Patient‐Reported Decisional Regret After Operative Otolaryngology Procedures: A Scoping Review

Abstract

ObjectiveTo review the published literature on decisional regret in adult patients undergoing operative otolaryngology procedures. The primary outcome was decisional regret scale (DRS) scores. DRS scores of 0 indicate no regret, 1–25 mild regret, and >25 moderate to strong/severe regret.Data SourcesA comprehensive librarian‐designed strategy was used to search MEDLINE, Embase, and CINAHL from inception to September 2023.Review MethodsInclusion criteria consisted of English‐language studies of adult patients who underwent operative otolaryngology treatments and reported DRS scores. Data was extracted by two independent reviewers. Preferred Reporting Items for Systematic Reviews and Meta‐analyses Extension for Scoping Reviews (PRISMA‐ScR) guidelines were followed. Oxford Centre's Levels of Evidence were used for quality assessment.ResultsIn total, 6306 studies were screened by two independent reviewers; 13 studies were included after full‐text analysis. Subspecialties comprised: Head and neck (10), endocrine (1), general (1), and rhinology (1). The DRS results of the included studies spanned a mean range of 10.1–23.9 or a median range of 0–20.0. There was a trend toward more decisional regret after large head and neck procedures or when patients underwent multiple treatment modalities. Depression, anxiety, and patient‐reported quality of life measures were all correlated with decisional regret. Oxford Centre's Levels of Evidence ranged from 2 to 4.ConclusionThis is the first comprehensive review of decisional regret in otolaryngology. The majority of patients had no or mild (DRS <25) decisional regret after otolaryngology treatments. Future research on pre‐operative counseling and shared decision‐making to further minimize patient decisional regret is warranted.Level of EvidenceN/A Laryngoscope, 2023