Telemedicine: Can In-Person Pre-treatment Communication be Expanded by Video Consultation?
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To the Editor,
Informed consent for radiological or other interventions should give a patient sufficient time to make an informed decision. Currently, patients typically have to be present, in-person, to be briefed about procedures and an extra appointment is often necessary. While in an urban setting this is mostly just a nuisance, in a rural area, similar to ours, it may not be possible at all for patients with limited access to transport. In some countries, teleconsultation via videoconference has proved beneficial in comparable situations .
Patients who received the pre-treatment briefing by videoconference remembered significantly more (Mann–Whitney U test: U = 210.000, p = 0.038, r = 0.2932) of the mentioned side effects compared to patients who received the pre-treatment briefing in-person (Fig. 1). Further, the recall of radiation exposure was significantly higher when communicated in a videoconference (χ2(1) = 3.947, p = 0.047, n = 50, φ = − 0.281, Fig. 2). For patient satisfaction with pre-treatment communication and the other variables related to knowledge acquisition, no significant differences emerged.
Preoperative discussion by videoconferencing was equal to, or better than, face-to-face discussion. We assume that patients easily focus on a monitor, and distraction is thus reduced . While there may be extra costs to cover the equipment, the process of informing patients about procedure may actually be facilitated (less logistical effort, patients may be given a specific time window for the call). Briefings via videoconference could be saved, with additional viewings made available to patients. Additional information material may also be provided easily.
In our opinion, it is worthwhile to evaluate “informed consent to treatment in low population density areas by teleconsultation” in larger studies. A higher number of participants are necessary as effect sizes were small; more realistic scenarios with clinic to home videoconferencing should be employed; improving the process of blinding of study nurses, if possible, as patients tended to mention the videoconference in interviews; legal aspects (saving the interviews digitally; use of electronic devices for getting informed consent in one study group) must be clarified beforehand, and endpoints of studies should be chosen in a way that validated questionnaires can be used.
This study was funded by Grant INT-08-0001 of INTERREG IV A of the European Union.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
Consent for Publication
For this type of study, consent for publication is not required.
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