Patient Attitudes Regarding Consent for Emergency Department Computed Tomographies

INTRODUCTION: Little is known about patient attitudes towards informed consent for computed tomography (CT) in the emergency department (ED). We set out to determine ED patient attitudes about providing informed consent for CTs. METHODS: In this cross-sectional questionnaire-based survey study, we evaluated a convenience sample of patients\u27 attitudes about providing informed consent for having a CT at 2 institutional sites. Historically, at our institutional network, patients received a CT at approximately 25% of their ED visits. The survey consisted of 17 yes/no or multiple-choice questions. The primary outcome question was which type of informed consent do you feel is appropriate for a CT in the Emergency Department? RESULTS: We analyzed 300 survey responses, which represented a 90% return rate of surveys distributed. Seventy-seven percent thought they should give their consent prior to receiving a CT, and 95% were either comfortable or very comfortable with their physician making the decision regarding whether they needed a CT. Forty percent of the patients felt that a general consent was appropriate before receiving a CT in the ED, while 34% thought a verbal consent was appropriate and 15% percent thought a written consent was appropriate. Seventy-two percent of the ED patients didn\u27t expect to receive a CT during their ED visit and 30% of the ED patients had previously provided consent prior to receiving a CT. CONCLUSION: Most patients feel comfortable letting the doctor make the decision regarding the need for a CT. Most ED patients feel informed consent should occur before receiving a CT but only a minority feel the consent should be written and specific to the test

Patient Attitudes Regarding Consent for Emergency Department Computed Tomography Scans

Study Objectives: With increasing awareness of physicians and layperson inregards to the radiation exposure associated with computed tomography (CT) scans, it is unclear whether a formal patient consent process for CT’s should exist. The existing literature does not reflect the current attitudes of patients regarding this important issue. We set out to assess patient attitudes about obtaining informed consent regarding emergency department (ED) CT scans. Methods: In this pilot study, surveys were distributed over a two-month period in fiscal year 2010 by utilizing a convenience sample of patients during weekday hours in a tertiary, suburban level-one trauma center with a yearly census of 74,000 patients. Historically, in this same fiscal year at this site, patients received a CT scan on 25% of their ED visits. Using simple frequency and proportions, we evaluated patients’ attitudes regarding obtaining informed consent prior to performing CT scans in the ED. After obtaining IRB approval, a convenience sample of approximately fifty surveys was obtained which represented a 90% return rate of surveys distributed. Either an ED registrar or a research assistant filled in the triage level on the survey and then gave the survey to the patient or patient’s surrogate to complete. A brief explanation of the study was provided to ensure that participation was voluntary and that subjects were reassured as to the anonymity of their response.The survey consisted of seventeen yes/no or multiple-choice questions, five of which were demographic questions. When completed, the surveys were placed in a sealed envelope and returned to research staff or by mail to the research department. Results: The median respondent age was 60 years or older, with a nearly even proportion of men to women (51%:49%). Ninety percent identified themselves as white or non-Hispanic or non-Latino. Ten percent identified themselves as black, Black or other. Ninety-eight percent identified english as his or her primary language. The majority (71%, 36/51) of survey respondents were high school graduates or had some college. Seventy-three percent (35/48) of the subjects did not expect to get a CT and 27% (13/48) did expect to receive a CT during their ED visit on the day they were surveyed. Seventy-three percent (36/49) of respondents felt that patients in the ED should give informed consent before they get a CT scan in the ED and eighty-six percent (42/49) felt either comfortable or very comfortable letting the ED physician decide if a patient needs a CT scan. Only six percent (3/49) either had themselves or had known of anyone having a problem that was caused by a CT scan. Conclusion: Based on this pilot study, the majority or emergency department patients feel informed consent should occur before receiving a CT scan and most patients feel comfortable letting the physician make the decision regarding the need for a CT scan