Responsiveness of goal attainment scaling in a randomized controlled trial of comprehensive geriatric assessment

Kenneth Rockwood, Susan Howlett, Karen Stadnyk, Daniel Carver, Colin Powell, Paul Stolee

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Background and Objective: Frail elderly patients have complex problems that require a multidimensional assessment and a range of treatment goals. Goal Attainment Scaling (GAS) measures multiple, individualized goals, but its responsiveness in comparative clinical trials has not been established. Methods: We assessed the responsiveness of GAS in a randomized, controlled trial of an interdisciplinary Mobile Geriatric Assessment Team (MGAT) in 265 rural frail older adults. Sensitivity to change was compared with standard measures; clinical meaningfulness was assessed in relation to a patient and a blinded physician global measure. Results: At 3 months follow-up, GAS was the most responsive measure (standardized response mean 1.22, Norman's responsiveness statistic 0.58) compared with the Barthel Index (1.13, 0.46), Physical Self-Maintenance Scale (0.10, 0.16, 0.02), Instrumental Activities of Daily Living (0.23, 0.00), and modified Spitzer Quality of Life Index (-0.04, 0.00). Conclusions: Only GAS detected clinically important change associated with the MGAT intervention in these frail elderly patients. Clinometric measures can offer a responsive means of evaluating complex interventions. © 2003 Elsevier Inc. All rights reserved.
    Original languageEnglish
    Pages (from-to)736-743
    Number of pages7
    JournalJournal of Clinical Epidemiology
    Volume56
    Issue number8
    DOIs
    Publication statusPublished - 1 Aug 2003

    Keywords

    • Comprehensive geriatric assessment
    • Elderly
    • Goal attainment scaling
    • Randomized controlled trial
    • Responsiveness
    • Specialized geriatric intervention

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