Study structure may compromise understanding of longitudinal decision regret stability: A systematic review

Abstract

Objectives: To perform a systematic review of decision regret studies in cancer patients to determine if regret is longitudinally stable, and whether these study structures account for late-emerging treatment effects.

Methods: Online databases including the George Mason Libraries, Global Health, Nursing and Allied Health, and PubMed were searched to identify decision regret studies with longitudinal components in patients with cancer.

Results: A total of 845 unique citations were identified; 20 studies met inclusion criteria. Data was also collected on the time horizon for 90 studies; 47 % of studies evaluated regret at time points of one year or less, although this has increased significantly in prostate cancer citations since 2010. Regret was infrequent, affecting less than 20 % of patients, and often stable. Effect sizes in studies where decision regret changed over time were small to negligible.

Conclusion: Longitudinal effects can influence the expression of decision regret, yet many studies are not designed to collect long-term data; prostate cancer studies may be particularly disadvantaged. The degree of this influence in current studies is small, though this outcome must be interpreted with caution.

Practice implications: Providers should be aware of the risk of late-emerging regret and counsel patients appropriately.

Keywords: Cancer; Decision regret; Study structure; Time horizon.