Key result
Carotid endarterectomy patients more often recall discussions of surgical stroke risk than nonsurgical risk, at ~86%.
Why the study?
Patients need accurate information about benefits and risks of carotid endarterectomy and non-treatment options to make informed decisions, but the extent of surgeons' preoperative risk disclosure and patient recall was unclear.
What is the extent of patient recall and accurate quantification of stroke risk following preoperative disclosure by surgeons before carotid endarterectomy?
Cross-Sectional (n=133)
What is the extent of patient recall and accurate quantification of stroke risk following preoperative disclosure by surgeons before carotid endarterectomy?
Patients undergoing carotid endarterectomy frequently recall discussions about stroke risk but are rarely able to accurately quantify their postoperative risk, highlighting the potential need for decision aids.
Answers are grounded in this paper and cite their sources.
Recall of stroke risks varies by context; leaves open whether decision aids improve quantification before carotid endarterectomy.
BACKGROUND: To make an informed decision about treatment, patients need accurate information about the benefits and risks of treatment and 'non-treatment' options. A survey was conducted to determine patients' recall of the extent and effect of preoperative disclosure by surgeons to patients of risks about carotid endarterectomy (CEA). METHODS: A self-administered questionnaire was given to 133 patients undergoing elective CEA in New South Wales. The primary outcome measures were patient recall of preoperative discussion, self-assessed estimates of stroke risk with and without surgery and receipt of written information before CEA. RESULTS: A significantly higher proportion of patients recalled that their surgeon discussed the short-term stroke risk (i.e. within 30 days) if they decided to undergo CEA (86.2%) than if they decided not to have the procedure (76.9%) (P = 0.04). Of those patients who recalled the surgeon discussing their short-term stroke risk with CEA, only 24 (18.0%) were accurately able to quantify this risk. Patients were significantly more likely to recall their surgeon discussing their long-term stroke risk (i.e. within 2 years) if they decided not to have CEA (72.4%) than if they decided to have the CEA (31.5%) (P < 0.0001). CONCLUSIONS: Patients recalled discussions with their surgeon about short-term stroke risk. Only a minority, however, accurately quantified their postoperative stroke risk. In view of variable patient recall, decision aids could assist.
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Middleton et al. (2006) conducted a cross-sectional in Elective carotid endarterectomy (n=133). Discussion of short-term stroke risk with surgery vs. Discussion of short-term stroke risk without surgery was evaluated on Patient recall of preoperative discussion of short-term stroke risk (p=0.04). Patients undergoing carotid endarterectomy more frequently recalled their surgeon discussing short-term stroke risk with surgery than without surgery (86.2% vs 76.9%, P=0.04).
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