Informed consent through 3D virtual reality: a randomized clinical trial.


Journal

Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000

Informations de publication

Date de publication:
02 2021
Historique:
received: 29 01 2020
accepted: 19 03 2020
pubmed: 4 4 2020
medline: 9 7 2021
entrez: 4 4 2020
Statut: ppublish

Résumé

The informed consent is a defining moment that should allow patients to understand their condition, what procedure they are undergoing, and what consequences may follow. This process should foster trust and promote confidence, without increasing patients' anxiety. New immersive 3D imaging technologies may serve as a tool to facilitate this endeavor. In a prospective, single-center, randomized controlled clinical trial (SPLICE Study: Surgical Planning and Informed Consent Study; ClinicalTrials.gov NCT03503487), 40 patients undergoing surgery for intracranial tumors were enrolled. After undergoing a traditional surgical informed consent acquisition, 33 patients were randomized 1:1:1 to 3 groups: in 2 experimental groups, patients underwent a 3D, immersive informed consent with two different surgical planners (group 1 and group 2); in the control group, patients underwent an informed consent supported by traditional 2D radiological images. Patients in the experimental groups appreciated this communication experience, while their objective comprehension was higher ((score mean (SD)): group 1 82.65 (6.83); group 2 77.76 (10.19)), as compared with the control group (57.70 (12.49); P < 0.001). Subjective comprehension and anxiety levels did not differ between experimental groups and control group. 3D virtual reality can help surgeons and patients in building a better relationship before surgery; immersive 3D-supported informed consent improves patients' comprehension of their condition without increasing anxiety. This new paradigm may foster trust between surgeons and patients, possibly restraining medical-legal acts. ClinicalTrials.gov NCT03503487.

Sections du résumé

BACKGROUND
The informed consent is a defining moment that should allow patients to understand their condition, what procedure they are undergoing, and what consequences may follow. This process should foster trust and promote confidence, without increasing patients' anxiety. New immersive 3D imaging technologies may serve as a tool to facilitate this endeavor.
METHODS
In a prospective, single-center, randomized controlled clinical trial (SPLICE Study: Surgical Planning and Informed Consent Study; ClinicalTrials.gov NCT03503487), 40 patients undergoing surgery for intracranial tumors were enrolled. After undergoing a traditional surgical informed consent acquisition, 33 patients were randomized 1:1:1 to 3 groups: in 2 experimental groups, patients underwent a 3D, immersive informed consent with two different surgical planners (group 1 and group 2); in the control group, patients underwent an informed consent supported by traditional 2D radiological images.
RESULTS
Patients in the experimental groups appreciated this communication experience, while their objective comprehension was higher ((score mean (SD)): group 1 82.65 (6.83); group 2 77.76 (10.19)), as compared with the control group (57.70 (12.49); P < 0.001). Subjective comprehension and anxiety levels did not differ between experimental groups and control group.
CONCLUSIONS
3D virtual reality can help surgeons and patients in building a better relationship before surgery; immersive 3D-supported informed consent improves patients' comprehension of their condition without increasing anxiety. This new paradigm may foster trust between surgeons and patients, possibly restraining medical-legal acts.
TRAIL REGISTRATION
ClinicalTrials.gov NCT03503487.

Identifiants

pubmed: 32242272
doi: 10.1007/s00701-020-04303-y
pii: 10.1007/s00701-020-04303-y
doi:

Banques de données

ClinicalTrials.gov
['NCT03503487']

Types de publication

Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

301-308

Références

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Auteurs

Alessandro Perin (A)

Neurosurgery Department, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta", Milan, Italy. aperin@gmail.com.
Besta NeuroSim Center, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta", Milan, Italy. aperin@gmail.com.
Department of Life Sciences, University of Trieste, Trieste, Italy. aperin@gmail.com.

Tommaso Francesco Galbiati (TF)

Neurosurgery Department, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta", Milan, Italy.
Besta NeuroSim Center, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta", Milan, Italy.

Roberta Ayadi (R)

Neurosurgery Department, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta", Milan, Italy.
Besta NeuroSim Center, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta", Milan, Italy.

Enrico Gambatesa (E)

Neurosurgery Department, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta", Milan, Italy.
Besta NeuroSim Center, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta", Milan, Italy.

Eleonora Francesca Orena (EF)

Neurosurgery Department, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta", Milan, Italy.
Besta NeuroSim Center, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta", Milan, Italy.

Nicole Irene Riker (NI)

Neurosurgery Department, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta", Milan, Italy.
Besta NeuroSim Center, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta", Milan, Italy.

Hagit Silberberg (H)

Besta NeuroSim Center, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta", Milan, Italy.

Donatella Sgubin (D)

Neurosurgery Department, Ospedale SS. Antonio e Biagio e C. Arrigo, Alessandria, Italy.

Torstein Ragnar Meling (TR)

Besta NeuroSim Center, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta", Milan, Italy.
Department of Neurological Surgery, Hôpitaux Universitaires de Genève HUG, Geneva, Switzerland.

Francesco DiMeco (F)

Neurosurgery Department, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta", Milan, Italy.
Besta NeuroSim Center, Fondazione IRCCS Istituto Neurologico Nazionale "C. Besta", Milan, Italy.
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.
Department of Neurological Surgery, Johns Hopkins Medical School, Baltimore, MD, USA.

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