Impact of Multimedia on Patient Comprehension in Thyroid Surgery: A Randomized Trial.

Abstract

To assess whether the Thyroid Informed Surgical Consent Augmenting Video (TISCAV) improves knowledge retention, reduces decisional conflict, alleviates anxiety, and enhances satisfaction in thyroidectomy decision-making compared to standard verbal consent. Randomized controlled trial. Academic tertiary care center with urban outpatient and community-based clinics. Forty-nine English-speaking adults scheduled for thyroid surgery were randomized to receive either standard verbal consent alone (control) or TISCAV followed by standard consent (intervention). Forty-three completed preoperative assessments and were included in the analysis. Knowledge was assessed before and after consent. Visual Analog Scale for Anxiety (VAS-A), Decisional Conflict Scale (DCS), and Satisfaction with Decision Scale (SDS) were measured preoperatively; SDS, Decision Regret Scale (DRS), and anxiety were reassessed at 22 and 100 days postoperatively. Both groups demonstrated significant knowledge gains post-consent (P < .0001), with no significant difference between groups (P = .1812). Patients with malignant/suspicious cytopathology had lower decisional conflict than those with benign findings (P = .03); scores in indeterminate cases trended similarly (P = .11). Among patients with indeterminate cytopathology, decisional conflict did not differ significantly (P = .06), while preoperative satisfaction was lower in the video group (P = .02); group differences resolved postoperatively (P ≥ .55). TISCAV and standard consent both improved knowledge acquisition. While video-based consent may transiently increase decisional conflict and reduce satisfaction among patients with indeterminate pathology, these effects did not persist postoperatively. Video tools may serve as a safe and accessible adjunct to verbal consent.