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- W2017195874 abstract "Research into treatments for acute strokes has dramatically increased in the last decade. Accordingly, the need for testing through randomized clinical trials has also increased. Because of the unique combination of factors that are common in acute stroke–related research, including narrow treatment windows, ethical concerns regarding research with acute stroke populations, and capacity for informed consent, stroke clinical trial enrollment levels have remained stagnant. Given the devastating consequences of acute stroke, researchers are intensifying their efforts to recruit and enroll larger sample sizes in clinical trials.1Capacity to consent to medical treatment or medical research is closely related to cognitive functioning, which is frequently impaired in stroke.2 Medical decision-making capacity (MDC) requires the ability to understand and appreciate diagnostic, treatment, and research information and risks and ability to express a choice that is based on adequate reasoning. The treating physician is responsible for the assessment of a patient’s decision-making capacity and clinically estimate their patient’s ability to provide informed consent.3 Many physicians request additional consultative assistance to assess cognitive capacity for consent from psychiatry or neuropsychology, which are considered to be the clinical gold standards4 or they perform standardized capacity questionnaires to aid the assessment of capacity.5,6One such tool, the aid-to-capacity evaluation (ACE) had 80% to 89% agreement with expert clinicians in 1 study and inter-rater reliability reported as ĸ=0.79 for medical hospitalized patients.7,8 The ACE has been validated and found to be one of the best available instruments to assist clinicians in making judgments on MDC.4 It is designed to be used by trained nonclinicians and takes ≈10 minutes to perform.4 For patients who lack capacity medical decisions are deferred to a surrogate decision maker. Surrogate decision makers in acute stroke are able to accurately predict …" @default.
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- W2017195874 date "2014-11-01" @default.
- W2017195874 modified "2023-09-29" @default.
- W2017195874 title "Comparison Between a Standardized Questionnaire and Expert Clinicians for Capacity Assessment in Stroke Clinical Trials" @default.
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- W2017195874 doi "https://doi.org/10.1161/strokeaha.114.006395" @default.
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