Comparing the ability of OPTION¹² and OPTION⁵ to assess shared decision-making in genetic counselling.

Objectives OPTION¹² is the most widely used tool to measure shared decision-making (SDM) in health care. A newer scale, OPTION⁵, has been proposed as a more parsimonious measure that better addresses core concepts of SDM. This study compares OPTION⁵ to OPTION¹² in prenatal genetic counselling. Methods Two raters independently used OPTION¹² and OPTION⁵ to score 27 clinical encounters between genetic counsellors (GC) and women with pregnancies at increased risk for genetic conditions. Global and item scores on the two instruments were compared to test concurrent validity and to identify usability in this context. Inter-rater reliability was also assessed for both instruments. Results Mean scores for OPTION¹² were 43.8 (SD = 9.7), and for OPTION⁵ were = 60.6 (SD = 12.5). The correlation between OPTION¹² and OPTION⁵ scores was r = 0.70. Inter-rater reliability was 0.70 and 0.85 for OPTION¹² and OPTION⁵ respectively, however mean inter-rater reliability for individual items was 0.31 and 0.63 for OPTION¹² and OPTION⁵ respectively. Conclusions GCs exhibit SDM as measured by both OPTION instruments. OPTION⁵ exhibits improved psychometric performance relative to OPTION¹², and more specifically targets the core constructs of SDM. However, refinement of OPTION instruments or manuals is needed to improve reliability and validity in GC assessment.