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Deer T, Patel AA, Sayed D, Bailey-Classen A, Comer A, Gill B, Patel K, Abd-Elsayed A, Strand N, Hagedorn JM, Hussaini Z, Khatri N, Budwany R, Murphy M, Nguyen D, Orhurhu V, Rabii M, Beall D, Hochschuler S, Schatman ME, Lubenow T, Guyer R, Raslan AM. Informed Consent for Spine Procedures: Best Practice Guideline from the American Society of Pain and Neuroscience (ASPN). J Pain Res 2023; 16:3559-3568. [PMID: 37908778 PMCID: PMC10613566 DOI: 10.2147/jpr.s418261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 09/27/2023] [Indexed: 11/02/2023] Open
Abstract
Introduction The evolution of treatment options for painful spinal disorders in diverse settings has produced a variety of approaches to patient care among clinicians from multiple professional backgrounds. The American Society of Pain and Neuroscience (ASPN) Best Practice group identified a need for a multidisciplinary guideline regarding appropriate and effective informed consent processes for spine procedures. Objective The ASPN Informed Consent Guideline was developed to provide clinicians with a comprehensive evaluation of patient consent practices during the treatment of spine pathology. Methods After a needs assessment, ASPN determined that best practice regarding proper informed consent for spinal procedures was needed and a process of selecting faculty was developed based on expertise, diversity, and knowledge of the subject matter. A comprehensive literature search was conducted and when appropriate, evidence grading was performed. Recommendations were based on evidence when available, and when limited, based on consensus opinion. Results Following a comprehensive review and analysis of the available evidence, the ASPN Informed Consent Guideline group rated the literature to assist with specification of best practice regarding patient consent during the management of spine disorders. Conclusion Careful attention to informed consent is critical in achieving an optimal outcome and properly educating patients. This process involves a discussion of risks, advantages, and alternatives to treatment. As the field of interventional pain and spine continues to grow, it is imperative that clinicians effectively educate patients and obtain comprehensive informed consent for invasive procedures. This consent should be tailored to the patient's specific needs to ensure an essential recognition of patient autonomy and reasonable expectations of treatment.
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Affiliation(s)
- Timothy Deer
- The Spine and Nerve Center of the Virginias, Charleston, WV, USA
| | - Ankur A Patel
- Weill Cornell Tri-Institutional Pain Medicine Program, Department of Anesthesiology, Weill Medical College of Cornell University, New York, NY, USA
| | - Dawood Sayed
- Department of Anesthesiology and Pain Medicine, the University of Kansas Medical Center, Kansas City, KS, USA
| | | | - Ashley Comer
- The Spine and Nerve Center of the Virginias, Charleston, WV, USA
| | - Benjamin Gill
- Department of Physical Medicine and Rehabilitation, University of Missouri, Columbia, MO, USA
| | - Kiran Patel
- Lenox Hill Hospital, Northwell Health, New York, NY, USA
| | - Alaa Abd-Elsayed
- Department of Anesthesiology, University of Wisconsin, Madison, WI, USA
| | - Natalie Strand
- Interventional Pain Management, Mayo Clinic, Scottsdale, AZ, USA
| | - Jonathan M Hagedorn
- Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Rochester, MN, USA
| | - Zohra Hussaini
- Department of Anesthesiology and Pain Medicine, the University of Kansas Medical Center, Kansas City, KS, USA
| | - Nasir Khatri
- Novant Health Spine Specialists, Charlotte, NC, USA
| | - Ryan Budwany
- The Spine and Nerve Center of the Virginias, Charleston, WV, USA
| | - Melissa Murphy
- North Texas Orthopedics and Spine Center, Grapevine, TX, USA
| | - Dan Nguyen
- Neuroradiology and Pain Solutions of Oklahoma, Oklahoma City, OK, USA
| | - Vwaire Orhurhu
- Department of Anesthesia, University of Pittsburgh Medical Center, Susquehanna, PA, USA
| | - Morteza Rabii
- Crimson Pain Management, Overland Park, Kansas, KS, USA
| | | | | | - Michael E Schatman
- Department of Anesthesiology, Perioperative Care and Pain Medicine, NYU Grossman School of Medicine, New York, NY, USA
- Department of Population Health – Division of Medical Ethics, NYU Grossman School of Medicine, New York, NY, USA
| | - Timothy Lubenow
- Department of Anesthesiology, Rush University Medical Center, Chicago, IL, USA
| | - Richard Guyer
- Texas Back Institute, Plano, TX, USA
- Department of Orthopedic Surgery, University of Texas Southwestern Medical School, Dallas, TX, USA
| | - Ahmed M Raslan
- Department of Neurological Surgery, Oregon Health and Science University, Portland, OR, USA
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