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

Gunes Sevinc,1 Andrea Escoto-Rivera,1 Katie Crespo,1,2 Sue Nesto,1 Chere AT Chapman,1 Kenneth Rockwood1,3,4 1Ardea Outcomes, Halifax, Nova Scotia, Canada; 2College of Pharmacy, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada; 3Division of Geriatric Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; 4Geriatric Medicine Research Unit, Nova Scotia Health Authority, Halifax, Nova Scotia, CanadaCorrespondence: Gunes Sevinc, Ardea Outcomes, 200-1741 Lower Water Street, Halifax, NS, B3J 0J2, Canada, Email gunes.sevinc@ardeaoutcomes.comPurpose: 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.Plain Language Summary: Goal Attainment Scaling (GAS) is a personalized way of measuring health outcomes. Instead of relying only on standardized tests, GAS focuses on goals that patients and caregivers identify as most important to them. This approach makes it possible to assess meaningful changes in quality of life, even when people have very different symptoms or needs. GAS has been used in many different contexts, including both research and clinical practice, but it is applied in various ways. We interviewed 11 clinicians/researchers about how they used GAS, the challenges they encountered, and opportunities to improve its consistency and utility in patient-centered care and research. Participants reported that they value GAS because it can capture what matters most to patients and show whether treatments are making a difference. Overall, the findings show that GAS is a promising, patient-centered outcome measure, however clearer guidelines, education, and supportive resources are needed to expand its use.