Abstract
One technique to enhance patient participation in clinical decision making is formal measurement of preferences and values. Three commonly applied methods are a visual analog scale(VAS), the standard gamble(SG), and the time trade-off(TTO). We studied participants subjective experience using computer implementations these methods using scale we call the VIBE (for Value Instrument Battery--Evaluation) that measures four aspects of user acceptance (clarity, difficulty, reasonableness, and comfort level) Studies were performed in two groups: patients with HIV infection (n=75) and a convenience sample of the general public(n=640). In the patient study, VIBE scores appeared reliable (Cronbach s alpha of 0.739, 0.826, and 0.716, for VAS, SG, and TTO ratings, respectively.) Patients acceptance of the VAS the highest, followed by the TTO and the SG method (p<0.05 for all comparisons). Despite significant enhancements in computer software for measuring SG preferences, observed differences in acceptance between SG and VAS methods were replicated in the general public study (p<0.0001 for differences). The results suggest developers of clinical decision support systems should use VAS and TTO rating methods where these methods are theoretically appropriate.
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Selected References
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