Proposal of criteria for appraising Goal Attainment Scales used as outcome measures in rehabilitation research

Agata Krasny-Pacini (1, 2, 3) , Jonathan Evans (4) , Mckay Moore Sohlberg (5) , Mathilde Chevignard (1, 6)

1 LIB - Laboratoire d'Imagerie Biomédicale [Paris]
2 IURC - Institut Universitaire de Réadaptation Clemenceau
3 Service de Chirurgie Orthopédique Infantile, hôpital de Hautepierre, CHU de Strasbourg
4 Department of Psychological Medicine, Mental Health and Wellbeing, Gartnavel Royal Hospital
5 University of Oregon, Eugene, OR 97403, United States
6 HNSM - Hôpitaux de Saint Maurice

Goal Attainment Scaling (GAS) is a method for writing personalized evaluation scales in order to quantify progress toward defined rehabilitation goals. In published literature, GAS methodology is used with different levels of rigor, ranging from precisely written GAS scales, that ensure minimal bias, explicitly describing five levels of goal attainment; to subjective rating of goal attainment by adjectives such as “worse/better than expected”, which are transformed into a T-score, wrongly giving the reader the impression of a truly standardized, interval scale. A drawback of GAS methodology is that it is highly dependent on the ability of the GAS setting team/person to generate valid, reliable and meaningful scales, therefore reliability and validity of GAS scales are idiosyncratic to each study. The aims of this article were to: (1) increase awareness of potential sources of bias in GAS processes; (2) propose Goal Attainment Scaling quality appraisal criteria, allowing judgment of the quality of GAS methodology in individual rehabilitation studies; and (3) propose directions to improve GAS implementation in order to increase its reliability and validity as a research measurement tool. Our proposed quality appraisal criteria are based on critical appraisal of GAS literature, and published GAS validity studies that have demonstrated that precision, validity and reliability can be obtained when using GAS as an outcome measure in clinical trials. We recommend that authors using GAS report accurately how GAS methodology was used based on these criteria.

Mots clés: goal attainment scaling; outcome measures; goal setting; methodology; scale validity; scale reliability; standards; quality appraisal; guidelines

Domaines: Médecine humaine et pathologie

Agata Krasny-Pacini, Jonathan Evans, Mckay Moore Sohlberg, Mathilde Chevignard. Proposal of criteria for appraising Goal Attainment Scales used as outcome measures in rehabilitation research. Archives of Physical Medicine and Rehabilitation, 2016, 97 (1), pp.157-170. ⟨10.1016/j.apmr.2015.08.424⟩. ⟨hal-01203473⟩