Evidence map›Paper›PMID 29440586›Full record

ArticleStroke2018

National Practice Patterns of Obtaining Informed Consent for Stroke Thrombolysis.

Scott J Mendelson, D Mark Courtney, Elisa J Gordon, Leena F Thomas, Jane L Holl, Shyam Prabhakaran

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Stroke, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Article
  5. Review
  6. Observational
  7. Article
  8. Thrombolytic Refusal Over Telestroke.Neurology. Clinical practice · 2021
    Article
  9. Article
  10. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Scott J MendelsonFrom the Department of Neurology (S.J.M., S.P.); Center for Healthcare Studies (S.J.M., E.J.G., L.F.T., J.L.H., S.P.); Feinberg School of Medicine (S.J.M., D.M.C., J.L.H., S.P.); and Department of Emergency Medicine (D.M.C.); Department of Surgery (E.J.G.); Department of Pediatrics (J.L.H.), Northwestern University, Chicago, IL (S.J.M., L.F.T., S.P.). scott.mendelson@northwestern.edu.
D Mark CourtneyFrom the Department of Neurology (S.J.M., S.P.); Center for Healthcare Studies (S.J.M., E.J.G., L.F.T., J.L.H., S.P.); Feinberg School of Medicine (S.J.M., D.M.C., J.L.H., S.P.); and Department of Emergency Medicine (D.M.C.); Department of Surgery (E.J.G.); Department of Pediatrics (J.L.H.), Northwestern University, Chicago, IL (S.J.M., L.F.T., S.P.).
Elisa J GordonFrom the Department of Neurology (S.J.M., S.P.); Center for Healthcare Studies (S.J.M., E.J.G., L.F.T., J.L.H., S.P.); Feinberg School of Medicine (S.J.M., D.M.C., J.L.H., S.P.); and Department of Emergency Medicine (D.M.C.); Department of Surgery (E.J.G.); Department of Pediatrics (J.L.H.), Northwestern University, Chicago, IL (S.J.M., L.F.T., S.P.).
Leena F ThomasFrom the Department of Neurology (S.J.M., S.P.); Center for Healthcare Studies (S.J.M., E.J.G., L.F.T., J.L.H., S.P.); Feinberg School of Medicine (S.J.M., D.M.C., J.L.H., S.P.); and Department of Emergency Medicine (D.M.C.); Department of Surgery (E.J.G.); Department of Pediatrics (J.L.H.), Northwestern University, Chicago, IL (S.J.M., L.F.T., S.P.).
Jane L HollFrom the Department of Neurology (S.J.M., S.P.); Center for Healthcare Studies (S.J.M., E.J.G., L.F.T., J.L.H., S.P.); Feinberg School of Medicine (S.J.M., D.M.C., J.L.H., S.P.); and Department of Emergency Medicine (D.M.C.); Department of Surgery (E.J.G.); Department of Pediatrics (J.L.H.), Northwestern University, Chicago, IL (S.J.M., L.F.T., S.P.).
Shyam PrabhakaranFrom the Department of Neurology (S.J.M., S.P.); Center for Healthcare Studies (S.J.M., E.J.G., L.F.T., J.L.H., S.P.); Feinberg School of Medicine (S.J.M., D.M.C., J.L.H., S.P.); and Department of Emergency Medicine (D.M.C.); Department of Surgery (E.J.G.); Department of Pediatrics (J.L.H.), Northwestern University, Chicago, IL (S.J.M., L.F.T., S.P.).

Funding

Stroke Trials Network - Regional Coordinating Stroke CentersU10NS086608 · NINDS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI PRABHAKARAN, SHYAM · 2013 to 2017
$1.8M
Development of SCRIPtS: Standardized Consent Redesign and Implementation Protocol for tPA in StrokeF32HS025330 · AHRQ · NORTHWESTERN UNIVERSITY AT CHICAGO · PI MENDELSON, SCOTT JAMES · 2017 to 2018
$153k
AHRQ HHS F32 HS025330NINDS NIH HHS U10 NS086608
6 · The paper itself

Abstract

background and purposeNo standard approach to obtaining informed consent for stroke thrombolysis with tPA (tissue-type plasminogen activator) currently exists. We aimed to assess current nationwide practice patterns of obtaining informed consent for tPA.

methodsAn online survey was developed and distributed by e-mail to clinicians involved in acute stroke care. Multivariable logistic regression analyses were performed to determine independent factors contributing to always obtaining informed consent for tPA.

resultsAmong 268 respondents, 36.7% reported always obtaining informed consent and 51.8% reported the informed consent process caused treatment delays. Being an emergency medicine physician (odds ratio, 5.8; 95% confidence interval, 2.9-11.5) and practicing at a nonacademic medical center (odds ratio, 2.1; 95% confidence interval, 1.0-4.3) were independently associated with always requiring informed consent. The most commonly cited cause of delay was waiting for a patient's family to reach consensus about treatment.

conclusionsMost clinicians always or often require informed consent for stroke thrombolysis. Future research should focus on standardizing content and delivery of tPA information to reduce delays.

Indexed as

Informed ConsentSurveys and QuestionnairesThrombolytic TherapyFemaleHumansMaleStrokeTissue Plasminogen ActivatorUnited StatesTissue Plasminogen Activatorconsensusinformed consentphysicianplasminogenstroke

Identifiers

PMID29440586
PMCPMC5829003

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.