Background: Informed consent has become a vital factor for the clinical treatment of modern practice in the medical field, it is participating in legal, ethical and administrative compliance side. However, informed consent is variably applicable and rarely fulfills its theoretical ideal. Disclosure of adequate information is very important before signing informed consent. It is important to make patient enable to take a proper decision with good knowledge about his/her case. Informed consent for the surgical procedure is consent that taken from the patient before surgical operations and invasive procedures after explaining advantages and disadvantages. Getting patient's signature for the consent of operations and the surgical procedure is surgeon's job. The opinion of the surgeon about informed consent is important, as that may affect the performance of surgeon in explaining procedure with its risks and benefits. Aim: Assessment of knowledge, opinion, and attitude of surgeons towards informed consents. Find out how to improve the quality of informed consent from surgeons' suggestions. Method: This cross-sectional study is questionnaire-based study. Our target was to reach many surgeons in Saudi Arabia with different specialties, different status and from different hospitals. We take our sample using random sampling technique. We selected surgeons from each hospital that our data collector can reach and enter easily. Collection of data was done by interview. Our questionnaire contained four parts in addition to demographic data part. The first part was asking about surgeons' opinions regarding informed surgical consent process. The second part was responsible for inquire about obtaining informed surgical consent. The third part is about the refusal to sign informed surgical consent. Last part is to ask about surgeons' suggestions to improve informed surgical consent. Result: Total number of respondents was 140 (Response rate is 93.3%). Around 34% of participants agreed that surgeons don't give adequate information about the surgical procedure. 33.6% insisted to know about their surgery. After asking each surgeon about the importance of informed surgical consent they selected the following answers in descending order; informing patients about advantages, hazards and alternatives (81.4%), Medico-legal importance (79.3%), decision taking about procedure (72.1%), hospital policy (50.7%) and surgical tradition (19.3%). Most of the doctors (85%) complained that sometimes, their patients refused to sign consent. Fear was the most common cause of singing consent refusal according to opinions of 62.9% of surgeons. Conclusion: Surgeons in Saudi Arabia have acceptable knowledge about informed surgical consent and how to obtain it. But still there were some opinions of surgeons opposite to what is practiced, and also some of them practiced something not ideal while obtaining informed surgical consents. However, most of the surgeons know the importance of consent and what is important to be disclosed in it. In general, the fre...
Background Shear wave elastography (SWE) is emerging as a valuable clinical tool for a variety of conditions. The aim of this pilot study was to assess the potential of SWE imaging of the common carotid arteries (CCA) in patients with spontaneous coronary artery dissection (SCAD), a rare but potentially life-threatening condition, hypothesized to be linked to changes in vessel wall elasticity. Methods Ultrasound shear wave elastography (SWE) estimates of artery wall elasticity were obtained from the left and right CCAs of 89 confirmed SCAD patients and 38 non-dissection controls. SWE images obtained over multiple cardiac cycles were analysed by a blinded observer to estimate elasticity in the form of a Young’s Modulus (YM) value, across regions of interest (ROI) located within the anterior and posterior CCA walls. Results YM estimates ranged from 17 to 133 kPa in SCAD patients compared to 34 to 87 kPa in non-dissection controls. The mean YM of 55 [standard deviation (SD): 21] kPa in SCAD patients was not significantly different to the mean of 57 [SD: 12] kPa in controls, p = 0.32. The difference between groups was 2 kPa [95% Confidence Interval − 11, 4]. Conclusions SWE imaging of CCAs in SCAD patients is feasible although the clinical benefit is limited by relatively high variability of YM values which may have contributed to our finding of no significant difference between SCAD patients and non-dissection controls.
To date there is a limited number of studies that specifically address the reliability of ultrasound point shear wave elastography (pSWE). Therefore, the aim of the present study was to assess the reproducibility of ultrasound pSWE within and between operators using two ultrasound scanners.Methods: iU22 and EPIQ7 ultrasound scanners were used to assess the reliability of pSWE measurements of lesions at a depth of 3.5 cm in an elasticity phantom using curvilinear 5-1MHz transducer. Intra and inter-operator, inter-scanner reproducibility of pSWE was assessed using Intraclass correlation coefficient (ICC). Bland-Altman plot was used to establish bias and limit of agreement between measurements. The accuracy of pSWE from manufacturer values was determined using one-sample t-test Results: Intra-operator agreement was excellent with Intraclass correlation coefficient (ICC) >0.90. Bias in measurements for operator A was -0.36±3.13 kPa (limit of agreement (LoA): -6.47 -5.75), and for operator B was -1.97 kPa (LoA: -10.25 -14.21). Inter-operator agreement was excellent with ICC values of 0.95. Bias in measurements between operators was -0.42±5 kPa (LoA: -10.24 -9.38). Interscanner agreement between EPIQ7 and iU22 was excellent with ICC values of 0.96. Bias in measurements between scanners was 1.74±4.44 kPa (LoA: -6.95 -10.45). There were significant overestimation for L I (17.75%) and L II (31.14%) and underestimation for L III (-15.28%) and L VI (-98%) from the values reported by the phantom manufacture. Conclusion:Phantom ultrasound pSWE is reproducible within and between operators, and between Philips ultrasound scanners; further studies using different ultrasound systems and transducers are required.
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