Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, University of Sydney, Camperdown, NSW 2006, Australia.
Patient Educ Couns. 2010 Feb;78(2):261-8. doi: 10.1016/j.pec.2009.06.009. Epub 2009 Aug 3.
The current study aimed to evaluate three coding systems which have been used to assess shared decision making in oncology consultations (OPTION, Decision Support Analysis Tool (DSAT) and Decision Analysis System for Oncology (DAS-O)): (i) comparing their ability to identify competencies of shared decision making, and (ii) determining their ability to predict patient outcomes in a single data set.
Twenty oncologists from Australia and New Zealand participated in the IBCSG Trial 33-03. The consultations of 55 women with early stage breast cancer were audio-taped, transcribed and then coded using the OPTION, DAS-O and DSAT coding systems by three different raters. Women completed the questionnaires 2 weeks and 4 months after their consultation.
DAS-O was strongly correlated with OPTION (r=0.73). DSAT was moderately correlated with DAS-O and OPTION (r<0.6). Decisional satisfaction and satisfaction with doctor SDM skills were significantly correlated with OPTION (r=0.39 and 0.42 respectively) and the latter variable was correlated with DAS-O (r=0.40). These relationships persisted in multiple linear regression analyses.
OPTION may be the most efficient and sensitive coding system for research purposes; however, DSAT appeared to document behaviours reducing decisional conflict and both DSAT and DAS-O offer more detailed feedback to doctors.
Optimal coding system will depend on research goals and training purposes.
本研究旨在评估三种已用于评估肿瘤学咨询中共同决策的编码系统（OPTION、决策支持分析工具（DSAT）和肿瘤学决策分析系统（DAS-O））：（i）比较它们识别共同决策能力的能力，以及（ii）确定它们在单个数据集预测患者结局的能力。
来自澳大利亚和新西兰的 20 名肿瘤学家参与了 IBCSG 试验 33-03。对 55 名早期乳腺癌女性的咨询进行了录音、转录，然后由三名不同的评分员使用 OPTION、DAS-O 和 DSAT 编码系统进行编码。女性在咨询后 2 周和 4 个月完成问卷。
DAS-O 与 OPTION 高度相关（r=0.73）。DSAT 与 DAS-O 和 OPTION 中度相关（r<0.6）。决策满意度和对医生 SDM 技能的满意度与 OPTION 显著相关（r=0.39 和 0.42 分别），后一变量与 DAS-O 相关（r=0.40）。这些关系在多元线性回归分析中仍然存在。
OPTION 可能是研究目的最有效和敏感的编码系统；然而，DSAT 似乎记录了减少决策冲突的行为，DSAT 和 DAS-O 都为医生提供了更详细的反馈。
最佳编码系统将取决于研究目标和培训目的。
