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

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 aspe...

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Autores principales: Kaltoft, Mette, Cunich, Michelle, Salkeld, Glenn, Dowie, Jack
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025621/
https://www.ncbi.nlm.nih.gov/pubmed/24335587
http://dx.doi.org/10.1177/1355819613511076
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author Kaltoft, Mette
Cunich, Michelle
Salkeld, Glenn
Dowie, Jack
author_facet Kaltoft, Mette
Cunich, Michelle
Salkeld, Glenn
Dowie, Jack
author_sort Kaltoft, Mette
collection PubMed
description 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.
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spelling pubmed-40256212014-05-20 Assessing decision quality in patient-centred care requires a preference-sensitive measure Kaltoft, Mette Cunich, Michelle Salkeld, Glenn Dowie, Jack J Health Serv Res Policy Essay 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. SAGE Publications 2014-04 /pmc/articles/PMC4025621/ /pubmed/24335587 http://dx.doi.org/10.1177/1355819613511076 Text en © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav http://creativecommons.org/licenses/by-nc/3.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(http://www.uk.sagepub.com/aboutus/openaccess.htm).
spellingShingle Essay
Kaltoft, Mette
Cunich, Michelle
Salkeld, Glenn
Dowie, Jack
Assessing decision quality in patient-centred care requires a preference-sensitive measure
title Assessing decision quality in patient-centred care requires a preference-sensitive measure
title_full Assessing decision quality in patient-centred care requires a preference-sensitive measure
title_fullStr Assessing decision quality in patient-centred care requires a preference-sensitive measure
title_full_unstemmed Assessing decision quality in patient-centred care requires a preference-sensitive measure
title_short Assessing decision quality in patient-centred care requires a preference-sensitive measure
title_sort assessing decision quality in patient-centred care requires a preference-sensitive measure
topic Essay
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4025621/
https://www.ncbi.nlm.nih.gov/pubmed/24335587
http://dx.doi.org/10.1177/1355819613511076
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