使用标准化视频检验共享决策过程量表的有效性：一项随机在线实验的结果。
Using Standardized Videos to Examine the Validity of the Shared Decision Making Process Scale: Results of a Randomized Online Experiment.
机构信息
Division of General Internal Medicine, Massachusetts General Hospital, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
出版信息
Med Decis Making. 2022 Jan;42(1):105-113. doi: 10.1177/0272989X211029267. Epub 2021 Aug 3.
BACKGROUND
The Shared Decision Making (SDM) Process scale is a brief, patient-reported measure of SDM with demonstrated validity in surgical decision making studies. Herein we examine the validity of the scores in assessing SDM for cancer screening and medication decisions through standardized videos of good-quality and poor-quality SDM consultations.
METHOD
An online sample was randomized to a clinical decision-colon cancer screening or high cholesterol-and a viewing order-good-quality video first or poor-quality video first. Participants watched both videos, completing a survey after each video. Surveys included the SDM Process scale and the 9-item SDM Questionnaire (SDM-Q-9); higher scores indicated greater SDM. Multilevel linear regressions identified if video, order, or their interaction predicted SDM Process scores. To identify how the SDM Process score classified videos, area under the curve (AUC) was calculated. The correlation between SDM Process score and SDM-Q-9 assessed construct validity. Heterogeneity analyses were conducted.
RESULTS
In the sample of 388 participants (68% white, 70% female, average age 45 years) good-quality videos received higher SDM Process scores than poor-quality videos (s < 0.001), and those who viewed the good-quality high cholesterol video first tended to rate the videos higher. SDM Process scores were related to SDM-Q-9 scores (s > 0.58; s < 0.001). AUC was poor (0.69) for the high cholesterol model and fair (0.79) for the colorectal cancer model. Heterogeneity analyses suggested individual differences were predictive of SDM Process scores.
CONCLUSION
SDM Process scores showed good evidence of validity in a hypothetical scenario but were lacking in ability to classify good-quality or poor-quality videos accurately. Considerable heterogeneity of scoring existed, suggesting that individual differences played a role in evaluating good- or poor-quality SDM conversations.
背景
共享决策制定（SDM）过程量表是一种简短的、患者报告的 SDM 测量工具，在外科决策研究中已证明其有效性。在此，我们通过高质量和低质量 SDM 咨询的标准视频来检查该评分在评估癌症筛查和药物决策中的 SDM 的有效性。
方法
在线样本被随机分配到临床决策-结肠癌筛查或高胆固醇-以及观看顺序-先观看高质量视频或先观看低质量视频。参与者观看了两个视频，并在每个视频后完成了一项调查。调查包括 SDM 过程量表和 9 项 SDM 问卷（SDM-Q-9）；得分越高表示 SDM 越高。多层次线性回归确定了视频、顺序或它们的交互作用是否预测 SDM 过程评分。为了确定 SDM 过程评分如何对视频进行分类，计算了曲线下面积（AUC）。SDM 过程评分与 SDM-Q-9 的相关性评估了结构有效性。进行了异质性分析。
结果
在 388 名参与者的样本中（68%为白人，70%为女性，平均年龄 45 岁），高质量视频的 SDM 过程评分高于低质量视频（s < 0.001），且先观看高质量高胆固醇视频的参与者倾向于对视频给予更高的评分。SDM 过程评分与 SDM-Q-9 评分相关（s > 0.58；s < 0.001）。高胆固醇模型的 AUC 较差（0.69），结直肠癌模型的 AUC 较好（0.79）。异质性分析表明，个体差异是 SDM 过程评分的预测因素。
结论
SDM 过程评分在假设情景中表现出良好的有效性证据，但在准确分类高质量或低质量视频方面能力不足。评分存在相当大的异质性，这表明个体差异在评估高质量或低质量 SDM 对话方面发挥了作用。
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