Video-assisted informed consent helps reduce decisional conflict in cancer patients

For patients undergoing gastric cancer surgery, informed consent (IC) can involve extensive information about surgical methods, complications, risks, benefits, and life after treatment. Conventional face-to-face explanations can be difficult to absorb in one sitting and require substantial time from both patients and surgeons. Decisional conflict, the uncertainty people may feel when making a treatment choice, adds to this challenge. 

A research team led by Senior Assistant Professor Kazumitsu Suzuki and Professor Susumu Shibasaki from the Department of Surgery, Fujita Health University, Japan, along with their colleagues Associate Professor Yusuke Watanabe, Professor Ichiro Uyama, and Professor Koichi Suda from the same institute, addressed this challenge. In cooperation with Contrea Inc., the team evaluated whether standardized video aids could help patients better understand the relevant information before their surgical consultation. Sixty patients scheduled for gastrectomy were randomly assigned either to watch video IC aids before their face-to-face consultation (PVIC group) or to receive the face-to-face consultation first and watch the videos afterward (standard IC group). The study was published online on September 27, 2026, in Volume 18, Issue 9, of the World Journal of Gastrointestinal Surgery. 

“Rather than replacing the doctor’s explanation, the video was designed to help patients understand essential information before meeting their doctor,” said Dr. Suzuki. “We wanted patients to understand the surgery at their own pace so the consultation could focus more on their questions and concerns, supporting shared decision-making.” 

The videos were delivered through a web-based platform in short segments totaling about 30 minutes. They used animations, illustrations, and subtitles to explain topics such as surgical procedures, complications, postoperative recovery, and reconstruction methods. Surgeons selected appropriate modules for each patient’s planned operation, allowing the material to be tailored while maintaining a standardized explanation. 

The results showed improved consultation efficiency. Face-to-face IC discussions lasted an average of 22.4 minutes in the PVIC group, compared with 35.9 minutes in the standard IC group, a reduction of about 40%.  

The primary outcome, the overall decisional conflict score, tended to be lower in the PVIC group after the consultation, although the difference did not reach statistical significance.　The mean score was 13.5 in the PVIC group and 20.5 in the standard group, with P = 0.056. In both groups, decisional conflict decreased after patients received the video and physician explanation. However, no patients in the pre-consultation video group had high decisional conflict after the consultation, compared with 20% in the standard group, a statistically significant difference. These findings suggest that timing may matter: having an opportunity to understand the information through multimedia before the face-to-face discussion may help prevent high levels of uncertainty. 

“Patients can watch the videos at home, revisit difficult parts, and share the information with family members before their appointment,” said Dr. Suzuki. “This could help shift the consultation from simply delivering information toward a more meaningful dialogue between patients and healthcare professionals.” 

The researchers emphasize that the videos are not intended to replace conversations with doctors. Because videos provide one-way information, they cannot respond to personal concerns or questions. Instead, the approach could give patients a clearer baseline understanding and allow consultation time to be used for individualized discussion. In the future, digital tools, potentially including AI, could provide more personalized information and identify patients’ questions and priorities before appointments. 

Overall, this randomized trial suggests that pre-consultation video aids may improve the efficiency of IC for gastric cancer surgery and help prevent high decisional conflict. Further larger-scale evaluations could provide more robust evidence of these effects. 

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Reference 
DOI: 10.4240/wjgs.123251 

 
About Fujita Health University 
Fujita Health University (FHU) is a private medical university located in Aichi, Japan. Established in 1964, it houses one of the largest university hospitals in Japan. It's 900 member faculty provides diverse learning and research opportunities to medical students worldwide. Guided by its founding philosophy of "Our creativity for the people" Fujita Health University believes that it's students can shape the future through creativity and innovation. FHU has earned global recognition, ranking eighth among all universities and second among private universities in Japan in the 2020 Times Higher Education (THE) World University Rankings. The university ranked fourth worldwide in the 2024 THE University Impact Rankings for contributions to the "Good Health and Well-being" SDG (Sustainable Development Goals) of the United Nations (UN). In June 2021, the university made history as the first Japanese institution to host the THE Asia Universities Summit. In 2024, Fujita Health University was awarded the Forming Japan’s Peak Research Universities (J-PEAKS) Program by the Japanese government to establish an innovative academic drug discovery ecosystem and hub of a multi-university consortium for research and education. 
Website: https://www.fujita-hu.ac.jp/ 

About Dr. Kazumitsu Suzuki from Fujita Health University  
Dr. Kazumitsu Suzuki is a Senior Assistant Professor and researcher in the Division of Gastrointestinal Surgery at Fujita Health University, Japan. His clinical and research expertise includes laparoscopic and minimally invasive surgery, with a focus on gastrointestinal and abdominal surgery. His research interests span the perioperative management of deep vein thrombosis in minimally invasive surgery, mesenchymal tumors, small bowel tumors, and leiomyosarcoma, as well as surgical approaches for gastrointestinal diseases and cancers. He has contributed to research across abdominal surgery, liver diseases, and musculoskeletal and nerve cancers. He has authored 32 publications and has received 129 citations, reflecting his contributions.   

Funding information 
This study was conducted in cooperation with Contrea Inc. (MediOS software provided).