Proposed Criteria for Appraising Goal Attainment Scales Used as Outcome Measures in Rehabilitation Research.
Goal Attainment Scaling (GAS) is a method for writing personalized evaluation scales to quantify progress toward defined rehabilitation goals. In the published literature, GAS methodology is used with different levels of rigor, ranging from precisely written GAS scales that ensure minimal bias and explicitly describe 5 levels of goal attainment to subjective ratings of goal attainment by adjectives (eg, 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 GAS quality appraisal criteria, allowing judgment of the quality of GAS methodology in individual rehabilitation studies; and (3) propose directions to improve GAS implementation 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.
Outreach Department for Patients With Acquired Brain Injury, University Rehabilitation Institute Clemenceau Strasbourg, Strasbourg, France; Sorbonne Universités, Univerisité Pierre et Marie Curie Paris 06 CNRS. INSERM, laboratoire d'imagerie biomédicale, Paris, France; Pediatric Orthopedics Department, Hautepierre Hospital, Strasbourg University Hospitals, Strasbourg, France. Electronic address: agatakrasny@yahoo.com.
Agata
A
Krasny-Pacini
Institute of Health and Wellbeing, University of Glasgow, The Academic Center, Gartnavel Royal Hospital, Glasgow, United Kingdom.
Jonathan
J
Evans
Communication Disorders and Sciences, University of Oregon, Eugene, OR.
McKay Moore
MM
Sohlberg
Sorbonne Universités, Univerisité Pierre et Marie Curie Paris 06 CNRS. INSERM, laboratoire d'imagerie biomédicale, Paris, France; Rehabilitation Department for Children with Acquired Brain Injury, Saint Maurice Hospitals, Saint Maurice, France.
Mathilde
M
Chevignard
D000124:Achievement; D015982:Bias; D035843:Biomedical Research; D006040:Goals; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010347:Patient Care Planning; D011594:Psychometrics; D012046:Rehabilitation / Q000592:standards*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*
Goals; Methods; Outcome assessment (health care); Reference standards; Rehabilitation; Reproducibility of results; Research design