Reliability and Validity of SymTrak, a Multi-Domain Tool for Monitoring Symptoms of Older Adults with Multiple Chronic Conditions

Patrick O. Monahan, Kurt Kroenke, Christopher M. Callahan, Tamilyn Bakas, Amanda Harrawood, Phillip Lofton, Danielle Frye, Claire Draucker, Timothy Stump, Debra Saliba, James E. Galvin, Amanda Keegan, Mary G. Austrom, Malaz Boustani

Research output: Contribution to journalArticle

Abstract

Background: A reliable and valid clinically practical multi-domain self-report and caregiver-report tool is needed for tracking actionable symptoms in primary care for elderly patients with multiple chronic conditions (MCCs). Objective: Assess internal consistency reliability, test–retest reliability, construct validity, and sensitivity to change for SymTrak. Design and Participants: Among 600 (200 patient–caregiver dyads, 200 patients without an identified caregiver) participants, SymTrak was telephone interviewer–administered at baseline and 3-month follow-up, and at 24 h post-baseline for assessing test–retest reliability in a random subsample of 180 (60 dyads, 60 individual patients) participants. Main Measures: Demographic questions, SymTrak, Health Utility Index Mark 3 (HUI3). Key Results: Exploratory factor analysis indicated a single dominant dimension for SymTrak items for both patients and caregivers. Coefficient alpha and 24-h test–retest reliability, respectively, were high for the 23-item SymTrak total score for both patient-reported (0.85; 0.87) and caregiver-reported (0.86; 0.91) scores. Construct validity was supported by monotone decreasing relationships between the mean of SymTrak total scores across the poor-to-excellent categories of physical and emotional general health, and by high correlations with HUI3 overall utility score, even after adjusting for demographic covariates (standardized linear regression coefficient = − 0.84 for patients; − 0.70 for caregivers). Three-month change in the SymTrak total score was sensitive to detecting criterion standard 3-month reliable change categories (Improved, Stable, Declined) in HUI3-based health-related quality of life, especially for caregiver-reported scores. Conclusions: SymTrak demonstrates good internal consistency and test–retest reliability, construct validity, and sensitivity to change over a 3-month period, supporting its use for monitoring symptoms for older adults with MCCs.

Original languageEnglish (US)
Pages (from-to)908-914
Number of pages7
JournalJournal of general internal medicine
Volume34
Issue number6
DOIs
StatePublished - Jun 15 2019

Keywords

  • aging
  • chronic disease
  • primary care
  • psychometrics
  • self-management
  • symptoms

ASJC Scopus subject areas

  • Internal Medicine

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