Khan Aimal, Sellyn Georgina E, Ali Danish, Moazzam Zorays, Samaras Hillary, McChesney Shannon L, Hopkins Michael B, Ford Molly M, Muldoon Roberta L, Geiger Timothy M, Martin Dann, Chu Daniel I, VanKoevering Kyle K, Hawkins Alexander T
Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
Department of Dermatology, Vanderbilt University School of Medicine, Nashville, Tennessee.
JAMA Netw Open. 2025 Jun 2;8(6):e2513187. doi: 10.1001/jamanetworkopen.2025.13187.
Patients undergoing surgery report a lack of involvement in health care decisions and increased anxiety. Three-dimensional (3D)-printed models serve as educational tools to encourage patient engagement, reduce anxiety levels, and aid understanding.
To determine the impact of 3D-printed anatomic models on shared decision-making (SDM) and patient anxiety during the preoperative surgical consultation for colon or rectal resection.
DESIGN, SETTING, AND PARTICIPANTS: This single-center cluster randomized clinical trial was conducted from March 2022 to June 2023 at a colorectal surgery clinic at an academic medical institution and included adult patients scheduled for partial or complete colon and/or rectal resection for colorectal cancer, diverticular disease, or inflammatory bowel disease.
Six surgeons (clusters) were randomized to counsel patients using a modular 3D-printed model or providing usual care during preoperative clinic visits.
The primary outcome was the patient's perception of involvement in decision-making using the 9-item Shared Decision Making Questionnaire. The secondary outcome was the change in anxiety level measured using the State-Trait Anxiety Inventory. Patient characteristics were compared between the 3D-printed model and usual care arms using a χ2 test for categorical variables and a t test for comparisons between continuous variables.
Among the 51 patients enrolled (mean [SD] age, 50.7 [14.5] years; 28 female [54.9%]), 28 (54.9%) were in the 3D-printed model arm and 23 (45.1%) were in the usual care arm. Patients counseled with the 3D-printed model reported a significantly higher involvement in SDM compared with those in the usual care group (mean [SD] score, 89.5 [17.6] vs 80.5 [14.4]; P = .01). Additionally, using a 3D-printed model significantly reduced mean anxiety scores (from 53.5 [SD, 21.2] to 44.1 [SD, 15.8]) compared with conventional methods (from 50.4 [SD, 18.3] to 48.0 [SD, 15.3]) (P = .04).
This cluster randomized clinical trial found that counseling aided with 3D models during preoperative clinic visits improved SDM among patients undergoing colorectal surgery. This study highlights the potential of 3D-printed models as a tool to enhance patient-clinician collaborations. Given the findings, further research into the effectiveness and implementation of these tools is recommended in more diverse clinical settings.
ClinicalTrials.gov Identifier: NCT06625008.
接受手术的患者表示在医疗保健决策中缺乏参与感且焦虑感增加。三维（3D）打印模型可作为教育工具，以促进患者参与、降低焦虑水平并帮助理解。
确定3D打印解剖模型对结肠或直肠切除术前手术咨询期间的共同决策（SDM）和患者焦虑的影响。
设计、地点和参与者：这项单中心整群随机临床试验于2022年3月至2023年6月在一所学术医疗机构的结直肠外科诊所进行，纳入了计划因结直肠癌、憩室病或炎症性肠病接受部分或完全结肠和/或直肠切除的成年患者。
六名外科医生（整群）被随机分配，在术前门诊就诊时使用模块化3D打印模型为患者提供咨询或提供常规护理。
主要结局是患者使用9项共同决策问卷对参与决策的感知。次要结局是使用状态-特质焦虑量表测量的焦虑水平变化。使用卡方检验比较分类变量，使用t检验比较连续变量，以比较3D打印模型组和常规护理组之间的患者特征。
在纳入的51名患者中（平均[标准差]年龄，50.7[14.5]岁；28名女性[54.9%]），28名（54.9%）在3D打印模型组，23名（45.1%）在常规护理组。与常规护理组相比，使用3D打印模型咨询的患者报告在SDM中的参与度显著更高（平均[标准差]分数，分别为89.5[17.6]和80.5[14.4]；P = 0.01）。此外，与传统方法相比，使用3D打印模型显著降低了平均焦虑分数（从53.5[标准差，21.2]降至44.1[标准差，15.8]）（传统方法从50.4[标准差，18.3]降至48.0[标准差，15.3]）（P = 0.04）。
这项整群随机临床试验发现，术前门诊就诊时使用3D模型进行咨询可改善结直肠手术患者的SDM。本研究强调了3D打印模型作为增强患者-临床医生合作工具的潜力。鉴于这些发现，建议在更多样化的临床环境中进一步研究这些工具的有效性和实施情况。
ClinicalTrials.gov标识符：NCT06625008。
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