Survey of Clinical Specialties Performing Informed Consent for Endovascular Thrombectomy

Survey of Clinical Specialties Performing Informed Consent for Endovascular Thrombectomy
Mbonde, A. A. Alsarah, B. Demaerschalk, A. A. Dmytriw, Q. J. Moyer, J. A. Hirsch, A. B. Singhal, T. M. Leslie‐Mazwi, N. S. Rost, A. B. Patel, M. J. Young, R. W. Regenhardt
Stroke: Vascular and Interventional Neurology, 15 January 2025
Open Access
Abstract
Introduction
Informed consent (IC) plays a central role in acute stroke care, especially endovascular thrombectomy (EVT). We investigated the clinical roles and medical specialties of individuals who obtain IC for EVT, aiming to provide insights for enhancing the process.
Methods
We conducted a survey from July to December 2023 among clinicians involved in acute stroke care. Utilizing Qualtrics, we disseminated a structured questionnaire through various national and international platforms. This analysis summarizes findings on the characteristics of those who obtain EVT IC at the respondents’ institution.
Results
Among 168 participants,71% were staff physicians, 70% practiced in the United States (US), and 70% were based at academic centers. The most common medical specialties obtaining EVT IC were neurology (77%), followed by neurosurgery (41%), radiology (30%) and emergency medicine (10%) (Table 1). Staff physician (61%) was the most common clinical role involved, followed by fellows (43%), residents (48%), and advanced practice providers (APP, 36%) (Table 2). Non‐US institutions were more likely to utilize a provider from neurology alone (50% vs. 31%, p=0.016) and staff physicians (76% vs. 54%, p=0.008), while US institutions were more likely to utilize providers from neurosurgery (51% vs. 18%, p<0.001), APPs (43 vs. 18%, p=0.002) and residents (56% vs. 28%, p=0.001). Non‐academic institutions more frequently used emergency medicine providers (25% vs. 5%, p<0.001) and APPs (50% vs. 31%, p=0.031), while academic institutions commonly utilized neurosurgery providers (48% vs. 18%, p=0.001), residents (59% vs. 13%, p<0.001) and fellows (52% vs. 18%, p<0.001).
Conclusion
This study highlights the diverse medical specialties and clinical roles of persons obtaining IC for EVT, with neurologists and staff physicians being the most frequently utilized. These variations likely reflect availability and capacity of certain providers in different settings. Future efforts to optimize the IC process should be multi‐disciplinary, with standardized content that addresses provider diversity.