Development of a measure of decision quality for implantable defibrillators.

Background: CMS reimbursement guidelines for implantable cardioverter‐defibrillators (ICDs) include mandated shared decision making (SDM), but without any manner of assessing the quality of decisions made. We developed and tested a scale meant to assess patients' knowledge of and preferences specifi...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 44; no. 4; pp. 677 - 685
Autores principales: Knoepke, Christopher E., Allen, Larry A., Sepucha, Karen, Masoudi, Frederick A., Kutner, Jean, Varosy, Paul, Magid, David, Matlock, Daniel D.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Apr2021
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
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        atl: Development of a measure of decision quality for implantable defibrillators.
      aug:
        au:
          Knoepke, Christopher E.
          Allen, Larry A.
          Sepucha, Karen
          Masoudi, Frederick A.
          Kutner, Jean
          Varosy, Paul
          Magid, David
          Matlock, Daniel D.
        affil: Department of Medicine, Division of Cardiology, University of Colorado School of Medicine, Aurora Colorado,, USA
      sug:
        subj:
          Defibrillators, Implantable
          Decision Making, Shared Evaluation
          Health Knowledge Evaluation
          Patient Preference Evaluation
          Instrument Construction
          Instrument Validation
          Scales
          Human
          Validation Studies
          Content Validity
          Descriptive Statistics
          Test-Retest Reliability
          Discriminant Validity
          Cardiologists
      ab: Background: CMS reimbursement guidelines for implantable cardioverter‐defibrillators (ICDs) include mandated shared decision making (SDM), but without any manner of assessing the quality of decisions made. We developed and tested a scale meant to assess patients' knowledge of and preferences specific to ICDs. Such a tool would assess these constructs in the clinical environment, targeting resources and support for patients considering a primary prevention ICD. Methods: Development of the ICD decision quality (ICD‐DQ) scale included (1) item creation, (2) content validation using surveys of patients (n = 23) and clinicians (n = 31), and (3) examination of validity and reliability using a survey of patients who previously received an ICD (n = 295, response rate = 72%). Results: The final scale consists of 12 knowledge and 8 preference items. With respect to content validity, clinician and patient respondents agreed on the importance of 19 of 24 candidate knowledge items (79%), and 9 of 11 treatment preference items (81%). Knowledge items exhibited moderate internal validity (α = 0.62, 1 factor), strong test‐retest reliability (mean % correct at first administration = 59%, 62% at follow‐up, P >.1) and discriminant validity (59% correct for patients, 93% among cardiologists). Short versions of the ICD‐DQ were developed for clinical settings, the scores from both of which correlated with the long version in this cohort (11‐item (r = 0.90) and a 5‐item (r = 0.75)). Conclusions: : The ICD‐DQ fills a critical gap in measuring the quality of patients' ICD decisions. They may be used to evaluate the effectiveness of patient decision aids or the quality of SDM in clinical practice.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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