Refining a Web-based goal assessment interview: item reduction based on reliability and predictive validity.

Area of Science:

• Psychology
• Health Services Research
• Sociology

Background:

• Patient goals are fundamental to quality-of-life (QOL) assessment and cognitive appraisal.
• Understanding goal themes is essential for developing effective QOL measurement tools.
• Existing QOL assessment methods may not fully capture the diversity of patient goals.

Purpose of the Study:

• To identify the optimal goal delineation items for QOL assessment.
• To develop new versions of the QOL Appraisal Profile: an interview tool and a survey version.
• To refine the measurement of patient-centered outcomes in health research.

Main Methods:

• Secondary analysis of longitudinal data from 1126 participants in the North American Research Committee on Multiple Sclerosis (MS) registry.
• Qualitative coding of open-ended goal data by trained coders with high inter-rater agreement.
• Quantitative analysis including descriptive statistics, reliability analysis, and hierarchical linear modeling to identify best-performing items.

Main Results:

• The "Solve" item (item 2) emerged as the best single item, anchoring approximately one-third of goal themes and explaining significant variance in outcomes and demographics.
• "Accomplish" (item 1) and "Maintain" (item 4) were identified as the next best items, useful for understanding cognitive deficits and demographic factors.
• Thirty-one distinct themes reflecting goal content were identified, including health, interpersonal relationships, independence, mental health, and financial concerns.

Conclusions:

• The identified optimal goal delineation items will inform the development of a shorter open-ended QOL Appraisal Profile and a close-ended survey version.
• These new tools will facilitate patient coaching in medical decision-making.
• The refined tools will support future research on appraisal processes and response shifts in QOL.