Related Experiment Video
Updated: May 18, 2026
04:01
Point of Care Transcranial Color-Coded Duplex Ultrasound of the Middle Cerebral Artery
Published on: August 9, 2024
Variability in the Perception of Informed Consent for IV-tPA during Telestroke Consultation
Lisa Thomas1, Anand Viswanathan, Thomas I Cochrane
1Department of Emergency Medicine, Mount Auburn Hospital Cambridge, MA, USA.
Frontiers in Neurology
|September 28, 2012
Summary
Informed consent for thrombolysis in acute ischemic stroke patients showed high rater variability but nearly 80% adequate patient understanding. A standardized process is needed to ensure clarity on tissue plasminogen activator (tPA) risks and benefits.
Area of Science:
- Neurology
- Medical Ethics
- Health Communication
Background:
- Informed consent is crucial for acute ischemic stroke treatment with intravenous tissue plasminogen activator (IV-tPA).
- Perceptions of informed consent quality and patient understanding can vary significantly among different stakeholders.
Purpose of the Study:
- To evaluate the perception of informed consent for IV-tPA in acute ischemic stroke patients.
- To assess the agreement among diverse raters regarding the adequacy of informed consent and patient comprehension.
Main Methods:
- Retrospective review of 20 telestroke consultations involving IV-tPA administration.
- Informed consent adequacy was assessed by a neurologist, emergency physician, paralegal, bioethicist, and layperson.
- Analysis of rater agreement and factors influencing consent quality and patient understanding.
Main Results:
- Patient-family understanding of consent was rated as adequate in 78.6% of cases.
- Poor agreement was observed among all raters regarding patient understanding (k < 0.20) and physician consent process quality (k = 0.07).
- Legal and bioethics reviewers rated the consent process lower than physicians and the layperson.
Conclusions:
- High variability exists in informed consent perception during time-sensitive stroke treatment.
- Despite variability, nearly 80% of patients demonstrated adequate understanding of tPA risks and benefits.
- A standardized, brief tPA consent process emphasizing patient/family understanding is recommended.
Related Concept Videos
01:26Types of Reports III: Telephone and Verbal Reports
Telephone and Verbal Reports in healthcare settings are two communication methods for conveying therapeutic instructions from healthcare providers to nurses or other healthcare staff.
Here's an overview of each type:
Telephone Orders
Here's an overview of each type:
Telephone Orders
01:27Regulation of Stroke Volume
The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...