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Aim: To present the Italian version of the OPTION (observing patient involvement) rating scale, developed in UK by Elwyn et al. (2005), and its psychometric characteristics, together with some findings when applied on the consultations transcripts of a group of Italian General Practitioners., Methods: The OPTION scale assesses the extent to which clinicians involve patients in decisions and consists of 12 items to be rated on a 5 point scale (from 0--behaviour not observed to 4--high standard). The scale was applied to 235 transcripts of audiotaped consultations conducted by 6 male GPs. Interrater and test-retest reliability and internal validity indices were calculated on a subsample of 30 transcripts., Results: The Italian language version of OPTION showed good psychometric properties, similar to those reported for the original version. The ratings obtained for 235 consultations showed for each OPTION item a skewed distribution: the majority of scores (> 70%) were between 0 (behaviour absent) and 2 (minimum skill level)., Conclusions: The Italian language version of OPTION seems a reliable instrument to assess patient involvement in primary care settings also in Italy. The clustering of low scores confirms previous findings that clinicians without a specific training obtain very low levels of patient involvement in the decision making process.