title: Assessing the quality of decision support technologies using the International Patient Decision Aid Standards instrument (IPDASi).
abstract: OBJECTIVE
  To describe the development, validation and inter-rater reliability of an instrument to measure the quality of patient decision support technologies (decision aids).
  
  
  METHODS
  Scale development study, involving construct, item and scale development, validation and reliability testing.
  
  
  METHODS
  There has been increasing use of decision support technologies--adjuncts to the discussions clinicians have with patients about difficult decisions. A global interest in developing these interventions exists among both for-profit and not-for-profit organisations. It is therefore essential to have internationally accepted standards to assess the quality of their development, process, content, potential bias and method of field testing and evaluation.
  
  
  METHODS
  Scale development study, involving construct, item and scale development, validation and reliability testing.
  
  
  METHODS
  Twenty-five researcher-members of the International Patient Decision Aid Standards Collaboration worked together to develop the instrument (IPDASi). In the fourth Stage (reliability study), eight raters assessed thirty randomly selected decision support technologies.
  
  
  RESULTS
  IPDASi measures quality in 10 dimensions, using 47 items, and provides an overall quality score (scaled from 0 to 100) for each intervention. Overall IPDASi scores ranged from 33 to 82 across the decision support technologies sampled (n = 30), enabling discrimination. The inter-rater intraclass correlation for the overall quality score was 0.80. Correlations of dimension scores with the overall score were all positive (0.31 to 0.68). Cronbach's alpha values for the 8 raters ranged from 0.72 to 0.93. Cronbach's alphas based on the dimension means ranged from 0.50 to 0.81, indicating that the dimensions, although well correlated, measure different aspects of decision support technology quality. A short version (19 items) was also developed that had very similar mean scores to IPDASi and high correlation between short score and overall score 0.87 (CI 0.79 to 0.92).
  
  
  CONCLUSIONS
  This work demonstrates that IPDASi has the ability to assess the quality of decision support technologies. The existing IPDASi provides an assessment of the quality of a DST's components and will be used as a tool to provide formative advice to DSTs developers and summative assessments for those who want to compare their tools against an existing benchmark.
authors.affiliation: Department of Primary Care and Public Health, School of Medicine and the School of Psychology, Cardiff University, Cardiff, United Kingdom. elwyng@cardiff.ac.uk
authors.forename: Glyn
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authors.lastname: Elwyn
authors.forename: Annette M
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authors.lastname: O'Connor
authors.forename: Carol
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authors.forename: Robert G
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authors.lastname: Newcombe
authors.forename: Mary
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authors.forename: Marie-Anne
authors.initials: MA
authors.lastname: Durand
authors.forename: Elizabeth
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authors.lastname: Drake
authors.forename: Natalie
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authors.lastname: Joseph-Williams
authors.forename: Sara
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authors.lastname: Khangura
authors.forename: Anton
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authors.lastname: Saarimaki
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authors.lastname: Sivell
authors.forename: Mareike
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authors.lastname: Stiel
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Bernstein
authors.forename: Nananda
authors.initials: N
authors.lastname: Col
authors.forename: Angela
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authors.lastname: Coulter
authors.forename: Karen
authors.initials: K
authors.lastname: Eden
authors.forename: Martin
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authors.lastname: Härter
authors.forename: Margaret Holmes
authors.initials: MH
authors.lastname: Rovner
authors.forename: Nora
authors.initials: N
authors.lastname: Moumjid
authors.forename: Dawn
authors.initials: D
authors.lastname: Stacey
authors.forename: Richard
authors.initials: R
authors.lastname: Thomson
authors.forename: Tim
authors.initials: T
authors.lastname: Whelan
authors.forename: Trudy
authors.initials: T
authors.lastname: van der Weijden
authors.forename: Adrian
authors.initials: A
authors.lastname: Edwards
mesh_terms: D003657:Decision Making; D003661:Decision Support Techniques; D006801:Humans; D010358:Patient Participation; D015203:Reproducibility of Results