Evaluating the Feasibility and Acceptability of a Personalized Endpoint: A Prospective Mixed Methods Study of Inventory-Facilitated Goal Attainment Scaling
Author(s)
Gunes Sevinc, BSc, MSc, PhD1, Andrea Escoto, MSc2, Aaqib Shehzad, MSc2, Chere Chapman, MBA, MPH2, Susan E Howlett, PhD3, Kenneth Rockwood, MD3.
1Director of Patient-Centered Outcomes, Ardea Outcomes, Vancouver, BC, Canada, 2Ardea Outcomes, Halifax, NS, Canada, 3Dalhousie University, Halifax, NS, Canada.
1Director of Patient-Centered Outcomes, Ardea Outcomes, Vancouver, BC, Canada, 2Ardea Outcomes, Halifax, NS, Canada, 3Dalhousie University, Halifax, NS, Canada.
OBJECTIVES: Standardized clinical outcome assessments often fail to capture meaningful change in heterogeneous populations due to variability in symptom expression. Personalized approaches such as Goal Attainment Scaling (GAS) address this limitation by facilitating patient-centered, individualized outcome evaluation, and the use of structured tools such as goal inventories may further support their standardization. This study examined the feasibility and acceptability of inventory-assisted GAS (GASi) compared to open-ended GAS (GASo) in the care of older adult outpatients.
METHODS: In a prospective, non-interventional study, 26 patient-caregiver dyads were randomized 1:1 to GASi or GASo across three memory clinics in Nova Scotia. GASi used a 58-item goal inventory spanning behaviour, cognition, daily, and executive functioning, and physical symptoms. Four clinicians facilitated goal setting and follow-up interviews at 3 months. Feasibility was assessed through goal quantity, scale completion, goal quality, and attrition. Acceptability was evaluated via post-visit surveys, and open-ended responses underwent thematic analysis.
RESULTS: All dyads set 1-4 goals (71, median=3), with 28% of goal scales completed across all five GAS levels. Follow-up interviews were completed by 25 participants (attrition rate 4%). Mean follow-up scores were 56.9 ± 10.3 for GASi and 57.7 ± 6.6 for GASo, with no significant difference between groups. Mean interview times, for GASi and GASo respectively, were 28.5±11.7 and 27±9 at baseline and 13.8±4.9, 15.8±7.8 at follow-up. Goal quality (11 vs 9 with all five levels) and quantity (38 vs 33) were comparable between GASi and GASo. Most GASi participants found the goal inventory helpful for identifying and setting goals. Qualitative findings revealed improved clinician rapport, symptom clarity, and engagement with both GAS implementations.
CONCLUSIONS: Both GAS approaches were feasible and acceptable. GAS supported goal clarity, motivation, and patient-provider engagement, offering a personalized approach to outcome assessment. Inventory-assisted GAS added structure and efficiency while maintaining patient relevance, supporting its use in real-world settings, particularly in drug development.
METHODS: In a prospective, non-interventional study, 26 patient-caregiver dyads were randomized 1:1 to GASi or GASo across three memory clinics in Nova Scotia. GASi used a 58-item goal inventory spanning behaviour, cognition, daily, and executive functioning, and physical symptoms. Four clinicians facilitated goal setting and follow-up interviews at 3 months. Feasibility was assessed through goal quantity, scale completion, goal quality, and attrition. Acceptability was evaluated via post-visit surveys, and open-ended responses underwent thematic analysis.
RESULTS: All dyads set 1-4 goals (71, median=3), with 28% of goal scales completed across all five GAS levels. Follow-up interviews were completed by 25 participants (attrition rate 4%). Mean follow-up scores were 56.9 ± 10.3 for GASi and 57.7 ± 6.6 for GASo, with no significant difference between groups. Mean interview times, for GASi and GASo respectively, were 28.5±11.7 and 27±9 at baseline and 13.8±4.9, 15.8±7.8 at follow-up. Goal quality (11 vs 9 with all five levels) and quantity (38 vs 33) were comparable between GASi and GASo. Most GASi participants found the goal inventory helpful for identifying and setting goals. Qualitative findings revealed improved clinician rapport, symptom clarity, and engagement with both GAS implementations.
CONCLUSIONS: Both GAS approaches were feasible and acceptable. GAS supported goal clarity, motivation, and patient-provider engagement, offering a personalized approach to outcome assessment. Inventory-assisted GAS added structure and efficiency while maintaining patient relevance, supporting its use in real-world settings, particularly in drug development.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR82
Topic
Clinical Outcomes, Methodological & Statistical Research, Patient-Centered Research
Topic Subcategory
Instrument Development, Validation, & Translation, Patient-reported Outcomes & Quality of Life Outcomes
Disease
Geriatrics, No Additional Disease & Conditions/Specialized Treatment Areas