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

J Clin Epidemiol. 2003 Aug;56(8):736-43. doi: 10.1016/s0895-4356(03)00132-x.


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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Family Practice
  • Follow-Up Studies
  • Frail Elderly*
  • Geriatric Assessment / methods*
  • Goals*
  • Humans
  • Interviews as Topic
  • Patient Acceptance of Health Care
  • Quality of Life
  • Sensitivity and Specificity
  • Treatment Outcome