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The Effect of Written Information on Memory of Surgical Risks from the Informed Consent Discussion: A Randomized Control Trial
Alison L Wong, MD, MSE; Janet Martin, MD; David Tang, MD; Martin Leblanc, MD; Steven Morris, MD, MSc; Justin Paletz, MD; Stein John, MD; Michael J Wong, MD; Michael Bezuhly, MD, MSc, SM
Dalhousie University, Halifax, NS, Canada

Background: Written information has been shown to help memory of surgical risks from the informed consent discussion. Informed consent is a key component of patient education and perceived lapses account for 70% of malpractice lawsuits. The effect of written information has not been assessed for carpal tunnel release (CTR), a procedure with the rare but serious risk of complex regional pain syndrome (CRPS). It was hypothesized that providing a pamphlet would improve patients' ability to remember the risks of surgery.
Methods: This was a prospective single-blind randomized study of 60 consecutive patients seen for CTR. Following a standardized consultation, patients received either a written pamphlet describing 7 risks of CTR surgery, or no additional information. Two weeks after the initial consultation, each patient was contacted to assess their recall of the risks and whether they had read about the surgery.
Results: There was no difference between pamphlet or control in total risk recall (1.33Ä1.21 vs. 1.45Ä1.22, respectively, p = 0.73). Recall of "infection" was better in the pamphlet group (p _< 0.05), but not other risks (p > 0.05), and no patients remembered CRPS. There was no difference in the proportion of people who read about CTR surgery between the pamphlet (34.8 percent) and control groups (21.4 percent, p = 0.39), but reading about CTR surgery was positively correlated with improved recall (2.45Ä1.13 vs. 0.77Ä0.91, p < 0.01).
Conclusions: Reading about surgery improved risk recall, but providing this information in the form of a pamphlet did not, nor did it affect patients' ability to recall the risk of CRPS. These results show that surgeons should implement additional measures to improve memory and comprehension of surgical risks.

Figure 1. Percentage of patients who recalled specific risks. A higher percentage of patients in the pamphlet group were able to recall the risk of infection (55.5 percent, p < 0.05) but there was not difference for other specific risks (p > 0.05).


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