Advancing Canine Treatment In Oncology (ACTION): development of a Canine Oncology Proxy-Reported Outcome Measure (CO-PROM) for routine remote symptom-monitoring

1) A rapid review of evidence to establish content and scope of a prototype CO-PROM. 2) The development and mixed methods testing of this CO-PROM, including item generation and stakeholder consensus on content.

Start date

01 September 2022

End date

31 May 2023



Poor management of severe adverse events (sAEs) during chemotherapy can impair dogs’ quality of life and be life-threatening. Owner-perceived quality of life (QoL) is one of the most important determinants of decision-making in veterinary oncology, and measuring this construct and its components in small animals has become the focus of several recently developed QoL questionnaires. However, to date, these instruments have primarily been designed as data collection tools for research purposes rather than for routine symptom-monitoring.


This study will adopt a mixed-methods approach to develop and test a CO-PROM. It will adhere to gold-standards for the development of outcome measures including a) a rapid review of the evidence to identify existing owner-reported instruments to monitor symptoms in dogs receiving chemotherapy.  b) the development of the CO-PROM (including item generation and stakeholder consensus on content), followed by c) real world pilot testing (n=30 families) of the CO-PROM over 7-days combined with cognitive interviews (e.g., using ‘think aloud’ techniques) and qualitative feedback (n=15).

Data analysis

Psychometric performance of the tool will be evaluated alongside the data from cognitive interviews and qualitative feedback. These outcomes will inform further refinement of the CO-PROM. Findings will be shared with stakeholders to gain consensus on the prototype CO-PROM and the next steps for testing/implementation.

Practical implications/ conclusions

With further validation, this CO-PROM has the potential to improve the assessment of chemotherapy-related symptoms in dogs, thus enhancing veterinary care as well as canine oncological outcomes and QoL.

Aims and objectives

This project aims to develop a prototype Canine Oncology Proxy (i.e. by family/owner)-Reported Outcome Measure (CO-PROM) to help detect and alleviate dog discomfort, distress and altered behaviour, and determine the user-centred requirements (family, veterinary and research users) for a future digital platform and remote-monitoring package (in which the CO-PROM will be hosted). 


  1. Rapid review of evidence and expert consensus to establish content and scope of a prototype CO-PROM
  2. Development and mixed methods testing of a prototype CO-PROM with high content validity and sensitive to measure change
  3. Preliminary specification of the user-centred requirements for digital platform and care package for future translation to digital (smartphone, web-based).

This is a collaborative project between the University of Surrey and AURA veterinary.

Funding amount




Research groups and centres

Our research is supported by research groups and centres of excellence.

Cancer research cluster

Research themes

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