Developing CollaboRATE: A fast and frugal patient-reported measure of shared decision making in clinical encounters

TLDR

Measuring shared decision making is challenging, hindering research and implementation. The study aimed to develop CollaboRATE, a brief patient‑reported measure of shared decision making that can be completed in under 30 s across routine settings. The authors developed CollaboRATE through item formulation, cognitive interviews, refinement, and pilot testing with adults recruited from Dartmouth‑Hitchcock Medical Center public areas. The study found that omitting terms such as “decisions,” “options,” and “preferences” is essential for creating a brief, accessible patient‑reported measure of shared decision making.

Abstract

Measuring the process of shared decision making is a challenge, which constitutes a barrier to research and implementation. The aim of the study was to report the development of CollaboRATE, brief patient-reported measure of shared decision making. We used the following stages: (1) item formulation; (2) cognitive interviews; (3) item refinement; and (4) pilot testing of final items. Participants were over 18 years old, recruited from the public areas of the Dartmouth-Hitchcock Medical Center. The key finding of this study is that developing a brief patient-reported measure of shared decision making requires a move away from terms such as 'decisions', 'options' and 'preferences'. Although technically correct, these terms act as barriers. They are often unfamiliar, and they also implicitly assume that patients are willing to take active roles in decision making; whereas patients are often unaware that decisions are required, or have taken place, never mind feel that they could or should have participated in them. These methods have allowed us to develop a brief, patient-reported measure of shared decision making that is highly accessible to intended users. The potential strength of the CollaboRATE will be the ability for completion in less than 30 s, and across a range of routine settings.