The Hopkins Competency Assessment Test: A Brief Method for Evaluating Patients' Capacity to Give Informed Consent

Janofsky, Jeffrey S.; McCarthy, Richard J.; Folstein, Marshal F.

doi:10.1176/ps.43.2.132

Cited by 130 publications

(117 citation statements)

References 6 publications

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“…35 In addressing issues of competence, suggestions have been made that patients should be screened before making treatment decisions. One approach is a screening instrument, the Hopkins Competency Assessment Test, 36 that requires the subject to answer a series of questions (true and false, and sentence completion) after reading a short essay presented at an appropriate reading comprehension level (sixth grade, eighth grade, or first-year college level). The authors concluded that screening for competency was possible and economically feasible.…”

Section: Introductionmentioning

confidence: 99%

The Use of Multimedia in the Informed Consent Process

Jimison

Sher

Appleyard

et al. 1998

Journal of the American Medical Informatics Association

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A b s t r a c t Objective:The goal of the project was to create recommendations and design specifications for a multimedia tool to enhance the informed consent process for clinical trials. The authors focused on the needs of patients with potential cognitive impairment. Design:The authors first performed a needs assessment using focus groups and interviews with health care researchers, institutional review board members, and three groups of patients (who had depression, breast cancer, or schizophrenia). Their feedback was incorporated into the design of a prototype multimedia tool. The design included general modules with information about clinical trials and informed consent as well as trial-specific modules. The authors then used the resulting prototype multimedia tool for informed consent in follow-up focus groups and interviews to obtain feedback on the feasibility and potential effectiveness of using such a tool routinely for clinical trials. Results:The authors showed that it was feasible to adapt a structured multimedia informed consent system to a specific clinical trial and to incorporate techniques to improve the understandability of informed consent content. Patients generally felt the prototype system was useful and could replace the paper document. They felt using the system would be less stressful, because they would have a greater sense of control and could proceed at their own pace. They liked the hierarchic and modular approach to providing information and felt that the use of video made information more understandable. Researchers and institutional review board members also found the system to be valuable in these ways but had concerns about how to review the system for potential biases in presentation and about the legal issues associated with replacing the paper document.Ⅲ JAMIA. 1998;5:245 -256. This paper explores the information needs of patients in the informed consent process for clinical research trials and how those needs might be met with the assistance of multimedia technology. Our objective was to use findings from the literature and feedback from patients and researchers to inform our recommendations for the design of a multimedia tool to enhance the informed consent process for clinical trials. We focused on the needs of patients with potential cognitive impairment. Our needs assessment included feedback from focus groups and interviews with patients who had depression, breast cancer, or schizophrenia, as well as interviews with health care researchers and institutional review board members.Consumers are demanding a greater choice and involvement at all levels of health care. In addition, the advancing sophistication of medical research necessitates a more sophisticated understanding of the process of informed consent in both clinical and research settings. With the increasing number of informed consent protocols being developed for new therapeutic trials, there is a clear need for improvements in informed consent.

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Section: Introductionmentioning

confidence: 99%

The Use of Multimedia in the Informed Consent Process

Jimison

Sher

Appleyard

et al. 1998

Journal of the American Medical Informatics Association

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show abstract

“…Researchers have studied decision-making capacity using a variety of instruments, including the MacArthur Competence Assessment Tools for treatment and research (Appelbaum et al 1999;Grisso and Appelbaum 1998), among others (Bean et al 1994;Janofsky et al 1992;Saks and Behnke 1999;Miller et al 1996). …”

mentioning

confidence: 99%

Enhancing Informed Consent for Research and Treatment

Dunn

Jeste

2001

Neuropsychopharmacology

222

169

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“…There are a number in the literature, including semistructured interviews largely based on the Lord Chancellor's criteria (Draper & Dawson, 1990) recognition tests -subjects are asked questions about a short essay on treatment rights (Hopkins Competency Assessment Test; Janofsky et al, 1992) and questions based on patient-centred clinical vignettes (Fazel et al, 1999). It should be borne in mind that verbal disabilities have been found to correlate with lack of capacity in both schizophrenia (Rosenfeld et al, 1992) and Alzheimer's disease (Marson et al, 1995), and so recognition rather than recall of information may be preferable in capacity assessment.…”

Section: Improving Clinical Assessmentmentioning

confidence: 99%

‘Not in perfect mind’ – the complexity of clinical capacity assessment

Raymont¹

2002

Psychiatr. bull.

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The Hopkins Competency Assessment Test: A Brief Method for Evaluating Patients' Capacity to Give Informed Consent

Cited by 130 publications

References 6 publications

The Use of Multimedia in the Informed Consent Process

The Use of Multimedia in the Informed Consent Process

Enhancing Informed Consent for Research and Treatment

‘Not in perfect mind’ – the complexity of clinical capacity assessment

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