• 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, and Malaz Boustani.
• School of Medicine, Indiana University, Indianapolis, IN, USA. pmonahan@iu.edu.
• J Gen Intern Med. 2019 Jun 1; 34 (6): 908-914.

BackgroundA 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).ObjectiveAssess internal consistency reliability, test-retest reliability, construct validity, and sensitivity to change for SymTrak.Design And ParticipantsAmong 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 MeasuresDemographic questions, SymTrak, Health Utility Index Mark 3 (HUI3).Key ResultsExploratory 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.ConclusionsSymTrak 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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