• Vibeke Sundling, Hege Anita Stene, Hilde Eide, and Hugaas Ofstad Eirik E Department of Medicine, Nordland Hospital Trust, Bodø, Norway; Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway.
• National Centre for Optics, Vision and Eye Care, Department of Optometry, Radiography and Lighting Design, Faculty of Health and Social Sciences, University of South-Eastern Norway, Kongsberg, Norway; Science Center Health and Technology, Faculty of Health and Social Sciences, University of University of South-Eastern Norway, Drammen, Norway. Electronic address: vibeke.sundling@usn.no.
• Patient Educ Couns. 2019 Jul 1; 102 (7): 1288-1295.

ObjectiveThe aim of this study was to assess the validity and reliability of the Decision Identification and Classification Taxonomy for Use in Medicine (DICTUM) applied to optometry, to compare decisions in medical and optometric consultations, and to describe decisions in optometry.MethodsThe study had a cross-sectional design. Data was collected from January to August 2016. Forty video-recorded patient-optometrist consultations were analysed. Clinical decisions were categorised according to DICTUM by two independent coders.ResultsThe framework was applied without modification. The inter-rater reliability was moderate, Cohen's kappa 0.57. The mean duration of the consultations was 41 (±9) minutes. In all, 891 clinical decisions were identified, mean 22 (±13) per consultation. Types of decisions were significantly different between optometric and medical consultations (chi-square, p < 0.001). More frequently, optometrists conveyed interpreted test results (27.6% vs 16.7%) and gave advice (23.6% vs 8%), while doctors defined the problem (30.4% vs 24.6%) and decided on treatment (17.8% vs 13.4%).ConclusionDICTUM is applicable to optometry encounters and may provide valuable insight to different health care settings.Practice ImplicationsDescriptive studiesofdecisions in patient-provider consultations is a first step for normative and prescriptive exploration of decision-making processes in health care.Copyright © 2019 The Authors. Published by Elsevier B.V. All rights reserved.

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