Evidence map›Paper›PMID 37815578›Full record

ReviewJournal of neurology2024

Informed consent practices for acute stroke therapy: principles, challenges and emerging opportunities.

Amir Mbonde, Michael J Young, Adam A Dmytriw, Quentin J Moyer, Joshua A Hirsch, Thabele M Leslie-Mazwi, Natalia S Rost, Aman B Patel, Robert W Regenhardt

Abstract readReview
PubMed Publisher
In one paragraph

Review in Journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.3field-weighted citation impact, top 18% of its field
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

3 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Article
  3. 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

9 authors at 2 institutions in 1 country.

Amir Mbonde *Harvard Medical School, Boston, MA, USA. Mbonde.amir@mayo.edu.ORCID http://orcid.org/0000-0001-8241-0262
Michael J Young *Harvard Medical School, Boston, MA, USA.
Adam A DmytriwHarvard Medical School, Boston, MA, USA.
Quentin J MoyerHarvard Medical School, Boston, MA, USA.
Joshua A HirschHarvard Medical School, Boston, MA, USA.
Thabele M Leslie-MazwiUniversity of Washington, Seattle, WA, USA.
Natalia S RostHarvard Medical School, Boston, MA, USA.
Aman B PatelHarvard Medical School, Boston, MA, USA.
Robert W RegenhardtHarvard Medical School, Boston, MA, USA.
Harvard University · USUniversity of Washington · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

importanceInformed consent (IC) plays a crucial yet underexplored role in acute stroke treatment, particularly in the context of intravenous thrombolysis (IVT) and endovascular thrombectomy (EVT). This narrative review examines data on current IC practices in acute ischemic stroke management, specifically for patients treated with IVT or EVT, with the aim of identifying areas for improvement and strategies to enhance the IC process. OBSERVATIONS: IC practices for IVT vary significantly among hospitals and physicians with the frequency of always requiring consent ranging from 21 to 37%. Factors influencing IC for IVT include patient decision-making capacity, standard of care, time sensitive nature of treatments, legal and moral obligations, risk of complications, physician age and speciality, treatment delays, and hospital size. Consent requirements tend to be stricter for patients presenting within the 3-4.5-h window. The content and style of information shared as part of the IC process revealed discrepancies in the disclosure of stroke diagnosis, IVT mechanism, benefits, and risks. Research on IC practices for EVT is scarce, highlighting a concerning gap in the available evidence base. CONCLUSIONS AND RELEVANCE: This review underscores the significant variability and knowledge gaps in IC for EVT and IVT. Challenges related to decision-making capacity assessment and the absence of standardised guidance substantially contributes to these gaps. Future initiatives should focus on simplifying information delivery to patients, developing formal tools for assessing capacity, standardising ethical frameworks to guide physicians when patients lack capacity and harmonizing IC standards across sites. The ultimate goal is to enhance IC practices and uphold patient autonomy, while ensuring timely treatment initiation.

Indexed as

Brain IschemiaEndovascular ProceduresIschemic StrokeStrokeFibrinolytic AgentsHumansInformed ConsentThrombectomyThrombolytic TherapyTreatment OutcomeFibrinolytic AgentsAcute ischemic strokeDecision-making capacityEndovascular thrombectomy (EVT)Informed consent (IC)Intravenous thrombolysis (IVT)

Identifiers

PMID37815578
OpenAlexW4387473310

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.