Patient rights and consent form language about intraoperative audiovisual recording

Intraoperative audiovisual recordings offer benefits in quality improvement, education, and research, but challenges hinder their routine use. No comprehensive guidelines exist on how intraoperative recordings should be communicated to patients, and no previous study has examined how informed consent documents (ICDs) address this topic. This study aims to analyze procedural consent forms for themes and readability of disclosures related to intraoperative audiovisual recording.

ICDs were collected from 104 high-volume U.S. hospitals identified via the American Hospital Association Annual Survey Database. Measures included hospital demographics (public/private, academic/non-academic, region, and Social Vulnerability Index), Flesch-Kincaid reading level, and audiovisual recording themes labeled by two independent researchers. Analyses examined the distribution of consent themes by hospital type and the association between reading level and the number of themes with U.S. census region, hospital type, and Social Vulnerability Index as covariates using ordinal logistic regressions.

Of 104 ICDs, 70 contained text about procedural recording. All 70 forms discussed modality, 66 (94.3%) discussed recording purpose, 38 (54.3%) discussed patient safeguards, and 10 (14.3%) discussed patient rights. The median reading level was 15.0 (IQR: 12.5-17.7), equivalent to third year of college. Higher reading level (aOR = 1.14, 95% CI 1.04-1.24) and academic hospital status (aOR = 2.83, 95% CI 1.11-7.23) were associated with more subthemes.

Most ICDs addressed recording modality and purpose but inadequately covered safeguards and patient rights. The median reading level significantly exceeded the recommended sixth- to eighth-grade standard. These findings will help guide ICD development to include often overlooked themes and use accessible language about intraoperative recording.