Anticipated regret in shared decision-making: a randomized experimental study. Issue 1 (December 2016)

• Record Type: Journal Article
• Authors: Speck, Rebecca; Neuman, Mark; Resnick, Kimberly; Mellers, Barbara; Fleisher, Lee
• Is Part Of: Perioperative medicine. Volume 5:Issue 1(2016)
• Page Start: 1
• Page End: 7
• Publication Date: 2016-12
• Subjects: Breast cancer -- Anticipated regret -- Decision-making -- Surgery; Preoperative care -- Periodicals; 617.919
• DOI: 10.1186/s13741-016-0031-6
• Languages: English
• ISSNs: 2047-0525

Abstract

Abstract Background Explicit consideration of anticipated regret is not part of the standard shared decision-making protocols. This pilot study aimed to compare decisions about a hypothetical surgery for breast cancer and examined whether regret is a consideration in treatment decisions. Methods In this randomized experimental study, 184 healthy female volunteers were randomized to receive a standard decision aid (control) or one with information on post-surgical regret (experimental). The main outcome measures were the proportion of subjects choosing lumpectomy vs. mastectomy and the proportion reporting that regret played a role in the decision made. We hypothesized that a greater proportion of the experimental group (regret-incorporated decision aid) would make a surgical treatment preference that favored the less regret-inducing option and that they would be more likely to consider regret in their decision-making process as compared to the control group. Results A significantly greater proportion of the experimental group subjects reported regret played a role in their decision-making process compared to the control counterparts (78 vs. 65 %;p = 0.039). Recipients of the regret-incorporated experimental decision aid had a threefold increased odds of choosing the less regret-inducing surgery (OR = 2.97; 95 % CI = 1.25, 7.09;p value = 0.014). Conclusions In this hypothetical context, the incorporation of regret in a decision aid for preference-sensitive surgery impacted decision-making. This finding suggests that keying in on anticipated regret may be an important element of shared decision-making strategies. Our results make a strong argument for applying this design and pursuing further research in a surgical patient population. Trial registration Clinicaltrials.gov, NCT02563808 .