Agreement between two different scoring procedures for goal attainment scaling is low

OBJECTIVE: To investigate the agreement between a patient's therapist and an independent assessor in scoring goal attainment by a patient. METHODS: Data were obtained on hospital patients with neurological disorders participating in a randomized trial. The patients' therapists set 2-4 goals using a goal attainment scaling method. Six weeks later attainment was scored by: (i) the treating therapists; and (ii) an independent assessor unfamiliar with the patient, using a semi-structured interview method with direct assessment as appropriate. RESULTS: A total of 112 goals in 29 neurological patients were used. The intraclass correlation coefficient (ICC(A,k) = 0.478) and limits of agreement (-1.52 +/- 24.54) showed poor agreement between the two scoring procedures. There was no systematic bias. CONCLUSION: The agreement between the patients' therapists scoring the goals and the independent assessor was low, signifying a large difference between the two scoring procedures. Efforts should be made to improve the reproducibility of goal attainment scaling before it is to be used as an outcome measure in blinded randomized controlled trials.