World Journal of Surgery

, Volume 41, Issue 6, pp 1454–1465 | Cite as

Regret in Surgical Decision Making: A Systematic Review of Patient and Physician Perspectives

  • Ana Wilson
  • Sean M. Ronnekleiv-Kelly
  • Timothy M. PawlikEmail author
Scientific Review



Regret is a powerful motivating factor in medical decision making among patients and surgeons. Regret can be particularly important for surgical decisions, which often carry significant risk and may have uncertain outcomes. We performed a systematic review of the literature focused on patient and physician regret in the surgical setting.


A search of the English literature between 1986 and 2016 that examined patient and physician self-reported decisional regret was carried out using the MEDLINE/PubMed and Web of Science databases. Clinical studies performed in patients and physicians participating in elective surgical treatment were included.


Of 889 studies identified, 73 patient studies and 6 physician studies met inclusion criteria. Among the 73 patient studies, 57.5% examined patients with a cancer diagnosis, with breast (26.0%) and prostate (28.8%) cancers being most common. Interestingly, self-reported patient regret was relatively uncommon with an average prevalence across studies of 14.4%. Factors most often associated with regret included type of surgery, disease-specific quality of life, and shared decision making. Only 6 studies were identified that focused on physician regret; 2 pertained to surgical decision making. These studies primarily measured regret of omission and commission using hypothetical case scenarios and used the results to develop decision curve analysis tools.


Self-reported decisional regret was present in about 1 in 7 surgical patients. Factors associated with regret were both patient- and procedure related. While most studies focused on patient regret, little data exist on how physician regret affects shared decision making.


Radical Prostatectomy Biliary Tract Cancer Anticipate Regret Decisional Regret Decision Curve Analysis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Compliance with ethical standards

Conflict of interest



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Copyright information

© Société Internationale de Chirurgie 2017

Authors and Affiliations

  • Ana Wilson
    • 1
  • Sean M. Ronnekleiv-Kelly
    • 1
  • Timothy M. Pawlik
    • 2
    Email author
  1. 1.Department of SurgeryThe Johns Hopkins University School of MedicineBaltimoreUSA
  2. 2.Department of Surgery, The Urban Meyer III and Shelley Meyer Chair for Cancer Research, Wexner Medical CenterThe Ohio State UniversityColumbusUSA

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