Development and Validation of a Nigerian Canine Orthopedic Outcome Scoring System for Long-Term Fracture Repair Assessment

Valid and culturally contextual outcome measurement tools are fundamental to advancing evidence-based orthopedic surgical practice, yet no validated canine orthopedic outcome scoring system has been developed for the Nigerian veterinary context. This doctoral study develops and psychometrically validates the Nigerian Canine Orthopedic Outcome Score (NiCOOS), a multidimensional instrument designed to measure functional recovery, owner-perceived quality of life, radiographic healing, and pain outcomes following orthopedic fracture repair in dogs treated at Nigerian teaching hospitals. The score development process followed a six-stage validation protocol encompassing expert item generation, face validity assessment with 18 specialist reviewers, cognitive interviewing with 32 dog owners across three geopolitical zones, pilot administration in 54 postoperative cases, and psychometric validation in a main sample of 180 dogs across four teaching hospitals between 2021 and 2024. Factor analysis confirmed a four-domain structure consistent with the theoretical model. Internal consistency reliability was high with Cronbach's alpha values of 0.84 to 0.91 across domains. Convergent validity was demonstrated by significant correlations with established international lameness assessment tools. Responsiveness to clinical change was confirmed by significant score improvement at six and twelve weeks postoperatively. The NiCOOS represents an original theoretical and practical contribution to the Nigerian veterinary surgery literature, offering a locally valid, psychometrically sound instrument for standardizing fracture repair outcome assessment across teaching hospitals and future multicenter clinical trials. Keywords: outcome measurement, canine orthopedics, fracture repair, score validation, Nigeria.