Enhancing patient decision-making in breast reconstruction: A systematic review of decision aid efficacy Review


Authors: Graziano, F. D.; White, D. R.; Plotsker, E. L.; Shammas, R. L.; Smith-Montes, E.; Nelson, J. A.; Stern, C. S.
Review Title: Enhancing patient decision-making in breast reconstruction: A systematic review of decision aid efficacy
Abstract: Background: Patients often struggle to select a breast reconstruction option that aligns with their personal values. Decision aids have become popular tools to assist patients in navigating these choices. This systematic review assesses the effectiveness of available breast reconstruction decision aids. Methods: We conducted a comprehensive search across five databases from inception to December 2022, identifying studies related to the development, validation, or implementation of decision aids in breast reconstruction. Results: Out of 4621 reports, 24 studies met inclusion criteria, covering 14 unique decision aids. These included 13 randomized controlled trials, 9 qualitative studies, and 2 case series. Nine studies reported reduced decisional conflict and 2 studies showed decreased decisional regret. Additionally, 13 studies found improved satisfaction with the information provided, and all seven studies that measured knowledge retention showed improvements. However, none of the studies found a reduction in anxiety or depression following the use of decision aids. Conclusions: Decision aids are effective in reducing decisional conflict, enhancing patient satisfaction, and improving knowledge retention in breast reconstruction. Future research should focus on integrating these tools into clinical practice. © 2024 Wiley Periodicals LLC.
Keywords: patient satisfaction; psychology; conflict; breast neoplasms; breast reconstruction; mammaplasty; patient participation; depression; medical information; systematic review; breast tumor; anxiety disorder; surgery; patient decision making; clinical effectiveness; decision making; decision support techniques; decision support system; decision aids; procedures; humans; human; female; article; decisional conflict; constructive feedback
Journal Title: Journal of Surgical Oncology
Volume: 131
Issue: 6
ISSN: 0022-4790
Publisher: Wiley Blackwell  
Date Published: 2025-05-01
Start Page: 1222
End Page: 1235
Language: English
DOI: 10.1002/jso.28038
PUBMED: 39711010
PROVIDER: scopus
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Carrie S. Stern -- Source: Scopus
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MSK Authors
  1. Carrie Stern
    46 Stern
  2. Jonas Allan Nelson
    221 Nelson
  3. Elizabeth Smith
    6 Smith
  4. Ronnie L. Shammas
    10 Shammas
  5. Donovan White
    3 White