Open AccessMeasurement challenges in shared decision making: putting the ‘patient’ in patient‐reported measures
Author(s) -
Barr Paul J.,
Elwyn Glyn
Publication year - 2016
Publication title -
health expectations
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.314
H-Index - 74
eISSN - 1369-7625
pISSN - 1369-6513
DOI - 10.1111/hex.12380
Subject(s) - incentive , interview , computer science , key (lock) , cognitive interview , motivational interviewing , point (geometry) , patient participation , field (mathematics) , knowledge management , health care , process management , cognition , psychology , medicine , nursing , business , psychological intervention , computer security , geometry , mathematics , neuroscience , political science , pure mathematics , law , economics , microeconomics , economic growth
Measuring clinicians' shared decision‐making ( SDM ) performance is a key requirement given the intensity of policy interest in many developed countries – yet it remains one of the most difficult methodological challenges, which is a concern for many stakeholders. In this V iewpoint A rticle, we investigate the development of existing patient‐reported measures ( PRM s) of SDM identified in a recent review. We find that patients were involved in the development of only four of the 13 measures. This lack of patient involvement in PRM development is associated with two major threats to content validity, common to all 13 PRM s of SDM : (i) an assumption of patient awareness of ‘decision points’ and (ii) an assumption that there is only one decision point in each healthcare consultation. We provide detailed examples of these threats and their impact on accurate assessment of SDM processes and outcomes, which may hamper efforts to introduce incentives for SDM implementation. We propose cognitive interviewing as a recommended method of involving patients in the design of PRM s in the field of SDM and provide a practical example of this approach.