Trial reportDiseases of the colon and rectum2025
A Novel Decision Aid for Colectomy in Diverticulitis: Cluster Randomized Pilot and Feasibility Study.
Trial report in Diseases of the colon and rectum, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundShared decision-making is crucial in choosing the ideal treatment for recurrent diverticulitis because it involves balancing medical management and surgical interventions in the context of patient preferences.
objectiveDescribe the feasibility of a previsit online patient Diverticulitis Decision Aid and explore the aid's effect on patient-centered outcomes.
designCluster randomized pilot trial.
settingSingle tertiary care center. PATIENTS: Patients with recurrent diverticulitis seen in a colorectal surgery clinic were included in the study.
interventionDiverticulitis Decision Aid.
main outcome measuresThe primary outcome was decisional conflict. Secondary outcomes included decision regret and quality of shared decision-making. Feasibility outcomes included recruitment timing, enrollment cadence, and participant retention.
resultsSix colorectal surgeons were enrolled in the study, with 3 randomly assigned to have their patients use the decision aid and 3 randomly assigned to usual care. Among the 57 eligible patients approached for participation in the trial, 31 (control n = 15, intervention n = 16) provided informed consent and were enrolled. The median age of participants was 57.0 years, and 51.6% of them were women. We observed baseline preconsultation decisional conflict median scores of 48.4 (interquartile range, 36.7-54.7), indicating high baseline levels of conflict. Marked reductions in conflict scales in both groups were observed between previsit and postvisit, but a greater median reduction was observed in the decision aid group (34.4 [19.5-49.2]) versus the control group (7.8 [-2.3 to 34.8]). LIMITATIONS: The limitation of this study was the short duration of follow-up.
conclusionsPatient use of an online Diverticulitis Decision Aid before their visit with a surgeon was feasible. Results suggest a greater difference in decisional conflict score reductions with use of the decision aid compared to routine care. See Video Abstract . UNA NUEVA HERRAMIENTA DE AYUDA PARA LA TOMA DE DECISIONES EN COLECTOMA POR DIVERTICULITIS ESTUDIO PILOTO ALEATORIZADO POR GRUPOS Y DE VIABILIDAD: ANTECEDENTES:La toma de decisiones compartida es crucial para elegir el tratamiento ideal para la diverticulitis recurrente, ya que implica equilibrar el manejo médico y las intervenciones quirúrgicas según las preferencias del paciente.OBJETIVO:Describir la viabilidad de una herramienta de toma de decisiones en línea para el tratamiento de la diverticulitis antes de la consulta y explorar su efecto en los resultados centrados en el paciente.DISEÑO:Ensayo piloto aleatorizado por grupos.ESCENARIO:Centro de atención terciaria.PACIENTES:Pacientes con diverticulitis recurrente atendidos en una clínica de cirugía colorrectal.INTERVENCIÓN:Herramienta de toma de decisiones para la diverticulitis.PRINCIPALES MEDIDAS DE RESULTADOS:El resultado primario fue el conflicto en la toma de decisiones. Los resultados secundarios incluyeron el arrepentimiento por la decisión y la calidad de la toma de decisiones compartida. Los resultados de viabilidad incluyeron el momento del reclutamiento, el ritmo de inscripción y la retención de participantes.RESULTADOS:Seis cirujanos colorrectales participaron en el estudio; tres fueron aleatorizados para que sus pacientes utilizaran la herramienta de toma de decisiones y tres para la atención habitual. De los 57 pacientes elegibles contactados para participar en el ensayo, 31 (control n=15, intervención n=16) dieron su consentimiento informado y fueron incluidos. La mediana de edad de los participantes fue de 57,0 años y el 51,6% eran mujeres. Se observaron puntuaciones basales de conflicto de decisión previas a la consulta de (mediana [rango intercuartil]) 48,4 [36,7, 54,7], lo que indica altos niveles basales de conflicto. Se observaron reducciones marcadas en las escalas de conflicto en ambos grupos entre la visita previa y la posterior, pero se observó una mayor reducción mediana en el grupo que recibió ayuda para la toma de decisiones (34,4 [19,5, 49,2]) en comparación con el grupo control (7,8 [-2,3, 34,8]).LIMITACIONES:Corta duración del seguimiento.CONCLUSIONES:El uso por parte de los pacientes de una herramienta de ayuda en línea para la toma de decisiones sobre diverticulitis antes de su visita con un cirujano fue viable. Los resultados sugieren una mayor diferencia en las reducciones de las puntuaciones de conflicto de decisiones con el uso de la ayuda para la toma de decisiones en comparación con la atención de rutina. (AI-generated translation ).
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