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Updated: Jan 7, 2026
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Qualitative and Quantitative Validation of Tools with Rating Scales Aimed at Assessing the Quality of University Service-Learning
Published on: August 29, 2025
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The OPTION scale for the assessment of shared decision making (SDM): methodological issues
Jennifer Nicolai1, Morten Moshagen, Wolfgang Eich
1Department of General Internal Medicine and Psychosomatics, Center for Psychosocial Medicine, University of Heidelberg, Germany. jennifer.nicolai@med.uniheidelberg.de
Summary
The OPTION scale, used to measure patient involvement in decision-making, shows weak evidence for its structure and validity. Further research is needed to improve patient involvement measurement tools.
Area of Science:
- Medical Education
- Health Services Research
- Psychometrics
Background:
- Patient involvement in medical decision-making is a key goal in healthcare.
- Valid measures are crucial for evaluating shared decision-making interventions.
- The OPTION scale is a primary tool for observing clinician-patient involvement.
Purpose of the Study:
- To critically evaluate the psychometric and methodological properties of the OPTION scale.
- To identify limitations in the current measurement of patient involvement.
- To guide future research on assessing shared decision-making.
Main Methods:
- Systematic review and critical appraisal of studies using the OPTION scale.
- Analysis of psychometric data including reliability and validity.
- Examination of methodological aspects such as item independence and dyadic considerations.
Main Results:
- Limited support for the OPTION scale's unidimensional structure.
- Acceptable reliability but high heterogeneity across studies.
- Insufficient evidence for validity, particularly convergent validity.
- Identified issues include lack of item independence, range restriction, and failure to address dyadic aspects.
Conclusions:
- Significant methodological and conceptual issues require addressing for accurate measurement of patient involvement.
- The current psychometric properties of the OPTION scale present challenges.
- Further research is essential to refine and validate instruments for measuring patient involvement in clinical decision-making.
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