A Critical Review of Existing Shared Decision-Making Measuring Approaches in Studies Using the Medical Expenditure Panel Survey (MEPS)
Author(s)
Jennifer Contreras, MPH, Ester Villalonga Olives, MsC, PhD;
University of Maryland, Baltimore, Practice, Sciences, and Health Outcomes Research (P-SHOR), Baltimore, MD, USA
University of Maryland, Baltimore, Practice, Sciences, and Health Outcomes Research (P-SHOR), Baltimore, MD, USA
Presentation Documents
OBJECTIVES: Shared decision-making (SDM) is a cornerstone of patient-centered care, fostering collaboration between patients and healthcare providers to create treatment plans that align with patients' preferences, values, and lifestyles. Studies utilizing the Medical Expenditure Panel Survey (MEPS) have explored the relationship between SDM and patient outcomes. However, approaches for measuring SDM in MEPS have not been thoroughly evaluated. Our objective is to evaluate how SDM is measured, identify gaps, and propose solutions for improvement.
METHODS: A targeted literature review was conducted on Pubmed, Scopus, and Embase to examine and evaluate the measurement of SDM in MEPS. The review included studies utilizing MEPS to examine the relationship between SDM and patient outcomes. SDM measurement was evaluated based on use of an established theoretical framework, and rigor (i.e., framework alignment, performance evaluation).
RESULTS: The review identified variability in SDM measurement approaches, with studies using either a single MEPS item or composite metrics using several questions from the self-administered questionnaire. Fiks et al. developed a 7-item composite metric based on the Charles, Gafri, and Wheelan SDM theoretical model to measure pediatric patient outcomes. While this approach demonstrates methodological rigor in its design and alignment with a well-established SDM framework, the evidence supporting its performance remains limited. Despite these limitations, the Fiks et al. composite metric has grown in use and has been applied in other MEPS studies examining adult patient outcomes.
CONCLUSIONS: The absence of a standardized and rigorous SDM measurement approach in MEPS reduces its ability in evaluating patient outcomes related to SDM across diverse populations, as well as diminishes the utility of MEPS data for advancing SDM research. Therefore, developing a standardized and well-tested SDM composite metric to use in MEPS would address these gaps by ensuring comparability across studies, enhancing the evaluation of SDM-related outcomes, and advance SDM research and policy.
METHODS: A targeted literature review was conducted on Pubmed, Scopus, and Embase to examine and evaluate the measurement of SDM in MEPS. The review included studies utilizing MEPS to examine the relationship between SDM and patient outcomes. SDM measurement was evaluated based on use of an established theoretical framework, and rigor (i.e., framework alignment, performance evaluation).
RESULTS: The review identified variability in SDM measurement approaches, with studies using either a single MEPS item or composite metrics using several questions from the self-administered questionnaire. Fiks et al. developed a 7-item composite metric based on the Charles, Gafri, and Wheelan SDM theoretical model to measure pediatric patient outcomes. While this approach demonstrates methodological rigor in its design and alignment with a well-established SDM framework, the evidence supporting its performance remains limited. Despite these limitations, the Fiks et al. composite metric has grown in use and has been applied in other MEPS studies examining adult patient outcomes.
CONCLUSIONS: The absence of a standardized and rigorous SDM measurement approach in MEPS reduces its ability in evaluating patient outcomes related to SDM across diverse populations, as well as diminishes the utility of MEPS data for advancing SDM research. Therefore, developing a standardized and well-tested SDM composite metric to use in MEPS would address these gaps by ensuring comparability across studies, enhancing the evaluation of SDM-related outcomes, and advance SDM research and policy.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
PCR122
Topic
Patient-Centered Research
Topic Subcategory
Patient Behavior and Incentives
Disease
STA: Multiple/Other Specialized Treatments