Measuring decision quality: psychometric evaluation of a new instrument for breast cancer chemotherapy
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Lee, Clara N, et al. Measuring Decision Quality: Psychometric Evaluation of a New Instrument for Breast Cancer Chemotherapy. BioMed Central Ltd, 2014. https://doi.org/10.17615/21dp-3f98APA
Lee, C., Wetschler, M., Chang, Y., Belkora, J., Moy, B., Partridge, A., & Sepucha, K. (2014). Measuring decision quality: psychometric evaluation of a new instrument for breast cancer chemotherapy. BioMed Central Ltd. https://doi.org/10.17615/21dp-3f98Chicago
Lee, Clara N, Matthew H Wetschler, Yuchiao Chang, Jeffrey K Belkora, Beverly Moy, Ann Partridge, and Karen R Sepucha. 2014. Measuring Decision Quality: Psychometric Evaluation of a New Instrument for Breast Cancer Chemotherapy. BioMed Central Ltd. https://doi.org/10.17615/21dp-3f98- Creator
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Lee, Clara N
- Affiliation: Cecil G. Sheps Center for Health Services Research, N.C. Cancer Hospital, UNC Lineberger Comprehensive Cancer Center
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Wetschler, Matthew H
- Other Affiliation: Department of Emergency Medicine, Stanford University, Palo Alto, USA
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Chang, Yuchiao
- Other Affiliation: General Medicine Division, Massachusetts General Hospital, Harvard Medical School, Boston, USA
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Belkora, Jeffrey K
- Other Affiliation: Institute for Health Policy Studies, University of California, San Francisco, CA, USA
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Moy, Beverly
- Other Affiliation: Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, USA
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Partridge, Ann
- Other Affiliation: Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA
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Sepucha, Karen R
- Other Affiliation: Health Decision Sciences Center, Massachusetts General Hospital, Harvard Medical School, Boston, USA
- Abstract
- Abstract Background Women diagnosed with early stage (I or II) breast cancer face a highly challenging decision – whether or not to undergo adjuvant chemotherapy. We developed a decision quality instrument for chemotherapy for early stage breast cancer and sought to evaluate its performance. Methods Cross-sectional, mailed survey of recent breast cancer survivors, providers, and healthy controls and a retest survey of survivors. The decision quality instrument includes questions on knowledge and personal goals. It results in a knowledge score and concordance score, which reflects the percentage of patients who received treatments that match their goals. Hypotheses related to acceptability, feasibility, validity, and reliability of the survey instrument were examined. Results Responses were received from 352 patients, 89 providers and 35 healthy controls. The decision quality instrument was feasible to implement with few missing data. The knowledge scores had good retest reliability (intraclass correlation coefficient (ICC) =0.75). Knowledge scores discriminated between providers and patients (mean difference 31.1%, 95% CI 26.9, 35.3) and between patients and healthy controls (mean difference 11.2, 95% CI 5.4, 17.1). Most providers reported that the knowledge items covered essential content. Two of the five goal items had a ceiling effect, and one goal had low content validity. The goal items had moderate retest reliability (ICC’s 0.57 to 0.78). In the multivariable model of treatment, none of the patient goals was associated with receipt of chemotherapy. Age and hormone receptor status were the only variables independently associated with chemotherapy. Most patients (77.6%) had treatment concordant with that predicted by the model. Patients who had concordant treatment had similar levels of confidence and regret as those who did not. Conclusions The Decision Quality Instrument is a reliable and valid measure of patient knowledge about chemotherapy, but its ability to measure concordance with patient goals is limited. In this sample, patient goals were not associated with treatment, and most patients reported they were not asked their preference, suggesting that goals were not adequately considered in decision making.
- Date of publication
- August 20, 2014
- DOI
- Identifier
- Resource type
- Article
- Rights statement
- In Copyright
- Rights holder
- Clara N Lee et al.; licensee BioMed Central Ltd.
- License
- Journal title
- BMC Medical Informatics and Decision Making
- Journal volume
- 14
- Journal issue
- 1
- Page start
- 73
- Language
- English
- Is the article or chapter peer-reviewed?
- Yes
- ISSN
- 1472-6947
- Bibliographic citation
- BMC Medical Informatics and Decision Making. 2014 Aug 20;14(1):73
- Publisher
- BioMed Central Ltd
- Access right
- Open Access
- Date uploaded
- August 26, 2015
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1472-6947-14-73.pdf | 2019-05-06 | Public | Download | |
Breast Cancer Systemic Therapy Decision Quality Instrument. | 2019-05-06 | Public | Download |