Study: 3D-printed models improve shared decision-making before colorectal surgery

Editor's Note

Using 3D-printed anatomical models during preoperative consultations significantly improved shared decision-making (SDM) and modestly reduced anxiety in colorectal surgery patients, according to a June 3 study published in JAMA Network Open. 

The single-center, cluster randomized clinical trial enrolled 51 adult patients scheduled for colon or rectal resection due to colorectal cancer, diverticular disease, or inflammatory bowel disease. Six colorectal surgeons were randomized to either use 3D-printed colon and rectum models or provide standard care, which included illustrations, scans, and verbal explanations. Patients were evaluated for SDM (via the SDM-Q-9 questionnaire), anxiety (via the 6-item State-Trait Anxiety Inventory), and disease understanding before and after their consultations.

Key findings include:

• Patients in the 3D model arm reported significantly higher SDM scores than those receiving usual care (mean [SD], 89.5 [17.6] vs 80.5 [14.4]; P = .01).
• This improvement exceeded the minimal clinically important difference of 4 points, indicating a meaningful enhancement in shared decision-making.
• Among patients with adequate health literacy, the SDM advantage remained significant (mean [SD], 94.1 [9.4] vs 81.9 [15.6]; P = .01).
• Anxiety decreased in both groups, but the reduction was statistically greater in the 3D model arm (from 53.5 to 44.1) than in usual care (from 50.4 to 48.0; P = .04), though it did not reach the 10-point threshold for clinical significance.
• Both arms showed improved scores on a patient education assessment questionnaire, but no statistically significant differences were observed between them after adjusting for baseline scores (P = .98).

Analysis of individual questionnaire items revealed that the 3D model group demonstrated improved understanding of anatomic structures at risk during surgery, while the usual care group showed greater improvement in understanding incision type. Recommending further research, authors conclude that incorporating 3D-printed models into surgical counseling significantly improves patients’ perceived involvement in decision-making and offers modest benefits for reducing anxiety.