The Sightline Score

What the Sightline Score is, and what it isn't

The Sightline Score is a first-party clinical composite authored and maintained by ConciergeVet. It is informed by the published veterinary literature on pain and quality-of-life assessment in dogs and cats, but it is not itself a validated instrument. Wherever the Score appears in the product or in PDF reports, this framing appears with it.

The clinical value is in the trajectory, not the absolute number. A single weekly Score is a data point; a series across weeks or months is the curve a vet can read at a glance. Sightline therefore reveals the trajectory from the first week, but withholds the absolute numeric Score until the third weekly assessment, once a baseline exists. The five-band classification (excellent / good / watch / concerning / critical) is shown from week one as the qualitative read.

The adaptive assessment

Owners answer a short weekly check-in (12 to 16 items, three to five minutes) drawn from a 44-item bank. Items branch on species, age, conditions on file, household-stairs and outdoor-inclines flags, and the pet's concern level (general tracking, active concern, or quality-of-life focus). A healthy young dog after an operation sees a different short subset than a senior cat in palliative care.

Pets in quality-of-life focus mode check in daily on a comfort-focused subset (under two minutes). The same 0-to-100 Score applies; the cadence shifts to match the pace of clinical change.

The full 44-item bank lives under version control in this repository. New items are added by Alastair MRCVS and Claire BVM&S MRCVS as the Sightline-Core spec evolves; the scoring_logic_version stamp on every assessment row makes historical scores reproducible.

Eight domains and their weights

Each item maps to one of eight clinical domains. Domain weights below are the headline weights used when every domain has at least one answered item; if a domain has no answered items in a given assessment (for example, a pet with no household stairs), its weight is reallocated proportionally across the domains that did contribute.

• Mobility × 0.20

  The single highest-yield signal for chronic pain and decline in both dogs and cats. Rising from rest, stairs, jumping onto furniture.

• Comfort and rest × 0.20

  Posture during sleep, willingness to lie down, restlessness at night. CBPI's pain-severity factor outweighs interference 4:1 in chronic pain contexts; comfort sits just below mobility in the literature.

• Demeanour × 0.15

  Owner-perceived mood, withdrawal, irritability, affection-seeking. Raised in v1.1 in line with the WSAVA 2022 elevation of emotion to co-equal status alongside pain.

• Activity and engagement × 0.13

  Play, interaction, interest in walks, environmental engagement. Lower than comfort and demeanour because the underlying signal is psychometrically noisier (Schneider Canine HRQoL-Q reports α 0.60 for social functioning).

• Owner goals (CSOM) × 0.13

  Up to five owner-defined activities tracked over time. Captures what matters to the household; weighted equal to engagement because no published instrument anchors a specific number for owner-defined items.

• Eating and drinking × 0.08

  Appetite changes are slower-moving but high-specificity for systemic decline. Lighter weight than comfort or mobility because generic instruments treat eating as a 1-2-item signal, not a full domain.

• Toileting × 0.03

  Continence, posture during urination/defecation, accidents. Rarely a standalone domain in the published literature; usually folded into hygiene or clinical signs.

• Grooming × 0.03

  Self-grooming behaviour. Mainly informative in cats (matted coat suggests reduced flexibility or pain). v1.2 candidate for species-conditional weighting.

From answers to a Score

score_total = Σ (domain_score × renormalised_weight)

• Each item answer is on a 0-to-4 anchor (with -1 reserved for not-applicable). The anchor maps linearly to a 0-to-100 contribution: 0 -> 0, 1 -> 25, 2 -> 50, 3 -> 75, 4 -> 100.
• A domain score is the weighted mean of its contributing items (item weights vary; not-applicable items are excluded). Domains with zero contributing items are dropped.
• Composite weights are re-normalised across contributing domains so the visible weights still sum to 1, then the per-domain scores are weighted-averaged into the headline 0-to-100 Sightline Score.
• Score 0 is best; score 100 is worst. The trajectory chart inverts the y-axis so a line moving up reads as worsening.

Five bands

Cutoffs are even 20-point intervals. Band copy is shown to owners alongside the Score; the trajectory chart paints the background of the chart in the band colours so a line crossing into amber or rose is legible at a glance.

• Excellent0 to 20

  Doing very well across the things we track. The kind of week most owners hope for.

• Good21 to 40

  A solid week. Small things to keep an eye on, but nothing that needs urgent action.

• Watch41 to 60

  Some areas have shifted. Worth keeping a closer eye on for the next week or two, and worth flagging at your next vet appointment.

• Concerning61 to 80

  Several things have changed for the worse. Consider getting in touch with your vet sooner rather than later.

• Critical81 to 100

  Significant decline. Please contact your vet today. The Sightline Score is not a diagnosis but it does suggest something needs looking at.

Trajectory rendering

The dashboard renders the per-assessment Sightline Score as a small line chart with the five band ranges painted as background zones. The default window is the last 30 days for pets in quality-of-life focus mode (where check-ins are daily) and the last 12 weeks for general-tracking and active-concern pets (where check-ins are weekly).

Each plotted point is coloured by its band so a single glance reads as both an absolute level and a direction of change. The Sightline Report PDF emails the same chart to a vet at the owner's request, with the full per-domain breakdown attached.

Aligned with

• WSAVA Global Pain Council guidelines for chronic and acute pain assessment in companion animals.
• AAHA 2022 Pain Management Guidelines for Dogs and Cats.
• ISFM 2024 Consensus Guidelines on the Long-term Use of NSAIDs in Cats.
• AAFP 2021 Senior Care Guidelines.

Version and changelog

Current scoring algorithm version: sightline-core-v1.1.0

Every assessment row carries a scoring_logic_version stamp so historical Scores can be reproduced against the exact weights that produced them, even after future revisions.

1. v1.1.0May 2026

   Domain weights revised after a structured audit of the published canine and feline pain and quality-of-life literature (LOAD, CBPI, VetMetrica, Belshaw scoping review, WSAVA 2022, AAHA 2022). Mobility 0.20 -> 0.25, Comfort 0.18 -> 0.20, Demeanour 0.12 -> 0.15 (raised); Activity 0.15 -> 0.13, Owner goals 0.15 -> 0.13, Eating 0.13 -> 0.08, Toileting 0.04 -> 0.03 (lowered); Grooming 0.03 (unchanged). Full per-domain reasoning in the weighting methodology document.

2. v1.0.0May 2026

   Initial Sightline Score composite, set during the architecture pivot from the eleven-validated-instruments model. Weights set as a clinical estimate without a formal literature audit.