SynthesisClinical medicine (London, England)2015
Systematic review on the prevalence of lack of capacity in medical and psychiatric settings.
Synthesis in Clinical medicine (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Capacity to Consent in Healthcare: A Systematic Review and Meta-Analysis Comparing Patients with Bipolar Disorders and Schizophrenia Spectrum Disorders.Medicina (Kaunas, Lithuania) · 2024Pooled it
- Informed consent and ethical reporting of research in clinical trials involving participants with psychotic disorders.Contemporary clinical trials · 2019Pooled it
- A Smartphone App to Promote Patient Activation and Support Shared Decision-making in People With a Diagnosis of Schizophrenia in Outpatient Treatment Settings (Momentum Trial): Randomized Controlled Assessor-Blinded Trial.Journal of medical Internet research · 2022Trial
- Navigating Autonomy: Enhancing Accuracy in Medical Decision-making Capacity Assessment.Annals of African medicine · 2026Review
- Managing Dermatologic Delusional Disorders: A US Psychodermatology Perspective for Clinicians.CNS drugs · 2026Review
- Restraint in somatic healthcare: how should it be regulated?Journal of medical ethics · 2026Article
- From inferring preferences to enabling choice: potentials of digital tools to improve substitute decision-making.Frontiers in digital health · 2026Article
- Advance care planning by proxy for residential aged care facility residents: results of a pilot interventional study.Innovation in aging · 2026Article
- Conceptualising Lived Experience in Mental Health Research: Problems, Insights and Implications.Sociology of health & illness · 2025Review
- Obstacles, Opportunities, and Ethical Considerations for Genomic Investigations of Individuals Continuously Hospitalized with Treatment-resistant Schizophrenia.Schizophrenia bulletin open · 2025Article
- Assessment of decision-making autonomy in chronic pain patients: a pilot study.BMC medical ethics · 2024Article
- Improving the systematic screening and documentation of mental capacity for patients with severe brain injury: The Mental Capacity Screening assessment tool (MCScreen).Clinical medicine (London, England) · 2024Article
- Reliability of clinical judgment for evaluation of informed consent in mental health settings and the validation of the Evaluation of Informed Consent to Treatment (EICT) scale.Frontiers in psychology · 2024Article
- Implications for Electronic Surveys in Inpatient Settings Based on Patient Survey Response Patterns: Cross-Sectional Study.Journal of medical Internet research · 2023Article
- Decision-making capacity in older medical in-patients: frequency of assessment and rates of incapacity by decision-type and underlying brain/mind impairment.Age and ageing · 2023Article
- Preferred Place of End-of-Life Care Based on Clinical Scenario: A Cross-Sectional Study of a General Japanese Population.Healthcare (Basel, Switzerland) · 2023Article
- Post-discharge follow-up system in psychiatric patients: A case study of Farabi Hospital in Isfahan.Journal of education and health promotion · 2023Article
- Optimized Informed Consent for Psychotherapy: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2022Article
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Corrections and comments
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- Commented on byResponse.2016
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Recent court cases in England and Wales have refocused attention on patients' decision-making capacity to consent. Little is known about the prevalence of incapacity across specialities but decision-making capacity is likely to be overestimated by clinicians. The aim of this systematic review is to estimate the prevalence of incapacity to consent to treatment or admission in different medical and psychiatric settings, and compare the two. We conducted an electronic search following PRISMA principles and included 35 studies in psychiatric and 23 studies in medical settings. The 58 included studies revealed 70 data sets across all settings. For psychiatric settings the weighted average proportion of patients with incapacity was 45% (95% confidence interval (CI) 39-51%). For medical settings, the weighted average proportion of patients with incapacity was 34% (95% CI 25-44%). The two groups are not significantly different from each other in terms of the proportion of incapacity (p=0.92). A considerable number of medical and psychiatric patients lack capacity to make treatment and assessment decisions. Clinicians should be more alert to the possibility that their patients may lack decision-making capacity. Assessment of capacity should be frequent using the appropriate legal frameworks to act in the best interest of patients.
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