Validation of a brief scale to assess ambulatory patients’ perceptions of reading visit notes: a scale development study
Objectives To develop and evaluate the validity of a scale to assess patients’ perceived benefits and risks of reading ambulatory visit notes online (open notes).Design Four studies were used to evaluate the construct validity of a benefits and risks scale. Study 1 refined the items; study 2 evaluat...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/10/e034517.full |
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| author | Alan Fossa Hannah Chimowitz Jan Walker Julie A Wright Suzanne G Leveille Rebecca Stametz Deserae Clarke |
| author_facet | Alan Fossa Hannah Chimowitz Jan Walker Julie A Wright Suzanne G Leveille Rebecca Stametz Deserae Clarke |
| author_sort | Alan Fossa |
| collection | DOAJ |
| description | Objectives To develop and evaluate the validity of a scale to assess patients’ perceived benefits and risks of reading ambulatory visit notes online (open notes).Design Four studies were used to evaluate the construct validity of a benefits and risks scale. Study 1 refined the items; study 2 evaluated underlying factor structure and identified the items; study 3 evaluated study 2 results in a separate sample; and study 4 examined factorial invariance of the developed scale across educational subsamples.Setting Ambulatory care in three large health systems in the USA.Participants Participants in three US health systems who responded to one of two online surveys asking about benefits and risks of reading visit notes: a psychometrics survey of primary care patients, and a large general survey of patients across all ambulatory specialties. Sample sizes: n=439 (study 1); n=439 (study 2); n=500 (study 3); and n=250 (study 4).Primary and secondary outcome measures Questionnaire items about patients’ perceived benefits and risks of reading online visit notes.Results Study 1 resulted in the selection of a 10-point importance response option format over a 4-point agreement scale. Exploratory factor analysis (EFA) in study 2 resulted in two-factor solution: a four-item benefits factor with good reliability (alpha=0.83) and a three-item risks factor with poor reliability (alpha=0.52). The factor structure was confirmed in study 3, and confirmatory factor analysis of benefit items resulted in an excellent fitting model, X2(2)=2.949; confirmatory factor index=0.998; root mean square error of approximation=0.04 (0.00, 0.142); loadings 0.68−0.86; alpha=0.88. Study 4 supported configural, measurement and structural invariance for the benefits scale across high and low-education patient groups.Conclusions The findings suggest that the four-item benefits scale has excellent construct validity and preliminary evidence of generalising across different patient populations. Further scale development is needed to understand perceived risks of reading open notes. |
| format | Article |
| id | doaj-art-2727b061d6b04cd6b3db4404d18966bb |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-2727b061d6b04cd6b3db4404d18966bb2024-11-16T03:40:08ZengBMJ Publishing GroupBMJ Open2044-60552020-10-01101010.1136/bmjopen-2019-034517Validation of a brief scale to assess ambulatory patients’ perceptions of reading visit notes: a scale development studyAlan Fossa0Hannah Chimowitz1Jan Walker2Julie A Wright3Suzanne G Leveille4Rebecca Stametz5Deserae Clarke6General Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USAGeneral Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA1 Histopathology, St James’ Hospital, Dublin, IrelandExercise and Health Sciences, University of Massachusetts, Boston, Massachusetts, USAGeneral Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USASteele Institute for Health Innovation, Geisinger, Danville, Pennsylvania, USAClinical Data Analytics and Decision Support, University of Arizona College of Medicine, Tucson, Arizona, USAObjectives To develop and evaluate the validity of a scale to assess patients’ perceived benefits and risks of reading ambulatory visit notes online (open notes).Design Four studies were used to evaluate the construct validity of a benefits and risks scale. Study 1 refined the items; study 2 evaluated underlying factor structure and identified the items; study 3 evaluated study 2 results in a separate sample; and study 4 examined factorial invariance of the developed scale across educational subsamples.Setting Ambulatory care in three large health systems in the USA.Participants Participants in three US health systems who responded to one of two online surveys asking about benefits and risks of reading visit notes: a psychometrics survey of primary care patients, and a large general survey of patients across all ambulatory specialties. Sample sizes: n=439 (study 1); n=439 (study 2); n=500 (study 3); and n=250 (study 4).Primary and secondary outcome measures Questionnaire items about patients’ perceived benefits and risks of reading online visit notes.Results Study 1 resulted in the selection of a 10-point importance response option format over a 4-point agreement scale. Exploratory factor analysis (EFA) in study 2 resulted in two-factor solution: a four-item benefits factor with good reliability (alpha=0.83) and a three-item risks factor with poor reliability (alpha=0.52). The factor structure was confirmed in study 3, and confirmatory factor analysis of benefit items resulted in an excellent fitting model, X2(2)=2.949; confirmatory factor index=0.998; root mean square error of approximation=0.04 (0.00, 0.142); loadings 0.68−0.86; alpha=0.88. Study 4 supported configural, measurement and structural invariance for the benefits scale across high and low-education patient groups.Conclusions The findings suggest that the four-item benefits scale has excellent construct validity and preliminary evidence of generalising across different patient populations. Further scale development is needed to understand perceived risks of reading open notes.https://bmjopen.bmj.com/content/10/10/e034517.full |
| spellingShingle | Alan Fossa Hannah Chimowitz Jan Walker Julie A Wright Suzanne G Leveille Rebecca Stametz Deserae Clarke Validation of a brief scale to assess ambulatory patients’ perceptions of reading visit notes: a scale development study BMJ Open |
| title | Validation of a brief scale to assess ambulatory patients’ perceptions of reading visit notes: a scale development study |
| title_full | Validation of a brief scale to assess ambulatory patients’ perceptions of reading visit notes: a scale development study |
| title_fullStr | Validation of a brief scale to assess ambulatory patients’ perceptions of reading visit notes: a scale development study |
| title_full_unstemmed | Validation of a brief scale to assess ambulatory patients’ perceptions of reading visit notes: a scale development study |
| title_short | Validation of a brief scale to assess ambulatory patients’ perceptions of reading visit notes: a scale development study |
| title_sort | validation of a brief scale to assess ambulatory patients perceptions of reading visit notes a scale development study |
| url | https://bmjopen.bmj.com/content/10/10/e034517.full |
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