Digitized and structured informed patient consent before contrast-enhanced computed tomography: feasibility and benefits in clinical routine.
Electronic medical records
Greenhouse gases
Helical computed tomography
Informed consent document
Personalized medicine
Journal
Insights into imaging
ISSN: 1869-4101
Titre abrégé: Insights Imaging
Pays: Germany
ID NLM: 101532453
Informations de publication
Date de publication:
11 Oct 2022
11 Oct 2022
Historique:
received:
04
08
2022
accepted:
24
09
2022
entrez:
11
10
2022
pubmed:
12
10
2022
medline:
12
10
2022
Statut:
epublish
Résumé
To evaluate the feasibility and benefits of digitized informed patient consent (D-IPC) for contrast-enhanced CT and compare digitized documentation with paper-based, conventional patient records (C-PR). We offered D-IPC to 2016 patients scheduled for a CT. We assessed patient history (e.g., CT examinations, malignant or cardiovascular diseases) and contraindications (red flags) for a CT (e.g., thyroid hyperfunction, allergies) using a tablet device. We evaluated the success rate of D-IPC and compared patient age between the subgroups of patients who were able or unable to complete D-IPC. We analyzed the prevalence of marked questions and red flags (RF). RF were compared with the documentation from C-PR. We estimated greenhouse gas (GHG) emissions for paperless workflow and provide a cost-benefit analysis. Overall, 84.4% of patients completed D-IPC. They were younger (median 61 years) than unsuccessful patients (65 years; p < 0.001). Patients who marked questions (21.7%) were older than patients without inquiries (median 63.9 vs 59.5 years; p < 0.001). The most prevalent RF was thyroid disease (23.8%). RF were considered critical for contrast-agent injection in 13.7%, requiring personalized preparation. The detection rate for RF documented with D-IPC was higher than for C-PR (n = 385 vs. 43). GHG emissions for tablet production are 80-90 times higher than for paper production. The estimated costs were slightly higher for D-IPC (+ 8.7%). D-IPC is feasible, but patient age is a relevant factor. Marked questions and RF help personalize IPC. The availability of patient history by D-IPC was superior compared to C-PR.
Sections du résumé
BACKGROUND
BACKGROUND
To evaluate the feasibility and benefits of digitized informed patient consent (D-IPC) for contrast-enhanced CT and compare digitized documentation with paper-based, conventional patient records (C-PR).
METHODS
METHODS
We offered D-IPC to 2016 patients scheduled for a CT. We assessed patient history (e.g., CT examinations, malignant or cardiovascular diseases) and contraindications (red flags) for a CT (e.g., thyroid hyperfunction, allergies) using a tablet device. We evaluated the success rate of D-IPC and compared patient age between the subgroups of patients who were able or unable to complete D-IPC. We analyzed the prevalence of marked questions and red flags (RF). RF were compared with the documentation from C-PR. We estimated greenhouse gas (GHG) emissions for paperless workflow and provide a cost-benefit analysis.
RESULTS
RESULTS
Overall, 84.4% of patients completed D-IPC. They were younger (median 61 years) than unsuccessful patients (65 years; p < 0.001). Patients who marked questions (21.7%) were older than patients without inquiries (median 63.9 vs 59.5 years; p < 0.001). The most prevalent RF was thyroid disease (23.8%). RF were considered critical for contrast-agent injection in 13.7%, requiring personalized preparation. The detection rate for RF documented with D-IPC was higher than for C-PR (n = 385 vs. 43). GHG emissions for tablet production are 80-90 times higher than for paper production. The estimated costs were slightly higher for D-IPC (+ 8.7%).
CONCLUSION
CONCLUSIONS
D-IPC is feasible, but patient age is a relevant factor. Marked questions and RF help personalize IPC. The availability of patient history by D-IPC was superior compared to C-PR.
Identifiants
pubmed: 36219277
doi: 10.1186/s13244-022-01304-6
pii: 10.1186/s13244-022-01304-6
pmc: PMC9554108
doi:
Types de publication
Journal Article
Langues
eng
Pagination
164Subventions
Organisme : Bundesministerium für Wirtschaft und Energie
ID : (iQCT
Organisme : Bundesministerium für Wirtschaft und Energie
ID : MED-1810-0020
Informations de copyright
© 2022. The Author(s).
Références
Eur Radiol. 2018 Jul;28(7):2856-2869
pubmed: 29417249
Eur Radiol. 2018 Jul;28(7):2845-2855
pubmed: 29426991
Conn Med. 1988 Feb;52(2):87-91
pubmed: 3278846
J Med Syst. 2021 Jan 28;45(3):30
pubmed: 33511485
J Digit Imaging. 2014 Aug;27(4):479-85
pubmed: 24687643
Int J Med Inform. 2007 Apr;76(4):283-8
pubmed: 16473548
Am J Health Syst Pharm. 2019 Feb 09;76(5):293-300
pubmed: 30753287
Radiology. 1992 Jul;184(1):145-8
pubmed: 1609071
J Digit Imaging. 2013 Jun;26(3):383-92
pubmed: 23250720
AJR Am J Roentgenol. 1987 Jan;148(1):219-27
pubmed: 3538833
Radiologe. 2020 Feb;60(2):162-168
pubmed: 31858158
AJR Am J Roentgenol. 2011 Aug;197(2):W359
pubmed: 21785067
J Gen Intern Med. 2008 Apr;23(4):476-80
pubmed: 18373148
JMIR Form Res. 2021 Oct 19;5(10):e20458
pubmed: 34665142