Assessing the Quality of Decision Support Technologies Using the International Patient Decision Aid Standards instrument (IPDASi)

Objectives To describe the development, validation and inter-rater reliability of an instrument to measure the quality of patient decision support technologies (decision aids). Design Scale development study, involving construct, item and scale development, validation and reliability testing. Setting There has been increasing use of decision support technologies – adjuncts to the discussions clinicians have with patients about difficult decisions. A global interest in developing these interventions exists among both for-profit and not-for-profit organisations. It is therefore essential to have internationally accepted standards to assess the quality of their development, process, content, potential bias and method of field testing and evaluation. Methods Scale development study, involving construct, item and scale development, validation and reliability testing. Participants Twenty-five researcher-members of the International Patient Decision Aid Standards Collaboration worked together to develop the instrument (IPDASi). In the fourth Stage (reliability study), eight raters assessed thirty randomly selected decision support technologies. Results IPDASi measures quality in 10 dimensions, using 47 items, and provides an overall quality score (scaled from 0 to 100) for each intervention. Overall IPDASi scores ranged from 33 to 82 across the decision support technologies sampled (n = 30), enabling discrimination. The inter-rater intraclass correlation for the overall quality score was 0.80. Correlations of dimension scores with the overall score were all positive (0.31 to 0.68). Cronbach's alpha values for the 8 raters ranged from 0.72 to 0.93. Cronbach's alphas based on the dimension means ranged from 0.50 to 0.81, indicating that the dimensions, although well correlated, measure different aspects of decision support technology quality. A short version (19 items) was also developed that had very similar mean scores to IPDASi and high correlation between short score and overall score 0.87 (CI 0.79 to 0.92). Conclusions This work demonstrates that IPDASi has the ability to assess the quality of decision support technologies. The existing IPDASi provides an assessment of the quality of a DST's components and will be used as a tool to provide formative advice to DSTs developers and summative assessments for those who want to compare their tools against an existing benchmark

Food and Faith in Christian Culture

Without a uniform dietary code, Christians around the world used food in strikingly different ways, developing widely divergent practices that spread, nurtured, and strengthened their religious beliefs and communities. Featuring never-before published essays, this anthology follows the intersection of food and faith from the fourteenth to the twenty-first century, charting the complex relationship among religious eating habits and politics, culture, and social structure. Theoretically rich and full of engaging portraits, essays consider the rise of food buying and consumerism in the fourteenth century, the Reformation ideology of fasting and its resulting sanctions against sumptuous eating, the gender and racial politics of sacramental food production in colonial America, and the struggle to define enlightened Lenten dietary restrictions in early modern France. Essays on the nineteenth century explore the religious implications of wheat growing and breadmaking among New Zealand\u27s Maori population and the revival of the Agape meal, or love feast, among American brethren in Christ Church. Twentieth-century topics include the metaphysical significance of vegetarianism, the function of diet in Greek Orthodoxy, American Christian weight loss programs, and the practice of silent eating rituals among English Benedictine monks. Two introductory essays detail the key themes tying these essays together and survey food\u27s role in developing and disseminating the teachings of Christianity, not to mention providing a tangible experience of faith.https://scholarlycommons.pacific.edu/cop-facbooks/1023/thumbnail.jp

Eating in the Christian Tradition

This panel will discuss the influence of Christianity upon patterns of eating, ways of thinking about food and the body, and how consumption in the broadest sense of that term has been profoundly shaped by matters of faith in Europe and the US from the Renaissance to today. There have been a number of specialized studies of food and religion, beginning with Caroline Walker Bynum’s Holy Feast and Holy Fast and Bridget Anne Henisch’s Fast and Feast as well as a number of studies of asceticism, constructions of gender and pathologies influenced by religion, such as Rudolph Bell’s Holy Anorexia. More recently published are White Bread Protestants by Daniel Sack and R. Marie Griffith’s Born Again Bodies. To date, however, there has been no interdisciplinary scholarly discussion which gathers together the various uses of food by Christians on both sides of the Atlantic. This panel will do so. Panelists will discuss the interweaving global themes and particular local distinctions of the multiple uses of food by Christians. All participants are contributors to the upcoming book The Lord’s Supper: Food and Christian Faith from the Middle Ages to the Present, ed. Ken Albala and Trudy Eden (Columbia University, 2010)

Eating in the Christian Tradition

This panel will discuss the influence of Christianity upon patterns of eating, ways of thinking about food and the body, and how consumption in the broadest sense of that term has been profoundly shaped by matters of faith in Europe and the US from the Renaissance to today. There have been a number of specialized studies of food and religion, beginning with Caroline Walker Bynum’s Holy Feast and Holy Fast and Bridget Anne Henisch’s Fast and Feast as well as a number of studies of asceticism, constructions of gender and pathologies influenced by religion, such as Rudolph Bell’s Holy Anorexia. More recently published are White Bread Protestants by Daniel Sack and R. Marie Griffith’s Born Again Bodies. To date, however, there has been no interdisciplinary scholarly discussion which gathers together the various uses of food by Christians on both sides of the Atlantic. This panel will do so. Panelists will discuss the interweaving global themes and particular local distinctions of the multiple uses of food by Christians. All participants are contributors to the upcoming book The Lord’s Supper: Food and Christian Faith from the Middle Ages to the Present, ed. Ken Albala and Trudy Eden (Columbia University, 2010)

Development of IPDASi versions and IPDASi-SF: item retention and dimension merging.

*<p>IPDASi v1 is equivalent to the IPDAS Checklist.</p>¶<p>Test dimension items applicable to relevant DSTs.</p

Thirty sampled decision support technologies: sample characteristics and adjusted full IPDASi (v3) ^* and SF scores based on duplicate assessment, with 95% confidence limits.

*<p>Adjusted scores: scores from the two raters were adjusted to take account of their personal propensity to give higher or lower scores. Components of variation were modelled by Bayesian modelling (Markov chain Monte Carlo) using WinBugs software, leading to estimated confidence intervals.</p><p><b>Abbreviations</b>: (APCC: Australian Prostate Cancer Collaboration; Barratt, UoS: University of Sydney; Crouch, Baylor: Baylor College of Medicine; Col, CORE: Center for Outcomes Research and Evaluation; Elwyn, CU: Cardiff University; FIMDM: Foundation for Informed Medical Decision Making; Lawrence, STVHCS: South Texas Veterans Health Care System; Leighl, UoT: University of Toronto; MCC: Michigan Cancer Consortium Prostate Cancer Action Committee; MIDIRS: Midwife Information and Resource Service; NERI: New England Research Institutes; OHDeC: Ottawa Health Decision Centre; Shorten, ACM: Australian College of Midwives; Taylor, GU: Georgetown University; US CDC: Centers for Disease Control and Prevention; Wakefield MU, Macquarie University).</p

IPDASi v3 Dimensions and Items.

<p>IPDASi v3 Dimensions and Items.</p