The use of e-consent in surgery and application to neurosurgery: a systematic review and meta-analysis
Published research co-authored by Mr Gordan Grahovac
This systematic review examined electronic consent in surgery and how it may apply to neurosurgery. It is relevant because consent processes should support patient understanding, shared decision-making and clear documentation.
Research snapshot
Article title: The use of e-consent in surgery and application to neurosurgery: a systematic review and meta-analysis
Authors: Asfand Baig Mirza, Abbas Khizar Khoja, Fizza Ali, Mustafa El-Sheikh, Ammal Bibi-Shahid, Jandira Trindade, Brett Rocos, Gordan Grahovac, Jonathan Bull, Alexander Montgomery, Babak Arvin, Ahmed-Ramadan Sadek
Publication type: Review
Publication date: 11 September 2023
Publication details: Acta Neurochirurgica. 2023;165(11):3149-3180.
PMID: 37695436
PMCID: PMC10624752
DOI: 10.1007/s00701-023-05776-3
Study type: Systematic review and meta-analysis
Mr Grahovac’s involvement: Listed author on the publication
Original publication: View the original publication on PubMed
What this paper looked at
This paper reviewed evidence on electronic consent platforms in surgery and considered their application to neurosurgery. It focused on how digital consent tools may affect the consent process, patient experience and documentation.
Key points from the publication
The publication is indexed as a systematic review and meta-analysis. The abstracted records describe e-consent as a growing area, with potential to make consent more accessible and robust, though implementation needs careful governance.
Clinical relevance
Consent is central to neurosurgical and spinal surgical care. This paper may help clinicians and services think about how digital tools can support informed consent without reducing the need for individual discussion.
What this means in context
Electronic consent should not be treated as a replacement for a careful conversation between clinician and patient. It may support understanding and documentation, but risks, alternatives and individual circumstances still need direct discussion.
View published abstract
The following abstract is reproduced from the original publication and is provided for reference. It may include technical terminology intended for clinical or academic audiences.
Introduction: The integration of novel electronic informed consent platforms in healthcare has undergone significant growth over the last decade. Adoption of uniform, accessible, and robust electronic online consenting applications is likely to enhance the informed consent process and improve the patient experience and has the potential to reduce medico-legal ramifications of inadequate consent. A systematic review and meta-analysis was conducted to evaluate the utility of novel electronic means of informed consent in surgical patients and discuss its application to neurosurgical cohorts.
Methods: A review of randomised controlled trials, non-randomised studies of health interventions, and single group pre-post design studies in accordance with the PRISMA statement. Random effects modelling was used to estimate pooled proportions of study outcomes. Patient satisfaction with the informed consent process and patients' gain in knowledge were compared for electronic technologies versus non-electronic instruments. A sub-group analysis was conducted to compare the utility of electronic technologies in neurosurgical cohorts relative to other surgical patients in the context of patient satisfaction and knowledge gain.
Results: Of 1042 screened abstracts, 63 studies were included: 44 randomised controlled trials (n = 4985), 4 non-randomised studies of health interventions (n = 387), and 15 single group pre-post design studies (n = 872). Meta-analysis showed that electronic technologies significantly enhanced patient satisfaction with the informed consent process (P < 0.00001) and patients' gain in knowledge (P < 0.00001) compared to standard non-electronic practices. Sub-group analysis demonstrated that neurosurgical patient knowledge was significantly enhanced with electronic technologies when compared to other surgical patients (P = 0.009), but there was no difference in patient satisfaction between neurosurgical cohorts and other surgical patients with respect to electronic technologies (P = 0.78).
Conclusions: Novel electronic technologies can enhance patient satisfaction and increase patients' gain in knowledge of their surgical procedures. Electronic patient education tools can significantly enhance patient knowledge for neurosurgical patients. If used appropriately, these modalities can shorten and/or improve the consent discussion, streamlining the surgical process and improving satisfaction for neurosurgical patients.
Keywords: Electronic technologies; Informed consent; Meta-analysis; Patient satisfaction; Surgery; e-Consent.
View the original publication on PubMed
About Mr Gordan Grahovac
Mr Gordan Grahovac is a Consultant Neurosurgeon and Complex Spinal Surgeon with expertise in managing complex spinal and neurosurgical conditions.
His work includes the assessment and treatment of patients with degenerative spinal conditions, spinal cord compression, spinal tumours, complex spinal pathology and conditions requiring specialist neurosurgical input.
His approach focuses on careful diagnosis, appropriate treatment planning and helping patients understand their options clearly.
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