BMC Med Inform Decis Mak - Measuring decision quality: psychometric evaluation of a new instrument for breast cancer surgery.

Tópicos

{ assess(1506) score(1403) qualiti(1306) }
{ decis(3086) make(1611) patient(1517) }
{ cancer(2502) breast(956) screen(824) }
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Resumo

CKGROUND: The purpose of this paper is to examine the acceptability, feasibility, reliability and validity of a new decision quality instrument that assesses the extent to which patients are informed and receive treatments that match their goals.METHODS: Cross-sectional mail survey of recent breast cancer survivors, providers and healthy controls and a retest survey of survivors. The decision quality instrument includes knowledge questions and a set of goals, and results in two scores: a breast cancer surgery knowledge score and a concordance score, which reflects the percentage of patients who received treatments that match their goals. Hypotheses related to acceptability, feasibility, discriminant validity, content validity, predictive validity and retest reliability of the survey instrument were examined.RESULTS: We had responses from 440 eligible patients, 88 providers and 35 healthy controls. The decision quality instrument was feasible to implement in this study, with low missing data. The knowledge score had good retest reliability (intraclass correlation coefficient=0.70) and discriminated between providers and patients (mean difference 35%, p<0.001). The majority of providers felt that the knowledge items covered content that was essential for the decision. Five of the 6 treatment goals met targets for content validity. The five goals had moderate to strong retest reliability (0.64 to 0.87). The concordance score was 89%, indicating that a majority had treatments concordant with that predicted by their goals. Patients who had concordant treatment had similar levels of confidence and regret as those who did not.CONCLUSIONS: The decision quality instrument met the criteria of feasibility, reliability, discriminant and content validity in this sample. Additional research to examine performance of the instrument in prospective studies and more diverse populations is needed.

Resumo Limpo

ckground purpos paper examin accept feasibl reliabl valid new decis qualiti instrument assess extent patient inform receiv treatment match goalsmethod crosssect mail survey recent breast cancer survivor provid healthi control retest survey survivor decis qualiti instrument includ knowledg question set goal result two score breast cancer surgeri knowledg score concord score reflect percentag patient receiv treatment match goal hypothes relat accept feasibl discrimin valid content valid predict valid retest reliabl survey instrument examinedresult respons elig patient provid healthi control decis qualiti instrument feasibl implement studi low miss data knowledg score good retest reliabl intraclass correl coeffici discrimin provid patient mean differ p major provid felt knowledg item cover content essenti decis five treatment goal met target content valid five goal moder strong retest reliabl concord score indic major treatment concord predict goal patient concord treatment similar level confid regret notconclus decis qualiti instrument met criteria feasibl reliabl discrimin content valid sampl addit research examin perform instrument prospect studi divers popul need

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