Goal Attainment Scaling:
A Comprehensive Guide

Enhance your Goal Attainment Scaling Knowledge, from Setting Meaningful Goals to Measuring Success.

What is Goal Attainment Scaling?

Goal Attainment Scaling (GAS) is an individualized patient-centered outcome that quantifies the effects of an intervention based on personal goals. Patients, caregivers, and healthcare professionals work together to identify and set treatment goals that area meaningful to them.

Since its introduction in 1968 by Kiresuk and Sherman1, Goal attainment scaling (GAS) has been a reliable and highly responsive measure of meaningful changes. Over 160 clinical trials have recorded GAS as an outcome, and it has been shown to be responsive to interventions in several disciplines.2

The use of GAS aligns with the FDA's Patient-Focused Drug Development: Incorporating Clinical Outcome Assessments Into Endpoints for Regulatory Decision-Making Draft Guidance #4, which highlights GAS as one of several useful personalized endpoints that can be used to reflect what is important for each patient in clinical trials specifically for diseases with variable clinical manifestations and impact on multiple aspects of feeling and functioning.3

How does Goal Attainment Scaling work?

Goal Attainment Scaling focuses on what matters most to the subject and their family.

Identify Goals

Clinician to facilitate interview for the patient or caregiver to identify goals.

Build GAS Scales

Together, they set the 5-point goal attainment scale for each identified goal.

Measure Attainment

Both rate during follow-up whether the goals have been attained.

Watch the video to learn more:

Goal Attainment Scaling Implementation

The Goal-Setting Visit: Identify Goals

The GAS interviewer (healthcare professional)  and the patient (and/or caregiver) work together to identify goals that matter most for the subject before the intervention begins. Patients are asked to identify at least 3 goal areas that are important to them and they would like to see improved by treatment.

Build GAS Scales

Once goal areas are identified, the patient describes their current state (baseline set at the -1 level on the scale) for each. Then, the GAS interviewer and the patient work together to specify the goal level and identify what improvement would look like (set at 0 level on the scale). The other attainment levels for better and worse outcomes are also identified, and a 5-point scale is developed for each goal area.

The GAS interviewer uses their clinical expertise to facilitate the goal-setting interview and ensure goals are SMART (Specific, Measurable, Achievable, Realistic/Relevant to the intervention, Time-bound).

The Follow-up Visit

At each predetermined follow-up visit, goal attainment is assessed. Patients are asked to describe their current state in relation to each goal area. The 5-point scale is reviewed together, and the patient is asked to rate their level of attainment. The GAS interviewer will also record their impression of attainment for each goal, which need not be the same as the participant’s rating.

For each participant, a summary score reveals the extent to which goals have been attained. The goals can be ranked by difficulty and importance. The scoring formula corrects for differential weighting of goals and differing number of goals between patients.

In Summary

GAS is a clinician-facilitated patient-centered outcome, and its strength relies on the dialogue that unites the clinician’s medical expertise with the patient's knowledge of their own subjective experience. Implementing GAS in clinical trials or practice depends on the patient's ability to achieve their goals and the clinicians' ability to predict treatment outcomes based on their knowledge and experience.4 A major strength of implementing GAS is the robust assessment of clinically meaningful change, a change that is unique to each patient and inherently relevant to the disease. 5,6

NOTE:  The  implementation of GAS may differ based on the disease type, population, and intervention.

Frequently Asked Questions


  1. Kiresuk, T. J., Smith, A., & Cardillo, J. E. (1994). Goal Attainment Scaling: Applications, Theory, and Measurement. Lawrence Erlbaum Associates.
  2.  A review of Goal Attainment Scaling in clinical trials. Taylor Dunn, Justin Stanley, Kari Knox, Chere Chapman, Sanja Stanojevic, Susan Howlett, Kenneth Rockwood (October 2020) https://isoqol27-isoqol.ipostersessions.com/Default.aspx?s=9A-22-6F-5E-39-E6-A2-D9-18-6F-79-DA-30-A6-6E-CC
  3.  U.S. Food and Drug Administration: Patient-Focused Drug Development: Incorporating Clinical Outcome Assessments Into Endpoints for Regulatory Decision-Making: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/patient-focused-drug-development-incorporating-clinical-outcome-assessments-endpoints-regulatory Published 2023. 
  4. Turner-Stokes, Goal Attainment Scaling (GAS) in Rehabilitation https://www.sralab.org/sites/default/files/2017-06/Tools-GAS-Practical-Guide.pdf
  5. Rockwood, K., Howlett, S., Stadnyk, K., Carver, D., Powell, C., & Stolee, P. (2003). Responsiveness of goal attainment scaling in a randomized controlled trial of comprehensive geriatric assessment. Journal of clinical epidemiology, 56(8), 736-743.
  6. Stolee, P., Stadnyk, K., Myers, A. M., & Rockwood, K. (1999). An individualized approach to outcome measurement in geriatric rehabilitation. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 54(12), M641-M647.