title: Validation of the Norwegian version of MAPPIN'SDM, an observation-based instrument to measure shared decision-making in clinical encounters.
abstract: To validate the Norwegian version of MAPPIN'SDM observer scales with regard to reliability, accuracy and the extent to which the scales include the essentials of the shared decision-making concept.
  
  
  
  Three MAPPIN'SDM scales, focusing on the skills of doctor, patient and dyad, were applied to audiovisual records of 35 decision sequences. Inter-rater reliabilities were determined based on kappa coefficients. Sensitivities and specificities were calculated with regard to an expert reference standard. Convergent validities were calculated with the OPTION5scale. MAPPIN'SDM was qualitatively compared to OPTION5 using Makoul & Clayman's Integrative Model structure.
  
  
  
  Inter-rater reliabilities were high on average over 11 items in each of three observer scales (MAPPINdoctor=0.77, MAPPINpatient=0.82, MAPPINdyad=0.77). Patient involvement was detected accurately (MAPPINdyad: mean sensitivity/specificity 93/91%). Comparison with OPTION5showed weak to moderate correlation (Spearman's ρ/p-value: MAPPINdoctor:=0.44/0.009, MAPPINpatient: 0.38/0.024, MAPPINdyad0.40/0.016) and little content overlap.
  
  
  
  MAPPIN'SDMnorgeis capable of assessing SDM highly reliably and accurately. Divergence from OPTION5reflects explicit disagreement regarding the concept's assumptions.
  
  
  
  MAPPIN'SDMnorgeis ready for use in Norway. In-depth debate on the SDM concept's essentials is urgently needed.
authors.affiliation: Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Kjeller, Norway; Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway. Electronic address: simone.kienlin@helse-sorost.no.
authors.forename: Simone
authors.initials: S
authors.lastname: Kienlin
authors.affiliation: Faculty of Health Sciences, Department of Health and Caring Sciences, University of Tromsø, Tromsø, Norway. Electronic address: maaskristiansen@gmail.com.
authors.forename: Maria
authors.initials: M
authors.lastname: Kristiansen
authors.affiliation: Department of Internal Medicine, Nordland Hospital, Bodø, Norway; Faculty of Health Sciences, Department of Community Medicine, University of Tromsø, Tromsø, Norway. Electronic address: eirikofstad@gmail.com.
authors.forename: Eirik
authors.initials: E
authors.lastname: Ofstad
authors.affiliation: Unit of Health Sciences and Education, Faculty of Mathematics, Informatics and Natural Sciences, University of Hamburg, Hamburg, Germany; Institute of Neuroimmunology and Multiple Sclerosis and Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. Electronic address: katrin.liethmann@uni-hamburg.de.
authors.forename: Katrin
authors.initials: K
authors.lastname: Liethmann
authors.affiliation: MSH Medical School Hamburg, Hamburg, Germany; Department of Pediatrics, University Medical Center Schleswig-Holstein, Kiel, Germany. Electronic address: f.geiger@uksh.de.
authors.forename: Friedemann
authors.initials: F
authors.lastname: Geiger
authors.affiliation: Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Kjeller, Norway. Electronic address: pal.joranger@hioa.no.
authors.forename: Pål
authors.initials: P
authors.lastname: Joranger
authors.affiliation: Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo and Akershus University College of Applied Sciences, Kjeller, Norway. Electronic address: sidsel.tveiten@hioa.no.
authors.forename: Sidsel
authors.initials: S
authors.lastname: Tveiten
authors.affiliation: Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway; Faculty of Health Sciences, Department of Health and Caring Sciences, University of Tromsø, Tromsø, Norway. Electronic address: juergen.kasper@uit.no.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Kasper
mesh_terms: D003657:Decision Making; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D009664:Norway; D010358:Patient Participation; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D011594:Psychometrics; D015203:Reproducibility of Results; D014177:Translations
keywords: Measurement; Patient involvement; Physician patient relation; Reliability; Shared decision-making; Validity