Are you SURE?: Assessing patient decisional conflict with a 4-item screening test

To assess the reliability and validity of the 4-item SURE (Sure of myself; Understand information; Risk-benefit ratio; Encouragement) screening test for decisional conflict in patients.

Cross-sectional study.

Four family medicine groups in Quebec and 1 rural academic medical centre in New Hampshire.

One hundred twenty-three French-speaking pregnant women considering prenatal screening for Down syndrome and 1474 English-speaking patients referred to watch condition-specific video decision aids.

Cronbach alpha was used to assess the reliability of SURE. A factorial analysis was performed to assess its unidimensionality. The Pearson correlation coefficient was computed between SURE and the Decisional Conflict Scale to assess concurrent validation. A t test procedure comparing the SURE scores of patients who had made decisions with the scores of those who had not was used to assess construct validation.

Among the 123 French-speaking pregnant women, 105 (85%) scored 4 out of 4 (no decisional conflict); 10 (8%) scored 3 (

The SURE screening test shows promise for screening for decisional conflict in both French- and English-speaking patients; however, future studies should assess its performance in a broader group of patients.