80 | Chapter 3 Results Five surgeons conducted 42 audiotaped consultations. Six consultations were excluded because questionnaires were not returned, leaving 36 consultations for analysis (Figure 1). The median duration of the consultations was 20 minutes (range 10-43 minutes). Most patients were male (25/36), and the mean age was 67.8 years (SD 2.0). Sixteen patients were diagnosed with an early stage of disease (stage I and II), and the predominant types of carcinoma were oral (10/36) and oropharyngeal (10/36). Most of the HN surgeons were male (4 out of 5), and their working experience ranged from 15 to 40 years. Only one surgeon had followed multiple courses on SDM (the only female) and two others had completed an SDM-related course, whilst the remaining two had no experience or training in SDM. Table 2 presents a full overview of characteristics. Figure 1. Flowchart of study inclusions Observed levels of SDM Inter-rater reliability Reliability calculations, including the ten calibration consultations, resulted in a good level of agreement with ICCs of 0.767 (surgeons) 0.762 (patients) and 0.809 (caregivers). OPTION-scores The median total OPTION-score for all surgeons was 48.0%, and ranged between 9.0 and 95.0 percent. OPTION-scores varied widely between the five surgeons. Three surgeons scored substantially lower for observed SDM level than perceived based on the SDMQ-Doc and SDM-Q-9 (Appendix C). When looking at the item level (Table 2), surgeons
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