Evidence map›Paper›PMID 40938742›Full record

ArticleAnnals of surgery2025

Patient and Caregiver Experiences with Surgical Decision-Making in the Context of Dementia.

Rachel R Adler, Richard E Chunga, Joely A Centracchio, Zeba N Ahmad, Karen R Sepucha, Christina Sheu, Sasha Boyers, Samir K Shah, Clancy Clark, Dae Kim and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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. Article
  2. Review
  3. Racial and Sex Differences in Postoperative Mortality Between Patients With Versus Without Dementia.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026
    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

16 authors.

Rachel R AdlerCenter for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA.ORCID 0000-0002-9482-7417
Richard E ChungaDepartment of Gerontology, University of Massachusetts Boston, Boston, Massachusetts, USA.
Joely A CentracchioDepartment of Psychology, University of Miami, Coral Gables, FL, USA.
Zeba N AhmadHarvard Medical School, Boston, Massachusetts, USA.
Karen R SepuchaDepartment of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.
Christina SheuCenter for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA.
Sasha BoyersDepartment of Psychology, University of Miami, Coral Gables, FL, USA.
Samir K ShahDepartment of Surgery, University of Florida, Gainesville, FL, USA.
Clancy ClarkDepartment of Surgery, Virginia Mason Medical Center, Seattle, WA, USA.
Dae KimHebrew SeniorLife, Marcus Institute for Aging Research, Boston, MA, USA.
Susan L MitchellHebrew SeniorLife, Marcus Institute for Aging Research, Boston, MA, USA.
Emily FinlaysonDepartment of Surgery, Phillip R. Lee Institute for Health Policy Studies, University of California - San Francisco, San Francisco, CA, USA.
Zara CooperCenter for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA.
John HsuMongan Institute, Massachusetts General Hospital, Boston, MA, USA.
Joel S WeissmanCenter for Surgery and Public Health, Brigham and Women's Hospital, Boston, MA, USA.
Lara TraegerDepartment of Psychology, University of Miami, Coral Gables, FL, USA.

Funding

Understanding and Improving Surgical Decision-Making for Persons Living with Dementia, their Family Caregivers, and their Providers: A Mixed Methods StudyR01AG067507 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI WEISSMAN, JOEL S. · 2020 to 2024
$4.4M
NIA NIH HHS R01 AG067507
6 · The paper itself

Abstract

objectiveTo explore patient and caregiver experiences of surgical decision-making for patients living with dementia (PLWD). SUMMARY BACKGROUND DATA: PLWD face heightened risks of poor surgical outcomes. For PLWD, surgical decisions are often made in collaboration with caregivers (family or close others who support the PLWD), yet there is limited research examining PLWD and caregiver experiences of surgical decision-making.

methodsWe conducted in-depth interviews with nationally recruited PLWD (n=11) and caregivers (n=36) facing a surgical decision within the past two years. Interviews explored surgical decision-making experiences. Using reflexive thematic analysis, we coded the transcribed interview data and developed themes related to decision-making priorities, strategies, experiences, and satisfaction.

resultsThe following themes were identified: (1) PLWD and caregivers prioritized quality-of-life outcomes, (2) They struggled to anticipate benefits and risks of treatment options for the PLWD, (3) Caregivers felt a heavy burden to make the "right" decision when PLWD were unable to participate in decision-making, and (4) Decisional regret stemmed from a lack of alignment between the decision and what the caregiver felt the PLWD would have wanted.

conclusionsPLWD and caregivers navigated fraught surgical decisions and sought the 'right' balance between potential cognitive and functional tradeoffs of surgical and non-surgical options. Findings highlight the need for targeted decisional support for PLWD as well as caregivers who face decision-making on behalf of PLWD. Results inform potential mechanisms for improving surgical decision-making quality and outcomes.

Indexed as

decision-makingdementiasurgery

Identifiers

PMID40938742
PMCPMC12743600

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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.