Kriston Levente, Härter Martin, Scholl Isabelle
Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Germany.
Z Evid Fortbild Qual Gesundhwes. 2012;106(4):253-63. doi: 10.1016/j.zefq.2012.03.021. Epub 2012 Apr 23.
The aim of our study is to introduce a statistical framework using latent variable modeling for the investigation of correspondence between patients' and physicians' perceptions that were measured using dyadic instruments. This statistical approach combines multitrait-multimethod and measurement invariance methodologies. In an illustrative example we used a sample of 285 primary care consultations on chronic diseases to test correspondence between patients' and physicians' views on the process of shared decision-making (SDM), which was measured by the patient and physician version of the nine-item Shared Decision-Making Questionnaire (SDM-Q-9 and SDM-Q-Doc), respectively. We revealed that while patients and physicians seem to agree on what is the core of SDM, they differ in their ratings regarding to which extent it is present in a certain consultation. The described statistical approach provides important insights into correspondence between perceptions of different stakeholders that cannot be gained using traditional approaches. However, its generalizability is questionable due to the partly explorative data-driven approach and its flexibility is limited by the requirement of samples including at least 200 cases.
我们研究的目的是引入一个使用潜在变量建模的统计框架，用于调查使用二元工具测量的患者和医生认知之间的对应关系。这种统计方法结合了多特质-多方法和测量不变性方法。在一个示例中，我们使用了285例慢性病初级保健会诊样本，以测试患者和医生对共同决策（SDM）过程的看法之间的对应关系，这分别由患者版和医生版的九项共同决策问卷（SDM-Q-9和SDM-Q-Doc）进行测量。我们发现，虽然患者和医生似乎在SDM的核心内容上达成了一致，但他们在特定会诊中SDM存在程度的评分上存在差异。所描述的统计方法为不同利益相关者的认知之间的对应关系提供了重要见解，而这是传统方法无法获得的。然而，由于部分探索性的数据驱动方法，其可推广性存在疑问，并且其灵活性受到样本至少包括200个案例这一要求的限制。
