Decision Quality Instruments

Over the last several years, Dr. Karen Sepucha 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)



Colon cancer

DQI-Coronary Artery Disease Treatment v1.0 (Short version PDF, User manual)
DQI-Colon Cancer Testing v2.0 (Short version PDF)


Mental health

DQI-Depression v2.0 (Short version PDF)



DQI-Knee Osteoarthritis v2.0 (Short version PDF,User manual)
DQI-Knee Osteoarthritis (Spanish language version) v2.0 (Short version PDF)



DQI-Hip Osteoarthritis v2.0 (Short version PDF,User manual)
DQI-Hip Osteoarthritis (Spanish language version) v2.0 (Short version PDF)



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 with any questions about the instruments and to receive a scoring guide.

Learn more about the DQI development processand readcase studiesof how these are being used in research and clinical practice. 

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James M Perrin, MD Edit This Profile
Honorary Pediatrician, Massachusetts General Hospital
Professor, Harvard Medical School

Department: Pediatric Service
Division: Primary Care
Massachusetts General Hospital
100 Cambridge Street, #1542
Boston, MA 02114

Research Email:

Case Western Reserve University School of Medicine**, 1968, MD
Harvard College, 1964, AB
Research Award, Academic Pediatric Association, 2008
George Armstrong Award, Academic Pediatric Association, 2004
Other Professional Activities:
President, 2014, American Academy of Pediatrics
Member, 1998-2002, National Advisory Council for Health Care Policy, Research, and Evaluation, DHHS

Keyword Medical Subject Headings:
Neonatal Screening
Disabled Children
Child Health Services
Chronic Disease
Health Services Needs and Demand