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Randomized Controlled Trial
. 2023 Feb 1;151(2):278-288.
doi: 10.1097/PRS.0000000000009830. Epub 2022 Nov 8.

Breast Reconstruction Decision Aids Decrease Decisional Conflict and Improve Decisional Satisfaction: A Randomized Controlled Trial

Cynthia Mardinger  1   2 , Anna K Steve  3 , Carmen Webb  3 , Kerry A Sherman  4 , Claire Temple-Oberle  3
Affiliations
Randomized Controlled Trial

Breast Reconstruction Decision Aids Decrease Decisional Conflict and Improve Decisional Satisfaction: A Randomized Controlled Trial

Cynthia Mardinger et al. Plast Reconstr Surg. .

Abstract

Background: Decision aids are useful adjuncts to clinical consultations for women considering breast reconstruction. This study compared the impact of two online decision aids, the Breast RECONstruction Decision Aid (BRECONDA) and the Alberta Health Services (AHS) decision aid, on decisional conflict, decisional satisfaction, and decisional regret.

Methods: This randomized controlled trial included 60 women considering whether or not to undergo breast reconstruction. Two online decision aids, the AHS and the BRECONDA, were compared using randomized two-arm equal allocation. Participants responded to questionnaires at baseline, after the first and second consultations, and at 6 weeks and 6 months after deciding to, or not to, undergo reconstruction. Change in decisional conflict scores was compared between the BRECONDA and the AHS decision aid. Secondary outcomes included decisional regret and decisional satisfaction.

Results: Both groups were similar in demographic, clinical, and behavioral characteristics. Women spent more time consulting the BRECONDA in comparison to women using the AHS decision aid (56.7 ± 53.8 minutes versus 28.4 ± 27.2 minutes; P < 0.05). Decisional conflict decreased (P < 0.05), and decisional satisfaction improved over time in both groups (P < 0.05). However, there were no differences based on the type of decision aid used (P > 0.05). Both decision aids had a similar reduction in decisional regret (P > 0.05).

Conclusions: Decision aids decrease decisional conflict and improve decisional satisfaction among women considering breast reconstruction. Physicians should therefore offer patients access to decision aids as an adjunct to breast reconstruction consultations to help patients make an informed decision.

Clinical question/level of evidence: Therapeutic, I.

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Conflict of interest statement

Disclosure: The authors do not have a financial interest in any of the products, devices, or drugs mentioned in this article. Dr. Sherman developed the BRECONDA and her institution collects user fees for its use. Professor Kerry Sherman has no conflict of interest to disclose for this research.

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