Use of an iPad™ application in preoperative counseling for pelvic reconstructive surgery: a randomized trial

Kinman, Casey L.; Meriwether, Kate V.; Powell, Cayse M.; Hobson, Deslyn; Gaskins, Jeremy; Francis, Sean L.

doi:10.1007/s00192-017-3513-2

Cited by 14 publications

(21 citation statements)

References 13 publications

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“…This randomized controlled trial showed that the addition of an easy-to-ready patient education card enhances patient recall of the planned procedure before surgery. This finding is in contrast to many previous studies that had not demonstrated improvement in patient scores with the use of more sophisticated patient education tools 11,14,15 . Some unique features of the patient education card used in this trial were its concise nature, readability, and format, which allowed patients to have it with them at all times.…”

Section: Discussioncontrasting

confidence: 80%

Improving Patient Recall of Planned Intervention After Surgical Counseling: The IRIS Randomized Controlled Trial

Chernyak

Caraballo

Chiu

et al. 2021

Female Pelvic Med Reconstr Surg

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The aim of the study was to determine whether an easy-toread patient education card given at the preoperative visit can increase patient recall of the planned surgery.Methods: This was a randomized controlled trial. Patients scheduled to undergo pelvic reconstructive surgery were recruited during their preoperative visits. All participants received standard surgical counseling, whereas the intervention group also received a 4 Â 6 inch card highlighting the anticipated procedure. The primary outcome was correct recall of the planned surgery as measured by a preoperative questionnaire. Secondary outcomes were correct recall of the surgery postoperatively and patient satisfaction with the information provided.Results: One hundred twenty-eight patients were enrolled with 64 participants in each arm. One hundred twenty-seven participants were analyzed because 1 patient was lost to follow-up. No difference was found between patient demographics, including types of surgical procedures performed. There was a statistically significant improvement in preoperative recall: 30 of 63 participants (47.6%) in the intervention group answered all questions correctly versus 18 of 64 patients (28.6%) patients in the standard counseling group (P = 0.021). There was no difference in the postoperative scores between the 2 groups: 48.3% (28 of 58) and 52.5% (32 of 61) of the participants answered all questions correctly in the intervention and standard counseling only groups, respectively (P = 0.648). There was no difference in satisfaction scores, with a median score of 20 out of 20 for either group (interquartile range = 19-20). Conclusions:A concise and easy-to-use education card enhanced patient preoperative recall of the proposed surgery. This difference was not sustained postoperatively. High satisfaction with the information provided was reported regardless of counseling method.

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Section: Discussioncontrasting

confidence: 80%

Improving Patient Recall of Planned Intervention After Surgical Counseling: The IRIS Randomized Controlled Trial

Chernyak

Caraballo

Chiu

et al. 2021

Female Pelvic Med Reconstr Surg

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“…Across the above categories, a total of 43 interventions (72%) were noninteractive and 17 (28%) were interactive. Eight of the interactive interventions included test/feedback or teach-back components, including 1 audiovisual intervention, 39 5 digital interventions, 72,76…”

Section: Resultsmentioning

confidence: 99%

“…Most studies did not specify participants' health literacy level (88%, 46/52) or race/ethnicity (79%, 41/52), and 4 studies explicitly excluded participants with low literacy levels. 38,72,73,75 Twenty-four studies (46%) included proficiency in the study language in their eligibility criteria, and only 3 specified inclusion of participants requiring interpreters. 37,57,71 Education was reported in a variety of ways, including the percentage of participants having completed certain school levels or mean education in years (Tables 1-6).…”

Section: Study and Participant Characteristicsmentioning

confidence: 99%

“…Eighty-six percent (6/7) of interactive digital intervention trials with some bias risk resulted in improved patient comprehension 71,72,[74][75][76][77] compared with 83% (5/6) of those with high bias risk. 38,41,[78][79][80] Nine were provided in addition to standard informed consent, 41,[71][72][73][74][75]79,80 of which 7 (78%) resulted in improved patient comprehension; 2 were provided in place of standard informed consent, both of which resulted in improved patient comprehension, 76,77 and 1 study did not specify. 78 All of the interactive digital interventions contained interactive features, and 5 included a test/feedback component.…”

Section: Group Favored Cmentioning

confidence: 99%

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Interventions to Improve Patient Comprehension in Informed Consent for Medical and Surgical Procedures: An Updated Systematic Review

et al. 2020

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Background. Patient comprehension is fundamental to valid informed consent. Current practices often result in inadequate patient comprehension. Purpose. An updated review to evaluate the characteristics and outcomes of interventions to improve patient comprehension in clinical informed consent. Data Sources. Systematic searches of MEDLINE and EMBASE (2008–2018). Study Selection. We included randomized and nonrandomized controlled trials evaluating interventions to improve patient comprehension in clinical informed consent. Data Extraction. Reviewers independently abstracted data using a standardized form, comparing all results and resolving disagreements by consensus. Data Synthesis. Fifty-two studies of 60 interventions met inclusion criteria. Compared with standard informed consent, a statistically significant improvement in patient comprehension was seen with 43% (6/14) of written interventions, 56% (15/27) of audiovisual interventions, 67% (2/3) of multicomponent interventions, 85% (11/13) of interactive digital interventions, and 100% (3/3) of verbal discussion with test/feedback or teach-back interventions. Eighty-five percent of studies (44/52) evaluated patients’ understanding of risks, 69% (41/52) general knowledge about the procedure, 35% (18/52) understanding of benefits, and 31% (16/52) understanding of alternatives. Participants’ education level was reported heterogeneously, and only 8% (4/52) of studies examined effects according to health literacy. Most studies (79%, 41/52) did not specify participants’ race/ethnicity. Limitations. Variation in interventions and outcome measures precluded conduct of a meta-analysis or calculation of mean effect size. Control group processes were variable and inconsistently characterized. Nearly half of studies (44%, 23/52) had a high risk of bias for the patient comprehension outcome. Conclusions. Interventions to improve patient comprehension in informed consent are heterogeneous. Interactive interventions, particularly with test/feedback or teach-back components, appear superior. Future research should emphasize all key elements of informed consent and explore effects among vulnerable populations.

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“…audiovisual materials, in addition to SIC, may reinforce knowledge without increasing patient anxiety [6]. Video media are useful for this purpose, and they are often used in trials [8][9][10]. Portable tablets and similar electronic devices allow clinicians to enhance information in a wide variety of situations.…”

Section: Original Articlementioning

confidence: 99%

Using hyperrealistic simulations to improve digital informed consent for endourological procedures

Lahoz¹,

Gomollón

Cortadellas

et al. 2022

BJU International

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Objectives To show that digital informed consent (DIC) improves the subjective understanding of information and, therefore, informed consent. Patients and Methods A nonblinded randomized controlled trial was performed in 84 patients who had undergone transurethral resection of bladder, transurethral resection of prostate, or ureterorenoscopy between July 2017 and March 2018. The DIC group watched a hyperrealistic simulation on a tablet device before surgery. After surgery and again 30 days later, both groups completed a validated questionnaire that measured subjective understanding, anxiety, and utility of and need for information. Results The mean ± SD age of the participants was 68.7 ± 11.1 years. Nine of 84 patients (10.7%) did not complete the questionnaire. A total of 42 patients were allocated to the DIC group and 42 to the control group. The mean ± SD score for immediate subjective understanding in the DIC group was 14.5% higher than in the control group (72% ± 17.5% vs 57.5% ± 23.5%, respectively; P = 0.006). There was no statistical difference in anxiety, utility of and need for information relative to delayed subjective understanding. In subgroup analysis, subjective understanding scores were higher, but not significantly so, among patients with low and higher education levels in the DIC group than in the control group (68% ± 18.1% vs 54% ± 22.5% [P = 0.06] and 76% ± 18.3% vs and 66% ± 21.9%, respectively [P = 0.89]). Conclusion Hyperrealistic simulations improved subjective understanding of information and, therefore, informed consent for endourological procedures.

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Use of an iPad™ application in preoperative counseling for pelvic reconstructive surgery: a randomized trial

Abstract: The addition of a POP-based iPad™ application to the informed consent process for POP surgery did not improve patient comprehension immediately postcounseling and resulted in poorer retention of information 6 weeks after surgery compared with SVC alone.

Cited by 14 publications

References 13 publications

Improving Patient Recall of Planned Intervention After Surgical Counseling: The IRIS Randomized Controlled Trial

Improving Patient Recall of Planned Intervention After Surgical Counseling: The IRIS Randomized Controlled Trial

Interventions to Improve Patient Comprehension in Informed Consent for Medical and Surgical Procedures: An Updated Systematic Review

Using hyperrealistic simulations to improve digital informed consent for endourological procedures

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