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Session: ePoster: Colon and Colorectal Cancer 3 (Sun1230)

EP425 - Effect Of Shared Decision-Making Intervention On Decision Regret After Abdominal Surgery- A Systematic Review

Sunday, May 11, 2025
12:40 PM – 12:45 PM PT
Location: Monitor 4, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • Temitope G. Joshua, MD, MSc

    PhD Candidate
    McGill University
    McGill University
    Montreal, QC, Canada

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • TP

    Tiffany Paradis, MD, MSc

    Resident
    McGill
    Montreal, Quebec, Canada

    Disclosure information not submitted.

  • LF

    Liane S. Feldman, MD FACS FRCSC

    Professor of Surgery
    McGill University
    montreal, Quebec, Canada

    Disclosure information not submitted.

  • JF

    Julio Flavio Fiore Junior, PhD

    Associate Professor
    McGill University
    Montreal, Quebec, Canada

    Disclosure information not submitted.

  • Alexander Sender Liberman, MD, FACS, FASCRS, FRCSC (he/him/his)

    Professor of Surgery & Oncology
    McGill University
    Montreal, Quebec, Canada

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Senior Author(s)

  • LL

    Lawrence Lee, MD PhD

    Associate Professor of Surgery
    McGill University Health Centre
    Montreal, Quebec, Canada

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

All of the relevant financial relationships listed below have been mitigated.
Temitope G. Joshua, MD, MSc: This individual has no financial relationships with ineligible companies.
Alexander Sender Liberman, MD, FACS, FASCRS, FRCSC: This individual has no financial relationships with ineligible companies.
Lawrence Lee, MD PhD: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Shared decision-making (SDM) is important in abdominal surgery where more treatment options are often available. Surgical treatments always run the risk of complications, which may cause clinical decision-making to be quite intricate. SDM has been suggested to be the most effective approach to clinical counseling. It is unclear if this applies to surgical decision-making especially regarding urgent, highly morbid operations. How patients make treatment choices may affect long-term regret and satisfaction, but this is poorly studied. Therefore, we review the extent to which SDM is associated with decisional regret after abdominal surgery.

Methods/Interventions: The search strategy was developed with a medical librarian, included five databases (Medline [Ovid], Embase [Ovid], CINAHL [Ebsco], Cochrane Central Register of Controlled Trials [CENTRAL] [Wiley], and Scopus were searched from 1970 to April 2024, in English language. Title and abstract review identified peer-reviewed articles that addressed shared decision-making interventions in abdominal surgery. Identified articles underwent full-text review by two independent investigators. Eligibility for the study was determined based on strict inclusion criteria, focusing on adult patients undergoing abdominal surgery who participated in shared decision-making (SDM) interventions. Studies that did not meet these criteria were excluded. All study designs were included. Study quality was assessed using the Cochrane Bias Risk Assessment Tool.

Results/Outcomes: 7653 articles were identified. After duplicates were removed, 5467 titles and abstracts were screened, and of 102 full-texts reviewed. 8 studies (colorectal Surgery, Pancreatic Surgery, Bariatric Surgery, Gastrectomy) were included in the final analysis. The mean number of patients included was 553 (SD1167). 80% of articles discussed oncologic decision-making. 50% of these focused on colorectal cancer. In all studies, SDM interventions reduced decisional conflict and regret. In all studies, a SDM intervention was associated with less regret and higher satisfaction. Patients with higher education level were more likely to participate in shared decision-making compared to those with lower level of education. Postoperative complications, female patients, and those undergoing urgent procedures were more likely to experience regret. Congruence between a patient’s preferred decision-making role and their actual role were critical factors in reducing decision regret. One study was identified as having a low risk of bias.

Conclusion/Discussion: Overall, shared decision-making and patient decision aids were associated with higher satisfaction and reduced decisional regret. Regret is often influenced by postoperative complications, expectation management, and alignment between preferred decision-making roles and actual roles. This review highlights the potential benefit of SDM for abdominal procedures, especially in colorectal cancer.