Assessing decision quality in patient-centred care requires a preference-sensitive measure

Mette Kjer Kaltoft, Michelle Cunich, Glenn Salkeld, Jack Dowie

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Abstrakt

A theory-based instrument for measuring the quality of decisions made using any form of decision technology, including both decision-aided and unaided clinical consultations is required to enable person- and patient-centred care and to respond positively to individual heterogeneity in the value aspects of decision making. Current instruments using the term 'decision quality' have adopted a decision- and thus condition-specific approach. We argue that patient-centred care requires decision quality to be regarded as both preference-sensitive across multiple relevant criteria and generic across all conditions and decisions. MyDecisionQuality is grounded in prescriptive multi criteria decision analysis and employs a simple expected value algorithm to calculate a score for the quality of a decision that combines, in the clinical case, the patient's individual preferences for eight quality criteria (expressed as importance weights) and their ratings of the decision just taken on each of these criteria (expressed as performance rates). It thus provides an index of decision quality that encompasses both these aspects. It also provides patients with help in prioritizing quality criteria for future decision making by calculating, for each criterion, the Incremental Value of Perfect Rating, that is, the increase in their decision quality score that would result if their performance rating on the criterion had been 100%, weightings unchanged. MyDecisionQuality, which is a web-based generic and preference-sensitive instrument, can constitute a key patient-reported measure of the quality of the decision-making process. It can provide the basis for future decision improvement, especially when the clinician (or other stakeholders) completes the equivalent instrument and the extent and nature of concordance and discordance can be established. Apart from its role in decision preparation and evaluation, it can also provide real time and relevant documentation for the patient's record.
OriginalsprogEngelsk
TidsskriftJournal of Health Services Research & Policy
Vol/bind19
Udgave nummer2
Sider (fra-til)110-117
ISSN1355-8196
DOI
StatusUdgivet - 2014

Bibliografisk note

Published online before print

Fingeraftryk Dyk ned i forskningsemnerne om 'Assessing decision quality in patient-centred care requires a preference-sensitive measure'. Sammen danner de et unikt fingeraftryk.

Citationsformater