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ASSESSING SURGEONS’ DISCLOSURE OF RISK INFORMATION BEFORE CAROTID ENDARTERECTOMY
Author(s) -
Middleton Sandy,
Gattellari Melina,
Harris John P,
Ward Jeanette E
Publication year - 2006
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2006.03788.x
Subject(s) - medicine , carotid endarterectomy , stroke (engine) , recall , receipt , risk assessment , surgery , general surgery , physical therapy , carotid arteries , mechanical engineering , linguistics , philosophy , computer security , world wide web , computer science , engineering
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.