Med Decis Making - Interventions to improve patient comprehension in informed consent for medical and surgical procedures: a systematic review.

Tópicos

{ studi(2440) review(1878) systemat(933) }
{ inform(2794) health(2639) internet(1427) }
{ studi(1410) differ(1259) use(1210) }
{ surgeri(1148) surgic(1085) robot(1054) }
{ record(1888) medic(1808) patient(1693) }
{ data(3963) clinic(1234) research(1004) }
{ perform(1367) use(1326) method(1137) }
{ clinic(1479) use(1117) guidelin(835) }
{ research(1085) discuss(1038) issu(1018) }
{ patient(2837) hospit(1953) medic(668) }
{ gene(2352) biolog(1181) express(1162) }
{ risk(3053) factor(974) diseas(938) }
{ patient(2315) diseas(1263) diabet(1191) }
{ data(1714) softwar(1251) tool(1186) }
{ howev(809) still(633) remain(590) }
{ import(1318) role(1303) understand(862) }
{ use(2086) technolog(871) perceiv(783) }
{ measur(2081) correl(1212) valu(896) }
{ cost(1906) reduc(1198) effect(832) }
{ method(1219) similar(1157) match(930) }
{ care(1570) inform(1187) nurs(1089) }
{ featur(1941) imag(1645) propos(1176) }
{ can(981) present(881) function(850) }
{ use(976) code(926) identifi(902) }
{ result(1111) use(1088) new(759) }
{ activ(1452) weight(1219) physic(1104) }
{ bind(1733) structur(1185) ligand(1036) }
{ imag(2675) segment(2577) method(1081) }
{ assess(1506) score(1403) qualiti(1306) }
{ control(1307) perform(991) simul(935) }
{ search(2224) databas(1162) retriev(909) }
{ model(2341) predict(2261) use(1141) }
{ intervent(3218) particip(2042) group(1664) }
{ estim(2440) model(1874) function(577) }
{ decis(3086) make(1611) patient(1517) }
{ method(1969) cluster(1462) data(1082) }
{ method(2212) result(1239) propos(1039) }
{ model(3404) distribut(989) bayesian(671) }
{ can(774) often(719) complex(702) }
{ imag(1947) propos(1133) code(1026) }
{ data(1737) use(1416) pattern(1282) }
{ system(1976) rule(880) can(841) }
{ imag(1057) registr(996) error(939) }
{ sequenc(1873) structur(1644) protein(1328) }
{ featur(3375) classif(2383) classifi(1994) }
{ imag(2830) propos(1344) filter(1198) }
{ network(2748) neural(1063) input(814) }
{ take(945) account(800) differ(722) }
{ motion(1329) object(1292) video(1091) }
{ treatment(1704) effect(941) patient(846) }
{ framework(1458) process(801) describ(734) }
{ problem(2511) optim(1539) algorithm(950) }
{ error(1145) method(1030) estim(1020) }
{ chang(1828) time(1643) increas(1301) }
{ learn(2355) train(1041) set(1003) }
{ concept(1167) ontolog(924) domain(897) }
{ algorithm(1844) comput(1787) effici(935) }
{ extract(1171) text(1153) clinic(932) }
{ method(1557) propos(1049) approach(1037) }
{ design(1359) user(1324) use(1319) }
{ model(2220) cell(1177) simul(1124) }
{ general(901) number(790) one(736) }
{ method(984) reconstruct(947) comput(926) }
{ case(1353) use(1143) diagnosi(1136) }
{ perform(999) metric(946) measur(919) }
{ system(1050) medic(1026) inform(1018) }
{ visual(1396) interact(850) tool(830) }
{ compound(1573) activ(1297) structur(1058) }
{ studi(1119) effect(1106) posit(819) }
{ blood(1257) pressur(1144) flow(957) }
{ spatial(1525) area(1432) region(1030) }
{ health(3367) inform(1360) care(1135) }
{ model(3480) simul(1196) paramet(876) }
{ monitor(1329) mobil(1314) devic(1160) }
{ ehr(2073) health(1662) electron(1139) }
{ state(1844) use(1261) util(961) }
{ research(1218) medic(880) student(794) }
{ model(2656) set(1616) predict(1553) }
{ data(2317) use(1299) case(1017) }
{ age(1611) year(1155) adult(843) }
{ medic(1828) order(1363) alert(1069) }
{ signal(2180) analysi(812) frequenc(800) }
{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ data(3008) multipl(1320) sourc(1022) }
{ first(2504) two(1366) second(1323) }
{ activ(1138) subject(705) human(624) }
{ time(1939) patient(1703) rate(768) }
{ patient(1821) servic(1111) care(1106) }
{ analysi(2126) use(1163) compon(1037) }
{ health(1844) social(1437) communiti(874) }
{ structur(1116) can(940) graph(676) }
{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
{ use(1733) differ(960) four(931) }
{ drug(1928) target(777) effect(648) }
{ implement(1333) system(1263) develop(1122) }
{ survey(1388) particip(1329) question(1065) }
{ process(1125) use(805) approach(778) }
{ detect(2391) sensit(1101) algorithm(908) }

Resumo

CKGROUND: Patient understanding in clinical informed consent is often poor. Little is known about the effectiveness of interventions to improve comprehension or the extent to which such interventions address different elements of understanding in informed consent.PURPOSE: . To systematically review communication interventions to improve patient comprehension in informed consent for medical and surgical procedures. Data Sources. A systematic literature search of English-language articles in MEDLINE (1949-2008) and EMBASE (1974-2008) was performed. In addition, a published bibliography of empirical research on informed consent and the reference lists of all eligible studies were reviewed. Study Selection. Randomized controlled trials and controlled trials with nonrandom allocation were included if they compared comprehension in informed consent for a medical or surgical procedure. Only studies that used a quantitative, objective measure of understanding were included. All studies addressed informed consent for a needed or recommended procedure in actual patients. Data Extraction. Reviewers independently extracted data using a standardized form. All results were compared, and disagreements were resolved by consensus. Data Synthesis. Forty-four studies were eligible. Intervention categories included written information, audiovisual/multimedia, extended discussions, and test/feedback techniques. The majority of studies assessed patient understanding of procedural risks; other elements included benefits, alternatives, and general knowledge about the procedure. Only 6 of 44 studies assessed all 4 elements of understanding. Interventions were generally effective in improving patient comprehension, especially regarding risks and general knowledge. Limitations. Many studies failed to include adequate description of the study population, and outcome measures varied widely.CONCLUSIONS: . A wide range of communication interventions improve comprehension in clinical informed consent. Decisions to enhance informed consent should consider the importance of different elements of understanding, beyond procedural risks, as well as feasibility and acceptability of the intervention to clinicians and patients. Conceptual clarity regarding the key elements of informed consent knowledge will help to focus improvements and standardize evaluations.

Resumo Limpo

ckground patient understand clinic inform consent often poor littl known effect intervent improv comprehens extent intervent address differ element understand inform consentpurpos systemat review communic intervent improv patient comprehens inform consent medic surgic procedur data sourc systemat literatur search englishlanguag articl medlin embas perform addit publish bibliographi empir research inform consent refer list elig studi review studi select random control trial control trial nonrandom alloc includ compar comprehens inform consent medic surgic procedur studi use quantit object measur understand includ studi address inform consent need recommend procedur actual patient data extract review independ extract data use standard form result compar disagr resolv consensus data synthesi fortyfour studi elig intervent categori includ written inform audiovisualmultimedia extend discuss testfeedback techniqu major studi assess patient understand procedur risk element includ benefit altern general knowledg procedur studi assess element understand intervent general effect improv patient comprehens especi regard risk general knowledg limit mani studi fail includ adequ descript studi popul outcom measur vari widelyconclus wide rang communic intervent improv comprehens clinic inform consent decis enhanc inform consent consid import differ element understand beyond procedur risk well feasibl accept intervent clinician patient conceptu clariti regard key element inform consent knowledg will help focus improv standard evalu

Resumos Similares

Res Synth Methods - A scoping review of scoping reviews: advancing the approach and enhancing the consistency. ( 0,867120727791466 )
J. Med. Internet Res. - Systematic reviews and meta-analyses of home telemonitoring interventions for patients with chronic diseases: a critical assessment of their methodological quality. ( 0,854315665845869 )
J. Med. Internet Res. - Effectiveness and cost-effectiveness of ehealth interventions in somatic diseases: a systematic review of systematic reviews and meta-analyses. ( 0,844515134779734 )
J Telemed Telecare - Telemedicine interventions for substance-use disorder: a literature review. ( 0,835314370840176 )
J Am Med Inform Assoc - Systematic review and evaluation of web-accessible tools for management of diabetes and related cardiovascular risk factors by patients and healthcare providers. ( 0,830888217486588 )
Res Synth Methods - Reporting quality of search methods in systematic reviews of HIV behavioral interventions (2000-2010): are the searches clearly explained, systematic and reproducible? ( 0,827401571903749 )
J. Med. Internet Res. - Effectiveness of eHealth interventions and information needs in palliative care: a systematic literature review. ( 0,819589870215387 )
J. Med. Internet Res. - Electronic symptom reporting between patient and provider for improved health care service quality: a systematic review of randomized controlled trials. part 2: methodological quality and effects. ( 0,818143305653324 )
Telemed J E Health - Quality and methodological challenges in Internet-based mental health trials. ( 0,817881784811953 )
Telemed J E Health - Critical appraisal of published systematic reviews assessing the cost-effectiveness of telemedicine studies. ( 0,816524173603238 )
J Am Med Inform Assoc - Clinical decision support for genetically guided personalized medicine: a systematic review. ( 0,816173070730181 )
Res Synth Methods - Issues relating to study design and risk of bias when including non-randomized studies in systematic reviews on the effects of interventions. ( 0,814570918562626 )
Res Synth Methods - Issues relating to confounding and meta-analysis when including non-randomized studies in systematic reviews on the effects of interventions. ( 0,809488699452328 )
Res Synth Methods - Clinical trial registries are of minimal use for identifying selective outcome and analysis reporting. ( 0,802256553056562 )
J. Med. Internet Res. - A systematic review of the impact of adherence on the effectiveness of e-therapies. ( 0,799610329154709 )
Int J Med Inform - Methodologies for assessing telemedicine: a systematic review of reviews. ( 0,799110112113381 )
J Telemed Telecare - Evidence of benefit from telerehabilitation in routine care: a systematic review. ( 0,798365157691401 )
Int J Med Robot - Robotically assisted coronary artery bypass grafting: a systematic review and meta-analysis. ( 0,795879678181271 )
Res Synth Methods - Issues relating to selective reporting when including non-randomized studies in systematic reviews on the effects of healthcare interventions. ( 0,795494035023969 )
J. Med. Internet Res. - Digital asthma self-management interventions: a systematic review. ( 0,793894421861293 )
Med Decis Making - It's Valid and Reliable Is Not Enough: Critical Appraisal of Reporting of Measures in Trials Evaluating Patient Decision Aids. ( 0,793092249078821 )
J Am Med Inform Assoc - Reducing caregiver stress with internet-based interventions: a systematic review of open-label and randomized controlled trials. ( 0,792894253934709 )
BMC Med Inform Decis Mak - In pursuit of certainty: can the systematic review process deliver? ( 0,790637106340344 )
Appl Clin Inform - The impact of health information exchange on health outcomes. ( 0,788896359807889 )
Res Synth Methods - An introduction to methodological issues when including non-randomised studies in systematic reviews on the effects of interventions. ( 0,784718043219813 )
Res Synth Methods - Use of indirect comparison methods in systematic reviews: a survey of Cochrane review authors. ( 0,783686856981774 )
AMIA Annu Symp Proc - Exploring the use of social media to measure journal article impact. ( 0,781358662913609 )
J Telemed Telecare - A systematic review of telehealth tools and interventions to support family caregivers. ( 0,779694817483215 )
BMC Med Inform Decis Mak - Criteria for assessing high-priority drug-drug interactions for clinical decision support in electronic health records. ( 0,779180774296378 )
J. Med. Internet Res. - Social network sites as a mode to collect health data: a systematic review. ( 0,77523620763076 )
BMC Med Inform Decis Mak - Is the coverage of Google Scholar enough to be used alone for systematic reviews. ( 0,774395635718192 )
J Telemed Telecare - Physicians' perceptions of clinical supervision and educational support via videoconference: a systematic review. ( 0,770584178616507 )
Res Synth Methods - Searching for grey literature for systematic reviews: challenges and benefits. ( 0,767014426337974 )
Res Synth Methods - The role of systematic reviews of qualitative evidence in evaluating interventions: a case study. ( 0,766499160434311 )
Res Synth Methods - Multi-context versus context-specific qualitative evidence syntheses: combining the best of both. ( 0,765231166388887 )
Int J Med Inform - A systematic review of IT for diabetes self-management: are we there yet? ( 0,764526474383977 )
J. Med. Internet Res. - Effects of eHealth interventions on medication adherence: a systematic review of the literature. ( 0,760253539999186 )
Res Synth Methods - A method for evaluating research syntheses: The quality, conclusions, and consensus of 12 syntheses of the effects of after-school programs. ( 0,756417613191372 )
J Telemed Telecare - Telerehabilitation in stroke care--a systematic review. ( 0,756306162702494 )
J Telemed Telecare - Teledentistry: a systematic review of the literature. ( 0,753521003111365 )
Int J Med Inform - Web-based interventions for the management of type 2 diabetes mellitus: a systematic review of recent evidence. ( 0,750005619697889 )
Res Synth Methods - Evidence synthesis, economics and public policy. ( 0,746564769833624 )
Int J Med Robot - Robotic-assisted colon and rectal surgery: a systematic review. ( 0,74524111468281 )
J. Med. Internet Res. - eHealth interventions for HIV prevention in high-risk men who have sex with men: a systematic review. ( 0,743568508790747 )
J. Med. Internet Res. - A review of online evidence-based practice point-of-care information summary providers. ( 0,743130301612387 )
Med Decis Making - Sponsorship-related outcome selection bias in published economic studies of triptans: systematic review. ( 0,742481891565236 )
Health Info Libr J - An evaluation of searching the German CCMed database for the production of systematic reviews. ( 0,741582129452436 )
J Telemed Telecare - A review of telemedicine interventions in diabetes care. ( 0,740615148044718 )
J Telemed Telecare - Costs and financial benefits of video communication compared to usual care at home: a systematic review. ( 0,740592338078629 )
Int J Med Inform - Reviewing the impact of computerized provider order entry on clinical outcomes: The quality of systematic reviews. ( 0,738044283354735 )
J. Med. Internet Res. - Effectiveness of web-based interventions on patient empowerment: a systematic review and meta-analysis. ( 0,737000976928162 )
J Telemed Telecare - The effectiveness of helplines for the treatment of alcohol and illicit substance use. ( 0,736082265540085 )
J. Med. Internet Res. - Assessing the internal and external validity of mobile health physical activity promotion interventions: a systematic literature review using the RE-AIM framework. ( 0,734910446901648 )
BMC Med Inform Decis Mak - A systematic review of speech recognition technology in health care. ( 0,733758383707689 )
Res Synth Methods - Potential uses of Bayesian networks as tools for synthesis of systematic reviews of complex interventions. ( 0,730747913771496 )
Res Synth Methods - Using logic models to capture complexity in systematic reviews. ( 0,728881607361522 )
J Telemed Telecare - A systematic review of the mediating role of knowledge, self-efficacy and self-care behaviour in telehealth patients with heart failure. ( 0,728586928555403 )
Health Info Libr J - Implementation of Web 2.0 services in academic, medical and research libraries: a scoping review. ( 0,725176439476661 )
J Telemed Telecare - Not all systematic reviews are systematic: a meta-review of the quality of systematic reviews for non-invasive remote monitoring in heart failure. ( 0,722286055244429 )
Res Synth Methods - Quality assessment of comparative diagnostic accuracy studies: our experience using a modified version of the QUADAS-2 tool. ( 0,72181515954604 )
J Am Med Inform Assoc - Effects of computer-aided clinical decision support systems in improving antibiotic prescribing by primary care providers: a systematic review. ( 0,719869207476633 )
BMC Med Inform Decis Mak - ASCOT: a text mining-based web-service for efficient search and assisted creation of clinical trials. ( 0,715496325903858 )
J Am Med Inform Assoc - Effects of clinical decision-support systems on practitioner performance and patient outcomes: a synthesis of high-quality systematic review findings. ( 0,715249887121632 )
J Telemed Telecare - A review of telerehabilitation for cardiac patients. ( 0,713531412905562 )
Telemed J E Health - A systematic review of the evidence base for telehospice. ( 0,712685109071615 )
Int J Med Robot - Robotic-assisted bariatric surgery: a systematic review. ( 0,712067629430368 )
AMIA Annu Symp Proc - A method for analyzing commonalities in clinical trial target populations. ( 0,711025353645752 )
J Telemed Telecare - Therapeutic videoconferencing interventions for the treatment of long-term conditions. ( 0,710829980595354 )
Int J Med Robot - Robotic-assisted hepatic resection: a systematic review. ( 0,709704475020411 )
Res Synth Methods - Search wide, dig deep: literature searching for qualitative research. An analysis of the publication formats and information sources used for four systematic reviews in public health. ( 0,707785853639578 )
J. Med. Internet Res. - An easily accessible Web-based minimization random allocation system for clinical trials. ( 0,706755436485434 )
Med Decis Making - Methods for systematic reviews of health economic evaluations: a systematic review, comparison, and synthesis of method literature. ( 0,705888805696388 )
J Biomed Inform - Automatic indexing and retrieval of encounter-specific evidence for point-of-care support. ( 0,705383244733569 )
J. Med. Internet Res. - Online and social networking interventions for the treatment of depression in young people: a systematic review. ( 0,704771004705042 )
Int J Med Inform - Impacts of structuring the electronic health record: a systematic review protocol and results of previous reviews. ( 0,703186214946972 )
Med Decis Making - Bridging health technology assessment (HTA) and efficient health care decision making with multicriteria decision analysis (MCDA): applying the EVIDEM framework to medicines appraisal. ( 0,703096125893113 )
J Am Med Inform Assoc - Design-phase prediction of potential cancer clinical trial accrual success using a research data mart. ( 0,702653019820469 )
J Biomed Inform - A human-computer collaborative approach to identifying common data elements in clinical trial eligibility criteria. ( 0,701216292274549 )
J. Med. Internet Res. - The role of social media in online weight management: systematic review. ( 0,697287991129385 )
J. Med. Internet Res. - Use of mobile phone text message reminders in health care services: a narrative literature review. ( 0,697203226231471 )
Int J Med Inform - Framing the evidence for health smart homes and home-based consumer health technologies as a public health intervention for independent aging: a systematic review. ( 0,695750873294162 )
Health Informatics J - The use of weblogs within palliative care: a systematic literature review. ( 0,694201792394815 )
Med Decis Making - Statistical methods for cost-effectiveness analyses that use data from cluster randomized trials: a systematic review and checklist for critical appraisal. ( 0,693087257690843 )
Res Synth Methods - Reporting standards for literature searches and report inclusion criteria: making research syntheses more transparent and easy to replicate. ( 0,691122138327543 )
Perspect Health Inf Manag - Motivating, influencing, and persuading patients through personal health records: a scoping review. ( 0,690694314231614 )
Int J Med Inform - The impact of medical informatics on patient satisfaction: a USA-based literature review. ( 0,688030228261886 )
Int J Med Inform - The effectiveness of computerized drug-lab alerts: a systematic review and meta-analysis. ( 0,68767838491268 )
Res Synth Methods - Development of a combined database for meta-epidemiological research. ( 0,685172477149427 )
J Telemed Telecare - Policy expectations and reality of telemedicine - a critical analysis of health care outcomes, costs and acceptance for congestive heart failure. ( 0,682255526721686 )
Health Informatics J - A systematic review of eHealth interventions to improve health literacy. ( 0,681493911482131 )
Perspect Health Inf Manag - Determination of problematic ICD-9-CM subcategories for further study of coding performance: Delphi method. ( 0,680984429870336 )
Health Info Libr J - Comparison of search strategies in systematic reviews of adverse effects to other systematic reviews. ( 0,680982833618632 )
BMC Med Inform Decis Mak - A systematic review of the implementation and impact of asthma protocols. ( 0,67668263303031 )
BMC Med Inform Decis Mak - Systematic review of clinical decision support interventions with potential for inpatient cost reduction. ( 0,676193118718942 )
J. Med. Internet Res. - Evidence of effectiveness of health care professionals using handheld computers: a scoping review of systematic reviews. ( 0,675853027262169 )
Res Synth Methods - Quality assessment of qualitative evidence for systematic review and synthesis: Is it meaningful, and if so, how should it be performed? ( 0,674588513153984 )
Int J Med Inform - Comparing semi-automatic systems for recruitment of patients to clinical trials. ( 0,674071253896616 )
Int J Med Inform - A systematic review of interventions promoting clinical information retrieval technology (CIRT) adoption by healthcare professionals. ( 0,673753082382644 )
J Telemed Telecare - A critical review of the use of telephone tests to identify cognitive impairment in epidemiology and clinical research. ( 0,673110088108935 )
J Telemed Telecare - The status of telerehabilitation in neurological applications. ( 0,672697326767829 )