CollaboRATE Measure: Shared Decision Making

What is the CollaboRATE measure?

Shared decision-making is the involvement of patients in their own healthcare decisions and is crucial for patient engagement and patient-centered care delivery. CollaboRATE is a brief, 3-question tool that was designed to evaluate the patient experience in the shared decision-making process. This patient-centric measure analyzes effort of the healthcare team in three distinct categories: (1) help understanding one’s own health issues, (2) listening to things that matter most to the patient about their own health issues, and (3) including what matters most to the patient in choosing next steps in care delivery.

CollaboRATE scoring methods

There are a couple of CollaboRATE scoring methods, each of which has been validated for use and been analyzed for psychometric properties with comparable results. 

1. CollaboRATE-5: This scoring method utilizes a 5-point Likert scale for each of the three questions. Responses range from 0, indicating no effort was made, to 4, indicating that every effort was made. These responses are summed for a final scale of 0-12.
2. CollaboRATE-10: Based on a 10-point Likert scale, this method allows respondents to select answers ranging from 0, indicating no effort was made, to 9, indicating every effort was made. Question scores are then summed and multiplied by 3.704 to convert to a final scale of 0 to 100.

Strengths of using CollaboRATE

The quick, 3-question nature of this tool makes implementation into clinical practice easy for both patients and clinical staff. Its generic question style allows for its utilization following encounters of all types with any specialty or provider. CollaboRATE has demonstrated excellent intrarater reliability and sensitivity to change, as well as concurrent validity with other measures of shared decision-making such as the SDM-Q-9 and the PICS-DFS. CollaboRATE is most effective at  distinguishing between no effort and any effort to partake in a shared decision-making process, while its sensitivity in determining moderate vs high shared-decision making efforts was less (i.e. the magnitude of score difference between moderate and high shared-decision making efforts is smaller). Additionally, CollaboRATE has been studied in pediatric settings and demonstrated high internal consistency in both English and Spanish when answered by patient guardians.

Considerations when implementing CollaboRATE

As one of the newer tools used to measure shared decision-making, CollaboRATE has not been as well established in the literature as some of its predecessors. However, recent literature evaluating its psychometric properties demonstrates promise that use of this tool will continue to grow as its validity, responsiveness and reliability match those of its competitors.

Costs and Licensing of CollaboRATE 

CollaboRATE is free to use. The developers request completion of a registration form for use of this tool in clinical practice or research which can be found here.

Conclusion: Why Use CollaboRATE in clinical practice?

The CollaboRATE tool is a quick, reliable method to evaluate the patient’s experience in the shared decision-making process that presents minimal burden to the patient and clinical staff.

Sources  |  [[1] CollaboRATE – Glyn Elwyn]  |  [[2] The Psychometric Properties of CollaboRATE]  |  [[3] Developing CollaboRATE]  |  [[4] Measuring shared decision-making in the pediatric outpatient setting]