Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Oct 22, 2023
Date Accepted: Apr 16, 2024
Web-based decision aids for postmastectomy breast reconstruction: a systematic review and meta-analysis of randomized controlled trials
ABSTRACT
Background:
Web-based decision aids (WDAs) have been shown to have a positive effect when used to improve the quality of decision-making for women facing postmastectomy breast reconstruction (PMBR). However, research to determine the effects of WDAs is limited.
Objective:
To compare the impact of WDAs on decisions about PMBR.
Methods:
This systematic review and meta-analysis followed the PRISMA guidelines. Six databases were searched from starting at the time of establishment of the database to May 2023. The Cochrane Risk of Bias Tool for randomized controlled trials (RCTs) was used to assess the risk of bias. The GRADE system was used to assess the quality of evidence.
Results:
Seven RCTs were included in the meta-analysis. The results showed that WDAs used audio and video to present the pros and cons of PMBR versus no PMBR, implants versus flaps, immediate versus delayed PMBR, and the appearance and feel of the PMBR results, and expected recovery time with photographs of actual patients. WDAs may improve in PMBR knowledge, decisional conflict and satisfaction, but have no effect on informed choice, decision regret or anxiety. The overall GRADE quality of the evidence was low.
Conclusions:
The results suggest that the WDAs provide a modern, low-cost, and high dissemination rate effective method to promote improved quality of decision-making in women undergoing PMBR. Clinical Trial: The review protocol was registered in the PROSPERO systematic review database (CRD42023450496).
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