Clinical utility, validity and reliability of the IPad application for goal-setting: The aid for decision-making in occupation choice-2

Abstract

Objective: To evaluate the clinical utility, reliability, and validity of the second-generation aid for decision-making in occupation choice-2 (ADOC2), an iPad application designed for client-centred and occupation-centred goal setting. Design: This study consisted of two components: (1) The development and refinement of the ADOC2 application, focusing on user interface design and structured goal-setting functionality; and (2) the clinical evaluation of its utility, validity, and reliability. Setting: Eleven rehabilitation facilities in Japan (10 hospitals, 1 home-based setting). Participants: A total of 116 occupational therapy clients and 56 occupational therapists participated in the study. Main measures: Clinical utility was assessed using a structured questionnaire previously validated for the original ADOC. Validity was examined through correlations with the Canadian Occupational Performance Measure (COPM) and the EuroQol 5-Dimension 5-Level (EQ-5D-5L). Test–retest reliability of satisfaction and performance scores was analysed using weighted kappa coefficients. Results: Over 90% of participants reported positive experiences with ADOC2 during the goal-setting process. The COPM scores showed strong correlations with ADOC2 ratings, while EQ-5D-5L scores showed weaker but expected correlations. Weighted kappa analyses indicated substantial to almost perfect agreement for test–retest reliability. Conclusions: ADOC2 is a clinically useful, valid, and reliable tool for facilitating client-centred goal setting in occupational therapy practice.