Clinical Scorecard: Customized Informed Consent in Neurosurgery Using Stereoscopic Visualization: Genuine Advantage for Patients or Just a Trend?

At a Glance

Key Highlights

• Informed consent is essential for respecting patient autonomy and improving patient-doctor trust.
• Modern technologies like VR, 3D printing, and stereoscopic visualization can improve patient comprehension of complex neurosurgical procedures.
• Stereoscopic visualization offers a cheaper, easier-to-implement alternative to 3D printing for personalized patient education during consent.

Guideline-Based Recommendations

Diagnosis

• Assess patient capacity to give informed consent, excluding those with cognitive or visual impairments.
• Test patients for stereopsis to ensure suitability for stereoscopic visualization.

Management

• Conduct conventional informed consent discussions covering patient-specific anatomy, symptoms, prognosis, surgical steps, and risks.
• Consider adding stereoscopic visualization of patient-specific CT/MRI images to improve patient understanding during consent.

Monitoring & Follow-up

• Evaluate patient comprehension and anxiety levels after informed consent discussions.
• Monitor patient trust and satisfaction with the consent process.

Risks

• Miscommunication during informed consent can lead to increased patient anxiety, unrealistic expectations, loss of trust, and potential litigation.
• Ensure that new visualization technologies do not increase patient anxiety.

Patient & Prescribing Data

Patients undergoing brain tumor surgery who are capable of providing informed consent

Stereoscopic visualization may enhance patient comprehension without increasing anxiety and could improve the patient-doctor relationship.

Clinical Best Practices

• Provide thorough, patient-specific information about the disease and surgical procedure to respect autonomy and reduce anxiety.
• Use personalized visualization tools such as stereoscopic imaging to aid patient understanding, especially in complex neurosurgical cases.
• Assess patient suitability for stereoscopic visualization prior to use.
• Maintain clear communication to prevent misperceptions and potential legal issues.

References

• Park et al. on patient autonomy and understanding
• Shlobin et al. systematic review on patient education in neurosurgery
• Perin et al. on VR improving patient-doctor relationship
• Yoon et al. on 3D printing improving patient knowledge
• Ethics committee approval Charité – Universitätsmedizin Berlin (EA2/019/18)
• German Clinical Trials Register (DRKS00014930)