The Psychometric Properties of CollaboRATE: A Fast and Frugal Patient-Reported Measure of the Shared Decision-Making Process
The Psychometric Properties of CollaboRATE: A Fast and Frugal Patient-Reported Measure of the Shared Decision-Making Process
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DOI：
10.2196/jmir.3085
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发表时间：
2014-01-01
影响因子：
7.4
通讯作者：
Elwyn, Glyn
中科院分区：
文献类型：
--
作者：
Barr, Paul James;Thompson, Rachel;Elwyn, Glyn
背景：以患者为中心的卫生保健是当前卫生政策议程的中心组成部分。共享决策(SDM)被认为是患者参与的顶峰，促进这一点的方法正变得司空见惯。然而，SDM的衡量仍然具有挑战性。审查强调了患者报告的SDM措施的必要性，该措施是实用、有效和可靠的，以帮助实施工作。在与患者的磋商中，我们开发了协作，这是一种SDM过程的3项测量。目的：需要可扩展的患者报告的SDM过程测量。在目前的项目中，我们评估了ColLaboRATE的心理测量学特性。方法：在网上招募具有代表性的美国人群样本，并随机分配观看2013年1月6次模拟医患接触中的1次。SDM的三个维度在接触中被操纵：(1)对健康问题的解释，(2)患者偏好的引出，以及(3)患者偏好的整合。然后，参与者完成协作(可能得分0-100)，以及患者报告的其他两个SDM测量：9个项目的共享决策制定问卷(SDM-Q-9)和患者感知护理参与程度量表(PICS)的医生促进分量表(PICS)。在最初调查后的7至14天内，对参与者进行了复查。结果：最终样本包括1341名受试者。当SDM的核心维度从0(平均分：46.0，95%CI 42.4~49.6)增加到3(平均分：85.8，95%CI 83.2~88.4)时，协作性得分显著增加。COLICATE与SDM的其他测量的同时效度、出色的内部信度和对变化的敏感度；然而，不同的效度并未被证明。结论：COLICATE的快速和节俭的性质适合于常规的临床应用。需要对现实环境中的协作进行进一步评估。
Background: Patient-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.Objective: There is a need for scalable patient-reported measure of the SDM process. In the current project, we assessed the psychometric properties of CollaboRATE.Methods: A 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.Results: The 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.Conclusions: The fast and frugal nature of CollaboRATE lends itself to routine clinical use. Further assessment of CollaboRATE in real-world settings is required.