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. 2023 Dec 25;14(1):83.
doi: 10.3390/ani14010083.

Psychometric Testing and Validation of the Italian Version of the Helsinki Chronic Pain Index (I-HCPI) in Dogs with Pain Related to Osteoarthritis

Giorgia Della Rocca  1 , Carlo Schievano  2 , Alessandra Di Salvo  1 , Anna K Hielm-Björkman  3 , Maria Federica Della Valle  4
Affiliations

Psychometric Testing and Validation of the Italian Version of the Helsinki Chronic Pain Index (I-HCPI) in Dogs with Pain Related to Osteoarthritis

Giorgia Della Rocca et al. Animals (Basel). .

Abstract

Pain assessment is of paramount importance for properly managing dogs with osteoarthritis (OA) pain. The aim of the present study was to develop and psychometrically validate the Italian version of the Helsinki Chronic Pain Index (I-HCPI). Owners of OA painful (n = 87) and healthy dogs (n = 40) were administered the I-HCPI once or twice after an eight-week meloxicam treatment. Sixty-nine owners of healthy and OA dogs also completed the Italian version of the Canine Brief Pain Inventory (I-CBPI). Pain on palpation on a 0-4 scale was assessed on all recruited dogs. Construct validity was tested both with hypothesis testing and principal component analysis, confirming the I-HCPI accurately measured chronic pain. Good convergent and criterion validity were shown through correlations with I-CBPI subscores and distribution among pain on palpation scores (p < 0.0001). The significant difference between the pre- and post-treatment I-HCPI scores (p < 0.0001) and Cohen's effect size (2.27) indicated excellent responsiveness. The I-HCPI was shown to be reliable through communalities (range 0.47-0.90) and Cronbach α (≥0.95). Discriminative ability and cut-off point, as tested through Receiver Operating Characteristic analysis, showed excellent diagnostic accuracy with a threshold value of 11 (specificity 0.98 and sensitivity 0.94). The I-HCPI was confirmed to be a valid, sensitive, reliable, and accurate tool to discriminate between dogs with and without pain.

Keywords: Helsinki Chronic Pain Index; Italian validation; chronic pain; dog; osteoarthritis.

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Conflict of interest statement

Carlo Schievano is employees of Innovative Statistical Research SRL, and Maria Federica della Valle is employees of CeDIS (Centro di Documentazione e Informazione Scientifica). The paper reflects the views of the scientists, and not the company. The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The most represented breeds in the OA (orange) and healthy (grey) dogs. Only breeds represented by more than one dog per group are illustrated.
Figure 2
Figure 2
Difference in I-HCPI scores between healthy (H) and osteoarthritis (OA) dogs. The crosses represent the mean; the horizontal line in the rectangle represents the median; the dots represent the outlier values.
Figure 3
Figure 3
Scree plot of the eigenvalues of the I-HCPI. The orange dashed line represents the cut-off score for the eigenvalue (i.e., 1 according to Kaiser criterion).
Figure 4
Figure 4
I-HCPI score distribution by pain on palpation. The crosses represent the mean; the horizontal line in the rectangle represents the median; the dots represent the outlier values.
Figure 5
Figure 5
Pearson’s correlation of I-HCPI and I-CBPI subscores (i.e., pain severity, light grey; pain interference, dark grey). Coefficient r = 0.84 and p < 0.0001 for both correlations.
Figure 6
Figure 6
Distribution of I-HCPI scores before and after treatment. The crosses represent the mean, while the horizontal line in the rectangle represents the median.
Figure 7
Figure 7
Receiver Operating Characteristic (ROC) curve.
See this image and copyright information in PMC

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