Evaluation of the shared decision-making process scale in cancer screening and medication decisions

Vo, Ha; Valentine, K. D.; Barry, Michael J.; Sepucha, Karen

doi:10.1016/j.pec.2022.107617

Cited by 3 publications

(6 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In general, lower SDM Process scores have been observed for life‐saving surgical decisions without alternative treatment options, and higher SDM Process scores are seen when there are multiple options or the decision is preference‐based, which is consistent with our findings. Outside of the surgical space, a recent analysis of 2423 participants who completed the SDM scale after discussing cancer screening decisions with a healthcare provider demonstrated mean SDM scores ranging from 1.24 to 1.94 for decisions around breast, prostate, and colon cancer screening (Vo et al, 2023). Our results indicate that the majority of patients recall that the genetic counselor asked about their testing preference and discussed reasons both to accept or decline genetic testing.…”

Section: Discussionmentioning

confidence: 99%

“…The 4‐item Shared Decision Making (SDM) Process Scale is an existing measure endorsed by the National Quality Forum (NQF) that assesses the extent to which shared decision making happens in interactions between patients and healthcare providers (Sepucha & Fowler, 2018). The scale has strong evidence of reliability and validity, and has been tested extensively in common medical decisions including cancer surveillance, medication initiation, and surgical decision making (Brodney et al, 2019; Fowler, Gallagher, et al, 2013; Fowler, Gerstein, et al, 2013; Sepucha et al, 2013; Sepucha et al, 2015; Valentine et al, 2021; Vo et al, 2023; Zikmund‐Fisher et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Performance of the shared decision‐making process scale for use in evaluation of hereditary cancer genetic testing decisions

Gore

Nieters

Valentine

et al. 2023

Journal of Genetic Counseling

Self Cite

View full text Add to dashboard Cite

This study aimed to evaluate feasibility, acceptability, reliability, and validity of the existing four‐item Shared Decision Making (SDM) Process Scale for use in evaluating genetic testing decisions. Patients from a large hereditary cancer genetics practice were invited to participate in a two‐part survey after completing pre‐test genetic counseling. The online survey included the SDM Process Scale and the SURE scale, a measure of decisional conflict. SDM Process scores were compared to SURE scores to test convergent validity, and respondents were sent a second survey 1 week later to assess retest reliability. The response rate was 65% (n = 259/398) and missing data was low (<1%). SDM scores ranged from zero to four with a mean of 2.3 (SD = 1.1). Retest reliability was good, with intraclass correlation of 0.84, 95% confidence interval (0.79, 0.88). No relationship was found between SDM Process scores and decisional conflict (p = 0.46), likely because 85% of participants reported no decisional conflict. The four‐item SDM Process Scale demonstrated feasibility, acceptability, and retest reliability, but not convergent validity with decisional conflict. These findings provide initial evidence for use of this scale to measure patient perceptions of SDM in pre‐test counseling for hereditary cancer genetic testing.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Performance of the shared decision‐making process scale for use in evaluation of hereditary cancer genetic testing decisions

Gore

Nieters

Valentine

et al. 2023

Journal of Genetic Counseling

Self Cite

View full text Add to dashboard Cite

show abstract

“…The primary outcome was the validated Shared Decision-Making Process survey (SDMP) score (0-4), which measures the extent to which patients are involved in a decision-making process. 22 , 36 , 37 Secondary outcomes were the patient knowledge score (0-4), presence of test conversation, satisfaction with test conversation, presence of discussion of next steps, and whether the physician explained tests in a way that was easy to understand (all binary).…”

Section: Methodsmentioning

confidence: 99%

“…Priming short, meaningful conversations about even seemingly routine tests could address proposed drivers of overuse, including clinician norms, patient misperceptions and knowledge gaps, and inadequate patient-clinician communication . Such conversations could also contribute to patient-centered care by improving patients’ medical test literacy and allowing nuanced consideration of patient values and preferences in testing decisions . Yet, to our knowledge, no studies have implemented or tested an intervention that prepares clinicians and patients to understand and discuss medical testing decisions in general and during routine care.…”

Section: Introductionmentioning

confidence: 99%

“… 19 , 20 Such conversations could also contribute to patient-centered care by improving patients’ medical test literacy and allowing nuanced consideration of patient values and preferences in testing decisions. 16 , 21 , 22 Yet, to our knowledge, no studies have implemented or tested an intervention that prepares clinicians and patients to understand and discuss medical testing decisions in general and during routine care.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effect of a Peer Comparison and Educational Intervention on Medical Test Conversation Quality

Ganguli,

Mulligan,

Chant

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceMedical test overuse and resulting care cascades represent a costly, intractable problem associated with inadequate patient-clinician communication. One possible solution with potential for broader benefits is priming routine, high-quality medical test conversations.ObjectiveTo assess if a peer comparison and educational intervention for physicians and patients improved medical test conversations during annual visits.Design, Setting, and ParticipantsRandomized clinical trial and qualitative evaluation at an academic medical center conducted May 2021 to October 2022. Twenty primary care physicians (PCPs) were matched-pair randomized. For each physician, at least 10 patients with scheduled visits were enrolled. Data were analyzed from December 2022 to September 2023.InterventionsIn the intervention group, physicians received previsit emails that compared their low-value testing rates with those of peer PCPs and included point-of-care–accessible guidance on medical testing; patients received previsit educational materials via email and text message. Control group physicians and patients received general previsit preparation tips.Main outcomes and measuresThe primary patient outcome was the Shared Decision-Making Process survey (SDMP) score. Secondary patient outcomes included medical test knowledge and presence of test conversation. Outcomes were compared using linear regression models adjusted for patient age, gender, race and ethnicity, and education. Poststudy interviews with intervention group physicians and patients were also conducted.ResultsThere were 166 intervention group patients and 148 control group patients (mean [SD] patient age, 50.2 [15.3] years; 210 [66.9%] female; 246 [78.3%] non-Hispanic White). Most patients discussed at least 1 test with their physician (95.4% for intervention group; 98.3% for control group; difference, −2.9 percentage points; 95% CI, −7.0 to 1.2 percentage points). There were no statistically significant differences in SDMP scores (2.11 out of 4 for intervention group; 1.97 for control group; difference, 0.14; 95% CI, −0.25 to 0.54) and knowledge scores (2.74 vs 2.54 out of 4; difference, 0.19; 95% CI, −0.05 to 0.43). In poststudy interviews with 3 physicians and 16 patients, some physicians said the emails helped them reexamine their testing approach while others noted competing demands. Most patients said they trusted their physicians’ advice even when inconsistent with educational materials.Conclusions and RelevanceIn this randomized clinical trial of a physician-facing and patient-facing peer comparison and educational intervention, there was no significant improvement in medical test conversation quality during annual visits. These results suggest that future interventions to improve conversations and reduce overuse and cascades should further address physician adoption barriers and leverage patient-clinician relationships.Trial RegistrationClinicalTrials.gov Identifier: NCT04902664

show abstract

Talking, not training, increased the accuracy of physicians’ diagnosis of their patients’ preferences for colon cancer screening

Valentine,

Leavitt,

Simmons

et al. 2024

Patient Education and Counseling

View full text Add to dashboard Cite

Evaluation of the shared decision-making process scale in cancer screening and medication decisions

Cited by 3 publications

References 40 publications

Performance of the shared decision‐making process scale for use in evaluation of hereditary cancer genetic testing decisions

Performance of the shared decision‐making process scale for use in evaluation of hereditary cancer genetic testing decisions

Effect of a Peer Comparison and Educational Intervention on Medical Test Conversation Quality

Talking, not training, increased the accuracy of physicians’ diagnosis of their patients’ preferences for colon cancer screening

Contact Info

Product

Resources

About