The development of incorpoRATE: A measure of physicians' willingness to incorporate shared decision making into practice.

To develop 'incorpoRATE', a brief and broadly applicable measure of physicians' willingness to incorporate shared decision making (SDM) into practice. incorpoRATE was developed across three phases: 1) A review of relevant literature to inform candidate domain and item development, 2) Cognitive interviews with US physicians to iteratively refine the measure, and 3) Pilot testing of the measure across a larger sample of US physicians to explore item and measure performance. The final measure consists of seven items that assess physician perspectives on various components of SDM use that may present as barriers in practice. During pilot testing, the majority of physicians expressed positive opinions about the overall concept of SDM, yet were less comfortable acting on informed patient choices when there was known incongruence with their own recommendations. incorpoRATE is a novel physician-reported measure that assesses physicians' willingness to incorporate SDM in practice. incorpoRATE has the potential to help us further understand the limited adoption of SDM and areas of focus for improving the use of SDM in the future. We recommend that incorpoRATE be subject to further psychometric, real-world testing, in order to explore its performance across different samples of physicians and organizations.

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Déclaration de conflit d'intérêts

Declaration of Competing Interest Julia Berkowitz, Pablo Martinez Camblor, and Gabrielle Stevens declare no competing interests. Glyn Elwyn’s academic interests are focused on shared decision making and coproduction. He has edited and published books that provide royalties on sales by the publishers: these books include Shared Decision Making (Oxford University Press) and Groups (Radcliffe Press). He has in the past provided consultancy for organizations, including: 1) Emmi Solutions LLC who developed patient decision support tools; 2) National Quality Forum on the certification of decision support tools; 3) Washington State Health Department on the certification of decision support tools; 4) SciMentum LLC, Amsterdam (workshops for shared decision making). He is the Founder and Director of &think LLC which owns the registered trademark for Option Grids ™ patient decision aids. Founder and Director of SHARPNETWORK LLC, a provider of training for shared decision making. He provides advice in the domain of shared decision making and patient decision aids to: 1) Access Community Health Network, Chicago (Federally Qualified Medical Centers); 2) EBSCO Health Option Grids ™ patient decision aid; 3) Bind Insurance; 4) PatientWisdom Inc. He owns copyright in measures of shared decision making and care integration, namely collaboRATE, integRATE, Observer OPTION-5 and Observer OPTION-12. These measures are freely available for use by researchers.