title: Refining a brief decision aid in stable CAD: cognitive interviews.
abstract: BACKGROUND
  We describe the results of cognitive interviews to refine the "Making Choices©" Decision Aid (DA) for shared decision-making (SDM) about stress testing in patients with stable coronary artery disease (CAD).
  
  
  METHODS
  We conducted a systematic development process to design a DA consistent with International Patient Decision Aid Standards (IPDAS) focused on Alpha testing criteria. Cognitive interviews were conducted with ten stable CAD patients using the "think aloud" interview technique to assess the clarity, usefulness, and design of each page of the DA.
  
  
  RESULTS
  Participants identified three main messages: 1) patients have multiple options based on stress tests and they should be discussed with a physician, 2) take care of yourself, 3) the stress test is the gold standard for determining the severity of your heart disease. Revisions corrected the inaccurate assumption of item number three.
  
  
  CONCLUSIONS
  Cognitive interviews proved critical for engaging patients in the development process and highlighted the necessity of clear message development and use of design principles that make decision materials easy to read and easy to use. Cognitive interviews appear to contribute critical information from the patient perspective to the overall systematic development process for designing decision aids.
authors: College of Human Medicine, Michigan State University, East Lansing, USA. kellyka1@msu.edu.
authors: Karen
authors: K
authors: Kelly-Blake
authors: Stacie
authors: S
authors: Clark
authors: Katherine
authors: K
authors: Dontje
authors: Adesuwa
authors: A
authors: Olomu
authors: Rebecca C
authors: RC
authors: Henry
authors: David R
authors: DR
authors: Rovner
authors: Marilyn L
authors: ML
authors: Rothert
authors: Margaret
authors: M
authors: Holmes-Rovner
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000175:diagnosis*; D003657:Decision Making; D003661:Decision Support Techniques; D005080:Exercise Test / Q000592:standards*; D005260:Female; D006801:Humans; D007406:Interview, Psychological / Q000379:methods; D008297:Male; D008875:Middle Aged; D010174:Pamphlets; D010358:Patient Participation / Q000379:methods