An Expert Consensus Study for Informed Consent in Primary Breast Augmentation Surgery

An Expert Consensus Study for Informed Consent in Primary Breast Augmentation Surgery
Chelsea O Hagopian, Thomas M Hagopian, Erik M Wolfswinkel, Teresa B Ades, W Grant Stevens
Aesthetic Surgery Journal, 6 December 2020
Abstract
Background
What constitutes adequate information for decision-making and informed consent is a practical question appropriately answered with deference to expertise.
Objectives
The specific objectives were to (1) establish consensus on a procedure-specific core information set of essential informed consent information by relevant medical experts for primary breast augmentation surgery and (2) to define from the clinical perspective, the data source and imminence elements of evidence-based risk communication.
Methods
The study follows a modified Delphi expert consensus model. Active members of The Aesthetic Society were identified as the relevant clinician experts and were recruited by email. Survey round one was informed by a scoping review of the relevant scientific and gray literature. Round two was informed by the initial survey round. Consensus was defined a priori as a 75% majority rating.
Results
Expert consensus of essential information was achieved for 16 risks, 1 risk factor and 8 expectations—including benefits and burdens, along with clarification of clinically appropriate options to present to all patients considering primary implant-based breast augmentation surgery. A basic, procedure-specific, structure for evidence-based risk data is also described.
Conclusions
This paper reports results for the first phase of a larger pilot study aiming to develop a patient decision aid to replace traditional informed consent documents for the specified procedure. Implications for practice are encouraging toward reducing unwanted variation in disclosure practices and information overload.

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