McGarrigle Lisa, Rockwood Kenneth
Division of Geriatric Medicine, Department of Medicine, Dalhousie University and Nova Scotia Health Authority, 5955 Veterans' Memorial Lane, Halifax, NS, B3H 2E1, Canada.
DGI Clinical Inc., 1730 Market St, Halifax, NS, B3J 3N9, Canada.
J Patient Rep Outcomes. 2020 May 12;4(1):35. doi: 10.1186/s41687-020-00196-8.
Goal Attainment Scaling (GAS) is an individualized outcome measure that allows the setting of personalized treatment goals. We compared the responsiveness of GAS when individuals set only one goal instead of the recommended three or more goals.
We conducted exploratory analyses on data from two randomized controlled trials: the Video-Imaging Synthesis of Treating Alzheimer's Disease (VISTA) (n = 130); and the Mobile Geriatric Assessment Team (MGAT) (n = 265). Independent t-tests and standardized response means (SRMs) were used to assess responsiveness of one- vs. multiple-goal GAS.
In VISTA, clinician-rated multiple-goal GAS detected higher goal attainment in the intervention group (p = 0.01; SRM = 0.48). One-goal GAS, whether rated by patients or by clinicians, did not detect differences in goal attainment between groups (patient: p = 0.56, SRM = 0.10; clinician: p = 0.10, SRM = 0.29). In MGAT, multiple-goal GAS (outcome goals: p < .001, SRM = 1.29; total goals: p < .001, SRM = 1.52) and one-goal GAS (outcome goals: p < .001, SRM = 0.89; total goals: p < .001, SRM = 0.75), detected significantly higher goal attainment in the intervention group.
One-goal GAS detected significant change in response to a patient-centred, multi-domain care initiative. As such, in similar contexts, one-goal GAS may be an effective means of optimizing personalization and improving GAS feasibility through reduced administration time. However, it is not yet clear if one-goal GAS is responsive in the context of a pharmacological intervention and further research is recommended.
目标达成量表（GAS）是一种个体化的结果测量方法，可用于设定个性化的治疗目标。我们比较了个体仅设定一个目标而非推荐的三个或更多目标时GAS的反应性。
我们对两项随机对照试验的数据进行了探索性分析：治疗阿尔茨海默病的视频成像综合研究（VISTA）（n = 130）；以及移动老年评估团队（MGAT）（n = 265）。采用独立t检验和标准化反应均值（SRM）来评估单目标与多目标GAS的反应性。
在VISTA中，临床医生评定的多目标GAS在干预组中检测到更高的目标达成率（p = 0.01；SRM = 0.48）。单目标GAS，无论是由患者还是临床医生评定，均未检测到组间目标达成的差异（患者：p = 0.56，SRM = 0.10；临床医生：p = 0.10，SRM = 0.29）。在MGAT中，多目标GAS（结果目标：p <.001，SRM = 1.29；总目标：p <.001，SRM = 1.52）和单目标GAS（结果目标：p <.001，SRM = 0.89；总目标：p <.001，SRM = 0.75）在干预组中均检测到显著更高的目标达成率。
单目标GAS检测到了针对以患者为中心的多领域护理举措的显著变化。因此，在类似情况下，单目标GAS可能是通过减少管理时间来优化个性化并提高GAS可行性的有效手段。然而，目前尚不清楚单目标GAS在药物干预背景下是否具有反应性，建议进一步研究。
