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Methods Inf Med 2013; 52(06): 514-521
DOI: 10.3414/ME13-01-0011
Original Articles
Schattauer GmbH

Trying to Optimise the German Version of the OPTION Scale Regarding the Dyadic Aspect of Shared Decision Making

H. Keller
1   Department of General Practice/Family Medicine, Philipps University Marburg, Marburg, Germany
,
O. Hirsch
1   Department of General Practice/Family Medicine, Philipps University Marburg, Marburg, Germany
,
M. Müller-Engelmann
1   Department of General Practice/Family Medicine, Philipps University Marburg, Marburg, Germany
,
M. Heinzel-Gutenbrunner
2   Department of Child and Adolescent Psychiatry and Psychotherapy, Philipps University Marburg, Marburg, Germany
,
T. Krones
1   Department of General Practice/Family Medicine, Philipps University Marburg, Marburg, Germany
3   Clinical Ethics, University Hospital Zurich, Zurich, Switzerland
,
N. Donner-Banzhoff
1   Department of General Practice/Family Medicine, Philipps University Marburg, Marburg, Germany
› Author Affiliations
Further Information

Publication History

received: 07 January 2013

accepted: 03 July 2013

Publication Date:
20 January 2018 (online)

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Summary

Objectives: The OPTION scale (“observing patient involvement in decision making”) assesses the extent to which clinicians involve patients in decisions across a range of situations in clinical practice. It so far just covers physician behavior. We intended to modify the scoring of the OPTION scale to incorpo -rate active patient behavior in consultations.

Methods: Modification was done on scoring level, attempting a dyadic, relationship-centred approach in that high ratings can be evoked also by the behaviour of active patients. The German version of the OPTION scale was compared with a modified version by analysing video recordings of primary care consultations dealing with cardiovascular prevention. Fifteen general practitioners provided 40 videotaped consultations. Videos were analysed by two rater pairs and two experts in shared decision making (SDM).

Results: Reliability measures of the modified version were lower than those of the original scale. Significant associations of the dichotomised scale with the expert SDM rating as well as with physicians’ expertise in SDM were only found for the modified OPTION scale. Receiver Operating Characteristic (ROC) analyses confirmed a valid differentiation between the presence of SDM (yes/no) on total score level, even though the cut-off point was quite low. Standard deviations of the single items in the modified version were higher compared to the original OPTION scale, while the means of total scores were similar.

Conclusions: The original OPTION scale is physician-centered and neglects the activity and a possible self-involvement of the patient. Our modified instruction was able to capture the dyadic element partially. The development of a separate dyadic instrument might be more promising.

Keywords

Decision making - weights and measures - patient participation - cross-over studies - physician-patient relations
 

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