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首页> 外文期刊>BMC Medical Informatics and Decision Making >Psychometric evaluation of a decision quality instrument for medication decisions for treatment of depression symptoms
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Psychometric evaluation of a decision quality instrument for medication decisions for treatment of depression symptoms

机译：用于治疗抑郁症症状的药物决策决策质量仪的心理测量评价

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A high quality treatment decision means patients are informed and receive treatment that matches their goals. This research examined the reliability and validity of the Depression Decision Quality Instrument (DQI), a survey to measure the extent to which patients are informed and received preferred treatment for depression. Participants were aged 18 and older from 17 US cities who discussed medication or counseling with a physician in the past year, and physicians who treated patients with depression who practiced in the same cities. Participants were mailed a survey that included the Depression-DQI, a tool with 10 knowledge and 7 goal and concern items. Patients were randomly assigned to either receive a patient decision aid (DA) on treatment of depression or no DA. A matching score was created by comparing the patient’s preferred treatment to their self-reported treatment received. Concordant scores were considered matched, discordant were not. We examined the reliability and known group?validity of the Depression-DQI. Most patients 405/504 (80%) responded, 79% (320/405) returned the retest survey, and 60% (114/187) of physicians returned the survey. Patients’ knowledge scores on the 10-item scale ranged from 14.6 to 100% with no evidence of floor or ceiling effects. Retest reliability for knowledge was moderate and for goals and concerns ranged from moderate to good. Mean knowledge scores differentiated between patients and physicians (M?=?63 [SD?=?15] vs. M?=?81 [SD?=?11], p??0.001), and between patients who did and didn’t receive a DA (M?=?64 [SD?=?16] vs. M?=?61 [SD?=?14], p?=?0.041). 60.5% of participants received treatment that matched their preference. Based on the multivariate logistic regression, ‘avoiding taking anti-depressants’ was the only goal that was predictive of taking mediation (OR?=?0.73 [0.66, 0.80], p??0.01).?Shared Decision Making Process scores were similar for those who matched their preference and those who didn’t (M?=?2.18 [SD?=?0.97] vs. M?=?2.06 [SD?=?1.07]; t(320)?= ??1.06, p?=?0.29). Those who matched had lower regret scores (matched M?=?1.72 [SD?=?0.74] vs. unmatched M?=?2.32 [SD?=?0.8]; t(301)?= ??6.6, p??.001). The Depression DQI demonstrated modest reliability and validity. More work is needed to establish validity of the method to determine concordance. Trial registration: NCT01152307.
机译：高质量的治疗决策意味着患者被告知并接受与其目标相符的治疗。本研究检测了抑郁症决策质量仪器（DQI）的可靠性和有效性，调查衡量患者的信息和接受抑郁症的优选治疗程度。参与者年龄18岁，从17名美国城市年龄较大，在过去的一年中讨论药物或与医生咨询，以及在同一城市练习抑郁症患者的医生。参与者邮寄了一项调查，其中包括Depression-DQi，一个具有10个知识和7个目标和疑虑项目的工具。患者被随机分配给接受患者决策辅助（DA）治疗抑郁症或没有DA。通过将患者的首选治疗与收​​到的自我报告治疗进行比较来创建匹配分数。符合协调评分被认为是匹配的，不和谐不是。我们检查了可靠性和已知的群体？抑郁症的有效性。大多数患者405/504（80％）回应，79％（320/405）退回了重新调查，60％（114/187）的医生返回了调查。患者的知识分数为10项等级的得分为14.6至100％，没有地板或天花板效应的证据。关于知识的重新获得可靠性是中等的，目标和担忧从中等到良好。患者和医生之间的平均知识分数（m？=Δ= 63 [sd？=Δ15]与m？=Δ=Δ=α11]，p？＆ 0.001），以及那些没有收到da（m？=？64 [sd吗？=α16] vs. m？=Δ61[sd吗？=？14]，p？= 0.041）。 60.5％的参与者接受了符合他们偏好的治疗。基于多变量逻辑回归，“避免采取抗抑郁药”是预测中调解的唯一目标（或？= = 0.73 [0.66,0.80]，P？＆ 0. 0.01）。？共享决策过程分数与那些匹配他们偏好的人和没有那些没有（m？= 2.18 [SD吗？0.97] Vs. m？2. 06 [SD吗？=？1.07]; T（320）？= ?? 1.06，p？=？0.29）。那些匹配的人的遗憾得分较低（匹配m？=？1.72 [SD吗？0.74] Vs.无与伦比的m？=？2.32 [SD吗？0.8]; t（301）？= ?? 6.6，p？= ?? 6.6，p？＆lt ;？001）。 Dquess DQi展示了适度的可靠性和有效性。需要更多的工作来建立方法的有效性来确定一致性。审判注册：NCT01152307。

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