The Multifocal Approach to Sharing in Shared Decision Making A Critical Appraisal of the MAPPINSDM.
Shared decision making integrates health care provider expertise with patient values and preferences. The MAPPINSDM is a recently developed measurement instrument that incorporates physician, patient, and observer perspectives during medical consultations. This review sought to critically appraise the development, sensibility, reliability, and validity of the MAPPINSDM and to determine in which settings it has been used. This critical appraisal was performed through a targeted review of the literature. Articles outlining the development or measurement property assessment of the MAPPINSDM or that used the instrument for predictor or outcome purposes were identified. Thirteen studies were included. The MAPPINSDM was developed by both adapting and building on previous shared decision making measurement instruments, as well as through creation of novel items. Content validity, face validity, and item quality of the MAPPINSDM are adequate. Internal consistency ranged from 0.91 to 0.94 and agreement statistics from 0.41 to 0.92. The MAPPINSDM has been evaluated in several populations and settings, ranging from chronic disease to acute oncological settings. Limitations include high reading levels required for self-administered patient questionnaires and the small number of studies that have employed the instrument to date. The MAPPINSDM generally shows adequate development, sensibility, reliability, and validity in preliminary testing and holds promise for shared decision making research integrating multiple perspectives. Further research is needed to develop its use in other patient populations and to assess patient understanding of complex item wording.