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

Rater reliability and responsiveness of GOT-Cog©, a novel occupational therapy cognitive screen | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Rater reliability and responsiveness of GOT-Cog©, a novel occupational therapy cognitive screen Emily Meise, John Corbett, Amanda Meyer, Pete Grevelding, Henry C. Hrdlicka This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6361869/v2 This work is licensed under a CC BY 4.0 License Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Abstract 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. Physical Medicine & Rehab Cognition Treatment Planning Screening Psychometric Properties Validity Reliability Long-Term Acute Care Hospital Inpatient Rehabilitation Adults Standardized Assessment Tool Figures Figure 1 Figure 2 Full Text Additional Declarations The authors declare no competing interests. Supplementary Files GOTCogReliabilityAndResponsivenessSupMaterials27Mar2025.pdf Supplemental Figures Cite Share Download PDF Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6361869","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":439402526,"identity":"451850bb-ae77-43a7-b841-0102fc39e872","order_by":0,"name":"Emily Meise","email":"","orcid":"","institution":"Gaylord Specialty Healthcare","correspondingAuthor":false,"prefix":"","firstName":"Emily","middleName":"","lastName":"Meise","suffix":""},{"id":439402527,"identity":"f292bacf-f075-41e2-ba80-532bbc3a7b18","order_by":1,"name":"John Corbett","email":"","orcid":"https://orcid.org/0000-0001-9593-6415","institution":"Gaylord Specialty Healthcare","correspondingAuthor":false,"prefix":"","firstName":"John","middleName":"","lastName":"Corbett","suffix":""},{"id":439402528,"identity":"4e839074-99d5-4e06-b908-02c084ce56ea","order_by":2,"name":"Amanda Meyer","email":"","orcid":"","institution":"Hartford Healthcare","correspondingAuthor":false,"prefix":"","firstName":"Amanda","middleName":"","lastName":"Meyer","suffix":""},{"id":439402529,"identity":"e5076b3e-d503-4270-bd54-9bdab37d9e6d","order_by":3,"name":"Pete Grevelding","email":"","orcid":"https://orcid.org/0000-0001-7734-3608","institution":"Gaylord Specialty Healthcare","correspondingAuthor":false,"prefix":"","firstName":"Pete","middleName":"","lastName":"Grevelding","suffix":""},{"id":439402530,"identity":"d8f70738-58ae-41fd-8d2c-68e4fce3075e","order_by":4,"name":"Henry C. Hrdlicka","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4klEQVRIiWNgGAWjYBACAwkGBokHBgwGDOwNQG4BEB8gRksCSAsPSKkB0VpAakEkUVrMpXsf3kgosDPmn/n84mceA5t8vgPMxz5+waPFcs5xY4sEg2Qzids5xdI8BmmWMw+wJc+WweewG2lsQL8csGG4nZMA1HLYwOAAjzGzBDFa5G+eSf5NkhYzgxvsx+C2MH7Ar4UZ5BdjwzM5bJZzDNIMJA+zJTPj0QHSwnjjwx87w3nHjz++8abCxoDvePNhxh/49CAAjwETD4gGWsHMQ5wW9gdww4m1ZRSMglEwCkYGAABIVkymweGMmgAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0002-7014-7919","institution":"Gaylord Specialty Healthcare","correspondingAuthor":true,"prefix":"","firstName":"Henry","middleName":"C.","lastName":"Hrdlicka","suffix":""}],"badges":[],"createdAt":"2025-04-02 13:45:16","currentVersionCode":2,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-6361869/v2","doiUrl":"https://doi.org/10.21203/rs.3.rs-6361869/v2","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":85243073,"identity":"aed98630-ffa2-47d3-8008-bc64d177c041","added_by":"auto","created_at":"2025-06-23 19:29:05","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":135587,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eStudy Criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNote. For this study, stopping criteria were primarily enacted between the first and second GOT-Cog assessment where the goal was to show agreement between the same or different raters. To capture change over time, stopping criteria were more conservatively enacted to account for the changes in cognition that are typically expected to occur the course of a patient’s medical stay.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"GOTCogReliabilityResponsivenessFigure1StudyCriteria.png","url":"https://assets-eu.researchsquare.com/files/rs-6361869/v2/8bbd1c123317bfd99834a8d5.png"},{"id":85243219,"identity":"694739c8-65df-4491-b7b6-1da35a2f42fd","added_by":"auto","created_at":"2025-06-23 19:37:05","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":667390,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eRater Reliability and Responsiveness.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eNotes. \u003c/em\u003e\u003cem\u003e\u003cstrong\u003e(A-D)\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e To assess rater reliability, the agreement of GOT-Cog scores when delivered to the same patient over multiple trials by either the same rater, n=89 \u003c/em\u003e\u003cem\u003e\u003cstrong\u003e(A,B)\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e or two different raters, n=87 \u003c/em\u003e\u003cem\u003e\u003cstrong\u003e(C,D)\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e was assessed. This data is represented both as a scatter plot with a linear regression \u003c/em\u003e\u003cem\u003e\u003cstrong\u003e(A,C)\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e, as well as box-and-whisker plots that more easily visualize the score distributions \u003c/em\u003e\u003cem\u003e\u003cstrong\u003e(B,D)\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e. Similarly, box-and-whisker plots were used to visualize the score distributions of the data collected to assess GOT-Cog responsiveness, n=149 \u003c/em\u003e\u003cem\u003e\u003cstrong\u003e(E)\u003c/strong\u003e\u003c/em\u003e\u003cem\u003eas well as the historical responsiveness of the SLUMS exam at the same study location, n=58 \u003c/em\u003e\u003cem\u003e\u003cstrong\u003e(F)\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e. \u003c/em\u003e\u003cem\u003e\u003cstrong\u003e(A,C)\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e Data are shown as a scatter plot with error bars indicating the mean with 95% confidence intervals. \u003c/em\u003e\u003cem\u003e\u003cstrong\u003e(B,D-F)\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e data are presented as box-and-whisker plots with the box representing the 25th to 75th quartiles, the midline representing the median, the (+) symbol representing the mean, the whiskers denoting the minimum and maximum of the data set excluding any outliers, and the circles representing individual outliers. \u003c/em\u003e\u003cem\u003e\u003cstrong\u003e(B,D-F)\u003c/strong\u003e\u003c/em\u003e\u003cem\u003e, the gray color represents the first GOT-Cog assessment delivered during the admission evaluation, while the green/darker shading represents the follow-up assessment collected at either the day 2 follow-up or at discharge, as indicated. Abbreviations: Admit = admission assessment; Disch = discharge assessment; GOT-Cog = Gaylord Occupational Therapy Cognitive Screen; ICC = interclass correlation coefficient; SLUMS = St. Louis University Mental Status Exam.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"GOTCogReliabilityResponsivenessFig2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6361869/v2/45a1425469f33ecc4a001c8b.jpg"},{"id":85244009,"identity":"c7e8e497-cdff-49dd-8ace-b3572cabd5cc","added_by":"auto","created_at":"2025-06-23 20:01:08","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1311105,"visible":true,"origin":"","legend":"","description":"","filename":"GOTCogReliabilityAndResponsivenessAJOT10Apr2025unmasked.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6361869/v2_covered_5217fb33-3640-49d0-9400-cacb0ccdaf65.pdf"},{"id":85243074,"identity":"2023d57d-624e-4f43-a274-91f55722a92b","added_by":"auto","created_at":"2025-06-23 19:29:05","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":115293,"visible":true,"origin":"","legend":"\u003cp\u003eSupplemental Figures\u003c/p\u003e","description":"","filename":"GOTCogReliabilityAndResponsivenessSupMaterials27Mar2025.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6361869/v2/efa0fe3cf72a9b3c31a0e59b.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"Rater reliability and responsiveness of GOT-Cog©, a novel occupational therapy cognitive screen","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Gaylord Hospital","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Cognition, Treatment Planning, Screening, Psychometric Properties, Validity, Reliability, Long-Term Acute Care Hospital, Inpatient Rehabilitation, Adults, Standardized Assessment Tool","lastPublishedDoi":"10.21203/rs.3.rs-6361869/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6361869/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eImportance:\u003c/h2\u003e \u003cp\u003eThe Gaylord Occupational Therapy Cognitive Screen (GOT-Cog\u0026copy;) 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.\u003c/p\u003e\u003ch2\u003eObjective\u003c/h2\u003e \u003cp\u003eTo assess the rater reliability and responsiveness of the GOT-Cog.\u003c/p\u003e\u003ch2\u003eDesign:\u003c/h2\u003e \u003cp\u003eConvergent parallel mixed methods research design.\u003c/p\u003e\u003ch2\u003eSetting:\u003c/h2\u003e \u003cp\u003eLong-term acute care hospital (LTACH).\u003c/p\u003e\u003ch2\u003eParticipants:\u003c/h2\u003e \u003cp\u003eParticipants were recruited from inpatients admitted with an order for occupational therapy services.\u003c/p\u003e\u003ch2\u003eIntervention:\u003c/h2\u003e \u003cp\u003eParticipants 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.\u003c/p\u003e\u003ch2\u003eOutcomes and Measures:\u003c/h2\u003e \u003cp\u003ePrimary 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.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eInterrater reliability of GOT-Cog was found to be moderate-to-good [ICC\u003csub\u003e2,1\u003c/sub\u003e (95% CI)\u0026thinsp;=\u0026thinsp;0.80 (0.71, 0.87), r\u0026thinsp;=\u0026thinsp;0.81, n\u0026thinsp;=\u0026thinsp;87], and intrarater reliability was good-to-excellent [ICC\u003csub\u003e2,1\u003c/sub\u003e (95% CI)\u0026thinsp;=\u0026thinsp;0.84 (0.76, 0.90), r\u0026thinsp;=\u0026thinsp;0.86, n\u0026thinsp;=\u0026thinsp;89]. GOT-Cog demonstrated a small effect size from admission to discharge (d\u0026thinsp;=\u0026thinsp;0.37, n\u0026thinsp;=\u0026thinsp;149) over a mean (95% CI) length of stay of 24.06 (20.70, 27.41, n\u0026thinsp;=\u0026thinsp;192) days.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThis 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.\u003c/p\u003e\u003ch2\u003ePlain-Language Summary:\u003c/h2\u003e \u003cp\u003eThis 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.\u003c/p\u003e","manuscriptTitle":"Rater reliability and responsiveness of GOT-Cog©, a novel occupational therapy cognitive screen","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2025-06-23 19:29:00","doi":"10.21203/rs.3.rs-6361869/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2025-04-07 09:30:51","doi":"10.21203/rs.3.rs-6361869/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"16549691-4af4-44eb-8c0a-9eaa06691bf3","owner":[],"postedDate":"June 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":46776461,"name":"Physical Medicine \u0026 Rehab"}],"tags":[],"updatedAt":"2025-04-07T09:30:51+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-23 19:29:00","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v2","identity":"rs-6361869","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6361869","identity":"rs-6361869","version":["v2"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}