Figure 2.

General framework to establish and validate a clinical scoring system in veterinary medicine. Our 6-step framework is depicted with an initial definition of the target condition (1), the potential items of interest (2), and their reliability (3). The modeling approach then determines the adequate repartition between and within item weights (4). The accuracy of the score is determined in step (5). The optimal threshold selection is then adapted to the specific conditions where the test is intended to be used (6). Score users also need to be adequately trained.