Measuring informed decision making about prostate cancer screening in primary care

Area of Science:

• Urology
• Health Services Research
• Medical Decision Making

Background:

• Prostate cancer screening decisions require informed patient participation.
• Assessing the quality of shared decision-making in clinical practice is crucial.

Purpose of the Study:

• To quantify informed decision making (IDM) in prostate cancer screening discussions.
• To detail the coding process for an IDM measure.
• To evaluate the reliability and internal consistency of the IDM measure.

Main Methods:

• Dual-coding of 146 audiorecorded physician-patient encounters from a randomized controlled trial.
• Utilized 9 elements reflecting information sharing, patient empowerment, and preference clarification.
• Calculated IDM-9 scores, coding reliability, and internal consistency.

Main Results:

• IDM-9 scores averaged 2.7 (SD, 2.1), indicating low overall IDM.
• High reliability (0.90) and internal consistency (0.81) were found for the IDM-9 measure.
• Information sharing was common (74%), but preference clarification engagement was rare (3.4%).

Conclusions:

• Physician-patient interactions regarding prostate cancer screening exhibit low levels of informed decision making.
• A dual-coding methodology using audiorecorded encounters provides a reliable and consistent measure of IDM.