Mbonde Amir A, Alsarah Ali A, Demaerschalk Bart M, Dmytriw Adam A, Moyer Quentin J, Hirsch Joshua A, Singhal Aneesh B, Leslie-Mazwi Thabele M, Rost Natalia S, Patel Aman B, Young Michael J, Regenhardt Robert W
Department of Neurology, Medical College of Georgia, Augusta University, GA, USA.
Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Neurohospitalist. 2025 Sep 6:19418744251377576. doi: 10.1177/19418744251377576.
Informed consent (IC) practices for endovascular thrombectomy (EVT) in acute stroke are not well elucidated. We investigated the roles and specialties of those obtaining EVT IC, aiming to provide insights for enhancing the process.
We conducted a survey from July- December 2023 among acute stroke care clinicians. Utilizing Qualtrics, we disseminated a questionnaire through various national and international online platforms. This analysis summarizes the characteristics of individuals who obtain IC at respondents' institution.
Among 168 respondents, 71% were staff physicians, 70% practiced in the US and 70% worked at academic centers. Neurology (77%) was the most common specialty obtaining EVT IC, followed by neurosurgery (41%), radiology (30%) and emergency medicine (EM) (10%). Staff physicians were the most frequently involved (61%), followed by fellows (43%), residents (48%) and advanced practice providers (APPs) (36%). Comparatvely, non-US institutions were more likely to utilize neurologists alone (50% vs 31%, = 0.016) and staff physicians (76% vs 54%, = 0.008), while US institutions more often utilized neurosurgeons (51% vs 18%, < 0.001), APPs (43% vs 18%, = 0.002) and residents (56% vs 28%, = 0.001). Non-academic institutions used EM (25% vs 5%, < 0.001) and APPs (50% vs 31%, = 0.031), while academic institutions commonly utilized neurosurgeons (48% vs 18%, = 0.001), residents (59% vs 13%, < 0.001) and fellows (52% vs 18%, < 0.001).
Neurologists and staff physicians are the primary providers obtaining EVT IC, with variations based on region and institution type. Future efforts to optimize the IC process should integrate various specialties and be widely adaptable.
急性卒中血管内血栓切除术（EVT）的知情同意（IC）实践尚未得到充分阐明。我们调查了获取EVT知情同意的人员的角色和专业，旨在为改进这一过程提供见解。
我们在2023年7月至12月期间对急性卒中护理临床医生进行了一项调查。利用Qualtrics，我们通过各种国内和国际在线平台分发了一份问卷。本分析总结了在受访者所在机构获取知情同意的人员的特征。
在168名受访者中，71%是主治医师，70%在美国执业，70%在学术中心工作。神经病学（77%）是获取EVT知情同意最常见的专业，其次是神经外科（41%）、放射科（30%）和急诊医学（EM）（10%）。主治医师参与得最为频繁（61%），其次是研究员（43%）、住院医师（48%）和高级实践提供者（APPs）（36%）。相比之下，非美国机构更有可能仅由神经科医生（50%对31%，P = 0.016）和主治医师（76%对54%，P = 0.008）进行，而美国机构更常使用神经外科医生（51%对18%，P < 0.001）、APPs（43%对18%，P = 0.002）和住院医师（56%对28%，P = 0.001）。非学术机构使用急诊医学（25%对5%，P < 0.001）和APPs（50%对31%，P = 0.031），而学术机构通常使用神经外科医生（48%对18%，P = 0.001）、住院医师（59%对13%，P < 0.001）和研究员（52%对18%，P < 0.001）。
神经科医生和主治医师是获取EVT知情同意的主要人员，因地区和机构类型而异。未来优化知情同意过程的努力应整合各个专业并具有广泛的适应性。
