title: The OPTION scale: measuring the extent that clinicians involve patients in decision-making tasks.
abstract: OBJECTIVE
  To examine the psychometric properties of a revised scale, named 'observing patient involvement in decision making' (OPTION), by analysing its reapplication to a sample of routine primary care consultations. The OPTION instrument assesses to what degree clinicians involve patients in decision making.
  
  
  METHODS
  Cross-sectional assessment of medical interaction by two calibrated raters.
  
  
  METHODS
  Primary care.
  
  
  METHODS
  Twenty-one general practitioners provided 186 consultations for assessment.
  
  
  METHODS
  Observational score using the OPTION instrument.
  
  
  RESULTS
  Compared with the first version of the OPTION scale, the revised scale that uses a magnitude instead of an attitude scale, when applied to the same data set, resulted in improvement in the scale's reliability and to lower scores for the levels of involvement achieved by the practitioners. Factor analysis confirms that it is acceptable to regard the scale as a single construct. Although there is moderate variability when raters are assessed on an item by item basis, the agreements between raters at the level of the overall OPTION score is high (the intraclass correlation coefficient scores for total OPTION score was 0.77), a level that is acceptable for the evaluation of a set of consultations per practitioner (e.g. between 5 and 10 consultations), where aggregate scores would be used for determining overall performance.
  
  
  CONCLUSIONS
  We conclude that OPTION is sufficiently reliable to be used for formal assessment at the level of the whole instrument (all 12 items).
authors.affiliation: Primary Care Group, School of Medicine, University of Wales Swansea, Swansea, UK. g.elwyn@swansea.ac.uk
authors.forename: Glyn
authors.initials: G
authors.lastname: Elwyn
authors.forename: Hayley
authors.initials: H
authors.lastname: Hutchings
authors.forename: Adrian
authors.initials: A
authors.lastname: Edwards
authors.forename: Frances
authors.initials: F
authors.lastname: Rapport
authors.forename: Michel
authors.initials: M
authors.lastname: Wensing
authors.forename: Wai-Yee
authors.initials: WY
authors.lastname: Cheung
authors.forename: Richard
authors.initials: R
authors.lastname: Grol
mesh_terms: D003430:Cross-Sectional Studies; D003657:Decision Making; D005163:Factor Analysis, Statistical; D006801:Humans; D015588:Observer Variation; D010358:Patient Participation; D010817:Physician-Patient Relations; D011594:Psychometrics; D006113:United Kingdom