Global rating of change

perspectives of patients with lumbar impairments and of their physical therapists

Ying Chih Wang, Bhagwant S. Sindhu, Jay Kapellusch, Sheng Che Yen, Leigh Ann Lehman

Research output: Contribution to journalArticle

Abstract

Background: Global rating of change (GROC) scores provide a means of measuring patients’ self-perceived change in health status over time. Objectives: The purposes of the study were to examine agreement of GROC ratings between the patient (GROCp) and the treating therapist (GROCt), the impact on the minimal clinically important difference (MCID) estimates by reporting resources, and the relationships between the subjective GROC scores and objective outcome measures. Methods: Data from 52,767 patients with orthopedic lumbar spine impairments treated in 623 outpatient rehabilitation clinics in 34 states (United States) were analyzed. Patient’s functional status (FS) before and after the treatment was measured using the Lumbar Computerized Adaptive Testing (LCAT) survey (0–100 scale). The GROC ratings were obtained from both the patients and their caring therapists at discharge. Results: On average, GROCp (mean [(SD] = 3.1 [4.1]) was 1.9 points lower than GROCt (mean [SD] = 5.0 [1.9]). There were negligible differences between MCID estimates derived from the patients’ GROC ratings (MCID cutoff = 9.2) and from the therapists’ GROC ratings (MCID cutoff = 9.5). While only analyzing patient data whose GROCp ≥ 0, the intraclass correlation coefficient between GROCp and GROCt was 0.61, the GROCp correlated with FS at intake at r = 0.12, with FS at discharge at r = 0.56, and with FS change scores at r = 0.47. Conclusions: Therapists tended to report higher GROC ratings than their patients did but there were negligible differences between MCID estimates derived from GROCp and that derived from GROCt.

Original languageEnglish (US)
Pages (from-to)851-859
Number of pages9
JournalPhysiotherapy theory and practice
Volume35
Issue number9
DOIs
StatePublished - Sep 2 2019

Fingerprint

Physical Therapists
Ambulatory Care Facilities
Health Status
Orthopedics
Spine
Rehabilitation
Outcome Assessment (Health Care)
Minimal Clinically Important Difference

Keywords

  • Minimal clinically important difference
  • minimum important change
  • rehabilitation

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Global rating of change : perspectives of patients with lumbar impairments and of their physical therapists. / Wang, Ying Chih; Sindhu, Bhagwant S.; Kapellusch, Jay; Yen, Sheng Che; Lehman, Leigh Ann.

In: Physiotherapy theory and practice, Vol. 35, No. 9, 02.09.2019, p. 851-859.

Research output: Contribution to journalArticle

Wang, Ying Chih ; Sindhu, Bhagwant S. ; Kapellusch, Jay ; Yen, Sheng Che ; Lehman, Leigh Ann. / Global rating of change : perspectives of patients with lumbar impairments and of their physical therapists. In: Physiotherapy theory and practice. 2019 ; Vol. 35, No. 9. pp. 851-859.
@article{d8fd741c42fc4932868cdbbffef3c276,
title = "Global rating of change: perspectives of patients with lumbar impairments and of their physical therapists",
abstract = "Background: Global rating of change (GROC) scores provide a means of measuring patients’ self-perceived change in health status over time. Objectives: The purposes of the study were to examine agreement of GROC ratings between the patient (GROCp) and the treating therapist (GROCt), the impact on the minimal clinically important difference (MCID) estimates by reporting resources, and the relationships between the subjective GROC scores and objective outcome measures. Methods: Data from 52,767 patients with orthopedic lumbar spine impairments treated in 623 outpatient rehabilitation clinics in 34 states (United States) were analyzed. Patient’s functional status (FS) before and after the treatment was measured using the Lumbar Computerized Adaptive Testing (LCAT) survey (0–100 scale). The GROC ratings were obtained from both the patients and their caring therapists at discharge. Results: On average, GROCp (mean [(SD] = 3.1 [4.1]) was 1.9 points lower than GROCt (mean [SD] = 5.0 [1.9]). There were negligible differences between MCID estimates derived from the patients’ GROC ratings (MCID cutoff = 9.2) and from the therapists’ GROC ratings (MCID cutoff = 9.5). While only analyzing patient data whose GROCp ≥ 0, the intraclass correlation coefficient between GROCp and GROCt was 0.61, the GROCp correlated with FS at intake at r = 0.12, with FS at discharge at r = 0.56, and with FS change scores at r = 0.47. Conclusions: Therapists tended to report higher GROC ratings than their patients did but there were negligible differences between MCID estimates derived from GROCp and that derived from GROCt.",
keywords = "Minimal clinically important difference, minimum important change, rehabilitation",
author = "Wang, {Ying Chih} and Sindhu, {Bhagwant S.} and Jay Kapellusch and Yen, {Sheng Che} and Lehman, {Leigh Ann}",
year = "2019",
month = "9",
day = "2",
doi = "10.1080/09593985.2018.1458930",
language = "English (US)",
volume = "35",
pages = "851--859",
journal = "Physiotherapy Theory and Practice",
issn = "0959-3985",
publisher = "Informa Healthcare",
number = "9",

}

TY - JOUR

T1 - Global rating of change

T2 - perspectives of patients with lumbar impairments and of their physical therapists

AU - Wang, Ying Chih

AU - Sindhu, Bhagwant S.

AU - Kapellusch, Jay

AU - Yen, Sheng Che

AU - Lehman, Leigh Ann

PY - 2019/9/2

Y1 - 2019/9/2

N2 - Background: Global rating of change (GROC) scores provide a means of measuring patients’ self-perceived change in health status over time. Objectives: The purposes of the study were to examine agreement of GROC ratings between the patient (GROCp) and the treating therapist (GROCt), the impact on the minimal clinically important difference (MCID) estimates by reporting resources, and the relationships between the subjective GROC scores and objective outcome measures. Methods: Data from 52,767 patients with orthopedic lumbar spine impairments treated in 623 outpatient rehabilitation clinics in 34 states (United States) were analyzed. Patient’s functional status (FS) before and after the treatment was measured using the Lumbar Computerized Adaptive Testing (LCAT) survey (0–100 scale). The GROC ratings were obtained from both the patients and their caring therapists at discharge. Results: On average, GROCp (mean [(SD] = 3.1 [4.1]) was 1.9 points lower than GROCt (mean [SD] = 5.0 [1.9]). There were negligible differences between MCID estimates derived from the patients’ GROC ratings (MCID cutoff = 9.2) and from the therapists’ GROC ratings (MCID cutoff = 9.5). While only analyzing patient data whose GROCp ≥ 0, the intraclass correlation coefficient between GROCp and GROCt was 0.61, the GROCp correlated with FS at intake at r = 0.12, with FS at discharge at r = 0.56, and with FS change scores at r = 0.47. Conclusions: Therapists tended to report higher GROC ratings than their patients did but there were negligible differences between MCID estimates derived from GROCp and that derived from GROCt.

AB - Background: Global rating of change (GROC) scores provide a means of measuring patients’ self-perceived change in health status over time. Objectives: The purposes of the study were to examine agreement of GROC ratings between the patient (GROCp) and the treating therapist (GROCt), the impact on the minimal clinically important difference (MCID) estimates by reporting resources, and the relationships between the subjective GROC scores and objective outcome measures. Methods: Data from 52,767 patients with orthopedic lumbar spine impairments treated in 623 outpatient rehabilitation clinics in 34 states (United States) were analyzed. Patient’s functional status (FS) before and after the treatment was measured using the Lumbar Computerized Adaptive Testing (LCAT) survey (0–100 scale). The GROC ratings were obtained from both the patients and their caring therapists at discharge. Results: On average, GROCp (mean [(SD] = 3.1 [4.1]) was 1.9 points lower than GROCt (mean [SD] = 5.0 [1.9]). There were negligible differences between MCID estimates derived from the patients’ GROC ratings (MCID cutoff = 9.2) and from the therapists’ GROC ratings (MCID cutoff = 9.5). While only analyzing patient data whose GROCp ≥ 0, the intraclass correlation coefficient between GROCp and GROCt was 0.61, the GROCp correlated with FS at intake at r = 0.12, with FS at discharge at r = 0.56, and with FS change scores at r = 0.47. Conclusions: Therapists tended to report higher GROC ratings than their patients did but there were negligible differences between MCID estimates derived from GROCp and that derived from GROCt.

KW - Minimal clinically important difference

KW - minimum important change

KW - rehabilitation

UR - http://www.scopus.com/inward/record.url?scp=85044718354&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044718354&partnerID=8YFLogxK

U2 - 10.1080/09593985.2018.1458930

DO - 10.1080/09593985.2018.1458930

M3 - Article

VL - 35

SP - 851

EP - 859

JO - Physiotherapy Theory and Practice

JF - Physiotherapy Theory and Practice

SN - 0959-3985

IS - 9

ER -