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

Patrick Monahan, Kurt Kroenke, Christopher Callahan, Tamilyn Bakas, Amanda Harrawood, Phillip Lofton, Danielle Frye, Claire Draucker, Timothy Stump, Debra Saliba, James E. Galvin, Amanda Keegan, Mary 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)
JournalJournal of General Internal Medicine
DOIs
StatePublished - Jan 1 2019

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Reproducibility of Results
Caregivers
Health
Demography
Telephone
Self Report
Statistical Factor Analysis
Multiple Chronic Conditions
Linear Models
Primary Health Care
Quality of Life

Keywords

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

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Reliability and Validity of SymTrak, a Multi-Domain Tool for Monitoring Symptoms of Older Adults with Multiple Chronic Conditions. / Monahan, Patrick; Kroenke, Kurt; Callahan, Christopher; Bakas, Tamilyn; Harrawood, Amanda; Lofton, Phillip; Frye, Danielle; Draucker, Claire; Stump, Timothy; Saliba, Debra; Galvin, James E.; Keegan, Amanda; Austrom, Mary; Boustani, Malaz.

In: Journal of General Internal Medicine, 01.01.2019.

Research output: Contribution to journalArticle

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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.",
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AU - Callahan, Christopher

AU - Bakas, Tamilyn

AU - Harrawood, Amanda

AU - Lofton, Phillip

AU - Frye, Danielle

AU - Draucker, Claire

AU - Stump, Timothy

AU - Saliba, Debra

AU - Galvin, James E.

AU - Keegan, Amanda

AU - Austrom, Mary

AU - Boustani, Malaz

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