Faculty Bibliography

STUDY OBJECTIVE: This study determined whether Spanish and English educational videos are superior to routine discussion for informing emergency department (ED) patients about risks, benefits, and alternatives to receiving intravenous contrast for computed tomography (CT). METHODS: A prospective randomized controlled trial was performed on a convenience sample of adult ED patients scheduled to receive intravenous contrast for CT. Patients randomized to the intervention group watched a video in Spanish or English explaining the procedure and its risks, benefits, and alternatives. The control group underwent routine discussion, receiving intravenous contrast information from their emergency physician. After their educational sessions, all participants completed a 10-question intravenous contrast knowledge measure and 1 question rating satisfaction with the informed consent process. Mean scores were compared to assess whether the videos were superior to routine discussion for educating patients about intravenous contrast. Secondary outcomes included the proportion of satisfied patients and refusals to sign consent. RESULTS: Of the 112 patients enrolled, 56 were randomized to the video group and 56 to routine discussion. Five patients withdrew from the study, leaving 107 for analysis (video N=53; control N=54). Mean knowledge scores were higher in the video group (68.1%) compared to routine discussion (47.8%) (95% confidence interval [CI] for the difference 12.6% to 28.1%). Video-group patients exhibited greater satisfaction than routine-discussion patients (86.8% [95% CI 74.6% to 94.5%] versus 77.4% [95% CI 63.8% to 87.7%]). All patients signed consent to receive intravenous contrast. CONCLUSION: Using Spanish and English educational videos yielded higher intravenous contrast knowledge scores compared with routine informed consent procedures

OBJECTIVES: Prior evidence suggests that physicians may alter process of care based on race/ethnicity. The objective of this study was to determine whether race/ethnicity predicts whether a patient receives computed tomography of the head (head CT) during evaluation of blunt head injury. METHODS: This was a nonconcurrent cohort study set in an emergency department of a Level 1 trauma center in a university medical center. Consecutive patients presenting with blunt head injury from January 2000 to December 2000 were enrolled. The main outcome measure was whether or not a patient received head CT during evaluation of blunt head injury. RESULTS: The unadjusted probability of receiving head CT was similar among minority (33.9%; 95% confidence interval [CI] = 30.0% to 38.1%) and non-Hispanic white patients (36.4%; 95% CI = 33.5% to 39.3%). After adjusting for important clinical and socioeconomic predictors, minority patients had a probability of receiving head CT 0.84 times as high as that of non-Hispanic whites, but this result was not statistically significant (95% CI = 0.67 to 1.09). CONCLUSIONS: Minority and non-Hispanic white patients may not have significantly different rates of receiving head CT during evaluation of blunt head injury. A multicenter prospective study is necessary to confirm these preliminary findings