Table 3.

Synthesized finding 1: The majority of patients expected improvement on several domains after treatment, but these expectations were often overly optimistic

Findings	Categories
Patients undergoing spinal surgery	Patients had overly optimistic expectations about treatment outcomes.
Patients planned for spinal surgery had much more optimistic expectations than their surgeons about their likely pain and activity level 3 months postoperative [16]. [U]
Patients undergoing spinal surgery had high expectations of the treatment outcomes [17]. [C]
Patients who had decompression surgery without fusion had overly optimistic expectations of the outcomes of surgery [22]. [U]
Most patients scheduled for surgical decompression for sciatica expected complete recovery, including resolution of their back pain [24]. [U]
Patients undergoing lumbar disc herniation surgery had high expectations [25]. [U]
Patients who had elective lumbar surgery had fairly high expectations of their postoperative QOL [6]. [U]
Patients who had undergone spinal fusion had overly optimistic expectations about recovery [28]. [U]
Patients receiving advanced cancer care
A substantial proportion of patients with metastatic cancer had the inaccurate expectation that cure after immunotherapy was likely [31]. [U]
A large proportion of the patients with incurable lung cancer had inaccurate beliefs about the likelihood of cure from radiotherapy [32]. [U]
About half of the patients with metastatic disease understood that their treatment was not curable, especially in patients without known brain metastases [33]. [U]
Many patients with metastatic disease believed that radiation treatment could prolong their lives [33]. [U]
Less than half of the patients with advanced cancer understood that their treatment was non-curative [35]. [U]
Many patients with recurrent ovarian cancer thought that chemotherapy would have a moderate to high chance of curing their disease [36]. [U]
After consultation with their radiation oncologist, about one-quarter of the patients undergoing palliative radiotherapy persist to believe their cancer is curable [39]. [U]
After consultation with their radiation oncologist, about half of the patients undergoing palliative radiotherapy persist to believe that treatment will prolong their life [39]. [U]
Almost half of the patients with lung cancer undergoing palliative chemotherapy were convinced that chemotherapy will cure them [40]. [U]
Some patients receiving palliative radiotherapy still expect/hope that their tumor will go away [42]. [C]
A substantial proportion of patients with advanced cancer had the inaccurate expectation that cure after chemotherapy was likely [43]. [U]
Many patients with metastatic lung or colorectal cancer who had opted to receive chemotherapy had inaccurate expectations about the curative potential of chemotherapy [44]. [U]
Patients undergoing spinal surgery	Patients’ expectations exceeded the actual outcome.
Expectations from patients who had undergone spinal surgery frequently exceeded the actual outcome [15]. [U]
In more than half of the patients who had undergoing lumbar spinal surgery, expectations were not fulfilled [21]. [U]
Patients who had undergone spinal surgery expected better outcomes than they achieved [23]. [U]
Prepoperative expectations were higher than their fulfilled postoperative expectations in patients who had undergone lumbar surgery [6]. [U]
Most expectations of patients who had undergone spinal fusion regarding the postoperative period were not fulfilled [28]. [U]
In patients who had undergone spinal surgery, outcomes were not better than expected and even worse. However, some expectations were met [30]. [U]
Patients receiving advanced cancer care
Patients with advanced cancer expected that they would benefit more from chemotherapy than they actually did [37]. [U]
Expected benefits from chemotherapy were higher than experienced benefits in patients who were treated with chemotherapy [41]. [U]
Patients undergoing spinal surgery	Patients expected improvement after treatment.
Patients undergoing cervical spine surgery had diverse expectations that encompass improvement after surgery [18]. [U]
Patients undergoing lumbar spine surgery expected that they would improve on many areas [19]. [U]
Patients expected (much) improvement after decompression surgery [22]. [U]
Patients planned for spinal surgery had optimistic expectations regarding post-treatment outcomes [26]. [U]
Most patients undergoing spinal surgery expected that surgery will be successful and will relieve their symptoms [27]. [U]
Patients undergoing spinal surgery had high expectations for relief of leg pain, improvement in sleep and return to household and recreational activities, and lower expectation for return to work-related activities [29]. [U]
Preoperatively, patients undergoing spinal surgery expected significant improvements in postoperative outcomes [30].[U]
Patients receiving advanced cancer care
Patients with recurrent ovarian cancer have positive expectations of chemotherapy [36]. [C]
Almost all patients with advanced cancer expected improvement from chemotherapy [41]. [U]
Patients undergoing spinal surgery	In the majority of the patients, some of the expectations were met.
Expectations were reached in approximately half of the patients who had undergone spinal surgery [17]. [U]
Almost all patients who had lumbar surgery had at least some of their expectations fulfilled [20]. [U]
Almost all patients who had cervical surgery had at least some of their expectations fulfilled [20]. [U]
Expectations were met in most of the patients who had undergone spinal surgery [27]. [U]
Patient expectations regarding post-treatment outcomes for spinal surgery were met in the majority of patients [29]. [U]
Patients undergoing spinal surgery	Fulfillment of expectations differed between expectations.
In patients who had lumbar surgery, the amount of improvement expected in pain was the expectation most often fulfilled [20]. [U]
In patients who had lumbar surgery, return to work was the expectation least often fulfilled [20]. [U]
In patients who had cervical surgery, the expected improvement in the ability to perform daily activities was the expectation most often fulfilled [20]. [U]
In patients who had cervical surgery, return to work was the expectation least often fulfilled [20]. [U]
Expectations regarding pain were most often fulfilled, while expectations regarding return to work and ability to work the least often fulfilled in patients who were planned for spinal surgery [26]. [U]

C credible, U Unequivocal