Decision Quality Instruments

The goal of shared decision making is to improve the quality of decisions.

Over the last several years, Karen Sepucha, PhD, and colleagues have developed 14 different Decision Quality Instruments (DQIs) covering many common medical conditions including treatment of knee and hip osteoarthritis, breast cancer, colon cancer screening, prostate cancer and herniated discs.

The DQIs contain three parts:

  1. Decision-specific knowledge questions that assess patient understanding of the options and outcomes
  2. Decision-specific goals and concerns that are used to examine the extent to which patients receive treatment that is concordant with their goals
  3. Involvement questions that assess the extent to which patients are meaningfully involved in the decision making process with their health care provider.

DQIs are available for the following decisions:


Back Pain DQI-Herniated Disc v2.0
(Short version PDF, User manual)
DQI-Spinal Stenosis v1.0
(Short version PDF, User manual)
Breast Cancer  DQI-Breast Surgery v2.1
(Short version PDF, User manual)
 DQI-Breast Surgery (Spanish language version) v1.1 (Short version PDF)
DQI-Chemotherapy and Hormone Therapy v2.1 (Short version PDF)
 DQI-Breast Reconstruction v1.0
(Short version PDF)
Cardiology DQI-Coronary Artery Disease Treatment v1.0 (Short version PDF, User manual)
Colon Cancer DQI-Colon Cancer Testing v2.0
(Short version PDF)
Mental Health DQI-Depression v2.0 (Short version PDF)
Osteoarthritis DQI-Knee Osteoarthritis v2.0
(Short version PDF, User manual)
DQI-Knee Osteoarthritis (Spanish language version) v2.0 (Short version PDF)
Prostate DQI-Benign Prostate Disease v1.0
(Short version PDF, User manual)
DQI-Early Prostate Cancer Treatment v1.0
(Short version PDF, User manual)
 DQI-PSA Screening v1.0
(Short version PDF, User manual)
Women’s Health DQI-Menopause v2.0
(Short version PDF)


The DQIs are copyrighted but available for researchers, clinicians and administrators to use free of charge. The short versions of the published instruments are available for download. The versioning reflects the amount of testing that has been done. DQIs that are v1.0 have had extensive development and cognitive testing; v2.0 have also been field tested and have data on psychometrics. We encourage users to complete a user agreement in order for us to track interest in the measures and to help us generate evidence to improve the instruments.

Please contact the research team at with any questions about the instruments and to receive a scoring guide.

Learn more about the DQI development process here.