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Informed consent comprehension and recollection in adult dental patients: A systematic review.
J Am Dent Assoc. 2016 May 10. pii: S0002-8177(16)30255-0. doi: 10.1016/j.adaj.2016.03.004. [Epub ahead of print]
Patients' ability to recollect and comprehend treatment information plays a fundamental role in their decision making.
TYPES OF STUDIES REVIEWED:
authors considered original studies assessing recollection or
comprehension of dental informed consent in adults. The authors searched
6 electronic databases and partial gray literature and hand searched
and cross-checked reference lists published through April 2015. The
authors assessed the risk of bias in the included studies via different
validated tools according to the study design.
studies were included: 5 randomized clinical trials, 8 cross-sectional
studies, 3 qualitative studies, 2 mixed-methods studies, and 1 case
series. Conventional informed consent processes yielded comprehension
results of 27% to 85% and recollection of 20% to 86%, whereas informed
consent processes enhanced by additional media ranged from 44% to 93%
for comprehension and from 30% to 94% for recollection. Patient
self-reported understanding ranged positively, with most patients
feeling that they understood all or almost all the information
presented. Results of qualitative data analyses indicated that patients
did not always understand explanations, although dentists thought they
did. Some patients firmly stated that they did not receive any related
information. Only a few patients were able to remember complications
related to their treatment options.
CONCLUSIONS AND PRACTICAL IMPLICATIONS:
of this systematic review should alert dentists that although patients
in general report that they understand information given to them, they
may have limited comprehension. Additional media may improve
conventional informed consent processes in dentistry in a meaningful