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Program Number: AHNS24
Session Name: Scientific Session 5 - Technology & Education
Session Date: Thursday, May 15, 2025
Session Time: 10:15 AM - 11:00 AM

Evaluating the Impact of Multimedia on Patient Comprehension and Decision-Making in Thyroid Surgery: A Randomized Controlled Trial of the Thyroid Informed Surgical Consent Augmenting Video (TISCAV)

Hani Samarah, BS; Kathryn Nunes, BS; Kalena Liu, BS; Annie Moroco, MD; Joseph Curry, MD; Elizabeth Cottrill, MD; Thomas Jefferson University

Background: The rise in detection of thyroid nodules has led to a corresponding increase in thyroid surgeries, with an estimated 150,000 thyroidectomies performed annually. Alongside surgical intervention, patients may opt for active surveillance of indeterminate or even small cancerous nodules, making informed consent a critical component of the decision-making process. However, fewer than 50% of patients retain the information discussed during clinic visits, leading to potential decision regret. To address this gap, the Thyroid Informed Surgical Consent Augmenting Video (TISCAV) was developed to enhance patient understanding and satisfaction.

Objective: This study aims to assess whether TISCAV improves patient comprehension, decision satisfaction, and reduces decisional regret compared to standard informed consent discussions.

Methods: A randomized controlled trial recruited 37 patients undergoing thyroid surgery, with 19 in the control group (standard consent) and 18 in the intervention group (TISCAV). Pre- and post-surgical comprehension, decision satisfaction, and regret were measured using validated tools: the Decisional Conflict Scale (DCS), Satisfaction with Decision Scale (SDS), Decision Regret Scale (DRS), and Visual Analog Scale for Anxiety (VAS-A). The intervention group received TISCAV during consent, while the control group received standard verbal consent. Surveys were administered pre-operatively, post-operatively, and at a three-month follow-up (Table 1). Satisfaction in the intervention group was assessed immediately after viewing TISCAV, prior to any interaction with the surgeon. Additional satisfaction measurements were taken at approximately 21 days and 100 days post-surgery.

Results: Preliminary findings suggest that the intervention group exhibited greater improvement in post-surgical comprehension, though this difference was not statistically significant (0.21 vs. 0.13, p = 0.443). Satisfaction scores were initially lower in the intervention group pre-surgery (8.65 vs. 9.79, p = 0.022) but were comparable post-surgery (10.74 vs. 10.76, p > 0.999) (Table 1). Although the difference in comprehension improvement between groups was not statistically significant (p = 0.443), the TISCAV group exhibited a higher mean improvement in knowledge assessment scores, suggesting potential practical benefits in patient comprehension. Decision regret scores remained low and consistent between groups post-operatively (p > 0.999).

Conclusion: Initial satisfaction scores were lower in the intervention group immediately after watching TISCAV, possibly reflecting a preference for direct interaction with the surgeon. However, satisfaction levels were comparable between groups in the long-term follow-ups, suggesting that the video intervention does not negatively impact overall satisfaction with the informed consent process. Although improvements in knowledge scores were not statistically significant, the observed trend indicates potential benefits in patient comprehension. These preliminary results are promising as we continue to collect more data. Larger sample sizes may further clarify TISCAV's impact on decision satisfaction and informed consent comprehension.

 

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