Technology-assisted informed consent in otolaryngology–head and neck surgery: a systematic review and meta-analysis

Abstract Background Technology-assisted tools may standardize and strengthen informed consent, but their effectiveness in otolaryngology–head and neck surgery has not been synthesized in a specialty-specific meta-analysis. Methods A systematic review and meta-analysis was conducted in accordance with PRISMA 2020. Randomized controlled trials comparing technology-assisted consent with conventional consent for otolaryngologic procedures were included. Primary outcomes were comprehension/knowledge, satisfaction, risk recall, and anxiety. Continuous outcomes were pooled using standardized mean differences (SMDs), and dichotomous outcomes using odds ratios (ORs), with 95% confidence intervals (CIs). Results Eight randomized trials were included in the systematic review, and seven contributed to quantitative synthesis. Technology-assisted consent did not significantly improve overall comprehension (SMD 0.42, 95% CI -0.05 to 0.90) or satisfaction (SMD 0.12, 95% CI -0.39 to 0.63). However, it improved immediate risk recall (SMD 0.76, 95% CI 0.43 to 1.08) and delayed risk recall at 3 to 4 weeks (SMD 0.54, 95% CI 0.22 to 0.86), and it increased the odds of reduced anxiety (OR 2.60, 95% CI 1.19 to 5.68). Narrative data from the non-pooled trial suggested similarly high satisfaction across counseling modalities without a clear recall advantage for video-based adjuncts. Conclusions Technology-assisted informed consent in otolaryngology improves recall of procedural risks and may reduce preprocedural anxiety, while preserving patient satisfaction. The evidence does not show a consistent overall benefit for comprehension, likely because of heterogeneity in interventions and outcome measures. multimedia-based consent tools show promise as adjuncts to standard counseling in otolaryngology–head and neck surgery.