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

Abbreviations: AI Anti-inflammatory, GA General anaesthesia, CT Connective tissue, MM Mucous membrane, N/A Not applicable