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

• OPTION5 demonstrates improved reliability and validity relative to OPTION12.
• OPTION5 targets constructs specific to SDM allowing for more efficient measurement.
• Genetic counsellors exhibit shared decision making (SDM) behaviours.

ObjectivesOPTION12 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.MethodsTwo 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.ResultsMean 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.ConclusionsGCs 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.