Abstract
BackgroundPatient-centered health care is a central component of current health policy agendas. Shared decision making (SDM) is considered to be the pinnacle of patient engagement and methods to promote this are becoming commonplace. However, the measurement of SDM continues to prove challenging. Reviews have highlighted the need for a patient-reported measure of SDM that is practical, valid, and reliable to assist implementation efforts. In consultation with patients, we developed CollaboRATE, a 3-item measure of the SDM process.ObjectiveThere is a need for scalable patient-reported measure of the SDM process. In the current project, we assessed the psychometric properties of CollaboRATE.MethodsA representative sample of the US population were recruited online and were randomly allocated to view 1 of 6 simulated doctor-patient encounters in January 2013. Three dimensions of SDM were manipulated in the encounters: (1) explanation of the health issue, (2) elicitation of patient preferences, and (3) integration of patient preferences. Participants then completed CollaboRATE (possible scores 0-100) in addition to 2 other patient-reported measures of SDM: the 9-item Shared Decision Decision Making Questionnaire (SDM-Q-9) and the Doctor Facilitation subscale of the Patient’s Perceived Involvement in Care Scale (PICS). A subsample of participants was resurveyed between 7 and 14 days after the initial survey. We assessed CollaboRATE’s discriminative, concurrent, and divergent validity, intrarater reliability, and sensitivity to change.ResultsThe final sample consisted of 1341 participants. CollaboRATE demonstrated discriminative validity, with a significant increase in CollaboRATE score as the number of core dimensions of SDM increased from zero (mean score: 46.0, 95% CI 42.4-49.6) to 3 (mean score 85.8, 95% CI 83.2-88.4). CollaboRATE also demonstrated concurrent validity with other measures of SDM, excellent intrarater reliability, and sensitivity to change; however, divergent validity was not demonstrated.ConclusionsThe fast and frugal nature of CollaboRATE lends itself to routine clinical use. Further assessment of CollaboRATE in real-world settings is required.
Highlights
Health care that is patient-centered and supports patient engagement has become an integral aspect of health policy [1,2,3]
CollaboRATE demonstrated discriminative validity, with a significant increase in CollaboRATE score as the number of core dimensions of Shared decision making (SDM) increased from zero to 3
We found 5 such measures: the dyadic OPTION scale [10], the Facilitation of Patient Involvement in Care Scale [11], the Perceived Involvement in Care Scale (PICS) [12], the 9-item Shared Decision Making Questionnaire (SDM-Q-9) [13], and the modified Control Preferences Scale [14]
Summary
Health care that is patient-centered and supports patient engagement has become an integral aspect of health policy [1,2,3]. We found 5 such measures: the dyadic OPTION scale [10], the Facilitation of Patient Involvement in Care Scale [11], the Perceived Involvement in Care Scale (PICS) [12], the 9-item Shared Decision Making Questionnaire (SDM-Q-9) [13], and the modified Control Preferences Scale [14]. Four of these measures [10,11,12,13] contain 5 or more items, which introduces a patient burden that complicates their integration into usual care. We developed CollaboRATE, a 3-item measure of the SDM process
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