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J Otolaryngol Head Neck Surg. 2008 Apr;37(2):273-8.

Informed consent in otologic surgery: prospective randomized study comparing risk recall with an illustrated handout and a nonillustrated handout.

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1
Division of Otolaryngology, Department of Surgery, Dalhousie University, Halifax, NS, Canada.

Abstract

OBJECTIVE:

Following consent, do pictures in a handout improve patients' recall of otologic surgical risks?

STUDY DESIGN:

Prospective, randomized trial in a tertiary care centre.

METHODS:

Patients undergoing otologic surgery were consented with a standardized checklist of risks by two surgeons. They were randomized (stratified by educational level) to receive either a pure text or a text and pictures handout outlining the risks of surgery. A telephone interview tested recall at a mean of 19 days. Twenty-six patients were resampled at 1 year.

MAIN OUTCOME MEASURES:

Recall was analyzed with respect to type of handout, age, sex, and level of education. A subset of 31 patients was analyzed for the effects of which surgeon consented, previous otologic surgery, and actually reading the handout.

RESULTS:

Fifty-one patients completed the study. The overall risk recall was 43%, with 45% in the pictorial group and 42% in the pure text group (p = .84). The illustrated handout did not improve the recall of any individual surgical risk either. Higher education improved risk recall from 36 to 54% (p = .009). Age, consenting surgeon, previous otologic surgery, and even reading the handout did not improve risk recall. A subgroup of 26 patients was followed up 1 year later, and their recall fell from 41 to 35%. The illustrated handout did not improve long-term recall (p = .674).

CONCLUSION:

Pictorial cues do not improve recall of surgical risks, but education level does.

PMID:
19128626
[Indexed for MEDLINE]
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