Decision analysis allows clinicians to compare different strategies in the context of uncertainty, through explicit and quantitative measures such as quality of life outcomes and costing data.

This is especially important in breast reconstruction, where multiple strategies can be offered to patients.

This systematic review aims to appraise and review the different decision analytic models used in breast reconstruction.

A search of English articles in PubMed, Ovid, and Embase databases was performed. All articles regardless of date of publishing were considered.

Two reviewers independently assessed each article, based on strict inclusion criteria.

Out of 442 articles identified, 27 fit within the inclusion criteria. These were then grouped according to aspects of breast reconstruction, with implant-based reconstruction (n = 13) being the most commonly reported.

Decision analysis (n = 19) and/or economic analyses (n = 27) were employed to discuss reconstructive options.

The most common outcome was cost (n = 27). The decision analysis models compared and contrasted surgical strategies, management options, and novel adjuncts.