Measurement properties of pain scoring instruments in farm animals: A systematic review protocol using the COSMIN checklist.

Society has been increasingly concerned about the impact of pain on farm animal welfare. This systematic review aims to provide evidence relating to the measurement properties (i.e. reliability, validity, and sensitivity) of pain scoring instruments used for pain assessment in farm animals. A literature search will be performed using five databases (MEDLINE, EMBASE, Web of Science, CAB abstracts and Biological Abstracts) and search terms related to pain, pain scales and different species of farm animals. Eligibility criteria will include full-text studies on the development and/or validation of acute and chronic pain scoring instruments for farm animals including bovine (beef and dairy), ovine, caprine, camel, swine and poultry. Exclusion criteria will include studies that report the use of pain scales for the validation of another instrument, or those reporting ethograms/list of behaviors potentially indicating pain without a scoring system. Study titles and their abstracts will be screened for eligibility by one investigator. Full-text articles will be independently reviewed for eligibility and evaluated by two investigators. Relevant information will be recorded and evaluated systematically according to the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist using an adapted data collection sheet. The following measurement properties and characteristics of the instruments will be assessed: content validity (internal consistency, structural and cross-cultural validity), reliability, measurement error, criterion and construct validity, responsiveness, interpretability and feasibility. Following the assessment of methodological quality and quality of the findings, evidence for each measurement property will be summarized into high, moderate, low or very low. This systematic review will provide further insights into the evidence-based measurement properties of pain scoring instruments in farm animals. It may identify possible gaps of knowledge with these tools as a potential target for future studies in farm animals with a positive impact on animal welfare