1423 - Reliability and Validity of the Centers for Medicare & Medicaid Services Section GG for Patients with Stroke: A Systematic Review

Section GG is a measurement instrument implemented by the Centers for Medicare & Medicaid Services in 2016 for use across all post-acute care (PAC) settings to assess patients' self-care and mobility abilities at admission and discharge. This systematic review aimed to summarize peer-reviewed literature on the reliability and validity of Section GG in stroke patient populations.


Design:

PubMed, PsycINFO, and CINAHL were searched using an algorithm that included: 1) Section GG, instrument pseudonyms, 2) relevant psychometric terms, 3) PAC settings, and 4) Stroke. Studies were included if they were published in English, conducted in the United States, and investigated the reliability and validity of the instrument in patients with stroke.


Results:

13 articles were identified, and four studies, with varying quality, conducted in inpatient rehabilitation (IRF) settings met the inclusion criteria, including two retrospective cohort studies, one secondary analysis, and one prospective cohort study. Findings demonstrated poor to adequate predictive validity for discharge destination (AUC 0.67–0.89), adequate to excellent concurrent validity compared with the modified Rankin Scale, and excellent concurrent validity compared with the FIM Motor Subscale (ρ = 0.788–0.931). The available literature also indicates excellent internal consistency, with Cronbach’s alpha scores >0.92.


Conclusions:

This systematic review highlights a small, but growing, body of literature supporting the validity and reliability of Section GG in the IRF setting for patients with stroke. Most studies examining the reliability and validity of the instrument included patients with a mix of primary medical conditions, rather than condition-specific populations. The limited number of studies focusing on stroke patients underscores the need for targeted research to analyze its reliability and optimize the use of Section GG in this population, particularly in other settings than IRF facilities.