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Grand RoundsWeekly Evidence Brief

Plastic Surgery

Edition

30-Second Takeaway

  • Decision aids for postmastectomy reconstruction reliably improve patient knowledge and reduce decisional conflict.
  • Stand-alone digital lifestyle programs produce small-to-moderate additional weight loss versus controls.

Week ending May 9, 2026

Decision aids, outcomes standardization, and digital tools: concise evidence briefs for surgical practice

Decision aids for postmastectomy reconstruction improve knowledge and reduce decisional conflict.

INTERNATIONAL JOURNAL OF CANCERMay 8, 2026

This systematic review of 32 studies (16 RCTs) found decision aids consistently increased patient knowledge by 15–30%. Decisional conflict declined across studies, typically by 20–50%, and values clarification improved. Effects on consultation behaviors and long-term outcomes were inconsistent, often limited by workflow integration and clinician engagement. Implementation studies show feasibility but highlight the need to embed aids into appointments and address psychosocial and equity gaps.

Seven core outcomes recommended for melasma clinical trials.

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGYMay 2, 2026

A Delphi-derived core outcome set recommends seven domains for melasma trials, including pigmentation metrics, overall severity, and quality of life. Patient satisfaction and adverse-event characterization are included to capture clinically relevant benefit–harm tradeoffs. Some recommended outcomes may be hard to measure in routine practice and Hispanic participants were underrepresented in the Delphi panel. Routine use of this core set should improve comparability and enable meta-analyses across future melasma trials.

Augmented reality did not improve satisfaction or knowledge versus monitor-based 3D models.

NPJ DIGITAL MEDICINEMay 3, 2026

In a multicentre RCT (n=60) of orthognathic surgery education, AR resulted in lower satisfaction versus monitor-based 3D models (p=0.04). Knowledge scores did not differ between AR and monitor groups (p=0.74). Women preferred the monitor-based consultation (p=0.01), suggesting patient subgroup differences in modality acceptability. Given no clear benefit, monitor-based 3D visualization remains the practical option for preoperative education.

References

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Additional Reads

Optional additional studies from this edition.

Edition context

Clinical signal

  • Integrate decision aids into clinic workflows and clinician training to realize SDM benefits.
  • Do not assume augmented reality improves patient education versus monitor-based 3D models.
  • Use the melasma core outcome set in trials to improve comparability and pooling of results.