Use of standardized visual aids improves informed consent for appendectomy in children: A randomized control trial

Background: Obtaining informed consent for surgical procedures is often compromised by patient and family educational background, complexity of the forms, and language barriers. We developed and tested a visual aid in order to improve the informed consent process for families of children with appendicitis. Methods: Families were randomized to receive either a standard surgical consent or a standard consent plus visual aid. Univariate and multivariate analyses were performed to assess the effectiveness of adding the visual aid to the consent procedure. Results: Parents in both cohorts were similar in age, gender and education level (p > 0.05). On multivariate analysis, visual consent had the strongest influence on parent/guardian comprehension (OR 4.0; 95% CI 2.2-7.2; p < 0.01), followed by post-secondary education (OR 2.7; 95% CI 1.5-4.9; p < 0.01), and use of external resources to look up appendicitis (OR 2.0; 95% CI 1.1-3.6; p = 0.02). Conclusion: Visual aids improve understanding and retention of information given during the informed consent process of children with appendicitis. (c) 2018 Elsevier Inc. All rights reserved.