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Study finds patients benefit from thorough discussion of recommended operations
Date:7/7/2010

heduled for one of four elective surgical procedures: total hip arthroplasty (hip replacement), carotid endarterectomy (surgical correction of the narrowing of the carotid artery), laparoscopic cholecystectomy (gallbladder removal), or radical prostatectomy (removal of the prostate gland and some of the tissue around it). All informed consent discussions were performed using iMedConsent, the VA's computerized informed consent platform that standardizes risk information and provides a structured, computer-based interview to create an informed consent document. Within iMedConsent, researchers utilized a unique module to select a random sample of patients to participate in a "repeat back" discussion at the time the consent was sought. During the "repeat back," the provider would ask the patient to correctly reiterate procedure-specific facts and would provide additional information as needed.

The comprehension of all patient participants was tested after the informed consent discussion using procedure-specific questionnaires. Each patient's comprehension score was calculated as the percentage of questions that were answered correctly. Time spent completing the informed consent process was measured using time stamps within iMedConsent.

While time for consent (that is, the time spent explaining the consent process) had the strongest impact on patient comprehension (p< 0.0001), other independent factors associated with improved comprehension included race (p< 0.01), ethnicity (p< 0.05), age (p< 0.02), and type of surgical procedure (p< 0.01). Some of these independent factors might suggest language and education barriers, highlighting the need for modified approaches to consent. The "repeat back" method of discussion was associated with an improvement in comprehension (p< 0.05), but the impact was weaker in the analysis that included consent time.

Study limitations included the predominance of male patients in the study (93 percent), the predo
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Contact: Sally Garneski
pressinquiry@facs.org
312-202-5409
Weber Shandwick Worldwide
Source:Eurekalert

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