title: Informed Consent in Pediatric Otolaryngology: What Risks and Benefits Do Parents Recall?
abstract: To evaluate parental recall of surgical risks and benefits in pediatric otolaryngology and to assess for factors that may influence recall.
  
  
  
  Prospective cohort study.
  
  
  
  Academic pediatric otolaryngology clinic.
  
  
  
  Eighty-four parents of children <6 years of age who underwent consultation for adeno/tonsillectomy and/or tympanostomy tube insertion were prospectively enrolled. Consultation visits were video recorded and the benefits and risks of surgery documented. Two weeks following the consultation, parents were contacted for assessment of recall of information discussed during the consultation.
  
  
  
  Overall, parents recalled only one-third of the risks of surgery mentioned by the surgeons. Parents were significantly more likely to recall the benefits of surgery as opposed to the risks (P < .001). Nine parents (10.7%) reported that no benefits were discussed during the consultation, and 10 (11.9%) reported no mention of any risks. Inconsistencies were present in which risks and benefits were mentioned by the providers. Parents who decided to proceed with surgery (58.3%) were significantly less likely to recall the surgical risks than those who did not (P < .001). The specific surgeon involved, the number of caregivers present, parental education level, and prior surgical history did not influence recall.
  
  
  
  Parental recall of benefits and risks associated with common pediatric otolaryngology procedures was poor. This information is important because a low rate of recall may influence parents' perspectives of the procedure and could alter their decision-making processes or expectations. Methods to improve parental recall should be further studied.
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, IWK Health Centre, Halifax, Canada.
authors.forename: Kiersten
authors.initials: K
authors.lastname: Pianosi
authors.affiliation: Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada.
authors.forename: Ayala Y
authors.initials: AY
authors.lastname: Gorodzinsky
authors.affiliation: Centre for Pediatric Pain Research, IWK Health Centre, Halifax, Canada Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, Canada.
authors.forename: Jill MacLaren
authors.initials: JM
authors.lastname: Chorney
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, IWK Health Centre, Halifax, Canada.
authors.forename: Gerard
authors.initials: G
authors.lastname: Corsten
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, IWK Health Centre, Halifax, Canada.
authors.forename: Liane B
authors.initials: LB
authors.lastname: Johnson
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, IWK Health Centre, Halifax, Canada School of Human Communication Disorders, Dalhousie University, Halifax, Canada Paul.Hong@iwk.nshealth.ca.
authors.forename: Paul
authors.initials: P
authors.lastname: Hong
mesh_terms: D000233:Adenoidectomy; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D007258:Informed Consent; D008297:Male; D011939:Mental Recall; D008876:Middle Ear Ventilation; D010036:Otolaryngology; D010290:Parents / Q000523:psychology*; D011446:Prospective Studies; D012017:Referral and Consultation; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D014068:Tonsillectomy
keywords: adenotonsillectomy; complications; informed consent; risks; tympanostomy tube insertion