Video-Assisted Electronic Consent versus Standard Consent for Percutaneous Kidney Biopsy

When I was first asked to write a Patient Voice article about a randomized controlled trial of video-assisted electronic consent (eConsent) versus standard consent for percutaneous kidney biopsy, I said to myself, I am not a writer or an author. Then the calm, still voice in my head said, but you are a patient. I have been a patient diagnosed with kidney disease for 32 years. In 1993, I was diagnosed with IgA nephropathy—nephrotic syndrome. Once I was diagnosed with kidney disease, everything started to spiral out of control with my cardio-kidney-metabolic conditions. My journey includes 2 years total on in-center hemodialysis. I am a grateful recipient of not one but two kidney transplants. One through a living donor from my amazing sister in 1999 and the other through a deceased donor in 2011. As a lifelong patient living with CKD and a host of other medical conditions, my cognitive abilities and mind wellness have also been affected. Thank you to the authors for this article titled a randomized controlled trial of video-assisted eConsent versus standard consent for percutaneous kidney biopsy.1 This article took me back to what the process looked like in real time for so many patients. After presenting with symptoms, your primary care physician says, “I think there might be something wrong with your kidneys, and I'm referring you to a nephrologist.” The nephrologist tells you, “We need to do a percutaneous kidney biopsy to see what's happening with your kidneys.” For me, I became numb and blanked out after that news. You try to process the information but feel overwhelmed. A decision must be made. You are presented with a standard consent form; you must sign to give permission to do a biopsy. Please read the consent form thoroughly and ask questions. However, you feel swamped and can barely process what you are reading. You must sign the consent form, schedule the surgery date, and move to the next phase. Do you truly grasp what you just read? After reading this article, I understand the importance of this clinical trial being conducted. Being able to streamline processes is very crucial in settings dealing with health care and medical management. Although the study was done as a single-center, open-label, randomized controlled trial, consisting of 120 enrolled participants, there is room to extend this trial to other centers to study, to see whether the outcomes varied tremendously. Groups were broken down to a 1:1 ratio in each group, in which the control group used the practice paper consent and the intervention video-assisted eConsent group viewed an 8-minute informational video with illustrations and follow-up questions to test your knowledge and comprehension of the consent. Participants with ages from 34 to 65 years with a median age of 52 reported education levels of <12 years. The eConsent group (intervention) was able to answer more questions correctly. There were no huge differences in patient experience, anxiety, or satisfaction. Participants can still ask questions in either group, which allows the personal connection of the doctor–patient relationship to remain intact. This study showed that either way the information was dispersed to patients, the key factors are comprehension and retention of knowledge. As a patient, it is our responsibility to advocate for ourselves no matter the situation or circumstances. I believe eConsent empowers you to fully understand exactly what will happen during your percutaneous kidney biopsy. I was overloaded with information and probably just signed the consent without reading it thoroughly. Like today with apps on our cellphones, we just give permission to download. How many of us really take the time to read the terms of use? We assume it is standard, and we are not signing our lives away, but do we really know what we are signing if we do not take the time to read. I am a new Patient Voice Author for CJASN and was excited to lend my voice to this patient article. When it comes to our health, we need to be present and in the moment. Being able to streamline eConsent can be extremely beneficial and a best-in-class practice. The visual aids included interactive elements allowing patients the ability to improve their understanding of the eConsent, followed by a questionnaire delivering you another advantage to recall what is going to occur throughout the entire process and procedure is priceless. The option to speak with the nephrologist is still accessible. I believe this process would allow patients to be empowered and to move forward effortlessly. As patients, we must be true stakeholders in our healthcare and equipped to make informed decisions. There should be no feelings of pressure, nor should you leave uniformed or confused about your procedure or decision. Anything to make the process more fluid and efficient is a game changer.