Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
Cluster of Excellence: "Matters of Activity. Image Space Material", Humboldt-Universität Zu Berlin, 10099, Berlin, Germany.
Acta Neurochir (Wien). 2023 Apr;165(4):1087-1098. doi: 10.1007/s00701-023-05512-x. Epub 2023 Feb 28.
Informed consent of the patient prior to surgical procedures is obligatory. A good and informative communication improves patients' understanding and confidence, thus may strengthen the patient-doctor relationship. The aim of our study was to investigate the usefulness of additional stereoscopic visualization of patient-specific imaging during informed consent conversation.
Patients scheduled for a brain tumor surgery were screened for this study prospectively. The primary exclusion criteria were cognitive or visual impairments. The participants were randomized into two groups. The first group underwent a conventional surgical informed consent performed by a neurosurgeon including a demonstration of the individual MRI on a 2D computer screen. The second group received an additional stereoscopic visualization of the same imaging to explain the pathology more in-depth. The patients were then asked to fill in a questionnaire after each part. This questionnaire was designed to assess the potential information gained from the patients with details on the anatomical location of the tumor as well as the surgical procedure and possible complications. Patients' subjective impression about the informed consent was assessed using a 5-point Likert scale.
A total of 27 patients were included in this study. After additional stereoscopic visualization, no significant increase in patient understanding was found for either objective criteria or subjective assessment. Participants' anxiety was not increased by stereoscopic visualization. Overall, patients perceived stereoscopic imaging as helpful from a subjective perspective. Confidence in the department was high in both groups.
Stereoscopic visualization of MRI images within informed consent conversation did not improve the objective understanding of the patients in our series. Although no objective anatomical knowledge gain was noted in this series, patients felt that the addition of stereoscopic visualization improved their overall understanding. It therefore potentially increases patient confidence in treatment decisions.
在进行手术前，患者的知情同意是强制性的。良好且信息丰富的沟通可以提高患者的理解和信心，从而可能加强医患关系。我们的研究目的是调查在知情同意谈话中额外使用患者特定成像的立体可视化来提高信息传递效果。
前瞻性地对计划接受脑肿瘤手术的患者进行了这项研究的筛选。主要排除标准是认知或视觉障碍。参与者被随机分为两组。第一组接受了由神经外科医生进行的常规手术知情同意，包括在 2D 计算机屏幕上演示个体 MRI。第二组则接受了相同成像的额外立体可视化，以更深入地解释病理学。然后，患者在每个部分结束后填写一份问卷。该问卷旨在评估患者从立体可视化中获得的潜在信息，包括肿瘤的解剖位置、手术过程和可能的并发症等详细信息。使用 5 分李克特量表评估患者对知情同意的主观印象。
本研究共纳入 27 例患者。在进行额外的立体可视化后，无论是客观标准还是主观评估，都没有发现患者的理解有显著增加。立体可视化并没有增加患者的焦虑。总体而言，患者从主观角度认为立体成像具有帮助。两组患者对科室的信心都很高。
在知情同意谈话中，立体可视化 MRI 图像并未改善我们系列中患者的客观理解。尽管本系列中没有注意到客观的解剖知识增益，但患者认为增加立体可视化增强了他们的整体理解。因此，它可能会增加患者对治疗决策的信心。
