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.
| Original language | English |
|---|---|
| Pages (from-to) | 736-743 |
| Number of pages | 8 |
| Journal | Journal of Clinical Epidemiology |
| Volume | 56 |
| Issue number | 8 |
| DOIs | |
| Publication status | Published - Aug 1 2003 |
Bibliographical note
Funding Information:This study was supported with grants from the National Health Research Development Program (NHRDP). Dr. Rockwood is supported by the Canadian Institutes of Health Research through an Investigator award.
ASJC Scopus Subject Areas
- Epidemiology