Effect of a Multimedia-Assisted Informed Consent Procedure on the Information Gain of Patients Undergoing Mastectomy and Implant-Based Reconstruction

Introduction: Implant-based reconstruction is the most frequent procedure after mastectomy. Effective preoperative counseling and a thorough informed consent process are crucial for informing patients about oncologic surgery, reconstruction options, and expected cosmetic outcomes. Recent studies indicate that a multimedia video-assisted informed consent procedure may enhance patient information retention compared to traditional methods. This study aims to compare the conventional informed consent process, supplemented with a written informational brochure, to a multimedia video-assisted approach. Materials and Methods: From January to June 2024, 265 consecutive breast cancer patients scheduled for mastectomy and implant-based reconstruction at the European Institute of Oncology in Milan, Italy, were enrolled in this controlled randomized prospective study. Of these, 200 patients completed evaluation questionnaires assessing information retention and anxiety. A six-minute video featuring simple schematic illustrations and automated text-to-speech narration in Italian was developed to enhance understanding of the risks, benefits, and alternatives of the surgical treatment. Patients were randomly assigned to two groups: Group A received the video presentation along with evaluation questionnaires via email, while Group B received only the questionnaires. Results: Patients in the multimedia video-assisted group demonstrated significantly higher overall comprehension compared to those in the control group. Although scores from the Spielberger State/Trait Anxiety Inventory (STAI) and the Decisional Conflict Scale (DCS) indicated greater anxiety and decisional conflict in the standard group, these differences were not statistically significant. Conclusions: The multimedia video-assisted informed consent process is an effective tool for enhancing patient knowledge and awareness regarding implant-based breast reconstruction. This method improves information uptake and retention, suggesting its superiority over traditional communication techniques in preoperative counseling. These findings support the integration of multimedia resources in patient education to facilitate better-informed decision-making. Level of Evidence II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.