Amir A Mbonde, Ali A Alsarah, Bart M Demaerschalk, Adam A Dmytriw, Quentin J Moyer, Joshua A Hirsch, Aneesh B Singhal, Thabele M Leslie-Mazwi, Natalia S Rost, Aman B Patel, Michael J Young, Robert W Regenhardt
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引用次数: 0
Abstract
Background and purpose: 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.
Methods: 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.
Results: 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%, P = 0.016) and staff physicians (76% vs 54%, P = 0.008), while US institutions more often utilized neurosurgeons (51% vs 18%, P < 0.001), APPs (43% vs 18%, P = 0.002) and residents (56% vs 28%, P = 0.001). Non-academic institutions used EM (25% vs 5%, P < 0.001) and APPs (50% vs 31%, P = 0.031), while academic institutions commonly utilized neurosurgeons (48% vs 18%, P = 0.001), residents (59% vs 13%, P < 0.001) and fellows (52% vs 18%, P < 0.001).
Conclusion: 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.
背景和目的：急性脑卒中患者血管内血栓切除术（EVT）的知情同意（IC）实践尚未得到很好的阐明。我们研究了获得EVT IC的人员的角色和特点，旨在为改进这一过程提供见解。方法：对2023年7月- 12月急性脑卒中临床医生进行调查。利用qualics，我们通过各种国内和国际在线平台分发了一份问卷。本分析总结了在被调查者所在机构获得IC的个人特征。结果：在168名受访者中，71%是员工医生，70%在美国执业，70%在学术中心工作。获得EVT IC的最常见专业是神经病学（77%），其次是神经外科（41%）、放射学（30%）和急诊医学（10%）。工作人员医生最常参与（61%），其次是研究员（43%），住院医生（48%）和高级执业医师（app）（36%）。相比之下，非美国机构更有可能单独使用神经科医生（50%对31%，P = 0.016）和主治医生（76%对54%，P = 0.008），而美国机构更经常使用神经外科医生（51%对18%，P < 0.001）， app（43%对18%，P = 0.002）和住院医生（56%对28%，P = 0.001）。非学术机构使用EM （25% vs 5%, P < 0.001）和APPs (50% vs 31%, P = 0.031)，而学术机构通常使用神经外科医生（48% vs 18%, P = 0.001），住院医生（59% vs 13%, P < 0.001）和研究员（52% vs 18%, P < 0.001）。结论：神经科医师和主治医师是获得EVT IC的主要提供者，根据地区和机构类型存在差异。未来优化集成电路工艺的努力应该整合各种专业并具有广泛的适应性。
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