Logo

American Heart Association

  6
  0


Final ID: TP141

Who Obtains Informed Consent for Endovascular Thrombectomy in Acute Stroke? A Survey of Clinicians.

Abstract Body: Introduction: Informed consent (IC) plays a central role in medical care and research. Practices for endovascular thrombectomy (EVT) in acute stroke are not well elucidated. We investigated the clinical roles and medical specialties of individuals who obtain IC for EVT, aiming to provide insights for enhancing the process in contemporary stroke care.

Methods: We conducted a survey from July to December 2023 among clinicians involved in acute stroke care. Utilizing Qualtrics, we disseminated a structured questionnaire through various national and international platforms including the American Academy of Neurology and StrokeNet. This analysis summarizes findings pertaining to the characteristics of those who obtain EVT IC at the respondents’ institution.

Results: Among 168 participants, 71% were staff physicians, 70% practiced in the United States (US), and 70% were based at academic centers. The most common medical specialties obtaining EVT IC were neurology (77%), followed by neurosurgery (41%), radiology (30%) and emergency medicine (10%) (Table 1). Staff physician (61%) was the most common clinical role involved, followed by fellows (43%), residents (48%), and advanced practice providers (APP, 36%) (Table 2). Non-US institutions were more likely to utilize a provider from neurology alone (50% vs. 31%, p=0.016) and staff physicians (76% vs. 54%, p=0.008), while US institutions were more likely to utilize providers from neurosurgery (51% vs. 18%, p<0.001), APPs (43 vs. 18%, p=0.002) and residents (56% vs. 28%, p=0.001). Non-academic institutions more frequently used emergency medicine providers (25% vs. 5%, p<0.001) and APPs (50% vs. 31%, p=0.031), while academic institutions commonly utilized neurosurgery providers (48% vs. 18%, p=0.001), residents (59% vs. 13%, p<0.001) and fellows (52% vs. 18%, p<0.001).

Conclusion: This study highlights the diverse medical specialties and clinical roles of persons obtaining IC for EVT, with neurologists and staff physicians being the most frequently utilized. These variations likely reflect availability and capacity of certain providers in different settings. Future efforts to optimize the IC process should be multi-disciplinary, with standardized content that addresses issues such as ischemic core volume, outcome expectations and diversity.
  • Mbonde, Amir  ( Medical College of Georgia , Scottsdale , Arizona , United States )
  • Patel, Aman  ( Massachusetts General Hospital , Boston , Massachusetts , United States )
  • Young, Michael  ( Massachusetts General Hospital , Boston , Massachusetts , United States )
  • Regenhardt, Robert  ( Massachusetts General Hospital , Watertown , Massachusetts , United States )
  • Alsarah, Ali  ( Massachusetts General Hospital , Boston , Massachusetts , United States )
  • Demaerschalk, Bart  ( Mayo Clinic College of Medicine , Scottsdale , Arizona , United States )
  • Dmytriw, Adam  ( Massachusetts General Hospital , Boston , Massachusetts , United States )
  • Moyer, Quentin  ( Massachusetts General Hospital , Boston , Massachusetts , United States )
  • Hirsch, Joshua  ( MGH , Boston , Massachusetts , United States )
  • Singhal, Aneesh  ( Massachusetts General Hospital , Boston , Massachusetts , United States )
  • Leslie-mazwi, Thabele  ( University of Washington , Seattle , Washington , United States )
  • Rost, Natalia  ( MASSACHUSETTS GENERAL HOSPITAL , Winchester , United States Minor Outlying Islands )
  • Author Disclosures:
    Amir Mbonde: DO NOT have relevant financial relationships | Aman Patel: DO have relevant financial relationships ; Consultant:microvention :Active (exists now) ; Consultant:medtronic:Active (exists now) ; Consultant:Stryker:Active (exists now) | Michael Young: No Answer | Robert Regenhardt: DO have relevant financial relationships ; Other (please indicate in the box next to the company name):Rapid Medical (DSMB):Active (exists now) ; Research Funding (PI or named investigator):SVIN:Past (completed) ; Research Funding (PI or named investigator):Heitman Foundation for Stroke:Active (exists now) ; Research Funding (PI or named investigator):NINDS:Past (completed) | Ali Alsarah: No Answer | Bart Demaerschalk: DO NOT have relevant financial relationships | Adam Dmytriw: DO NOT have relevant financial relationships | Quentin Moyer: No Answer | Joshua Hirsch: DO have relevant financial relationships ; Consultant:Medtronic:Active (exists now) ; Consultant:Viz AI:Active (exists now) ; Consultant:Sanofi:Active (exists now) ; Consultant:Rapid Medical:Active (exists now) ; Consultant:Cerenovus:Active (exists now) ; Consultant:Relievant:Active (exists now) | Aneesh Singhal: DO have relevant financial relationships ; Royalties/Patent Beneficiary:UptoDate Mecicine:Active (exists now) ; Consultant:Medical Expert Witness:Active (exists now) ; Research Funding (PI or named investigator):NIH-NINDS:Active (exists now) ; Other (please indicate in the box next to the company name):Medlink, Inc (honoraria):Active (exists now) | Thabele Leslie-Mazwi: DO NOT have relevant financial relationships | Natalia Rost: DO NOT have relevant financial relationships
Meeting Info:
Session Info:

Health Services, Quality Improvement, and Patient-Centered Outcomes Posters II

Thursday, 02/06/2025 , 07:00PM - 07:30PM

Poster Abstract Session

More abstracts on this topic:
Cost of Stroke Treatment: A Comparative Analysis of Mobile Stroke and Standard Treatment

Davis Nicolle, Lykens David, Khanna Anna, Jacobs Molly

Association of Hypoperfusion Intensity Ratio, Cerebral Blood Volume Index, and the CRISP2 Collateral Score with Good Outcome for Patients Transferred for Thrombectomy

Asimos Andrew, Hines Andrew, Rhoten Jeremy, Karamchandani Rahul, Yang Hongmei, Strong Dale, Teli Katelynn, Clemente Jonathan, Defilipp Gary, Bernard Joe, Stetler William, Parish Jonathan

More abstracts from these authors:
ADC-based Infarct Density – Validating a Novel Imaging Biomarker of Functional Outcome after Endovascular Thrombectomy

Favilla Christopher, Bonkhoff Anna, Rost Natalia, Messe Steven, Regenhardt Robert, Denny Braden, Simonsen Claus, Shakibajahromi Banafsheh, Patel Aman, Leslie-mazwi Thabele, Dmytriw Adam, Schirmer Markus

Association of pre-thrombectomy infarct topography and hemorrhagic transformation in patients with acute ischemic stroke: A multicenter Bayesian analysis

Bonkhoff Anna, Simonsen Claus, Patel Aman, Rost Natalia, Regenhardt Robert, Schirmer Markus, Favilla Christopher, Das Alvin, Dmytriw Adam, Gupta Rajiv, Rabinov James, Stapleton Christopher, Leslie-mazwi Thabele

You have to be authorized to contact abstract author. Please, Login
Not Available

Readers' Comments

We encourage you to enter the discussion by posting your comments and questions below.

Presenters will be notified of your post so that they can respond as appropriate.

This discussion platform is provided to foster engagement, and simulate conversation and knowledge sharing.

 

You have to be authorized to post a comment. Please, Login or Signup.


   Rate this abstract  (Maximum characters: 500)