title: Validation study of the Self-Assessment Goal Achievement (SAGA) questionnaire for lower urinary tract symptoms.
abstract: BACKGROUND
  Patients' treatment goals for overactive bladder (OAB) and other lower urinary tract symptoms (LUTS) may not be aligned with their healthcare provider's goals. Successful management of OAB symptoms is improved by individualised treatment plans with attainable treatment goals. Goal attainment setting may facilitate patient-provider interaction and the development of a personalised treatment plan based on realistic, individual goals, thereby increasing patient satisfaction and therapeutic outcomes. The purpose of this study was to validate the utility of the Self-Assessment Goal Achievement (SAGA) questionnaire for LUTS in helping patients identify and achieve realistic treatment goals.
  
  
  METHODS
  The 2-module SAGA questionnaire consists of nine prespecified (fixed) items and five open-ended items for goal identification and ranking (baseline module) and goal achievement rating (follow-up module). Adult patients in the United States (n = 104) seeking treatment for LUTS, including symptoms of OAB, completed the SAGA baseline module, micturition diary, other patient-reported outcome measures (PROs), and discussed their urinary goals with a clinician at baseline. The SAGA follow-up module was completed 2-4 months later. SAGA was validated based on analyses of face, concurrent, known-groups, and convergent validity and item distribution.
  
  
  RESULTS
  Among the nine fixed goals of SAGA, four were ranked as very important by > 50% of patients (i.e. reduce night-time frequency, daytime frequency, urine leakage, urgency). Most patients did not change the importance level of their goals after discussion with their healthcare provider. Pearson correlations between SAGA, diary variables and PRO scores were generally of low to moderate strength. The global mean (SD) follow-up SAGA T-score was 32.54 (12.54), indicating that overall goal attainment was not achieved after 3 months. The goal attainment score was significantly different between groups differing in symptom severity, health-related quality of life, bladder control and continence status.
  
  
  CONCLUSIONS
  The results support the validity of SAGA as a measure of patients' goals and goal achievement for the treatment of LUTS, including symptoms of OAB. SAGA may improve healthcare provider-patient interactions and treatment outcomes in clinical practice.
authors.affiliation: Department of Obstetrics & Gynecology and Urology, Stritch School of Medicine, Loyola University Chicago, Chicago, IL 60153, USA. lbrubaker@lumc.edu
authors.forename: L
authors.initials: L
authors.lastname: Brubaker
authors.forename: E C
authors.initials: EC
authors.lastname: Piault
authors.forename: S E
authors.initials: SE
authors.lastname: Tully
authors.forename: C J
authors.initials: CJ
authors.lastname: Evans
authors.forename: T
authors.initials: T
authors.lastname: Bavendam
authors.forename: J
authors.initials: J
authors.lastname: Beach
authors.forename: Y
authors.initials: Y
authors.lastname: Yeh
authors.forename: Z S
authors.initials: ZS
authors.lastname: Kopp
authors.forename: V
authors.initials: V
authors.lastname: Khullar
authors.forename: C J
authors.initials: CJ
authors.lastname: Kelleher
authors.forename: J
authors.initials: J
authors.lastname: Trocio
mesh_terms: D000124:Achievement; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059026:Diagnostic Self Evaluation; D005260:Female; D006040:Goals; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010465:Perception; D011369:Professional-Patient Relations; D011795:Surveys and Questionnaires / Q000592:standards*; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D055815:Young Adult