Informed consent for third molar extraction; a comparison of conventional verbal consent versus video-assisted consent

Abstract

Background: The goal of the informed consent process is to provide patients with the necessary educational information, defend their autonomy, and allow active involvement in treatment planning and decision-making. The informed consent process must not only describe the operation in full, but also provide information on the procedure's rationale, alternative therapies, associated benefits, risks, and complications. However, the process of acquiring informed consent is fraught with issues.

Objective: This research aims to assess if presenting information about third molar extraction via an informative, narrated, animated video changes a patient s perception of the consent process for third molar extraction when compared to conventional verbal/written consent. The outcomes that are evaluated include patient understanding, patient satisfaction and patient anxiety.

Methods: In this posttest-only control clinical trial patients scheduled for surgical removal of an impacted mandibular third molar that fulfilled the predetermined criteria were invited to participate in the study. The criterion variable was the presentation of an animated information consent video. Participants were randomly assigned into 2 equal groups receiving either verbal consent or video-assisted consent. After signing the consent form patients then filled out an electronic questionnaire rating their experience of the consent process. At the postoperative review, 7-14 days after the procedure, patients were asked to fill out a questionnaire rating their experience of the consent retrospectively. The outcome variables were patients self-reported level of understanding, patient anxiety measured on the Dental Anxiety Scale and patient satisfaction. The data were analysed with Pearson s chi-squared tests, Fisher s Exact test, and linear regression analysis.

Results: Ninety patients fulfilled the inclusion criteria and were included in the study. The video-assisted group reported higher levels of understanding of the proposed procedure (P<0.001) and the associated risks/complications (P < 0.004 ). Patients were more satisfied with information delivered to them via video. 98% of patients in the video consent group felt that the video-assisted consent was beneficial. There was no statistically significant change in the reported level of anxiety when video-assisted consent was used.

Conclusion: The present study suggests that video-assisted consent may improve patients level of understanding of the potential postoperative risks and complications involved in surgical removal of an impacted mandibular third molar. This improved understanding did not increase patients dental anxiety compared with conventional verbal/written consent but improved patients level of satisfaction with the amount of information that they received.