Suzanne V. Arnold|Carole Decker|Homaa Ahmad|Olawale Olabiyi|Surya Mundluru|Kimberly J. Reid|Gabriel E. Soto|Sarah Gansert|John A. Spertus
Converting the Informed Consent From a Perfunctory Process to an Evidence-Based Foundation for Patient Decision Making
Saint Luke's Hospital|Washington University in St. Louis|Children's Mercy Hospital|Saint Luke's Hospital|Washington University in St. Louis|Children's Mercy Hospital|Saint Luke's Hospital|Washington University in St. Louis|Children's Mercy Hospital|Saint Luke's Hospital|Washington University in St. Louis|Children's Mercy Hospital|Saint Luke's Hospital|Washington University in St. Louis|Children's Mercy Hospital|Saint Luke's Hospital|Washington University in St. Louis|Children's Mercy Hospital|Saint Luke's Hospital|Washington University in St. Louis|Children's Mercy Hospital|Saint Luke's Hospital|Washington University in St. Louis|Children's Mercy Hospital|Saint Luke's Hospital|Washington University in St. Louis|Children's Mercy Hospital
standard consent forms result highly variable communication patients physicians enhance consent process facilitate shared decision making developed world wide webbased program predict patient refined expectations deciding invasive cardiac treatments systematically embed patientspecific estimates death bleeding restenosis individualized percutaneous coronary intervention informed consent documents compared patients experiences informed consent implementation predictbetween august 2006 may 2007 patients undergoing nonemergent cardiac catheterization received original consent form n142 interviewed compared received predict consent form n193 hierarchical modified poisson regression models used adjust clustering patients within physicians compared original consent group predict group reported higher rates reading consent form 72 versus 44 relative risk rr 164 95 confidence interval ci 124 216 increased perception shared decision making 67 versus 45 rr 148 95 ci 099 222 decreased anxiety 35 versus 55 rr 070 95 ci 053 091 although differences groups patients ability name complications percutaneous coronary intervention among patients identified either death bleeding potential complication patients predict group recalled informed estimated risk complication death 85 versus 62 rr 137 95 ci 103 182 bleeding 92 versus 71 rr 128 95 ci 106 156in preliminary singlecenter experience individualized consent forms patientspecific risks associated improved participation consent process reduced anxiety better risk recall predict one potential strategy improving current practice obtaining informed consent percutaneous coronary intervention