Measuring informed decision making about prostate cancer screening in primary care.

Authors

• Amy Leader
• Constantine Daskalakis
• Clarence H Braddock
• Elisabeth J S Kunkel
• James R Cocroft
• Sylvia Bereknyei
• Jeffrey M Riggio
• Mark Capkin
• Ronald E Myers

Publication/Presentation Date

1-1-2012

Abstract

PURPOSE: To measure the extent of informed decision making (IDM) about prostate cancer screening in physician-patient encounters, describe the coding process, and assess the reliability of the IDM measure.

METHODS: Audiorecoded encounters of 146 older adult men and their primary care physicians were obtained in a randomized controlled trial of mediated decision support related to prostate cancer screening. Each encounter was dual coded for the presence or absence of 9 elements that reflect several important dimensions of IDM, such as information sharing, patient empowerment, and engaging patients in preference clarification. An IDM-9 score (range = 0-9) was determined for each encounter by summing the number of elements that were coded as present. Estimates of coding reliability and internal consistency were calculated.

RESULTS: Male patients tended to be white (59%), married (70%), and between the ages of 50 and 59 (70%). Physicians tended to be white (90%), male (74%), and have more than 10 years of practice experience (74%). IDM-9 scores ranged from 0 to 7.5 (mean [SD], 2.7 [2.1]). Reliability (0.90) and internal consistency (0.81) of the IDM-9 were both high. The IDM dimension observed most frequently was information sharing (74%), whereas the dimension least frequently observed was engagement in preference clarification (3.4%).

CONCLUSIONS: In physician-patient encounters, the level of IDM concerning prostate cancer screening was low. The use of a dual-coding approach with audiorecorded encounters produced a measure of IDM that was reliable and internally consistent.

Volume

32

Issue

2

First Page

327

Last Page

336

ISSN

1552-681X

Published In/Presented At

Leader, A., Daskalakis, C., Braddock, C. H., 3rd, Kunkel, E. J., Cocroft, J. R., Bereknyei, S., Riggio, J. M., Capkin, M., & Myers, R. E. (2012). Measuring informed decision making about prostate cancer screening in primary care. Medical decision making : an international journal of the Society for Medical Decision Making, 32(2), 327–336. https://doi.org/10.1177/0272989X11410064

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

21685377

Department(s)

Administration and Leadership

Document Type

Article