A Randomized Controlled Trial of Video-Assisted Electronic Consent versus Standard Consent for Percutaneous Kidney Biopsy

Key Points Video-assisted electronic consent significantly improved patient comprehension of percutaneous kidney biopsy without affecting patient-reported experience. Audiovisual aids support clinicians in delivering patient-centered informed consent, enhancing comprehension and engagement. Background Informed consent is crucial in health care because it respects and honors patient autonomy. However, the process of consenting a patient to a procedure or intervention is often unstandardized, leading to gaps in comprehension, which in turn affects decision making. The aim of this study was to assess the patient-reported benefits of video-assisted electronic consent (eConsent) compared with the usual consent practices for percutaneous kidney biopsies (PKBs). Methods In this single-center, open-label, randomized controlled trial, consecutive patients undergoing PKB between July 2021 and January 2024 were randomized (1:1) to either video-assisted eConsent (intervention) or usual practice of consent (control). The intervention group accessed an eight-minute explanatory animation on an online platform covering the procedure, its risks, and pre- and postbiopsy care before providing digital consent. The control group was consented to by clinicians in the usual manner and signed a paper form. The primary outcome was questionnaire-based patient comprehension, with secondary outcomes including patient-reported experience, anxiety, and satisfaction with the consent process. Results Of 178 eligible patients, 120 were enrolled (60 in each group), with a median age of 52 (interquartile range, 34–65) years; 56% were female; and 59% had <12 years of education. Comprehension scores were significantly higher in the eConsent group, with participants answering on average three more questions correctly out of nine compared with the control group ( P < 0.001). Comprehension did not differ significantly by sex or education level, but younger patients scored higher. The eConsent group also had better comprehension of pre- and post-PKB care. No significant differences were observed in patient-reported experience, anxiety, or satisfaction between groups. Conclusions Video-assisted eConsent improves patient comprehension of PKB compared with the usual consent practice without affecting patient experience, anxiety, or satisfaction. Clinical Trial registry name and registration number: Australian New Zealand Clinical Trials Registry (ACTRN12621000768897).