Shared decision making: developing the OPTION scale for measuring patient involvement
BMJ Quality & SafetyPublished 1 April 2003Open access
Glyn Elwyn
Citations541
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
The OPTION scale provided reliable scores for detecting differences between groups of consultations in the extent to which patients are involved in decision making processes in consultations and provides a validated outcome measure for future empirical studies.
Abstract
Involvement in decision making is a key facet of patient participation in health care and the OPTION scale provides a validated outcome measure for future empirical studies.
Keywords
MedicineHealth ProfessionsBusiness, Management and Accounting
PsychometrikaCoefficient Alpha and the Internal Structure of Tests
43,211 Citations1951Lee J. Cronbach
Practical Statistics for Medical Research
9,764 Citations1990Douglas G. Altman
Health Measurement Scales: A Practical Guide to Their Development and Use
9,651 Citations1989David L. Streiner, Geoffrey R. Norman +1 more
This chapter discusses the design of items, their properties, and methods of administration, and some of the considerations that went into designing the items.
Social Science & MedicineShared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango)
4,130 Citations1997Cathy Charles, Amiram Gafni +1 more
This paper attempts to provide greater conceptual clarity about shared treatment decision-making, identify some key characteristics of this model, and discuss measurement issues.
Social Science & MedicinePatient-centredness: a conceptual framework and review of the empirical literature
2,964 Citations2000Nicola Mead, Peter Bower
This paper reviews the conceptual and empirical literature in order to develop a model of the various aspects of the doctor-patient relationship encompassed by the concept of 'patient-centredness' and to assess the advantages and disadvantages of alternative methods of measurement.
Social Science & MedicineDecision-making in the physician–patient encounter: revisiting the shared treatment decision-making model
2,318 Citations1999Cathy Charles, Amiram Gafni +1 more
This revised framework provides a dynamic view of treatment decision-making by recognizing that the approach adopted at the outset of a medical encounter may change as the interaction evolves and has practical applications for clinical practice, research and medical education.
Patient-Centered Medicine: Transforming the Clinical Method
1,300 Citations1995Moira Stewart, Judith Belle Brown +4 more
The Patient-Centered Clinical Method and the Human Dimensions of Medical Education: Dealing with Common Difficulties in learning and teaching.
BMJTowards a global definition of patient centred care
1,079 Citations2001Moira Stewart
Strong agreement exists between the definition of patient centredness that arises empirically from this observational study of patients in the United Kingdom and another definition arising from reflections on practice in South Africa and Canada, suggesting an international definition ofpatient centred medicine.
BMJDecision aids for patients facing health treatment or screening decisions: systematic review
877 Citations1999Annette M. O’Connor, Alaa Rostom +7 more
Teaching and Learning Communication Skills in Medicine
827 Citations2017Suzanne Kurtz, Jonathan Silverman +3 more
This book discusses principles of how to teach communication skills, and introduces research, and theory: expanding and consolidating learning.
Social Science & MedicinePatient participation in decision-making
798 Citations1998Edward Guadagnoli, Patricia Ward
It is proposed that methods be developed to evaluate a patient's level of "readiness" to participate in decision-making and that interventions that match the patient'slevel of readiness be applied to increase participation.
BMJPreferences of patients for patient centred approach to consultation in primary care: observational study
777 Citations2001Paul Little, Hazel Everitt +6 more
Patients in primary care strongly want a patient centred approach, with communication, partnership, and health promotion—those vulnerable either psychosocially or because they are feeling unwell should be sensitive to patients who have a strong preference for patient centre.
PubMedShared decision making and the concept of equipoise: the competences of involving patients in healthcare choices.
736 Citations2000Glyn Elwyn, Adrian Edwards +2 more
Experienced GPs with educational roles have positive attitudes to the involvement of patients in decisions, provided the process matches the role individuals wish to play, and a set of competences and steps that would enable clinical practitioners (generalists) to undertake 'shared decision making' in their clinical environment are proposed.
BMJPatients' unvoiced agendas in general practice consultations: qualitative study
580 Citations2000Christine A. Barry
Investigation of patients' agendas before consultation and the effects of unvoiced agendas on outcomes suggests that when patients and their needs are more fully articulated in the consultation better health care may be effected.
Behavioral MedicinePatients' Preferences for Participation in Clinical Decision Making: A Review of Published Surveys
550 Citations1998Jochanan Benbassat, Dina Pilpel +1 more
The ability to communicate health-related information and to determine the patients' desire to participate in medical decisions should be viewed as a basic clinical skill.
Medical EducationThe Calgary—Cambridge Referenced Observation Guides: an aid to defining the curriculum and organizing the teaching in communication training programmes
519 Citations1996Suzanne Kurtz, Jonathan Silverman
A practical teaching tool is described that delineates and structures the skills which aid doctor‐patient communication, and provides detailed references to substantiate the research and theoretical basis of these individual skills.
PubMedShared decision-making in primary care: the neglected second half of the consultation.
502 Citations1999Glyn Elwyn, Amanda Edwards +1 more
It is indicated that future developments in this area depend on increasing the time available within consultations, require improved ways of communicating risk to patients, and an acquisition of new communication skills.
Journal of Health Services Research & PolicyPartnerships with Patients: The Pros and Cons of Shared Clinical Decision-Making
493 Citations1997Angela Coulter
There is considerable evidence that patients want more information and greater involvement, although knowledge about the circumstances in which shared decision-making should be encouraged, and the effects of doing so, is sparse.
Patient Education and CounselingPatient-centred medicine: Transforming the clinical method
457 Citations1998Judith Belle Brown
Social Science & MedicineDoctor–patient communication about drugs: the evidence for shared decision making
437 Citations2000Fiona Stevenson, Christine A. Barry +3 more
There was little evidence that doctors and patients both participate in the consultation in this way, and as a consequence there was no basis upon which to build a consensus about the preferred treatment and reach an agreement on which treatment to implement.
The Practice of Autonomy Patients, Doctors, and Medical Decisions
404 Citations1998
Journal of General Internal MedicineHow Doctors and Patients Discuss Routine Clinical Decisions Informed Decision Making in the Outpatient Setting
341 Citations1997Clarence H. Braddock, Stephan D. Fihn +3 more
BMJTowards a feasible model for shared decision making: focus group study with general practice registrars
298 Citations1999Glyn Elwyn, Anne Edwards +2 more
Assessment of the views of general practice registrars about involving patients in decisions and the feasibility of using the shared decision making model by means of simulated general practice consultations shows the steps that need to be taken if further progress is to be made in this direction.
BMJThe intracluster correlation coefficient in cluster randomisation
294 Citations1998Sally Kerry, John M. Bland
Patient Education and CounselingPatient-physician communication assessment instruments:
244 Citations1998Heather Boon, Moira Stewart
It is suggested that further validation of existing instruments and incorporation of assessment of non-verbal communication between the patient and the doctor are needed.
Patient Education and CounselingMeasuring the involvement of patients in shared decision-making: a systematic review of instruments
239 Citations2001Glyn Elwyn, Adrian Edwards +5 more
Investigation of the relevant literature found no instruments that had been specifically designed to measure the concept of 'involving patients' in decisions, and reveals that little attention has been given to the processes of patient involvement in decision-making.
Patient Education and CounselingMeasuring patient-centredness: a comparison of three observation-based instruments
221 Citations2000Nicola Mead, Peter Bower
Differences in construct validity of the three measures were evident and their concurrent validity was relatively low, and the implications for research, and for assessing the quality of individual doctors' 'interpersonal' care are discussed.
Sociology of Health & IllnessDoing Nothing is No Choice: Lay Constructions of Treatment Decision‐making Among Women with Early‐stage Breast Cancer
177 Citations1998Cathy Charles, Timothy J. Whelan +3 more
It was found that many women who were presented with the choice to undergo some form of adjuvant treatment versus no treatment felt that ‘doing nothing was no choice’ and retained the idea of probability but thought that they personally would beat the odds.
Patient Education and CounselingThe development of COMRADE—a patient-based outcome measure to evaluate the effectiveness of risk communication and treatment decision making in consultations
170 Citations2003Adrian Edwards, Glyn Elwyn +7 more
A patient-based outcome measure to evaluate risk communication and decision making effectiveness, addressing these further domains and validated for use in the UK, which allows for paternalistic, shared or informed choice decision making models.
Social Science & MedicineWhen is a shared decision not (quite) a shared decision? Negotiating preferences in a general practice encounter
157 Citations1999Richard Gwyn, Glyn Elwyn
It is illustrated how a general practitioner's (GP's) efforts to reach a 'shared decision' come unstuck through a combination of the embedded power imbalance and the conflict between the GP's own prescription preferences and those of the parent.
Health PsychologyGender in medical encounters: An analysis of physician and patient communication in a primary care setting.
140 Citations1994Judith A. Hall, Julie T. Irish +3 more
PubMedMeasuring quality in general practice. Pilot study of a needs, process and outcome measure.
127 Citations1997J. G. R. Howie, David Heaney +1 more
Primary analysis of the available dataset undertaken to explore whether the approach used to evaluate quality of care for patients with specific clinical problems could be extended to the generality of general practice consultations found that doctors who take longer time are likely to be more patient centred, and those who take less time arelikely to be less patient Centred.
Medical EducationReliability and feasibility of measuring medical interviewing skills: the revised Maastricht History‐Taking and Advice Checklist
109 Citations1991Jana Thiel, Herro F. Kraan +1 more
A revised version of the Maastricht History‐Taking and Advice Checklist (MAAS), a check‐list of concrete interview behaviour, has been investigated concerning feasibility and reliability for examination purposes and the results of generalizability analysis are encouraging.
Journal of Legal MedicineThe practice of autonomy: Patients, doctors and medical decisions
107 Citations1999F A Rozovsky
This chapter discusses patients' preferences about Autonomy, the Empirical Evidence, and the Arguments for Mandatory Autonomy.
Evidence-based patient choice : inevitable or impossible?
94 Citations2001Adrian Edwards, Glyn Elwyn
This document discusses evidence-based patient choice in health care, and the next and possible future development for clinical practice.
Health ExpectationsConsumers’ views of quality in the consultation and their relevance to ‘shared decision‐making’ approaches
92 Citations2001Adrian Edwards, Glyn Elwyn +3 more
This paper presents a meta-analysis of evidence of ‘effectiveness’ of shared decision‐making and other communication interventions in eight countries over a 12-month period and shows clear patterns of decline in the effects of these interventions on quality and satisfaction.
BMJDescriptive study of cooperative language in primary care consultations by male and female doctors
80 Citations1999J. Skelton, Richard Hobbs
These data show that male and female doctors use a speech style which is not gender specific, contrary to findings elsewhere; doctors consulted in an overtly non-directive, negotiated style, which is realised through suggestions and affective comments.
Journal of General Internal MedicineHow Doctors and Patients Discuss Routine Clinical Decisions: Informed Decision Making in the Outpatient Setting
71 Citations1997Clarence H. Braddock, Stephan D. Fihn +3 more
The informed consent process in routine, primary care office practice did not fulfill the criteria considered integral to informed decision making, and Physicians frequently described the nature of the decision, less frequently discussed risks and benefits, and rarely assessed the patient's understanding of the decisions.
Journal of Evaluation in Clinical PracticeShared decision making observed in clinical practice: visual displays of communication sequence and patterns
70 Citations2001Glyn Elwyn, Adrian Edwards +4 more
The results demonstrate that some theoretical competences are not distinguishable in practice and other stages, not previously described, such as the 'portrayal of equipoise', are observed.
Health ExpectationsIs ‘shared decision‐making’ feasible in consultations for upper respiratory tract infections? Assessing the influence of antibiotic expectations using discourse analysis
67 Citations1999Glyn Elwyn, Richard Gwyn +2 more
To examine the discourse of consultations in which conflict occurs between parents and clinicians about the necessity of antibiotics to treat an upper respiratory tract infection and to appraise the feasibility of shared decision‐making in such consultations.
PubMedLevels of physician involvement with patients and their families. A model for teaching and research.
28 Citations1994M. Kim Marvel, R. S. F. Schilling +2 more
This investigation suggests that the levels of physician involvement model can be reliably measured and may be a useful tool for education and research, particularly the study of physician interview skills appropriate to family medicine.
