ArticleBMC medical informatics and decision making2019
Item response theory analysis and properties of decisional conflict scales: findings from two multi-site trials of men with localized prostate cancer.
Article in BMC medical informatics and decision making, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed.
- Role of pharmacists in providing information on cancer genome medicine and patient decision making: Open-label randomized controlled study.Exploratory research in clinical and social pharmacy · 2026Article
- Decisional Conflict and Patient Experiences in Dialysis Treatment Decision-Making: A Mixed-Methods Study in a Portuguese Cohort.Healthcare (Basel, Switzerland) · 2026Article
- Medical Decision-Making and Bereavement Experiences After Cardiac Arrest: Qualitative Insights From Surrogates.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2024Article
- Unpacking the relationship between shared decision-making and decisional quality, decision to screen, and screening completion in lung cancer screening.Patient education and counseling · 2024Observational
- Chinese cross-cultural adaptation and validation of the Well-being Numerical Rating Scales.Frontiers in psychiatry · 2023Article
- Reply to What is a good medical choice?Cancer · 2021Article
Corrections and comments
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Authors and funding
3 authors.
Funding
Abstract
backgroundDecisional conflict is associated with decision quality and may affect decision outcomes. In the health sciences literature, the Decisional Conflict Scale is widely used to measure decisional conflict, yet limited research has described the psychometric properties of the Decisional Conflict Scale subscales and of the low literacy version of the scale. The purpose of this secondary data analysis was therefore to examine properties of the original (DCS-12) and low literacy (LL DCS-10) Decisional Conflict Scales using Classical Measurement Theory and Item Response Theory.
methodsData from two multi-site trials of men with prostate cancer were used to analyze the DCS-12, LL DCS-10, and an aggregated DCS-12 dataset in which five response options were aggregated into three. Internal consistency was estimated with Cronbach's alphas. Subscale correlations were evaluated with Pearson's correlation coefficient. Item difficulty, item discrimination, and test information were evaluated using Graded Response Modeling (GRM). The likelihood ratio test guided model selection.
resultsCronbach's alphas for the total scales and three of four subscales were ≥ 0.85. Alphas ranged from 0.34-0.57 for the support subscales. Subscale correlations ranged from 0.42-0.71 (P < 0.001). Items on the DCS-12 exhibited the widest range of difficulty. Two items on the support subscale had low to moderate discrimination and contributed little information. Only the DCS-12 was informative across the full range of decisional conflict values.
conclusionsLack of precision in the support subscale raises concerns about subscale validity. The DCS-12 is most capable of discriminating between respondents with high and low decisional conflict. Evaluation of interventions to reduce decisional conflict must consider the above findings.
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