Rater reliability and responsiveness of GOT-Cog©, a novel occupational therapy cognitive screen

Importance: The Gaylord Occupational Therapy Cognitive Screen (GOT-Cog©) is a novel screen developed to better inform inpatient occupational therapy treatment planning. Previous studies have shown that GOT-Cog has excellent content, construct, and criterion validity, and good internal consistency. Objective To assess the rater reliability and responsiveness of the GOT-Cog. Design: Convergent parallel mixed methods research design. Setting: Long-term acute care hospital (LTACH). Participants: Participants were recruited from inpatients admitted with an order for occupational therapy services. Intervention: Participants were given GOT-Cog three times, twice at admission over two consecutive days, and again at discharge. When the first two assessments were collected by different investigators, interrater reliability was tested; when collected by the same investigator, intrarater reliability was tested. The first and final GOT-Cog scores were used to assess effect size and responsiveness. Outcomes and Measures: Primary outcome measure was the GOT-Cog total score. Rater reliability was evaluated using interclass correlation coefficients (ICCs), while responsiveness was calculated using effect size and score change. Results Interrater reliability of GOT-Cog was found to be moderate-to-good [ICC _2,1 (95% CI) = 0.80 (0.71, 0.87), r = 0.81, n = 87], and intrarater reliability was good-to-excellent [ICC _2,1 (95% CI) = 0.84 (0.76, 0.90), r = 0.86, n = 89]. GOT-Cog demonstrated a small effect size from admission to discharge (d = 0.37, n = 149) over a mean (95% CI) length of stay of 24.06 (20.70, 27.41, n = 192) days. Conclusions This work supports our previously published works, which indicate GOT-Cog has the necessary validity and reliability needed to support its use in the LTACH setting with a mixed medically complex inpatient population. Plain-Language Summary: This publication summarizes the measures' overall reliability and responsiveness by reporting on the intrarater and interrater reliability in addition to the responsiveness of the Gaylord Occupational Therapy Cognitive screen.