Construct and Criterion Validity Testing of GOT-Cog, a Novel Cognitive Screen to Better Inform Occupational Therapy Treatment Planning

Research Objectives: To assess the construct and criterion validity of the novel Gaylord Occupational Therapy Cognitive (GOT-Cog) screen developed to better inform inpatient occupational therapy (OT) treatment planning.

Design: Randomized cross-over controlled study design using the St. Louis University Mental Status (SLUMS) exam as a comparator.

Setting: Gaylord Specialty Healthcare (GSH), a long-term acute care hospital (LTACH) in Wallingford, Connecticut, USA.

Participants: Inpatients 18 years and older, admitted to GSH, and prescribed OT services were approached for study inclusion. Patients had to be alert and oriented to attend cognitive testing and able understand and respond to verbal instructions in English. As GOT-Cog is not intended to diagnose, those with pre-existing cognitive impairment or a diagnosis of dementia were excluded.

Interventions: During their initial OT evaluation, participants were randomly delivered either the SLUMS exam or the GOT-Cog screen. Twenty-two to twenty-six hours later, the alternative cognitive tool was delivered.

Main Outcome Measures: Primary outcome measures consisted of total GOT-Cog and SLUMS scores and total domain scores. Secondary outcomes were demographic info, speech-language pathology cognitive evaluations, vision assessment, discharge disposition, assessment completion time, and mobility scores.

Results: 129 participants were approached, with 98 participants yielding sufficient data for analysis. Total GOT-Cog and SLUMS scores were shown to positively correlate (p < 0.0001). All shared domains between GOT-Cog and SLUMS showed a significant correlation (p≤0.0155) and all unique domains showed significant correlations to both GOT-Cog and SLUMS total score (p≤0.0194). No ordering effects were observed, and despite containing 11 more items, GOT-Cog only took 6 minutes longer to complete (10 versus 16 minutes).

Conclusions: Following our review, we conclude that the GOT-Cog screen shows criterion and construct validity compared to the SLUMS exam when tested in the LTACH setting. Reliability and responsiveness testing will be conducted in the next study phase.

Author(s) Disclosures: None