title: Measuring informed decision making about prostate cancer screening in primary care.
abstract: To measure the extent of informed decision making (IDM) about prostate cancer screening in physician-patient encounters, describe the coding process, and assess the reliability of the IDM measure.
  
  
  
  Audiorecoded encounters of 146 older adult men and their primary care physicians were obtained in a randomized controlled trial of mediated decision support related to prostate cancer screening. Each encounter was dual coded for the presence or absence of 9 elements that reflect several important dimensions of IDM, such as information sharing, patient empowerment, and engaging patients in preference clarification. An IDM-9 score (range = 0-9) was determined for each encounter by summing the number of elements that were coded as present. Estimates of coding reliability and internal consistency were calculated.
  
  
  
  Male patients tended to be white (59%), married (70%), and between the ages of 50 and 59 (70%). Physicians tended to be white (90%), male (74%), and have more than 10 years of practice experience (74%). IDM-9 scores ranged from 0 to 7.5 (mean [SD], 2.7 [2.1]). Reliability (0.90) and internal consistency (0.81) of the IDM-9 were both high. The IDM dimension observed most frequently was information sharing (74%), whereas the dimension least frequently observed was engagement in preference clarification (3.4%).
  
  
  
  In physician-patient encounters, the level of IDM concerning prostate cancer screening was low. The use of a dual-coding approach with audiorecorded encounters produced a measure of IDM that was reliable and internally consistent.
authors.affiliation: Department of Medical Oncology (AL, JRC, REM) Thomas Jefferson University, Philadelphia, Pennsylvania
authors.forename: Amy
authors.initials: A
authors.lastname: Leader
authors.affiliation: Department of Pharmacology & Experimental Therapeutics (CD) Thomas Jefferson University, Philadelphia, Pennsylvania
authors.forename: Constantine
authors.initials: C
authors.lastname: Daskalakis
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, California (CHB, SB)
authors.forename: Clarence H
authors.initials: CH
authors.lastname: Braddock
authors.affiliation: Department of Psychiatry and Human Behavior (EJSK) Thomas Jefferson University, Philadelphia, Pennsylvania
authors.forename: Elisabeth J S
authors.initials: EJ
authors.lastname: Kunkel
authors.affiliation: Department of Medical Oncology (AL, JRC, REM) Thomas Jefferson University, Philadelphia, Pennsylvania
authors.forename: James R
authors.initials: JR
authors.lastname: Cocroft
authors.affiliation: Department of Medicine, Stanford University School of Medicine, Stanford, California (CHB, SB)
authors.forename: Sylvia
authors.initials: S
authors.lastname: Bereknyei
authors.affiliation: Department of Internal Medicine, Albert Einstein Medical Center, Philadelphia, Pennsylvania (JMR)
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Riggio
authors.affiliation: Department of Medicine (MC) Thomas Jefferson University, Philadelphia, Pennsylvania
authors.forename: Mark
authors.initials: M
authors.lastname: Capkin
authors.affiliation: Department of Medical Oncology (AL, JRC, REM) Thomas Jefferson University, Philadelphia, Pennsylvania
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Myers
mesh_terms: D000368:Aged; D032882:Comprehension; D003657:Decision Making; D055088:Early Detection of Cancer; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010358:Patient Participation; D010817:Physician-Patient Relations; D011320:Primary Health Care; D011471:Prostatic Neoplasms / Q000175:diagnosis*