What Form of Informed Consent? A Nationwide Pilot SurveyBenjamin K Stoff1*, Lauren C Payne2, Jennifer Shih3, Emir Veledar4 and Suephy C Chen5
- *Corresponding Author:
- Benjamin K Stoff
MD, Assistant Professor of Dermatology and Pathology
Emory University School of Medicine, Department of Dermatology
Emory University School of Medicine, 101 Woodruff Circle
Woodruff Memorial Building Suite 5001, Atlanta, GA 30322, USA
E-mail: [email protected]
Received date: July 23, 2012; Accepted date: September 12, 2012; Published date: September 22, 2012
Citation: Stoff BK, Payne LC, Shih J, Veledar E, Chen SC (2012) What Form of Informed Consent? A Nationwide Pilot Survey. J Clin Exp Dermatol Res 3:158. doi: 10.4172/2155-9554.1000158
Copyright: ©2012 Stoff BK, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Informed consent practices in dermatology are unknown.
Objective: Assess informed consent practices and opinions regarding minimum standards of care for dermatologic procedures.
Methods/materials: 500 randomly-selected, American dermatologists received mailed surveys, listing 19 dermatologic procedures. For each procedure, responders selected the informed consent method-none, verbal only, written only, or written and verbal representing their usual practice and opinion regarding minimum standard of care.
Procedures were grouped into: Destruction of non-malignant lesions, biopsy, electrodessication and curettage (ED&C), cosmetic, and excision (including Mohs surgery).
Results: Among 97 responders, mean age (SD) was 50 years (10.7). The most common informed consent practice (*) and opinion regarding standard of care (+) was verbal only for destructive procedures (66.5%*, 67.8%+), biopsy(46%*, 55.7%+), and ED&C (49.6%*, 53.9%+). Written and verbal informed consent was most common for excision (62.1%*, 41.1%+) and cosmetics (70.7%*, 51.6%+). No consent was in frequent (6.2% of responses), more common for destruction (11.9%) than biopsy (5.8%), ED&C (6.6%), cosmetic (3.3%) or excision (2.9%) (p=0.0002).
Multivariate regression analysis revealed factors predicting no consent (odds ratio>5, 95% confidence interval) including practice <5 years (234.9, 11.2-999.9), surgical subspecialty (8.7, 2.9-25.8), solo private practice (14.7, 1.2-200), and destructive procedures (10, 3-33.3). Informed consent practice responses frequently equaled opinions about minimum standard (78.7%). Factors predicting practice exceeding opinion (estimate, p-value) included practice in Western US (-0.35, <0.0001) and academia (-0.67, <0.0001), practice >25years (0.16, 0.018), and history of malpractice litigation (-0.13, 0.008).
Conclusion: Numerous factors influence informed consent practices and opinions, including procedure type.