Evidence map›Paper›PMID 40588633›Full record

SynthesisBreast cancer research and treatment2025

Patient decision aids in breast surgery and breast reconstruction reduce decisional conflict: a systematic review and meta-analysis.

Tokoya Williams, Keenan Fine, Emily Duckworth, Tarifa Adam, Caden Bozigar, Annie McFarland, Antoinette Nguyen, Brigid M Coles, Robert D Galiano

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing 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

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

  1. Pooled it
  2. Review
  3. Article
  4. 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

9 authors.

Tokoya WilliamsNorthwestern University Feinberg School of Medicine, 259 East Erie Street, Suite 2060, Chicago, IL, 60611, USA.
Keenan FineNorthwestern University Feinberg School of Medicine, 259 East Erie Street, Suite 2060, Chicago, IL, 60611, USA.
Emily DuckworthUniversity of South Carolina School of Medicine Greenville, Greenville, SC, USA.
Tarifa AdamNorthwestern University Feinberg School of Medicine, 259 East Erie Street, Suite 2060, Chicago, IL, 60611, USA.
Caden BozigarLoyola University Chicago College of Arts and Sciences, Chicago, IL, USA.
Annie McFarlandUniversity of Illinois College of Medicine, Chicago, IL, USA.
Antoinette NguyenUniversity of Rochester School of Medicine and Dentistry, Rochester, NY, USA.
Brigid M ColesNorthwestern University Feinberg School of Medicine, 259 East Erie Street, Suite 2060, Chicago, IL, 60611, USA.
Robert D GalianoNorthwestern University Feinberg School of Medicine, 259 East Erie Street, Suite 2060, Chicago, IL, 60611, USA. Robert.Galiano@nm.org.ORCID http://orcid.org/0000-0001-9552-6483

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAround 310,000 new cases of breast cancer (BC) are diagnosed each year. Complex treatment options often overwhelm patients. Patient decision aids (PDAs) assist in surgical decision-making, but reviews of their quality and efficacy are limited. This study systematically reviews breast surgery (BS) and breast reconstruction (BR) PDAs using the International Patient Decision Aid Standards and Cochrane tools to identify gaps and provide evidence-based recommendations.

methodsA systematic review following PRISMA guidelines examined the impact of PDAs on decision-making for BC patients considering BS and BR. From 1198 articles, 35 met the inclusion criteria. Data on PDA components, study design, and results were extracted, focusing on decisional conflict and anxiety, measured by the Decisional Conflict Scale (DCS) and the State-Trait Anxiety Inventory (STAI). PDA quality and study design were assessed using Cochrane, IPDASi, and ROBINS-I tools.

resultsEight studies evaluated the effect of PDAs on decisional conflict. The pooled mean difference of 3.08 points (95% CI: - 0.62 to 6.79, p = 0.10) favored the PDA group but was not statistically significant. Two studies, however, reported notable reductions in decisional conflict with effect sizes of 13.50 and 12.80 points, respectively. The pooled effect size of PDA exposure on patient anxiety was 1.93 (95% CI: - 0.46 to 4.31) in favor of PDAs, but was not statistically significant (p = 0.11). The evaluation of PDA content quality revealed variable results.

conclusionBS and BR PDAs were not found to significantly reduce decisional conflict and anxiety in breast cancer patients. Standardized, evidence-based tools are needed.

Indexed as

Breast NeoplasmsDecision MakingDecision Support TechniquesMammaplastyMastectomyPatient ParticipationConflict, PsychologicalFemaleHumansBreast cancerBreast reconstructionBreast surgeryPatient decision aids

Identifiers

PMID40588633
PMCPMC12259761

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.