Literature DB >> 20562609

Enhancement of surgical informed consent by addition of repeat back: a multicenter, randomized controlled clinical trial.

Aaron S Fink1, Allan V Prochazka, William G Henderson, Debra Bartenfeld, Carsie Nyirenda, Alexandra Webb, David H Berger, Kamal Itani, Thomas Whitehill, James Edwards, Mark Wilson, Cynthia Karsonovich, Patricia Parmelee.   

Abstract

OBJECTIVE: In this randomized, controlled, unblinded trial, we sought to test Repeat Back's (RB) effect on comprehension following informed consent discussions. SUMMARY BACKGROUND DATA: RB has been suggested as a method to improve patient comprehension when obtaining informed consent. In this technique, patients are asked to recount what they have been told in the informed consent discussion. Despite preliminary data, this practice has not been evaluated in any large scale study.
METHODS: This study was conducted in 7 Veterans Health Administration Medical Centers where informed consent is obtained using iMedConsent, the VA's computer based platform. Patients scheduled for elective surgeries were randomized to RB (a module added to the iMedConsent package) or standard iMedConsent (no RB). Comprehension was tested after the informed consent using procedure-specific questionnaires. Time stamps in the iMedConsent program estimated the time spent completing the informed consent process. Provider and patient satisfaction were measured using 5-point Likert scales. Statistical comparisons of groups were performed using t-tests and chi tests.
RESULTS: A total of 575 patients were enrolled. In the RB group, providers spent 2.6 minutes longer (P < 0.0001) obtaining informed consent. The mean comprehension score was significantly higher in the RB group (71.4%) versus the no RB group (68.2%, P = 0.03); the effect was greatest in carotid endarterectomy patients (RB = 73.4% vs. no RB = 67.7%, P = 0.02). Quality of decision making was rated similarly. Providers were neutral to slightly favorable regarding RB.
CONCLUSIONS: RB implemented within an electronic informed consent system improved patient comprehension. The additional time required was acceptable to providers. RB should be considered as an enhancement to surgical informed consent.This clinical trial was registered at http://www.clinicaltrials.gov (Identifier NCT00288899).

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Year:  2010        PMID: 20562609     DOI: 10.1097/SLA.0b013e3181e3ec61

Source DB:  PubMed          Journal:  Ann Surg        ISSN: 0003-4932            Impact factor:   12.969


  35 in total

1.  An audit of the knowledge and attitudes of doctors towards Surgical Informed Consent (SIC).

Authors:  Bushra Ashraf; Nasira Tasnim; Muhammad Saaiq; Khaleeq-Uz- Zaman
Journal:  Int J Health Policy Manag       Date:  2014-10-27

Review 2.  Informed consent for clinical treatment.

Authors:  Daniel E Hall; Allan V Prochazka; Aaron S Fink
Journal:  CMAJ       Date:  2012-03-05       Impact factor: 8.262

3.  Informed surgical consent for a mesh/graft-augmented vaginal repair of pelvic organ prolapse. Consensus of the 2nd IUGA Grafts Roundtable: optimizing safety and appropriateness of graft use in transvaginal pelvic reconstructive surgery.

Authors:  Dennis Miller; Alfredo L Milani; Suzette E Sutherland; Bonnie Navin; Rebecca G Rogers
Journal:  Int Urogynecol J       Date:  2012-03-07       Impact factor: 2.894

4.  Does an interactive trust-enhanced electronic consent improve patient experiences when asked to share their health records for research? A randomized trial.

Authors:  Christopher A Harle; Elizabeth H Golembiewski; Kiarash P Rahmanian; Babette Brumback; Janice L Krieger; Kenneth W Goodman; Arch G Mainous; Ray E Moseley
Journal:  J Am Med Inform Assoc       Date:  2019-07-01       Impact factor: 4.497

5.  Consensus conference on best practices in live kidney donation: recommendations to optimize education, access, and care.

Authors:  D LaPointe Rudow; R Hays; P Baliga; D J Cohen; M Cooper; G M Danovitch; M A Dew; E J Gordon; D A Mandelbrot; S McGuire; J Milton; D R Moore; M Morgievich; J D Schold; D L Segev; D Serur; R W Steiner; J C Tan; A D Waterman; E Y Zavala; J R Rodrigue
Journal:  Am J Transplant       Date:  2015-02-03       Impact factor: 8.086

6.  Innovating consent for pediatric HCT patients.

Authors:  J Platt; D B Thiel; S L R Kardia; S W Choi
Journal:  Bone Marrow Transplant       Date:  2016-02-29       Impact factor: 5.483

Review 7.  Informed consent in surgery.

Authors:  Miguel A Cainzos; S González-Vinagre
Journal:  World J Surg       Date:  2014-07       Impact factor: 3.352

8.  PERTINENT DRY NEEDLING CONSIDERATIONS FOR MINIMIZING ADVERSE EFFECTS - PART TWO.

Authors:  John S Halle; Rob J Halle
Journal:  Int J Sports Phys Ther       Date:  2016-10

9.  Association of parental health literacy with oral health of Navajo Nation preschoolers.

Authors:  A G Brega; J F Thomas; W G Henderson; T S Batliner; D O Quissell; P A Braun; A Wilson; L L Bryant; K J Nadeau; J Albino
Journal:  Health Educ Res       Date:  2015-11-26

10.  "Like a dialogue": Teach-back in the emergency department.

Authors:  Margaret Samuels-Kalow; Emily Hardy; Karin Rhodes; Cynthia Mollen
Journal:  Patient Educ Couns       Date:  2015-11-10
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