Evidence map›Paper›PMID 41806994›Full record

ArticleBMJ open2026

Protocol RCT for active informed consent in spine and urologic surgery in the metropolitan city of Bologna: does an increased patient engagement improve satisfaction of complex surgical procedures?

Luca Boriani, Irene Quattrini, Bruna Maccaferri, Chiara Lima, Alice Benuzzi, Marco Salvador, Riccardo Schiavina, Eugenio Brunocilla, Federico Deiure, Vania Maselli and 3 more

Registry-linked trialAbstract readClinical Trial Protocol
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06059599 (Active Informed Consent), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

NCT06059599 narecruitingnot on this map

Active Informed Consent: a New Solution to Improve and Objectively Test the Patient Understanding of Complex Surgical Procedures Proposals

TypeinterventionalSponsorIstituto Ortopedico RizzoliRan2024 to 2026Enrolled300ConditionsSpine Disease, Urologic DiseasesArmsactive informed consent
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
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

13 authors.

Luca BorianiIRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.ORCID http://orcid.org/0000-0002-7069-7638
Irene QuattriniIRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Bruna MaccaferriSpine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy bruna.maccaferri@ior.it.ORCID http://orcid.org/0000-0002-7224-3314
Chiara LimaIRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Alice BenuzziIRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Marco SalvadorIRCCS Azienda Ospedaliero-Universitaria di Bologna -Policlinico di Sant'Orsola, Bologna, Italy.
Riccardo SchiavinaUrology, Universita degli Studi di Bologna Dipartimento di Scienze Mediche e Chirurgiche, Bologna, Italy.
Eugenio BrunocillaIRCCS Azienda Ospedaliero-Universitaria di Bologna -Policlinico di Sant'Orsola, Bologna, Italy.
Federico DeiureOspedale Maggiore Carlo Alberto Pizzardi, Bologna, Italy.
Vania MaselliIRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
Roberta De StefanoOspedale Maggiore Carlo Alberto Pizzardi, Bologna, Italy.
Francesco VommaroSpine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Emilia-Romagna, Italy.
Alessandro GasbarriniSpine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Emilia-Romagna, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionInformed consent is an essential component of surgical care; however, patients often struggle to fully understand procedures, associated risks and available alternatives. Factors such as preoperative anxiety, limited health literacy and the complexity of consent documents can further impair comprehension and information retention. The active informed consent (CIA) pathway, based on a Patient Educational Program that combines multimedia resources with a comprehension test, aims to enhance patient understanding, improve satisfaction and reduce medicolegal issues. METHODS AND ANALYSIS: The study will be conducted as a multicentre, non-pharmacological, randomised controlled trial in three hospitals in the Emilia-Romagna region (Italy). A total of 300 patients undergoing elective complex spinal surgery or robotic radical prostatectomy will be enrolled and randomised (1:1) to the experimental arm or to the standard informed consent arm, using block randomisation stratified by centre. Outcomes will include patient satisfaction (Client Satisfaction Questionnaire), comprehension, psychological distress (Depression Anxiety Stress Scales), pain (Numeric Rating Scale), functional recovery (Oswestry Disability Index/International Prostate Symptom Score/International Consultation on Incontinence Questionnaire Short Form/International Index of Erectile Function) and medicolegal complaints. Assessments will be performed at baseline (T0), discharge (T1), 2 months (T2) and 6 months (T3), with extended monitoring of medicolegal outcomes for up to 5 years. ETHICS AND DISSEMINATION: The study has been approved by the Regional Ethics Committee of Emilia-Romagna (protocol CIA21, V.1.3 dated 14 December 2022). Participation is voluntary and does not affect standard care. Results will be disseminated through peer-reviewed journals, conference presentations and communication with health authorities. If effective, the intervention may be implemented as a scalable model to improve patient empowerment and transparency in surgical consent. TRIAL REGISTRATION NUMBER: NCT06059599.

Indexed as

Informed ConsentPatient Education as TopicPatient ParticipationPatient SatisfactionSpineUrologic Surgical ProceduresComprehensionHumansItalyMaleMulticenter Studies as TopicProstatectomyRandomized Controlled Trials as TopicClinical Decision-MakingETHICS (see Medical Ethics)Health Literacy

Identifiers

PMID41806994
PMCPMC12983854

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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.