Evidence map›Paper›PMID 39414667›Full record

Trial reportSurgical endoscopy2025

Patient expectations and decisional regret in the management of ventral hernias.

Cameron A Casson, Bradley S Kushner, Timothy R Holden, Arnab Majumder, Jeffrey A Blatnik, Sara E Holden

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Ventral hernia is a chronic disease: a systematic review of long-term outcomes beyond 5 years.Hernia : the journal of hernias and abdominal wall surgery · 2025
    Pooled it
  2. Article
  3. Article
  4. Article
  5. Article
  6. Advances, Overuse, and Shared Decision-Making in Abdominal Wall Surgery.Journal of abdominal wall surgery : JAWS · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Cameron A CassonDepartment of Surgery, Washington University in St. Louis, St. Louis, MO, USA. ccasson@wustl.edu.
Bradley S KushnerDepartment of Surgery, Washington University in St. Louis, St. Louis, MO, USA.
Timothy R HoldenDepartment of Medicine, Division Of Geriatrics And Nutritional Science, Washington University in St. Louis, St. Louis, MO, USA.
Arnab MajumderDepartment of Surgery, Division of Minimally Invasive Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8109, Saint Louis, MO, 63110, USA.
Jeffrey A BlatnikDepartment of Surgery, Division of Minimally Invasive Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8109, Saint Louis, MO, 63110, USA.
Sara E HoldenDepartment of Surgery, Division of Minimally Invasive Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8109, Saint Louis, MO, 63110, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionOlder adult patients have many factors to contemplate when considering elective ventral hernia repair. In this study, we aimed to understand whether our novel shared decision-making (SDM) aid helped reduce this population's decisional regret when choosing hernia management strategy.

methodsPatients ≥ 60 years of age presenting for ventral hernia evaluation were randomized to two groups. The experimental group had their visit guided by our novel SDM aid. All patients took a survey prior to consultation outlining their treatment expectations. All patients were called within 6 months to complete the Decision Regret Scale, which measures remorse after a healthcare decision.

resultsSeventy-two patients (36 control, 36 experimental) completed final follow-up. On initial expectations evaluation, 53 patients (74%) reported wanting surgical repair and 58 patients (81%) reported expecting surgical repair. Ultimately, 18 patients in the control group and 17 patients in the experimental group did not undergo surgery. The use of the SDM aid did not affect if patients chose observation (OR 0.44, p = 0.24) or result in a lower decision regret score (9.86 vs 9.31, p = 0.89). Surgery was associated with a lower decision regret score (3.38 vs 16.14; p = 0.001). Of those who did not undergo repair, patients initially wanting or expecting surgery had higher decision regret scores (22.83 vs 3.33, p < 0.001; 20.40 vs 5.50, p = 0.009). Nonoperative patients who chose observation had less regret than those needing medical optimization (9.50 vs 25.00, p = 0.04). There were no differences in decision regret scores based on initial wants or expectations for those who had surgical repair.

conclusionDecisional regret following ventral hernia management is associated with patients' expectations prior to initial surgical consultation. The use of a decisional aid did not lower decision regret scores. These findings emphasize the need for upfront expectation setting and longitudinal programs to help patients reach their treatment goals.

Indexed as

Decision Making, SharedEmotionsHernia, VentralHerniorrhaphyAgedElective Surgical ProceduresFemaleHumansMaleMiddle AgedPatient ParticipationDecision regretGeriatricShared decision-makingVentral hernia

Identifiers

PMID39414667

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.