Decision aids help patients better understand imaging procedures

2020 02 27 23 28 4046 Doctor Cancer Patient 400

Decision aids with lay-friendly language help improve patients' understanding of image-guided procedures without needing additional clinician time or effort, a study published December 14 in the American Journal of Roentgenology has found.

A team led by Dr. Shanmukha Srinivas from the University of California, San Diego also found that patients were more satisfied with consent conversations with their clinicians after being provided with decision aids.

"These findings are important in light of studies suggesting that consent practices are often limited by time constraints and variable health literacy among decision-makers," Srinivas and colleagues wrote.

While patient decision aids have been shown to improve informed consent practices, their quality regarding image-guided procedures has been criticized, with some noting that aids for imaging have poor readability scores and use language above average health literacy levels.

Srinivas's group sought to explore the impact of education aids for imaging on understanding and satisfaction among patients who have informed consent conversations with their doctors before undergoing outpatient image-guided procedures.

They conducted a study that included 105 patients randomized to receive electronic decision aids (53 did and 52 did not) before consultation with their clinician. The decision aids described procedures and their benefits, risks, and alternatives using language between sixth- to eighth-grade health literacy levels. After their visit with their clinician, patients filled out a survey which the researchers then used to measure knowledge and satisfaction using a five-point scale.

The team found that patients who received decision aids prior to their consent conversation with clinicians reported more knowledge of image-guided procedures.

Comparison of patients who received decision aids regarding understanding of imaging procedures and patients who did not (rated on a 5-point scale)
Measure No decision aids Decision aids p-values
Greater understanding of benefits 4 4.5 < 0.001
Greater understanding of risks 3.6 4.4 < 0.001
Greater understanding of alternatives 3.3 4 < 0.001
Greater understanding of what procedures involve 4.1 4.4 0.02

The researchers also found that patients who received decision aids were more likely to feel that they were given enough time with the clinician (p = 0.03), as well as listened to carefully (p < 0.001) and free to choose any option (p < 0.001). Additionally, patients with decision aids reported feeling they were given enough time to make decisions (p < 0.001), encouraged to ask questions (p < 0.001), and had questions answered (p = 0.001).

Although the study authors did not assess medicolegal liability in this study, they suggested that patient decision aids could help decrease such liability.

"Inadequate periprocedural communication is a common source of malpractice claims," they wrote. "Patient decision aids could help decrease liability by standardizing and documenting the information for a given procedure that clinicians provide to patients."

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