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Research ArticleOMERACT 12 — International Consensus Conference on Outcome Measures in Rheumatology, Budapest, Hungary, May 7–11, 2014

Development of a Draft Core Set of Domains for Measuring Shared Decision Making in Osteoarthritis: An OMERACT Working Group on Shared Decision Making

Karine Toupin-April, Jennifer Barton, Liana Fraenkel, Linda Li, Viviane Grandpierre, Francis Guillemin, Tamara Rader, Dawn Stacey, France Légaré, Janet Jull, Jennifer Petkovic, Marieke Scholte-Voshaar, Vivian Welch, Anne Lyddiatt, Cathie Hofstetter, Maarten De Wit, Lyn March, Tanya Meade, Robin Christensen, Cécile Gaujoux-Viala, Maria E. Suarez-Almazor, Annelies Boonen, Christoph Pohl, Richard Martin and Peter S. Tugwell
The Journal of Rheumatology December 2015, 42 (12) 2442-2447; DOI: https://doi.org/10.3899/jrheum.141205
Karine Toupin-April
From the Children’s Hospital of Eastern Ontario Research Institute and Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada; VA Portland Health Care System, and Oregon Health and Science University, Portland, Oregon, USA; Department of Internal Medicine, Yale University, New Haven, Connecticut, USA; Department of Physical Therapy, University of British Columbia and Arthritis Research Centre of Canada, Vancouver, British Columbia, Canada; School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada; Rheumatic Diseases, University of Lorraine, Nancy, France; Institute of Population Health, Centre for Global Health, and School of Nursing, University of Ottawa, Ottawa, Ontario, Canada; Department of Family Medicine and Emergency Medicine, Université Laval, Québec City, Québec, Canada; Bruyere Research Institute, University of Ottawa, Ottawa, Ontario, Canada; University of Twente, Enschede; VU Medical Centre, Amsterdam, The Netherlands; Department of Medicine, University of Sydney, Institute of Bone and Joint Research; University of Western Sydney, Sydney, Australia; Musculoskeletal Statistics Unit, The Parker Institute, Department of Rheumatology, University of Copenhagen, Bispebjerg and Frederiksberg Hospitals, Copenhagen, Denmark; Department of Rheumatology, Nîmes University Hospital, Montpellier I University, Nîmes, France; Department of General Internal Medicine, Section of Rheumatology and Clinical Immunology, University of Texas MD Anderson Cancer Center, Houston, Texas, USA; Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and Caphri Research Institute, Maastricht University, Maastricht, The Netherlands; Department of Internal Medicine II Rheumatology, Clinical Immunology, Osteology, Physical Therapy and Sports Medicine, Schlosspark-Klinik, Teaching Hospital of the Charité, University Medicine, Berlin, Germany; Rheumatology, Michigan State University College of Human Medicine, Grand Rapids, Michigan, USA; Department of Medicine, Faculty of Medicine, University of Ottawa, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
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  • For correspondence: ktoupin@cheo.on.ca
Jennifer Barton
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Liana Fraenkel
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Linda Li
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Viviane Grandpierre
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Francis Guillemin
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Tamara Rader
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Dawn Stacey
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France Légaré
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Janet Jull
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Jennifer Petkovic
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Marieke Scholte-Voshaar
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Vivian Welch
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Anne Lyddiatt
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Cathie Hofstetter
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Maarten De Wit
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Lyn March
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Tanya Meade
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Robin Christensen
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Cécile Gaujoux-Viala
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Maria E. Suarez-Almazor
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Annelies Boonen
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Christoph Pohl
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Richard Martin
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Peter S. Tugwell
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Article Figures & Data

Tables

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    Table 1.

    Checklist of core set of shared decision-making domains presented to participants.

    Are the following elements present in the vignettes?Low SDM VignetteHigh SDM Vignette
    Identifying the decision
      The decision to be made is pointed out
    Exchanging information
      The treatment options are listed and their pros and cons explained
    Clarifying patients’ views
      The patients’ feelings about the pros and cons of the options are discussed
    Deliberating
      The pros and cons of the options are weighted and the feasibility of the options is considered
    Making the decision
      A decision is made or postponed
    Putting into practice
      The steps are arranged to put the decision into practice
    Effect of the decision
    Comments
    • SDM: shared decision making.

    • View popup
    Table 2.

    Subdomains of shared decision making with their number of votes.

    Domains and SubdomainsNo. Votes (10 per person)
    Patient Research Partners, N = 5 (weighted opinion)*Health Professionals / Researchers, N = 21 (weighted opinion)*Total, N = 26 (weighted opinion)*
    Exchanging information13 (26%)52 (25%)65 (25%)
      General domain6 (12%)12 (6%)18 (7%)
      Presenting the evidence for the risks and benefits of options and uncertainties in an unbiased manner0 (0%)18 (9%)18 (7%)
      Tailoring the information (format and language patients understand)4 (8%)15 (7%)19 (7%)
      Clarifying patient understanding3 (6%)7 (3%)10 (4%)
    Clarifying views13 (26%)35 (17%)48 (18%)
      General domain6 (12%)12 (6%)18 (7%)
      Clarifying patients’ values4 (8%)6 (3%)10 (4%)
      Clarifying patients’ expectations regarding the courses of action3 (6%)7 (3%)10 (4%)
      Clarifying health practitioners’ views (global assessment of the patient)0 (0%)10 (5%)10 (4%)
    Assessing the effect of the decision7 (14%)39 (19%)46 (18%)
      General domain1 (2%)10 (5%)11 (4%)
      Patient satisfaction, comfort with decision1 (2%)4 (2%)5 (2%)
      Patient informed consent, understanding of information2 (4%)12 (6%)14 (5%)
      Health outcomes1 (2%)4 (2%)5 (2%)
      Trust in healthcare system0 (0%)4 (2%)4 (2%)
      Health practitioner’s liability1 (2%)1 (0%)2 (1%)
      Time and resources needed1 (2%)4 (2%)5 (2%)
    Deliberating6 (12%)27 (13%)33 (13%)
      General domain1 (2%)8 (4%)9 (3%)
      Considering the benefit/risk ratio of the options3 (6%)11 (5%)14 (5%)
      Considering the feasibility of the options2 (4%)8 (4%)10 (4%)
    Identifying the decision2 (4%)9 (4%)11 (4%)
    Making the decision0 (0%)6 (3%)6 (2%)
    Putting the decision into practice0 (0%)4 (2%)4 (2%)
      General domain0 (0%)4 (2%)4 (2%)
      Preparing plans for implementation and followup0 (0%)0 (0%)0 (0%)
    • ↵* Analyzed as the no. votes/(participants × 10).

    • View popup
    Table 3.

    Contextual factors of shared decision making with their number of votes.

    Contextual FactorsNo. Votes (10 per person)
    Patient Research Partners, N = 5 (weighted opinion)*Health Professionals / Researchers, N = 21 (weighted opinion)*Total, N = 26 (weighted opinion)*
    Establishing partnership and mutual respect4 (8%)28 (13%)32 (12%)
      General domain1 (2%)4 (2%)5 (2%)
      Health professionals’ empathy and desire to let patients speak (by using open-ended questions, empathetic non-verbal language)2 (4%)22 (10%)24 (9%)
      No time pressure1 (2%)0 (0%)1 (0%)
      Patients’ ability to speak their mind0 (0%)2 (1%)2 (1%)
    Considering patient sociodemographic context and social support4 (8%)4 (2%)8 (3%)
    Health professional’s assertiveness1 (2%)6 (3%)7 (3%)
    Educational material and decision aids0 (0%)0 (0%)0 (0%)
    Total9 (18%)38 (18%)47 (18%)
    • ↵* Analyzed as the number of votes/(participants × 10)

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The Journal of Rheumatology
Vol. 42, Issue 12
1 Dec 2015
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Development of a Draft Core Set of Domains for Measuring Shared Decision Making in Osteoarthritis: An OMERACT Working Group on Shared Decision Making
Karine Toupin-April, Jennifer Barton, Liana Fraenkel, Linda Li, Viviane Grandpierre, Francis Guillemin, Tamara Rader, Dawn Stacey, France Légaré, Janet Jull, Jennifer Petkovic, Marieke Scholte-Voshaar, Vivian Welch, Anne Lyddiatt, Cathie Hofstetter, Maarten De Wit, Lyn March, Tanya Meade, Robin Christensen, Cécile Gaujoux-Viala, Maria E. Suarez-Almazor, Annelies Boonen, Christoph Pohl, Richard Martin, Peter S. Tugwell
The Journal of Rheumatology Dec 2015, 42 (12) 2442-2447; DOI: 10.3899/jrheum.141205

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Development of a Draft Core Set of Domains for Measuring Shared Decision Making in Osteoarthritis: An OMERACT Working Group on Shared Decision Making
Karine Toupin-April, Jennifer Barton, Liana Fraenkel, Linda Li, Viviane Grandpierre, Francis Guillemin, Tamara Rader, Dawn Stacey, France Légaré, Janet Jull, Jennifer Petkovic, Marieke Scholte-Voshaar, Vivian Welch, Anne Lyddiatt, Cathie Hofstetter, Maarten De Wit, Lyn March, Tanya Meade, Robin Christensen, Cécile Gaujoux-Viala, Maria E. Suarez-Almazor, Annelies Boonen, Christoph Pohl, Richard Martin, Peter S. Tugwell
The Journal of Rheumatology Dec 2015, 42 (12) 2442-2447; DOI: 10.3899/jrheum.141205
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Keywords

SHARED DECISION MAKING
OSTEOARTHRITIS
OMERACT
IMPLEMENTATION
OUTCOMES
OUTCOME ASSESSMENT

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