A medical risk attitude subscale for DOSPERT

Background: The Domain-Specific Risk Taking scale (DOSPERT) is a widely used instrument that measures perceived risk and benefit and attitude toward risk for activities in several domains, but does not include medical risks. Objective: To develop a medical risk domain subscale for DOSPERT. Methods: Sixteen candidate risk items were developed through expert discussion. We conducted cognitive telephone interviews, an online survey, and a random-digit dialing (RDD) telephone survey to reduce and refine the scale, explore its factor structure, and obtain estimates of reliability. Participants: Eight patients recruited from UIC medical center waiting rooms participated in 45-60 minute cognitive interviews. Thirty Amazon Mechanical Turk workers completed the online survey. One hundred Chicago-area residents completed the RDD telephone survey. Results: On the basis of cognitive interviews, we eliminated five items due to poor variance or participant misunderstanding. The online survey suggested that two additional items were negatively correlated with the scale, and we considered them candidates for removal. Factor analysis of the responses in the RDD telephone survey and non-statistical factors led us to recommend a final set of 6 items to represent the medical risk domain. The final set of items included blood donation, kidney donation, daily medication use for allergies, knee replacement surgery, general anesthesia in dentistry, and clinical trial participation. The interitem reliability (Cronbach's alpha) of the final set of 6 items ranged from 0.57-0.59 depending on the response task. Older respondents gave lower overall ratings of expected benefit from the activities. Conclusion: We refined a set of items to measure risk and benefit perceptions for medical activities. Our next step will be to add these items to the complete DOSPERT scale, confirm the scale's psychometric properties, determine whether medical risks constitute a psychologically distinct domain from other risky activities, and characterize individual differences in medical risk attitudes.