title: Comparing the ability of OPTION(12) and OPTION(5) to assess shared decision-making in genetic counselling.
abstract: OPTION(12) is the most widely used tool to measure shared decision-making (SDM) in health care. A newer scale, OPTION(5), has been proposed as a more parsimonious measure that better addresses core concepts of SDM. This study compares OPTION(5) to OPTION(12) in prenatal genetic counselling.
  
  
  
  Two raters independently used OPTION(12) and OPTION(5) to score 27 clinical encounters between genetic counsellors (GC) and women with pregnancies at increased risk for genetic conditions. Global and item scores on the two instruments were compared to test concurrent validity and to identify usability in this context. Inter-rater reliability was also assessed for both instruments.
  
  
  
  Mean scores for OPTION(12) were 43.8 (SD=9.7), and for OPTION(5) were=60.6 (SD=12.5). The correlation between OPTION(12) and OPTION(5) scores was r=0.70. Inter-rater reliability was 0.70 and 0.85 for OPTION(12) and OPTION(5) respectively, however mean inter-rater reliability for individual items was 0.31 and 0.63 for OPTION(12) and OPTION(5) respectively.
  
  
  
  GCs exhibit SDM as measured by both OPTION instruments. OPTION(5) exhibits improved psychometric performance relative to OPTION(12), and more specifically targets the core constructs of SDM. However, refinement of OPTION instruments or manuals is needed to improve reliability and validity in GC assessment.
authors.affiliation: Department of Medical Genetics, University of British Columbia. Vancouver, Canada. Electronic address: martina.vortel@gmail.com.
authors.forename: Martina A
authors.initials: MA
authors.lastname: Vortel
authors.affiliation: Department of Medical Genetics, University of British Columbia. Vancouver, Canada. Electronic address: shelin.adam@ubc.ca.
authors.forename: Shelin
authors.initials: S
authors.lastname: Adam
authors.affiliation: Department of Medical Genetics, University of British Columbia. Vancouver, Canada. Electronic address: ashley.v.port@gmail.com.
authors.forename: Ashley V
authors.initials: AV
authors.lastname: Port-Thompson
authors.affiliation: Department of Medical Genetics, University of British Columbia. Vancouver, Canada. Electronic address: jfriedman@cfri.ca.
authors.forename: Jan M
authors.initials: JM
authors.lastname: Friedman
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, USA. Electronic address: stuart.w.grande@dartmouth.edu.
authors.forename: Stuart W
authors.initials: SW
authors.lastname: Grande
authors.affiliation: Department of Medical Genetics, University of British Columbia. Vancouver, Canada. Electronic address: patricia.birch@ubc.ca.
authors.forename: Patricia H
authors.initials: PH
authors.lastname: Birch
mesh_terms: D003142:Communication; D003657:Decision Making; D005260:Female; D005817:Genetic Counseling; D006801:Humans; D008297:Male; D015588:Observer Variation; D010358:Patient Participation; D057240:Patient Preference; D018802:Patient-Centered Care / Q000592:standards; D010817:Physician-Patient Relations; D011594:Psychometrics / Q000295:instrumentation*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*; D055815:Young Adult
keywords: Anxiety; Decisional conflict; Genetic counselling; Informed decision-making; OPTION instrument; Shared decision-making