Department of Dermatology, New York University School of Medicine, New York, New York.
Georgia Regents University Medical College of Georgia, Augusta, Georgia.
J Am Acad Dermatol. 2016 Mar;74(3):477-83.e7. doi: 10.1016/j.jaad.2015.10.014. Epub 2016 Jan 14.
Several treatment options exist for uncomplicated basal cell carcinoma. Standardized and effective informed consent is difficult in busy dermatology clinics.
We investigated whether an educational video depicting 3 treatment options for uncomplicated basal cell carcinoma-excision, electrodessication and curettage, and topical therapy-before standard in-office informed consent affected patient knowledge and consent time compared with standard in-office consent alone.
Patients were randomized to receive video education plus verbal discussion (video) or standard verbal discussion alone (control). Both groups completed baseline and final knowledge assessments. The primary outcome measure was change in knowledge scores between groups. Secondary outcomes were patient satisfaction, physician satisfaction, and informed consent time.
In all, 32 eligible patients (16 control, 16 video) from an academic institution and affiliate Department of Veterans Affairs Medical Center dermatology clinics participated. The video group had significantly greater gains in knowledge compared with the control group (mean ± SD: 9 ± 3.6 vs 2.9 ± 2.2) (P = .0048). There was no significant difference in total consent time between groups. Patients and physicians were highly satisfied with the video.
Small sample size and slight methodological difference between recruitment sites are limitations.
Video-based education for basal cell carcinoma improved patient knowledge with no additional physician time when compared with standard communication.
对于非复杂性基底细胞癌，存在几种治疗选择。在繁忙的皮肤科诊所中，很难实现标准化且有效的知情同意。
我们研究了在标准门诊知情同意前展示 3 种非复杂性基底细胞癌治疗选择（切除、电干燥和刮除术以及局部治疗）的教育视频是否会影响患者的知识水平和同意时间，与仅接受标准门诊知情同意相比。
将患者随机分为接受视频教育加口头讨论（视频组）或仅接受标准口头讨论（对照组）。两组均完成基线和最终知识评估。主要观察指标为组间知识评分的变化。次要结局指标为患者满意度、医生满意度和知情同意时间。
共有来自学术机构和附属退伍军人事务部医疗中心皮肤科诊所的 32 名合格患者（对照组 16 名，视频组 16 名）参与了研究。与对照组相比，视频组的知识水平显著提高（平均 ± 标准差：9 ± 3.6 对 2.9 ± 2.2）（P =.0048）。两组的总同意时间无显著差异。患者和医生对视频非常满意。
样本量小和招募地点之间的方法学差异是限制因素。
与标准沟通相比，基底细胞癌的基于视频的教育可提高患者的知识水平，且不会增加医生的时间。
