ArticleBMC medical ethics2021
Practice variation in the informed consent procedure for thrombolysis in acute ischemic stroke: a survey among neurologists and neurology residents.
Article in BMC medical ethics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 11 citations in OpenAlex.
- Authorized surrogate presence and its association with early in-hospital delays and outcomes in acute ischemic stroke.International journal of emergency medicine · 2026Article
- Who Obtains Informed Consent for Endovascular Thrombectomy in Acute Stroke? A Survey of Clinicians.The Neurohospitalist · 2026Article
- Article
- Thrombolytic therapy efficacy in cardiopulmonary resuscitation: Investigating the effect of recombinant tissue plasminogen activator (Review).Molecular medicine reports · 2025Review
- Informed consent practices for acute stroke therapy: principles, challenges and emerging opportunities.Journal of neurology · 2024Review
- Informed Consent in the Stroke Care Continuum.Stroke (Hoboken, N.J.) · 2024Review
- Ability of patients with acute ischemic stroke to recall given information on intravenous thrombolysis: Results of a prospective multicenter study.European stroke journal · 2023Observational
- AI and professional liability assessment in healthcare. A revolution in legal medicine?Frontiers in medicine · 2023Review
- Critical role of accompanying authorized surrogates among the multifactorial determinants of in-hospital delays in patients with acute stroke.Frontiers in neurologyArticle
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundObtaining informed consent for intravenous thrombolysis in acute ischemic stroke can be challenging, and little is known about if and how the informed consent procedure is performed by neurologists in clinical practice. This study examines the procedure of informed consent for intravenous thrombolysis in acute ischemic stroke in high-volume stroke centers in the Netherlands.
methodsIn four high volume stroke centers, neurology residents and attending neurologists received an online questionnaire concerning informed consent for thrombolysis with tissue-type plasminogen activator (tPA). The respondents were asked to report their usual informed consent practice for tPA treatment and their considerations on whether informed consent should be obtained.
resultsFrom the 203 invited clinicians, 50% (n = 101) completed the questionnaire. One-third of the neurology residents (n = 21) and 21% of the neurologists (n = 8) reported that they always obtain informed consent for tPA treatment. If a patient is not capable of providing informed consent, 30% of the residents (n = 19) reported that they start tPA treatment without informed consent. In these circumstances, 53% of the neurologists (n = 20) reported that the resident under their supervision would start tPA treatment without informed consent. Most neurologists (n = 21; 55%) and neurology residents (n = 45; 72%) obtained informed consent within one minute. None of the respondents used more than five minutes for informed consent. Important themes regarding obtaining informed consent for treatment were patients' capacity, and medical, ethical and legal considerations.
conclusionThe current practice of informed consent for thrombolysis in acute ischemic stroke varies among neurologists and neurology residents. If informed consent is obtained, most clinicians stated to obtain informed consent within one minute. In the future, a shortened information provision process may be applied, making a shift from informed consent to informed refusal, while still considering the patient's capacity, stroke severity, and possible treatment delays.
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