Impact of Informative Videos on Proxy Consent by Parents for Pediatric Surgery: A Randomized Controlled Trial
Original Article
Shreyas Dudhani, Bindey Kumar, Amit Kumar Sinha, Amit Kumar, Rashi Rashi, Gaurav Shandilya
Journal of Indian Association of Pediatric Surgeons, November–December 2024; 29(6) pp 573-578
Abstract
Background
Consent is never truly exercised in children as parents act as their proxy and often do not understand the advantages, disadvantages, risks, and benefits of the procedure. Their high anxiety state is mirrored in the child, leading to slower recovery. Hence, this study was designed to understand if an intervention can impact the effect of consent on parents’ anxiety, satisfaction, and knowledge.
Methodology
A two-arm, parallel design, randomized controlled trial was conducted from March 2020 to March 2022 to analyze the effect of an educational video in comparison to an informational leaflet in parents giving proxy consents for various listed pediatric surgical procedures.
Results
Parents in the video group had a higher mean knowledge score (6.97 vs. 6.77, P = 0.40), comparable satisfaction scores (27.45 vs. 27.58, P = 0.88), and statistically insignificant difference between anxiety scores. We noted highest score of satisfaction (28.5/40) in the parents educated up to High School level or less. Knowledge scores were lowest in pelvic-ureteric junction obstruction (5.1/10) patients.
Conclusions
Our study done over a period of 2 years included a variety of diagnoses, and the videos and information leaflets were self-designed. It showed comparable anxiety, knowledge, or satisfaction in parents. Studies with more participants would be needed to take this research forward.

Comprehensive consent in urology using decision aids, leaflets, videos and newer technologies: empowering patient choice and shared decision-making
Review article
Carlotta Nedbal, Nithesh Naik, Niall Davis, Sanjeev Madaan, Theodoros Tokas, Giovanni Cacciamani, Eugenio Ventimiglia, Robert M. Geraghty, Dmitry Enikeev, Bhaskar K. Somani
Therapeutic Advances in Urology, 23 November 2024
Open access
Abstract
In this paper, we explore the usage of decision aids, patient information leaflets (PILs), videos, social media and modern technology to empower patients and enable shared decision-making (SDM). It explores the role of enhanced consent processes in urology. A re-evaluation of the conventional consent process is required towards more patient-centred care and SDM, which prioritises patient education and understanding of their medical conditions and treatment pathways. The use of decision aids, such as multimedia resources and PILs, is crucial in enhancing patients’ understanding, level of satisfaction, quality of life and healthcare utilisation. New tools are opening exciting possibilities for patient education and information distribution, such as Chat Generative Pre-Trained Transformer (ChatGPT). The effectiveness of ChatGPT in comparison to well-established PILs is still up for debate, despite the fact that it makes information easily accessible. Improving patients’ involvement, understanding and engagement in SDM procedures relies heavily on decision aids, PILs and current technological integration. Patients and healthcare practitioners should work together in accordance with the principles of SDM, which include considering patients’ values, backgrounds, priorities and preferences when making treatment decisions. The emphasis on patient-centred care has prompted a re-evaluation of traditional consent processes in urology, with more emphasis on the shared decision-making process. Several informative aids are currently available as reported in the literature, ranging from 3D models, multimedia presentations and virtual reality (VR) devices. While the costs of these tools might be substantial, the advantages of adopting such informative resources are unmistakable. Social media and platforms such as patient–physician blogs are increasingly popular sources of medical information. Urologists should embrace these platforms to enhance patient engagement and the quality of information provided. Despite recent progress, there remains significant room for improvement in patient education and engagement which is achievable via concerted efforts of a wider medical community.

Short-Form Video Informed Consent Compared With Written Consent for Adolescents and Young Adults: Randomized Experiment
Aliyyat Afolabi, Elaine Cheung, Joanne Chen Lyu, Pamela M Ling
JMIR Formative Research, 22 November 2024
Abstract
Background
Adolescents and young adults have the highest prevalence of e-cigarette use (“vaping”), but they are difficult to enroll in health research studies. Previous studies have found that video consent can improve comprehension and make informed consent procedures more accessible, but the videos in previous studies are much longer than videos on contemporary social media platforms that are popular among young people.
Objective
This study aimed to examine the effectiveness of a short-form (90-second) video consent compared with a standard written consent for a vaping cessation study for adolescents and young adults.
Methods
We conducted a web-based experiment with 435 adolescents and young adults (aged 13-24 years) recruited by a web-based survey research provider. Each participant was randomly assigned to view either a short-form video consent or a written consent form describing a behavioral study of a social media–based vaping cessation program. Participants completed a postexposure survey measuring three outcomes: (1) comprehension of the consent information, (2) satisfaction with the consent process, and (3) willingness to participate in the described study. Independent sample 2-tailed t tests and chi-square tests were conducted to compare the outcomes between the 2 groups.
Results
In total, 435 cases comprised the final analytic sample (video: n=215, 49.4%; written: n=220, 50.6%). There was no significant difference in characteristics between the 2 groups (all P>.05). Participants who watched the short-form video completed the consent review and postconsent survey process in less time (average 4.5 minutes) than those in the written consent group (5.1 minutes). A total of 83.2% (179/215) of the participants in the video consent condition reported satisfaction with the overall consent process compared with 76.3% (168/220) in the written consent condition (P=.047). There was no difference in the ability to complete consent unassisted and satisfaction with the amount of time between study conditions. There was no difference in the composite measure of overall comprehension, although in individual measures, participants who watched the short-form video consent performed better in 4 measures of comprehension about risk, privacy, and procedures, while participants who read the written document consent had better comprehension of 2 measures of study procedures. There was no difference between the groups in willingness to participate in the described study.
Conclusions
Short-form informed consent videos had similar comprehension and satisfaction with the consent procedure among adolescents and young adults. Short-form informed consent videos may be a feasible and acceptable alternative to the standard written consent process, although video and written consent forms have different strengths with respect to comprehension. Because they match how young people consume media, short-form videos may be particularly well suited for adolescents and young adults participating in research.

Virtual reality for patient informed consent in skull base tumors and intracranial vascular pathologies: A pilot study
Research
Emilia Westarp, Attill Saemann, Marek Zelechovski, Balazs Faludi, Philippe Cattin, Jehuda Soleman, Raphael Guzman
Acta Neurochirurgica, 15 November 2024
Open Access
Abstract
Purpose
With the growing demand for shared decision-making and patient-centered care, optimal informed consent (IC) has gained relevance. Virtual reality (VR) has seen significant technological advancements, and its medical applications currently include surgical planning and medical education. This pilot study investigates the feasibility of VR-enhanced informed consent (VR-IC) in neurosurgery to improve preoperative IC and patient satisfaction.
Methods
We included patients aged 18 to 75 years who were scheduled for skull base meningioma or brain aneurysm surgery between May and December 2023. Exclusion criteria were visual/auditory impairments and severe cognitive/psychiatric disorders. Patients received standard IC followed by VR-IC using patient-specific VR models of their pathology. After an initial demonstration by the surgeon, the patients used the VR station independently. A questionnaire with 18 questions on a 5-point Likert scale assessed the subjective impression of VR-IC.
Results
Ten patients participated in the study, with six (60%) undergoing aneurysm clipping and four (40%) undergoing skull base meningioma resection. The mean age of the participants was 58 years (± 15, range 27 to 75 years), with four female patients (40%). Patients overall rated the VR-informed consent (VR-IC) positively with a mean of 4.22 (± 0.84). There was a better understanding of their pathology (mean 4.30 ± 0.92) and the planned procedure (mean 3.95 ± 1.04). Trust in the surgeon was rated with a mean of 3.47 (± 0.94). Only minimal side effects from the VR experience including dizziness or discomfort were noted (mean 4.60 ± 0.22). None of the participants dropped out of the study.
Conclusion
VR-enhanced informed consent is feasible and improves patient understanding and satisfaction without significant side effects. These findings will guide the planning of a randomized controlled trial to validate the benefits of VR-IC in neurosurgery further.

A Randomized Controlled Trial of Video-Assisted Electronic Consent vs. Standard Consent for Percutaneous Kidney Biopsy (eConsent Bx)
Pedro Henrique Franca Gois, Vera Y. Miao, Rebecca Saunderson, Marina Wainstein, Kylie-Ann Mallitt, Shaun Patrick Chandler, Belinda Elford, Rebecca Hudson, Julia Jefferis, Helen Healy, Ann Bonner,
Journal of the American Society of Nephrology, October 2024
Abstract
Background
Video-assisted electronic consent (eConsent) enhances understanding, reduces anxiety, and boosts satisfaction in medical procedures. Yet, its impact on percutaneous kidney biopsies (PKB) remains unexplored. We aimed to assess patient-reported benefits of eConsent versus conventional consent for PKB.
Methods
In a single-center, open-label, RCT, consecutive patients undergoing PKB were randomized (1:1) to either video-assisted eConsent (intervention) or conventional consent (control). The intervention group accessed an online platform featuring an 8-minute explanatory animation before providing eConsent, while the control group was consented by clinicians and signed a paper form. The primary outcome was questionnaire-based patient comprehension, with secondary outcomes including patient-reported experience (KidneyPREM), anxiety, and satisfaction with consent.
Results
Median participant age was 52 years (IQR [34-65]), 30.7% had ≤ year 12 education and 69.3% post-secondary qualifications. Baseline characteristics were similar between groups. PKB comprehension was significantly higher in the intervention group compared to control (3 more questions correct/9; p<0.001), regardless of education level. Moreover, the intervention group demonstrated better understanding of critical information related to pre- and post-PKB care and when to seek medical attention for complications. There were no statistically significant differences in KidneyPREM, anxiety, or satisfaction between groups.
Conclusion
Video-assisted eConsent enhances PKB comprehension without affecting KidneyPREM, anxiety or satisfaction. These benefits extend to patients with lower education levels. Its implementation could standardize and streamline consent processes in PKB, with potential application in other nephrology domains.