{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T08:25:33Z","timestamp":1786868733609,"version":"build-2736575974"},"reference-count":38,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Institutes of Health\/National Cancer Institute","award":["K22-CA234400"],"award-info":[{"award-number":["K22-CA234400"]}]},{"name":"National Institutes of Health\/National Cancer Institute","award":["P30-CA008748"],"award-info":[{"award-number":["P30-CA008748"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Med Decis Making"],"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Decision aids aim to improve the quality of and satisfaction with decision making. Few scales exist that directly evaluate decision aids from the patient\u2019s perspective, particularly with respect to information overload.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We developed a Decision Aid Evaluation Scale with domains assessing acceptability, satisfaction, cognitive load, and helpfulness for decision making. Cognitive interviews and iterative testing were performed. Convergent and discriminant construct validity were assessed by comparing the novel scale with domains from the validated Decisional Conflict Scale (DCS; values clarity, uncertainty, feeling informed subscales). Internal consistency was measured using Cronbach\u2019s alpha. The final scale consisted of Likert-type scale items assessing information amount, values clarity, ease of use, cognitive effort required, nervousness, and overall helpfulness. Participants (any sex or gender, aged 40\u201360 y) completed the scale after viewing a cancer screening decision aid within a hypothetical screening decision scenario.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      We surveyed 1,249 participants; 778 completed the Decision Aid Evaluation Scale. As hypothesized, a larger proportion of participants who reported low cognitive load had higher DCS values clarity subscale scores than those with high cognitive load (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.003). Participants who found the decision aid helpful had significantly higher DCS values clarity (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), informed (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.004), and certainty subscale scores (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Scores on the acceptability questions were higher among those who found the decision aid helpful (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), except for questions related to \u201clength,\u201d \u201crelatability of photo,\u201d and \u201cphoto helped make decision.\u201d Participants reporting nervousness had lower DCS certainty subscale scores (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Cronbach\u2019s alpha for the acceptability and satisfaction domains were 0.74 and 0.75, respectively, indicating internal consistency.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>We developed a patient-centered scale that captures users\u2019 perceptions of decision aid usability and information overload. The scale demonstrated acceptable construct validity and internal consistency, supporting its use in evaluating decision aids from the patient perspective.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0272989x261473303","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T06:57:05Z","timestamp":1786690625000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and Validation of a Patient-Centered Scale to Evaluate Decision Aid Usability and Information Overload"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9902-6603","authenticated-orcid":false,"given":"Nicholas A.","family":"Pickersgill","sequence":"first","affiliation":[{"name":"Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8005-0694","authenticated-orcid":false,"given":"Amy L.","family":"Tin","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3417-7261","authenticated-orcid":false,"given":"Sunny","family":"Nalavenkata","sequence":"additional","affiliation":[{"name":"Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7169-739X","authenticated-orcid":false,"given":"Mia D.","family":"Austria","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Stevanovic","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oskar","family":"Bergengren","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason P.","family":"Gonsky","sequence":"additional","affiliation":[{"name":"Department of Medicine, NYC Health + Hospitals, Kings County Hospital Center, SUNY Downstate Medical School, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jada G.","family":"Hamilton","sequence":"additional","affiliation":[{"name":"Department of Psychiatry &amp; Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA"},{"name":"Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA"},{"name":"Weill Cornell Medical College, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer L.","family":"Hay","sequence":"additional","affiliation":[{"name":"Department of Psychiatry &amp; Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1525-6503","authenticated-orcid":false,"given":"Andrew J.","family":"Vickers","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Fagerlin","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3553-5710","authenticated-orcid":false,"given":"Sigrid V.","family":"Carlsson","sequence":"additional","affiliation":[{"name":"Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA"},{"name":"Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA"},{"name":"Division of Clinical Epidemiology of Early Cancer Detection, German Cancer Research Center (DKFZ), Heidelberg, Germany"},{"name":"Department of Translational Medicine, Lund University, Malm\u00f6, Sweden"},{"name":"Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1109283"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urpr.2015.10.006"},{"key":"e_1_3_2_4_2","unstructured":"National Comprehensive Cancer Network. 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