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Shared decision making coding systems: how do they compare in the oncology context?

Phyllis Butow1, Ilona Juraskova, Sarah Chang

  • 1Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, University of Sydney, Camperdown, NSW 2006, Australia. phyllisb@psych.usyd.edu.au

Patient Education and Counseling
|August 4, 2009
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Summary
This summary is machine-generated.

The OPTION tool is efficient for shared decision making research, while DSAT and DAS-O provide more detailed feedback for oncologists. The best system depends on specific research or training needs.

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Area of Science:

  • Oncology
  • Health Services Research
  • Medical Education

Background:

  • Shared decision making (SDM) is crucial in oncology consultations.
  • Several coding systems exist to assess SDM, including OPTION, DSAT, and DAS-O.
  • Evaluating these systems' effectiveness is essential for research and clinical practice.

Purpose of the Study:

  • To compare the ability of OPTION, DSAT, and DAS-O to identify SDM competencies.
  • To determine the predictive ability of these coding systems for patient outcomes.
  • To assess the utility of different SDM coding systems in a single dataset.

Main Methods:

  • Twenty oncologists from Australia and New Zealand participated in IBCSG Trial 33-03.
  • Fifty-five audio-taped and transcribed consultations of women with early-stage breast cancer were coded.
  • Three different raters used OPTION, DAS-O, and DSAT coding systems; patient outcomes were assessed via questionnaires.

Main Results:

  • DAS-O strongly correlated with OPTION (r=0.73); DSAT showed moderate correlations with both (r<0.6).
  • Decisional satisfaction and satisfaction with doctor's SDM skills correlated significantly with OPTION and DAS-O.
  • These relationships remained significant in multiple linear regression analyses.

Conclusions:

  • OPTION may be the most efficient and sensitive system for SDM research.
  • DSAT appears effective in documenting behaviors that reduce decisional conflict.
  • Both DSAT and DAS-O offer more detailed feedback for physician training and development.