Clinician and Researcher Experiences with Goal Attainment Scaling: A Qualitative Study on Opportunities and Challenges for Personalized Outcome Assessments.

Abstract

Purpose: Goal Attainment Scaling (GAS) is a personalized outcome measure that evaluates treatment response based on patient- and caregiver-prioritized goals, offering a structured yet flexible framework for assessing meaningful change. Although GAS is increasingly applied in clinical trials, its implementation remains inconsistent, and the perspectives of clinicians and researchers who use it in practice remain poorly understood. This study explored the experiences of clinicians and researchers with GAS to better understand how it is operationalized, the challenges encountered, and opportunities to improve its consistency and utility in patient-centered care and research.

Participants and methods: Semi-structured interviews were conducted with 11 clinicians and academics from Canada, the United States, the United Kingdom, and Australia who had experience using GAS in clinical or research settings. Data were analyzed thematically using the Framework Method, with coding conducted inductively and supported by NVivo 12.

Results: Participants valued GAS for capturing outcomes most meaningful to patients and demonstrating treatment responsiveness in heterogeneous conditions. However, clinician resistance, time demands, limited familiarity, and variability in implementation across settings were identified as key challenges. Education, peer advocacy, and digital tools were suggested as strategies to improve feasibility and consistency.

Conclusion: Clinicians and researchers view GAS as a valuable patient-centered outcome measure but highlight variability in implementation as a barrier to broader adoption. Guidelines for GAS implementation, training, and supportive tools may strengthen the use of GAS in both clinical practice and research, ultimately improving the measurement of outcomes that matter most to patients.