Does a decision aid for prostate cancer affect different aspects of decisional regret, assessed with new regret scales? A randomized, controlled trial

Abstract

Objective To develop and validate new regret scales and examine whether a decision aid affects different aspects of regret in the treatment choice for prostate cancer.Methods This was a multicentre trial (three sites) with imbalanced randomization (1 : 2). From 2008 to 2011, patients with localized prostate cancer were randomized 1 : 2 to usual care (N = 77) or usual care plus a decision aid presenting risks and benefits of different treatments (N = 163). The treatments were surgery and (external or interstitial) radiotherapy. Regret was assessed before, and 6 and 12 months after treatment, using the Decisional regret scale by Brehaut et al. (Medical Decision Making, 23, 2003, 281), and three new scales focusing on process, option and outcome regret. The relation between decision aid and regret was analysed by ANOVA.Results The concurrent validity of the new regret scales was confirmed by correlations between regret and anxiety, depression, decision evaluation scales and health-related quality of life. With a decision aid, patient participation was increased (P = 0.002), but regret was not. If anything, in patients with serious morbidity the decision aid resulted in a trend to less option regret and less Brehaut regret (P = 0.075 and P = 0.061, with effect sizes of 0.35 and 0.38, respectively). Exploratory analyses suggest that high-risk patients benefitted most from the decision aid. ConclusionThe new regret scales may be of value in distinguishing separate aspects of regret. In general, regret was not affected by the decision aid. In patients with serious morbidity, a trend to lower option regret with a decision aid was observed.

Urinary Incontinence, Patient Satisfaction, and Decisional Regret after Prostate Cancer Treatment: A French National Study

“…The urologist could provide decision aids for those patients not able to make a treatment choice, especially those with comorbidities, given that the use of the decision aids was not previously found to have been associated with decisional regret [18]. The decision aids should not only provide information but also facilitate shared decision-making [19].…”

Assessing decision regret in caregivers of deceased German people with cancer—A psychometric validation of the Decision Regret Scale for Caregivers

“…The DRS has been applied in observational studies, for example, demonstrating that higher physician empathy predicts lower decision regret in people with cancer or patients with cancer . The DRS has also been used in randomized controlled trials of decision aids which recently have been shown to reduce decisional conflict . Indeed, decision regret often reaches high levels (increasing 6 months or more after a decision) due to very poor outcomes and definitive knowledge about the outcome .…”

“…5,6 The DRS has also been used in randomized controlled trials of decision aids which recently have been shown to reduce decisional conflict. [7][8][9] Indeed, decision regret often reaches high levels (increasing 6 months or more after a decision) due to very poor outcomes and definitive knowledge about the outcome. 10 Several risk factors have been identified as temporal predictors for decisional regret including decisional conflict, unmet information needs, serious adverse physical health outcomes and anxiety.…”

Effectiveness of a web‐based treatment decision aid for men with lower urinary tract symptoms due to benign prostatic hyperplasia

“…One item was added to assess satisfaction with participation in decision‐making. Decisional regret was measured using the Brehaut Regret Scale and a new regret scale, which measures three different aspects of decisional regret: process, option, and outcome regret .…”