DECISION QUALITY IS A PREFERENCE-SENSITIVE FORMATIVE CONCEPT- HOW DO SOME EXISTING MEASURES COMPARE?
Author(s)
ABSTRACT WITHDRAWN
The primary output of a decision making process is a decision and a key outcome measure is therefore ‘decision quality’. However, like all quality indices, decision quality is a formative not reflective construct. Measurements of it are therefore preference-sensitive, reflecting the value judgments made in the selection and weighting of the component items. Accordingly alternative constructs and measures of decision quality can legitimately exist, and none can claim to be the measure. A decision maker choosing a measure of decision quality in evaluating a decision supporting or making process, needs to be fully aware of the attributes and value bases of the measures on offer. We establish four key differences in three existing measures of decision quality: the Decision Quality Instruments, the Brief Subjective Decision Quality Measure, and MyDecisionQuality. These differences relate to: the timing of measurement (at the point of decision or at follow-up when some ‘downstream’ outcome is known); to whether or not an ‘objective’ assessment of the information/knowledge state of the individual is included (as opposed to a self-reported assessment, or no knowledge assessment as such); to whether the measure is to be used in clinical practice at the point of care or only to produce group-level results for feedback to a provider or stakeholder later; and to whether the instrument is sensitive to the preferences of the decision owner or reflects the value judgments of the instrument developers (or their chosen sample). We argue that the preference basis of any decision quality measure should be made explicit and justified, as in Health-Related Quality of Life. To illustrate our point, as a matter of preference we reject the Decision Conflict Scale as a proxy for decision quality (as it is often used), because it encourages ‘false clarity’ by including items that punish near equipoise or toss-up results.
Conference/Value in Health Info
2019-11, ISPOR Europe 2019, Copenhagen, Denmark
Code
PNS30
Topic
Health Service Delivery & Process of Care, Patient-Centered Research
Topic Subcategory
Instrument Development, Validation, & Translation, Patient-reported Outcomes & Quality of Life Outcomes, Quality of Care Measurement
Disease
No Specific Disease