Involving patient partners as appraisers of shared decision making: an explanatory sequential mixed-methods study.

Area of Science:

• Health Services Research
• Patient Engagement in Research
• Shared Decision Making (SDM)

Background:

• Patient and Public Involvement (PPI) is crucial in health research but often excluded from data analysis in SDM studies.
• This study assessed the feasibility and value of patient partners appraising SDM using the OPTION5 instrument.
• Objectives included examining interrater reliability between patient partners and researchers and exploring patient perspectives on reliability differences.

Purpose of the Study:

• To evaluate the feasibility and value of involving patient partners as appraisers of shared decision making (SDM).
• To assess the interrater reliability between patient partners and researchers when using the OPTION5 instrument.
• To explore patient partners' perspectives on any observed differences in scoring.

Main Methods:

• An explanatory sequential mixed-methods design was employed.
• Four patient partners and three researchers independently scored 102 audio-recorded oncology consultations using the OPTION5 instrument.
• Interrater reliability was assessed using intraclass correlation coefficients (ICC), and qualitative data were gathered through focus group interviews with patient partners.

Main Results:

• Patient partners' total OPTION5 scores (median 60.0) were higher than researchers' (median 52.5).
• Overall single-rater agreement was moderate (ICC=0.60), improving to good when averaging raters (ICC=0.75).
• Qualitative themes included emotion-driven scoring, navigating the instrument, and evolving roles as co-researchers.

Conclusions:

• Involving patient partners as appraisers of SDM using the OPTION5 instrument is feasible.
• Patient appraisal ratings demonstrated moderate reliability with researcher ratings.
• Patient partners may utilize broader relational cues than researchers when assessing SDM behaviors in consultations.