Development and first validation of the shared decision-making questionnaire (SDM-Q)

Objective: Due to a lack of valid German instruments measuring shared decision-making (SDM), a theory-driven questionnaire (SDM-Q) to measure the process of SDM was developed and validated. Methods: As a theoretical basis steps of the SDM process were defined in an expert panel. Item formulation was then conducted according to the Delphi method. For the first validation on a mixed sample Rasch analysis was used to eliminate items not fitting the construct thus receiving a unidimensional scale. Results: After eliminating 4 items the remaining 11 form a unidimensional scale with an acceptable reliability for person measures (0.77) and very good reliability for item difficulties (0.95). Analysis of subgroups revealed a different use of items in different conditions. Furthermore the scale showed high ceiling effects. Conclusion: A new theory-driven instrument to measure the process of SDM has been developed and validated, by use of a rigorous method revealing first promising results. Yet the ceiling effects require the addition of more discriminating items, and the different use of items in different conditions demands an in depth analysis. Practice implications: While the concept of SDM is constantly receiving more attention in medical practice, its valid and reliable measurement remains challenging. (c) 2006 Elsevier Ireland Ltd. All rights reserved.