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心脏成像中的视频辅助知情同意:对CT检查期间患者体验的影响——随机对照VAICICI试验

Video-assisted informed consent in cardiac imaging: influence on patient experience during CT-the randomized controlled VAICICI Trial.

作者信息

Gohmann Robin F, Mettke Sophia M, Krieghoff Christian, Lücke Christian, Kaiser Fyn, Seitz Patrick, Desch Steffen, Steglich Jonas, Bäuerle Alexander, Schaarschmidt Benedikt, Thiele Holger, Strotdrees Elfriede, Buske Maria, Borger Michael A, Abdel-Wahab Mohamed, Horn Matthias, Gutberlet Matthias

机构信息

Department of Diagnostic and Interventional Radiology, Heart Center Leipzig, Leipzig, Germany.

Medical Faculty, University of Leipzig, Leipzig, Germany.

出版信息

Eur Radiol. 2025 Jun 27. doi: 10.1007/s00330-025-11741-8.

Abstract

OBJECTIVE

Patient compliance and comfort during cardiac computed tomography (CT) are crucial for optimal imaging outcomes. Insufficient understanding or heightened anxiety can negatively impact patient experience and potentially image quality. This study evaluates the effectiveness of video-assisted informed consent in cardiac imaging (VAICICI) in improving patient satisfaction, preparedness, and anxiety during cardiac CT.

MATERIALS AND METHODS

In this randomized controlled trial, 205 patients scheduled for cardiac CT were assigned to Video I (n = 67), Video II (n = 69), or Control (n = 69). Video I featured an instructional video incorporating visuals, narration, and subtitles. Video II included audio and subtitles only. All groups received a standard physician consultation. Experiences were assessed before and after cardiac CT using patient-reported outcome measures. Statistical analyses included group comparisons and multivariate analysis of anamnestic and demographic factors.

RESULTS

Video I and II significantly improved patient satisfaction and understanding compared to the Control (p < 0.05). Patients with Video II placed more importance on the informed consent form for understanding than the Control (p = 0.02). Satisfaction was higher in both video groups (p = 0.02), with no significant difference between them. Anxiety and nervousness levels were low and similar across groups, but notably higher among women (p = 0.008) and patients with suspected coronary artery disease (p = 0.04). Age, prior CT/MRI, and eight other baseline demographics partially predicted responses.

CONCLUSION

VAICICI improves patient satisfaction and understanding of the cardiac CT examination, with only slight variations in effectiveness across demographics, suggesting it is a valuable addition to the informed consent process. No reduction in anxiety was observed.

KEY POINTS

Question Can video-assisted informed consent improve patients' understanding and reduce anxiety associated with cardiac CT examinations? Findings Video-assisted informed consent improves patient satisfaction and understanding of the cardiac CT examination, with both video formats significantly outperforming the standard consent. Clinical relevance Video-assisted informed consent improves patient satisfaction and understanding of cardiac CT, with only slight variation in effectiveness across baseline demographics, suggesting it to be of value in the consent process and promoting patient-centered imaging practices.

摘要

目的

心脏计算机断层扫描(CT)检查期间患者的依从性和舒适度对于获得最佳成像结果至关重要。理解不足或焦虑加剧会对患者体验以及潜在的图像质量产生负面影响。本研究评估心脏成像视频辅助知情同意(VAICICI)在提高心脏CT检查期间患者满意度、准备程度和焦虑方面的有效性。

材料与方法

在这项随机对照试验中,205名计划进行心脏CT检查的患者被分配到视频I组(n = 67)、视频II组(n = 69)或对照组(n = 69)。视频I包含一个带有视觉效果、旁白和字幕的教学视频。视频II仅包含音频和字幕。所有组均接受标准的医生咨询。使用患者报告的结局指标在心脏CT检查前后评估患者体验。统计分析包括组间比较以及对既往史和人口统计学因素的多变量分析。

结果

与对照组相比,视频I组和视频II组显著提高了患者满意度和理解程度(p < 0.05)。视频II组患者比对照组更重视知情同意书对于理解的作用(p = 0.02)。两个视频组的满意度均更高(p = 0.02),两组之间无显著差异。各组的焦虑和紧张程度较低且相似,但女性(p = 0.008)和疑似冠状动脉疾病患者(p = 0.04)的焦虑和紧张程度明显更高。年龄、既往CT/MRI检查以及其他八项基线人口统计学因素部分预测了患者的反应。

结论

VAICICI提高了患者对心脏CT检查的满意度和理解程度,不同人口统计学特征的有效性仅有轻微差异,表明它是知情同意过程中的一项有价值的补充。未观察到焦虑程度降低。

关键点

问题 视频辅助知情同意能否提高患者对心脏CT检查的理解并减轻相关焦虑? 研究结果 视频辅助知情同意提高了患者对心脏CT检查的满意度和理解程度,两种视频形式均显著优于标准同意方式。 临床意义 视频辅助知情同意提高了患者对心脏CT的满意度和理解程度,不同基线人口统计学特征的有效性仅有轻微差异,表明其在同意过程以及促进以患者为中心的成像实践中具有价值。

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