more cases underwent procedures no deeper than skin/CT/MM under GA or sedation | Median disorder-related overnight hospitalisations per case during study year: 1 to 5 | 1–3% of study cases referred for investigation/management/treatment of the disorder |
Sub-score 3 | > 50% of cases presented at least once with disorder as primary complaint | Median > 5 disorder-related visits per case | > 50% of cases prescribed > 14 consecutive days analgesia / AI therapy for the disorder | > 50% of cases were sold disorder-related, non-analgesic/AI interventions from > 2 distinct therapeutic groups | Many major procedures: > 50% cases underwent procedures deeper than skin/CT/MM under GA or sedation | Median disorder-related overnight hospitalisations per case: > 5 | > 3% of study cases referred for investigation/management/treatment of the disorder |
If no single relevant results category contains > 50% of dogs…… | If % of dogs in categories 1 and 2 (above) combined exceeds % in categories 2 and 3 combined: Assign sub-score 2 If % of dogs in categories 2 and 3 combined exceeds % in categories 1 and 2 combined: Assign sub-score 3 | N/A | If % of dogs in categories 1 and 2 (above) combined exceeds % in categories 2 and 3 combined: Assign sub-score 2 If % of dogs in categories 2 and 3 combined exceeds % in categories 1 and 2 combined: Assign sub-score 3 | N/A | If % of dogs in categories 1 and 2 (above) combined exceeds % in categories 2 and 3 combined: Assign sub-score 2 If % of dogs in categories 2 and 3 combined exceeds % in categories 1 and 2 combined: Assign sub-score 3 | N/A | N/A |