{
  "abstract": "Background Informed consent (IC) is a foundational element of medical ethics, serving to safeguard patient autonomy. In the context of time-sensitive interventions such as endovascular thrombectomy (EVT) for acute ischemic stroke, IC may be challenging. We, therefore sought to identify and assess the challenges that clinicians face when obtaining IC for EVT.Methods A cross-sectional online survey was conducted from July to December 2023. The survey targeted clinicians involved in acute stroke management. The survey was created using Qualtrics and distributed via institutional networks, professional societies, StrokeNet, and social media.Results Among 406 respondents, 75% were staff physicians, predominantly from the United States (79%) and employed at academic medical centers (76%). The mean duration in clinical practice was 13 ±10 years. When asked how often there was uncertainty regarding the optimal approach to IC for EVT, responses were: ‘never’ (36%), ‘sometimes’ (52%), ‘often’ (9%), and ‘always’ (3%). Respondents answered ‘no’ (20%), ‘yes’ (57%), or ‘unsure’ (23%), when asked if their institutions had policies around IC for EVT. Furthermore, 82% stated they never received training at their institutions on the topic. In free-text responses about perceived challenges to IC for EVT, several key themes emerged: time constraints in emergency settings (56%), lack of patient capacity (19%), availability of surrogates/family (23%), communication barriers (9%), institutional practices/policies (8%), and legal/ethical considerations (7%). Respondents stated: ‘time is brain,’ ‘seems excessive like consent for CPR,’ ‘overly ambitious to provide EVT outside of guidelines,’ ‘wildly different physician opinions,’ and ‘patients are unusually incapacitated.’Conclusions This study underscores the clinician uncertainty, lack of specific training, and challenges associated with obtaining IC for EVT in acute stroke care. To address these challenges, there is a critical need for standardized training, protocols, and guidelines that can be applied across varied geographical regions and multidisciplinary environments.Disclosures A. Alsarah: None. P. Krieger: None. A. Mbonde: None. A. Dmytriw: None. A. Bonkhoff: None. A. Patel: None. M. Young: None. R. Regenhardt: None.",
  "authors": [
    {
      "affiliations": [
        "Neurology, University of Missouri School of Medicine, Columbia, MO"
      ],
      "name": "A Alsarah"
    },
    {
      "affiliations": [
        "Neurology, Mass General Hospital, Boston, MA"
      ],
      "name": "P Krieger"
    },
    {
      "affiliations": [
        "Neurology, Medical College of Georgia, Augusta, GA"
      ],
      "name": "A Mbonde"
    },
    {
      "affiliations": [
        "Radiology, University of Oxford, Oxford, United Kingdom",
        "Radiology, Neurosurgery, Mass General Hospital, Boston, MA"
      ],
      "name": "A Dmytriw"
    },
    {
      "affiliations": [
        "Massachusetts General Hospital, Boston, MA"
      ],
      "name": "J Hirsch"
    },
    {
      "affiliations": [
        "Neurology, Mass General Hospital, Boston, MA",
        "University of Washington, Seattle, WA"
      ],
      "name": "A Singhal"
    },
    {
      "affiliations": [
        "University of Washington, Seattle, WA"
      ],
      "name": "T Leslie-Mazwi"
    },
    {
      "affiliations": [
        "Neurology, Mass General Hospital, Boston, MA"
      ],
      "name": "A Bonkhoff"
    },
    {
      "affiliations": [
        "Neurosurgery, Mass General Hospital, Boston, MA"
      ],
      "name": "A Patel"
    },
    {
      "affiliations": [
        "Neurology, Mass General Hospital, Boston, MA"
      ],
      "name": "M Young"
    },
    {
      "affiliations": [
        "Neurosurgery, Massachusetts General Hospital, Boston, MA",
        "UTHealth Houston, Houston, TX"
      ],
      "name": "R Regenhardt"
    }
  ],
  "title": "E-125 Challenges in obtaining informed consent for endovascular thrombectomy in acute stroke: a survey of clinicians",
  "uid": "13ece6a6-176e-5efa-a9e3-302d4ef4a757"
}