title: Rochester Participatory Decision-Making Scale (RPAD): reliability and validity.
abstract: OBJECTIVE
  We wanted develop a reliable and valid objective measure of patient-physician collaborative decision making, the Rochester Participatory Decision-Making Scale (RPAD).
  
  
  METHODS
  Based on an informed decision-making model, the RPAD assesses physician behavior that encourages patient participation in decision making. Data were from a study of physician-patient communication of 100 primary care physicians. Physician encounters with 2 standardized patients each were audio recorded, resulting in 193 useable recordings. Transcribed recordings were coded both with RPAD and the Measure of Patient-Centered Communication (MPCC), which includes a related construct, Finding Common Ground. Two sets of dependent variables were derived from (1) surveys of the standardized patients and (2) surveys of 50 patients of each physician, who assessed their perceptions of the physician-patient relationship.
  
  
  RESULTS
  The RPAD was coded reliably (intraclass correlation coefficient [ICC] = 0.72). RPAD correlated with Finding Common Ground (r = 0.19, P < .01) and with the survey measures of standardized patient's perceptions of the physician-patient relationship (r = 0.32 - 0.36 [P < .005]) but less with the patient survey measures (r = 0.06 to 0.07 [P < .005]). Multivariate, hierarchical analyses suggested that the RPAD made a more robust contribution to explaining variance in standardized patient perceptions than did the MPCC Finding Common Ground.
  
  
  CONCLUSIONS
  The RPAD shows promise as a reliable, valid, and easy-to-code objective measure of participatory decision making.
authors.affiliation: Department of Family Medicine, University of Rochester Medical Center, Rochester Center to Improve Communication in Health Care, Rochester, NY, USA. Cleveland_Shields@URMC.Rochester.edu
authors.forename: Cleveland G
authors.initials: CG
authors.lastname: Shields
authors.forename: Peter
authors.initials: P
authors.lastname: Franks
authors.forename: Kevin
authors.initials: K
authors.lastname: Fiscella
authors.forename: Sean
authors.initials: S
authors.lastname: Meldrum
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Epstein
mesh_terms: D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D005764:Gastroesophageal Reflux; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D016544:Patient Simulation; D010817:Physician-Patient Relations; D010821:Physicians, Family