Consent Practices Research Articles

Dental outpatient departments and patient safety: Priority for a safe care

Patient safety is an essential aspect of healthcare, including dentistry. Dental Outpatient Departments (OPDs) pose unique challenges, where the risk of infections, procedural errors, and patient discomfort can compromise safety. This review examines patient safety issues in dental OPDs, focusing on common hazards, preventive measures, and evolving strategies to ensure safer care. Infection control, medical emergencies, equipment sterilization, and patient data protection are key concerns. The complex interplay of patient management, dental procedures, and clinician awareness requires robust protocols to mitigate risks. Dental professionals must be vigilant in managing cross-contamination risks, such as through the use of personal protective equipment (PPE) and strict hand hygiene practices. Moreover, regular staff training in handling medical emergencies, such as allergic reactions or fainting, is crucial for effective management.This article also explores the role of technological advancements in enhancing patient safety, such as digital record-keeping, which minimizes documentation errors, and advanced diagnostic tools that reduce invasive procedures. Additionally, patient-centered approaches, including improved communication and informed consent practices, foster trust and reduce misunderstandings. The implementation of evidence-based guidelines and adherence to professional standards further contribute to a culture of safety. By synthesizing current research, this review aims to highlight best practices for improving patient safety in dental OPDs and underscores the importance of continuous monitoring and improvement in these settings. Addressing these safety concerns is critical not only to improve patient outcomes but also to ensure that dental OPDs remain a safe and trusted environment for all.

Knowledge, Attitude, and Practices of Dentists in Maharashtra Regarding Sharing Patients’ Data on Social Media: A Questionnaire-Based Study

Background: Social media has become an integral part of dental practice, offering opportunities for professional interaction and patient engagement. However, it raises significant ethical concerns, particularly regarding patient confidentiality. Objective: To gauge the knowledge, attitude, and practice of dental professionals in Maharashtra regarding the sharing of patient data on Social media, and to assess the ethical considerations associated with this practice. Methods: A cross-sectional study was conducted among dental professionals in Maharashtra from October to December 2023. Participants were recruited from six dental institutions and various private clinics. A self-structured questionnaire was validated and distributed via Google Forms. Data were analyzed using MedCalc Statistical Software, with demographic characteristics and response frequencies summarized in tables and graphs. Results: Of the 312 participants, 265 completed the survey (response rate: 84.94%). WhatsApp (88.3%) was the most preferred platform, followed by Facebook (54.34%) and Instagram (54.34%). The majority rarely shared patient data on SM. Marketing (63.4%), showcasing treatment results (46.79%), and educating colleagues (46.79%) were primary motivations. While 56.98% agreed that sharing patient data infringes privacy, only 46.04% consistently obtained patient consent. A significant portion (92%) supported establishing guidelines for social media usage. Conclusion: Dental professionals in Maharashtra frequently use SM for professional purposes, with WhatsApp being the most popular platform. Despite recognizing privacy concerns, there is a lack of consistent patient consent practices. The findings highlight the need for clear guidelines to balance the benefits of social media with ethical obligations to patient confidentiality and professional conduct.

ThP1.11 - Harnessing digital consent analytics to highlight multicentre operative and consent trends in breast surgery

Abstract Introduction Paper-based consent is difficult to audit at scale, therefore hospital episode statistics data is used to provide insights into national breast surgical practice. However, as digital consent is becoming routine, analysis of amalgamated data is possible to provide a better understanding of consent practice. Methods Between 22/04/2020-29/11/23, patient anonymised digital consent data was analysed retrospectively using Concentric Health analytics (Audit ID:1123ABS). Inclusion criteria required the responsible clinician to be a breast surgeon, with non-breast surgical procedures excluded. Results n=6860 digital consent episodes were performed across 10 NHS Trusts and 4 private institutions (n=890 unique operations. n=82 unique responsible clinicians, n=191 consenting clinicians). 45.6% (n=3125/6860) of the cases were consented by consultants. 18.7% (n=1286/6860) underwent a mastectomy; 78.5% simple & 21.5% reconstruction (of which 82.6% implant and 17.4% autologous reconstruction). 40.1% (n=2750/6860) underwent breast conserving surgery (79.2% WLE, 18.9% therapeutic mammoplasty, 1.9% Intercostal perforator). Re-excision of margins accounted for 16% of BCS cases (n=441/2750). SLNB was performed in 40.6% and ANC in 11.5% of all breast surgery cases. Regarding localisation; 44.5% Seed, 30.6% Wire, 21.7% palpable/other, 3.2% USS skin mark. Conclusion As well as providing benefits in terms of information sharing and improved patient satisfaction, digital consent also provides an opportunity to provide high-level data, regarding which operations are being consented to, when and by whom.

Practices of Informed Written Consent for Elective Urological Procedures at a Tertiary Care Hospital in Sudan.

Objective This study aimed to assess informed consent practices in elective urological surgeries at a tertiary care facility. Materials and methods A retrospective cross-sectional survey was carried out between March 1, 2023and April 1, 2023, at the Department of Urology, Omdurman Military Hospital, Sudan. We included all patients who had undergone elective urological procedures under local, spinal, or general anesthesia. The medical records were accessed to analyze the consent forms' standards. A total of 42 consent forms were included and analyzed. We use the General Medical Council's (GMC) Guidance on Professional Standards and Ethics for Doctors: Decision Making and Consent, and the Royal College of Surgeons (RCS) of England's Consent: Supported Decision-Makingas the standard for our study. The GMC and the RCS of England have provided comprehensive and standardized guidelines for obtaining informed written consent, including indications, benefits, risks involved, and alternatives in addition to demographics, patient details, responsible consultant, diagnosis, and title of the surgery, intended benefits, probable risks, type of anesthesia, consenting doctor's name, designation, and signature, and the patient's signature and name. Results A total of 42 consent forms were included. The diagnosis and the intended surgical procedure were mentioned in all consents. The potential benefits and risks were discussed in 36 (85.7%) and 18 (42.9%) cases, respectively. The type of anesthesia was discussed in 39 (92.9%) of cases. The likely result of not having the procedure and the alternative treatment: Recorded completion rates of 10 (23.8%) and 12 (28.6%), respectively. Patient demographics were completely documented in 41 (97.6%) forms. Senior doctors were only involved in 14 (33.3%) of the consents. Details of the consenting doctor, including name, title, and signature, were present in 30 cases (71.4%), and the date of signing the consent was documented in 38 cases (90.5%). The completeness of the consent form correlated with the level of the doctor obtaining it, with consultants achieving the highest completion rates (100%), followed by registrars (66.7%) and medical officers (35.7%). Conclusion The current practices of informed consent were found to be substandard. Handwritten consent forms do not adhere to the recommended guidelines for informed consent in elective urological procedures. It is preferable to utilize a pre-designed consent form, allowing for personalized additions based on the patient's specifics. Our recommendation is to organize an educational session for junior doctors to emphasize proper consent procedures, and deepen their knowledge of common urological elective procedures, and associated risks. This approach promotes adherence to best clinical practices and minimizes the risk of legal challenges.

54798 Informed Consent Practices for Publication of Patient Images in Dermatology Journals

54798 Informed Consent Practices for Publication of Patient Images in Dermatology Journals

Insights into patient awareness and preferences in medical imaging procedures involving ionizing radiation

Abstract Introduction: Advancements in technology have revolutionized the landscape of medical imaging, offering a multitude of modalities. However, this progress is not always fully traceable to patients, necessitating studies in this area to bridge the gap between technological advancements and patients’ insights. This study delves into patient awareness, preferences, and understanding concerning radiation risk in medical imaging procedures using ionizing radiation. Material and methods: An anonymous survey was conducted among 152 patients in Bulgaria who underwent X-ray procedures to gauge their insights into medical imaging. Data analysis utilized SPSS version 20.0, computing frequencies and percentages for categorical variables like gender, age, and education. Results: Significant correlations were found between gender and the need for knowledge related to radiation risks (χ2 = 4.622, p = 0.032), as well as patient understanding of radiation dose information and decision-making preferences (χ2 = 10.800; p = 0.020). Female participants showed higher awareness levels in these areas compared to male participants. Younger patients, notably aged 36-50 (52.6%), comprised a significant portion undergoing X-ray imaging, diverging from global trends. Age correlated with the frequency of X-ray examinations (χ2 = 171.256; p = 0.000) and decision-making preferences (χ2 = 8.324; p = 0.016), with older patients favoring informed decisions with physician input. Education levels significantly influenced radiation risk awareness (χ2 = 7.084, p = 0.008) and understanding of radiation dose information (χ2 = 14.752, p = 0.001). Patients with higher education levels demonstrated a significantly better understanding of absorbed radiation doses compared to those with secondary education. These findings highlight the influence of demographic factors such as gender, age, and education on patient awareness, knowledge acquisition, and decision-making processes regarding medical imaging and radiation risks. Conclusions: Tailored communication strategies, informed consent practices, and ongoing specialist education are crucial to enhancing patient awareness, optimizing decision-making processes, and ensuring radiation safety in medical imaging. Implementation of electronic health records can further improve radiation exposure monitoring, aligning with evolving technological standards and patient needs.

Safe Ketamine Use and Pregnancy: A Nationwide Survey and Retrospective Review of Informed Consent, Counseling, and Testing Practices.

Safe Ketamine Use and Pregnancy: A Nationwide Survey and Retrospective Review of Informed Consent, Counseling, and Testing Practices.

Genomic sequencing in newborn screening: balancing consent with the right of the asymptomatic at-risk child to be found.

In this paper, we explore key aspects of the complex ethical and legal landscape surrounding consent in the context of incorporating genomic sequencing into existing newborn bloodspot screening programs. In particular, we consider the potential impact of genomic sequencing on the health rights of the child in relation to existing consent practices in newborn screening. We begin with an introduction to newborn screening programs and their population health goals. We then discuss public health ethics as a rationale underpinning newborn screening before turning to consent. We go on to describe seven current research projects on genomic sequencing in newborn screening and then introduce the 'right of the asymptomatic at-risk child to be found' as a useful concept to draw on when considering consent to newborn screening. We draw on this novel right to argue for the adoption of "appropriate consent" when it comes to certain uses of genomics in newborn screening. We contend that, for 'virtual panels' at least, appropriate consent proportionately balances the ongoing universality of newborn screening for important health conditions with an acknowledgement of the complex outcomes that bringing a complicated diagnostic technology into the screening domain will generate.

Children’s sensemaking of algorithms and data flows across YouTube and social media

PurposeThis study aims to explore children’s cognitions about data flows online and their understandings of algorithms, often referred to as algorithmic literacy or algorithmic folk theories, in their everyday uses of social media and YouTube. The authors focused on children ages 8 to 11, as these are the ages when most youth acquire their own device and use social media and YouTube, despite platform age requirements.Design/methodology/approachNine focus groups with 34 socioeconomically, racially and ethnically diverse children (8–11 years) were conducted in California. Groups discussed data flows online, digital privacy, algorithms and personalization across platforms.FindingsChildren had several misconceptions about privacy risks, privacy policies, what kinds of data are collected about them online and how algorithms work. Older children had more complex and partially accurate theories about how algorithms determine the content they see online, compared to younger children. All children were using YouTube and/or social media despite age gates and children used few strategies to manage the flow of their personal information online.Practical implicationsThe paper includes implications for digital and algorithmic literacy efforts, improving the design of privacy consent practices and user controls, and regulation for protecting children’s privacy online.Originality/valueResearch has yet to explore what socioeconomically, racially and ethnically diverse children understand about datafication and algorithms online, especially in middle childhood.

Longevity of acrylic and cobalt-chromium removable partial dentures–A ten-year retrospective survival analysis of 1246 denture-wearing patients

Objectivesto assess the survival rates of removable partial dentures (RPDs) and identify factors impacting their longevity. Methodselectronic health records were retrieved of patients aged ≥18 who received RPDs between 2010 – 2021 with a follow-up of ≥ three months. Data extracted included demographics, medical history, dental charting, periodontal screening and recording scores, prostheses details and related interventions, including new dentures/denture remakes, and maintenance. Multivariate Mixed-Effect Cox regression was performed to identify potential RPD survival risk factors. Reduced model selection was reached using a backward step-down by comparing the performance of these multivariable models using the ANOVA test. Results1893 RPDs from 1246 patients were included, with a median follow-up of 21.8 months (range from 3 to 131.3 months). Three hundred and twelve patients received a maxillary RPD, 460 received a mandibular RPD, and the remaining 474 patients received both maxillary and mandibular RPDs. Metal-based RPDs had a median survival of 73 months (95%CI: 70 – 82) versus 45 months (95% CI: 37-67) for acrylic ones. Multivariable mixed effects Cox model showed that the lifespans of RPDs were longer amongst patients receiving more maintenance care within three months [Hazards Ratio (HR)=0.89 (0.83, 0.96)] and after three months [HR=0.53 (0.46, 0.61)] of denture delivery, patients wearing both maxillary and mandibular RPDs [HR=0.67 (0.52, 0.87)], and patients receiving metal-based RPDs [HR=0.31 (0.23, 0.42)]. ConclusionsMetal-based dentures, dual arch restoration, and increased maintenance positively impact the survival of RPDs. Clinical significanceAdapting consent and warranty practices is advised to reflect RPD performance variations.

Protocol for a hybrid effectiveness-implementation clinical trial evaluating video-assisted electronic consent vs standard consent for patients initiating and continuing haemodialysis in Australia (eConsent HD)

IntroductionCommunicating complex information about haemodialysis (HD) and ensuring it is well understood remains a challenge for clinicians. Informed consent is a high-impact checkpoint in augmenting patients’ decision awareness and engagement...

Senior High School Students’ Level of Internet Cookie Responsibility

Students nowadays often turn to the internet for aid in their academic tasks. However, the cookies of which these websites on the internet operate on is something that they are not so knowledgeable about. This study investigated the level of internet cookie responsibility in terms of awareness of cookies, understanding of cookie functionality, knowledge of cookie policy, and consent practices in a university in Ozamiz City, Philippines. The data in this study was obtained through a researcher-made questionnaire where analysis was performed using frequency and percentage, as well as mean and standard deviation. The findings indicate that the students have a proficient level of awareness in terms of cookies. Moreover, their level of understanding of cookie functionality is acceptable as well as their level of knowledge in cookie policy. Furthermore, they maintain an acceptable level of consent practices. Based on these findings, educational institutions are encouraged to integrate knowledge and understanding of cookies and cookie disclaimers into the curriculum. Further research is encouraged especially those concerning the actuality of the students in observing their responsibilities with cookies. In the world today where it is convenient to use technology, students should learn to be responsible with internet cookies and most importantly apply what they have learned.

Commonalities and differences in injured patient experiences of accessing and receiving quality injury care: a qualitative study in three sub-Saharan African countries

ObjectivesTo understand commonalities and differences in injured patient experiences of accessing and receiving quality injury care across three lower-income and middle-income countries.DesignA qualitative interview study. The interviews were audiorecorded, transcribed...

Informed Consent Practices for Hip Fracture Surgeries at a Tertiary Care Hospital in Wad Madani, Sudan.

An essential component of medical ethics and practice is informed consent. The General Medical Council (GMC) and the Royal College of Surgeons of England (RCS) provide guidelines for obtaining valid consent. Failing to obtain sufficient or valid consent can have legal consequences. Over a period of two and a half months, from March 12 to May 28, 2022, a retrospective cross-sectional study was conducted to evaluate consenting practices for neck of femur fracture surgeries. A total of 88 patient consent forms were reviewed. The standard consent forms utilized in this study were those endorsed by the British Orthopaedics Association (BOA) and were based on the guidelines provided by the RCS and the GMC. Resident surgical trainees and medical officers obtained the majority of the consents, 31 (35.22%) and 49 (55.68%), respectively. The most frequently reported risks included infection, blood clots (deep vein thrombosis and pulmonary embolism), bleeding, and wound complications. Neurovascular injury was not mentioned in 75 (85.33%) consent forms. Additionally, hip stiffness, prosthetic dislocation, death, and leg length discrepancy were not discussed with any of the patients. Additionally, we observed that the diagnosis or reason for surgery was mentioned in only 60 (68.18%) consent forms. Furthermore, none of the forms specified the intended benefits, the necessity for a blood transfusion, or the patient identification details. Our study revealed inadequate documentation of surgical risks in patient consent forms for neck of femur fracture surgeries, with orthopaedic-specific risks often overlooked. This issue likely results from insufficient orthopaedic training among the medical officers and junior resident trainees responsible for obtaining consent. We recommend induction teaching sessions to improve their understanding of standard consenting practices and associated risks, along with implementing patient identification stickers.

Research with Refugee Populations in North America: Applying the NIH Guiding Principles for Ethical Research

ABSTRACTThis article examines the ethics of research design and the initiation of a study (e.g., recruitment of participants) involving refugee participants. We aim to equip investigators and members of IRBs with a set of ethical considerations and pragmatic recommendations to address challenges in refugee‐focused research as it is developed and prepared for IRB review. We discuss challenges including how refugees are being defined and identified; their vulnerabilities before, during, and following resettlement that impacts their research participation; recruitment; consent practices including assent and unaccompanied minors; and conflicts of interest. Ethical guidance and regulatory oversight provided by international bodies, federal governments, and IRBs are important for enforcing the protection of participants. We describe the need for additional ethical guidance and awareness, if not special protections for refugee populations as guided by the National Institutes of Health (NIH) Guiding Principles for Ethical Research.

Reviewing past and present consent practices in unplanned obstetric interventions: an eye towards the future

Many first-time mothers (primiparous) within UK National Health Service (NHS) settings require an obstetric intervention to deliver their babies safely. While the antepartum period allows time for conversations about consent...

Clinical trial recruitment of people who speak languages other than English: a Children's Oncology Group report.

Persons who speak languages other than English are underrepresented in clinical trials, likely in part because of inadequate multilevel resources. We conducted a survey of institutions affiliated with the Children's Oncology Group (COG) to characterize current research recruitment practices and resources regarding translation and interpretation services. In October 2022, a 20-item survey was distributed electronically to institutions affiliated with COG to assess consent practices and resources for recruiting participants who speak languages other than English to COG trials. Descriptive statistics were used to summarize responses; responses were compared by institution size and type as well as respondent role. The survey was sent to 230 institutions, and the response rate was 60% (n = 139). In total, 60% (n = 83) of those respondents had access to short-form consent forms. Full consent form translation was required at 50% of institutions, and 12% of institutional review boards restricted use of centrally translated consent forms. Forty-six percent (n = 64) of institutions reported insufficient funding to support translation costs; 19% (n = 26) had access to no-cost translation services. Forty-four percent (n = 61) were required to use in-person interpreters for consent discussions; the most frequently cited barrier (56%) to obtaining consent was lack of available in-person interpreters. Forty-seven percent (n = 65) reported that recruiting persons who speak languages other than English to clinical trials was somewhat or very difficult. Institutions affiliated with COG face resource-specific challenges that impede recruitment of participants who speak languages other than English for clinical trials. These findings indicate an urgent need to identify strategies aimed at reducing recruitment barriers to ensure equitable access to clinical trials.

Understanding moderators of consent regarding the sharing of supermarket shopping data in ALSPAC.

Introduction & BackgroundShopping data is a valuable resource, offering insights into consumer behaviour and health. In recent years, there has been a growing interest in using shopping data for the purposes of health research. However, little is known about the characteristics of those who are willing to share their shopping data with researchers. Objectives & ApproachThis study aims to investigate the factors that influence individuals' decisions to consent to sharing their shopping data for research purposes. We will leverage data from a cohort study – the Avon Longitudinal Study of Parents and Children (ALSPAC) – to address this question. We will draw upon the responses of a 2018 survey, which asked ALSPAC participants about their use of supermarket loyalty cards, their perceived acceptability of sharing this data with ALSPAC, and their perspectives on potential privacy concerns. Of the 4,462 respondents, 65.4% indicated ownership of at least one major UK supermarket or store loyalty card. Among these, 88.4% expressed a potential willingness to share this data with ALSPAC for research purposes. In the present day – around 2023 – participants have explicitly either granted or withheld consent for the sharing of this data. Our analysis approach will consider factors such as biological gender, ethnicity, education, employment, socioeconomic status, and anxiety as potential moderators to the consent process. We plan to employ a mix of standard statistical methods to analyse sampling biases in the dataset, including regression modelling and correlation tests. Relevance to Digital FootprintsOur study will contribute to the growing body of literature on data linkage between cohort studies and digital footprints datasets. ResultsThe findings from this study will offer valuable insights into the factors influencing participants' consent decisions regarding data sharing. We will contribute to ongoing discussions about privacy and the ethical use of digital footprints data, informing the development of more inclusive consent processes in this field. Conclusions & ImplicationsThis study will inform consent practices in the realm of digital footprints, identifying and addressing potential barriers to consent, and contributing to the ongoing discourse on the responsible and ethical use of shopping data.

Consent and Educational Sensitive Exams on Anesthetized Patients: Experiences of Medical Students Across Canada

ObjectivesThis study investigates experiences of medical students across Canada related to consent for educational sensitive (i.e., pelvic, rectal) exams under anesthesia (EUAs). MethodsA bilingual online questionnaire was developed and distributed to medical students across Canada. ResultsOf 134 respondents, 63% had performed a pelvic EUA, 35% a rectal EUA, and 11% another sensitive EUA during their training. For those who had performed pelvic EUA, 28% were unsure if consent had taken place, 26% reported no specific consent, 20% reported specific consent, and 25% had mixed experiences of consent. For rectal EUAs, 48% reported no specific consent, 37% were unsure if consent had taken place, 13% reported that there had been specific consent, and 2% reported mixed experiences. Most respondents were uncomfortable (36%) or not sure if they were comfortable (32%) with how the consent process was handled for student pelvic EUAs; 31% were comfortable. In open-ended responses, respondents described experiences related to variability, discomfort, and authority. ConclusionsNon-consensual educational sensitive EUAs continue to take place in medical training across Canada, although practices of consent are highly variable. The majority of respondents reported being uncomfortable or unsure if they were comfortable with how consent for educational sensitive EUAs was practised during their training, and some respondents struggled to express their discomfort given the power dynamics at play.

The Primacy of Ethics in Aesthetic Medicine: A Review.

The landscape of modern aesthetic medicine has witnessed a paradigm shift from traditional doctor-led care to a consumer-driven model, presenting a plethora of ethical challenges. This review discusses the ethical dimensions of medical aesthetics, exploring the implications of consumer demand, societal influences, and technological advancements on patient care and well-being. Drawing upon a comprehensive analysis of existing literature, this review synthesizes evidence regarding the rise of aesthetic medicine, ethical challenges encountered in practice, and the implications of social media and marketing in shaping patient perceptions and decision-making. Aesthetic medicine confronts unique ethical challenges stemming from its elective nature and the pervasive influence of societal beauty standards. Concerns include the commodification of beauty, conflicts of interest, limited evidence-base of treatments, and the rise of nonphysician providers. Moreover, the evolving role of social media influencers and medical marketing raises ethical dilemmas regarding transparency, patient autonomy, and professional integrity. The ethical landscape of aesthetic medicine necessitates a proactive approach to address emerging challenges and safeguard patient well-being. Guided by principles of autonomy, beneficence, nonmaleficence, and justice, recommendations are proposed to enhance informed consent practices, mitigate appearance anxiety, facilitate shared decision-making, and promote responsible use of social media. Professional societies are urged to establish clear ethical guidelines and standards to uphold professionalism and patient trust in the field of aesthetic medicine.