OPTION5 versus OPTION12 instruments to appreciate the extent to which healthcare providers involve patients in decision-making

Fabienne E. Stubenrouch, Arwen H. Pieterse, Rijan Falkenberg, T. Katrien B. Santema, Anne M. Stiggelbout, Trudy van der Weijden, J. Annemijn W. M. Aarts, Dirk T. Ubbink*

*Corresponding author for this work

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Objective: The 12-item "observing patient involvement" (OPTION12)-instrument is commonly used to assess the extent to which healthcare providers involve patients in health-related decision-making. The five-item version (OPTION5) claims to be a more efficient measure. In this study we compared the Dutch versions of the OPTION-instruments in terms of inter-rater agreement and correlation in outpatient doctor-patient consultations in various settings, to learn if we can safely switch to the shorter OPTION(5-)instrument. Methods: Two raters coded 60 audiotaped vascular surgery and oncology patient consultations using OPTION12 and OPTION5. Unweighted Cohen's kappa was used to compute inter-rater agreement on item-level. The association between the total scores of the two OPTION-instruments was investigated using Pearson's correlation coefficient (r) and a Bland & Altman plot. Results: After fine-tuning the OPTION-manuals, inter-rater agreement for OPTION12 and OPTION5 was good to excellent (kappa range 0.69-0.85 and 0.63-0.72, respectively). Mean total scores were 23.7 (OPTION12; SD = 7.8) and 39.3 (OPTION5; SD = 12.7). Correlation between the total scores was high (r = 0.71; p = 0.01). OPTION5 scored systematically higher with a wider range than OPTION12. Conclusion: Both OPTION-instruments had a good inter-rater agreement and correlated well. OPTION5 seems to differentiate better between various levels of patient involvement. Practical implication: The OPTION5-instrument is recommended for clinical application.
Original languageEnglish
Pages (from-to)1062-1068
JournalPatient Education and Counseling
Issue number6
Publication statusPublished - Jun 2016


  • OPTION-instrument
  • Shared decision-making
  • Patient involvement
  • Inter-rater agreement
  • Inter-observer agreement
  • Correlation
  • Objective measure
  • Coding manual
  • Oncology
  • Surgery

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