Of blind men and elephants: suggesting SDM-MASS as a compound measure for shared decision making integrating patient,...

Area of Science:

• Health Services Research
• Patient-Physician Communication
• Clinical Practice Improvement

Background:

• Shared decision making (SDM) is crucial for patient-centered care.
• Existing SDM measures often rely on single perspectives (patient, physician, or observer), which can diverge.
• This divergence limits accurate assessment of the SDM process.

Purpose of the Study:

• To introduce and validate SDM Meeting its concept's ASSumptions (SDM(MASS)), a novel compound measure for SDM.
• To integrate multiple perspectives (patient, physician, observer) into a single SDM index.
• To compare the SDM(MASS) measure against unilateral perspectives in assessing SDM training.

Main Methods:

• SDM(MASS) was developed using theoretical derivation.
• The measure was empirically compared to patient, physician, and observer perspectives.
• Data from 10 physicians and 40 consultations following SDM training were analyzed.

Main Results:

• The components of SDM(MASS) demonstrated high reliability (Cronbach's alpha .94) and interrater reliability (.74-.87).
• Unilateral assessments of SDM training effects showed divergent results.
• The integrated SDM(MASS) measure indicated no significant effect of the SDM training.

Conclusions:

• SDM(MASS) offers a more comprehensive and plausible assessment of SDM processes by integrating multiple viewpoints.
• This compound measure has the potential to overcome limitations inherent in unilateral SDM assessment approaches.
• Further validation is required for this complex SDM measurement tool.