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196 Psychometric evaluation of the Danish version of the hip and knee decision quality instrument (HK-DQI)
  1. Trine A Pedersen1,2,
  2. Karina D Steffensen2,3,
  3. Karen Sepucha4,5,
  4. Martin Lindberg-Larsen6,7,
  5. Charlotte M Jensen6,7,
  6. Kim G Ingwersen2,8,
  7. Christina N Bræmer1,
  8. Claus Varnum1,2
  1. 1Department of Orthopaedic Surgery, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
  2. 2Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
  3. 3Center for Shared Decision Making, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark
  4. 4Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
  5. 5Harvard Medical School, Boston, Massachusetts, USA
  6. 6Department of Clinical Research, University of Southern Denmark, Odense, Denmark
  7. 7Department of Orthopaedic Surgery, Odense University Hospital, Odense, Denmark
  8. 8Department of Physio- and Occupational Therapy, Lillebaelt Hospital, University Hospital of Southern Denmark, Vejle, Denmark


Introduction Severe osteoarthritis (OA) significantly affects quality of life, and treatment decisions can be complex. The Hip and Knee Decision Quality Instrument (HK-DQI) is a patient-centred questionnaire designed to evaluate the quality of decision-making for arthroplasty in severe hip or knee OA. Comprising three sections, it assesses decision-specific goals and concerns, decision- specific knowledge, and the decision-making process. This study aims to evaluate the psychometric properties of HK-DQI in a Danish population.

Methods Following COSMIN guidelines, HK-DQI underwent translation and psychometric assessment. Content validity was established with 40 patients’ interview. Psychometric properties were evaluated by 236 hip or knee OA patients. Reliability was assessed through a test-retest, with 219 patients and IntraClass Correlation (ICC), Limits of Agreement, and Bland-Altman plots were performed. Construct validity was evaluated through predefined hypotheses and compared to CollaboRATE and The Shared Decision-Making Questionnaire (SDM-Q-9).

Results The content validity was acceptable. The ICC indicated moderate reliability for individual questions in section 1 (ICC 0.62–0.69) and strong reliability for sum-score of sections 2 and 3 (ICC 0.77–0.86). An acceptable level of agreement, with no indications of systematic errors, and acceptable 95% Limits of Agreement on the Bland Altmann plot was found. An acceptable construct validity, confirming 75% of a-priori hypothesized associations and correlations. Ceiling and floor effects was observed in section 1.

Discussion HK-DQI psycometric properties was acceptable. However, the observed ceiling and floor effects in section 1 may limit its ability to discriminate between patient responses.

Conclusion The content validity was acceptable in the Danish context, with only minor adjustments. It is a valid and reliable measurement tool for assessing decision quality in a Danish context.

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