Global Rating of Change (GROC)

What Are GROC Surveys?

Global Rating of Change (GROC) scales are simple, one‑item questions that capture a patient’s overall impression of change over time for a specific condition. Rather than rating pain, function, or satisfaction separately, a GROC asks the patient to summarise how they feel their overall situation has changed.

The patient chooses what matters most to them—making the score truly global.

A standard GROC structure is:

“With respect to your [condition], how would you describe yourself now compared to [time anchor]?”

Physitrack GROC Surveys

We created four ready‑to‑use GROC outcome measures to reflect common clinical scenarios. Each uses a different recall anchor and scale length to provide variety and clinical relevance.

These surveys have not been formally validated, but they were developed following the principles described by Kamper et al. (2009), who highlight:

• The importance of naming the specific condition.
• The need for a clear comparison time point.
• The value of balanced, symmetric scales with a central “no change” point.

Why Editing Is Encouraged

Because GROC questions must be specific to the patient’s condition and context, no single version fits everyone. Instead, these four examples act as flexible blueprints.

These measures were designed to:

• Serve as plug‑and‑play options.
• Showcase different anchor styles.
• Provide a template library that clinicians can easily copy and adapt.

The Physitrack templates provide the structure—your edits make them clinically precise.

How to Personalise a GROC Measure in Physitrack (Step‑by‑Step)

Below is a clear process for customising any of the templates.

Step 1: Copy the survey you want to use

Duplicate the GROC survey with the scale length you prefer (7, 9, or 11 points) so you can safely edit your own version.

Step 2: Identify the patient’s specific condition

Edit the opening line to name the condition clearly:

• “With respect to your ankle sprain…”
• “With respect to your low back pain…”
• “With respect to your post‑operative shoulder…”

This ensures the patient reflects on the correct problem.

Step 3: Choose a meaningful time anchor

Patients recall changes best when comparing to a distinct, personally meaningful event, such as:

• “…compared to immediately after the injury”
• “…compared to when you first began treatment”
• “…compared to just before your operation”

Tip. People may recall events better, not arbitrary dates.

Step 4: Keep the question global

Use neutral, open phrasing such as:

• “..how would you describe yourself now…?”
• “..how has it changed…?”

Avoid steering patients toward a specific domain (pain, function, sleep, etc.) unless a domain‑specific version is your intention.

Step 5: Edit the scale if needed

• A scale of 7, 9, or 11 points is recommended.
• Always keep the midpoint as “No change.”
• Ensure wording is balanced and symmetrical.
• Limit descriptive anchors to each end of the scale and the midpoint.

Step 6: Confirm clarity before assigning

Read your customised version aloud and check:

• Is the condition precise?
• Is the anchor meaningful?
• Does the question feel global?
• Will the patient understand it easily?

If yes—save the survey. When sharing it with the patient, remember to schedule follow‑up time points and explain the importance of answering each survey.

Final Thoughts

The four GROC measures added to Physitrack provide a fast, flexible way to capture patients’ perceived change. Guided by the principles from Kamper et al., these tools balance simplicity with methodological soundness.

Use the templates as they are—or adapt them using the steps above to make each version specific to your patient’s situation. This keeps your outcomes tracking both efficient and patient‑centred.

References

Kamper SJ, Maher CG, Mackay G. Global rating of change scales: a review of strengths and weaknesses and considerations for design. J Man Manip Ther. 2009;17(3):163-170. doi:10.1179/jmt.2009.17.3.163