Is There a Difference Between the Readabilities of Informed Consent Forms Used for Elective and Emergency Procedures in Turkey?

Background:: Informed consent is an important aspect of ethical medical practice. In legal terms, making an intervention without informed consent may mean negligence or malpractice and may lead to legal action, maltreatment, and even attack against the doctor. This study aims to evaluate the readability of informed consent forms (ICFs) used for elective (urology and general surgery) and emergency procedures (emergency medicine and intensive care) by comparing through readability formulas. Method:: Elective and emergency ICFs were accessed through the web sites of national health care associations. A total of 387 consent forms were evaluated and the same forms were included only once. A total of 35 consent forms were evaluated for emergency procedures, while a total of 55 consent forms were evaluated for elective procedures. Ateşman and Bezirci-Yılmaz formulas defined for determining the readability level of Turkish texts and Gunning fog and Flesch Kincaid formulas measuring the general readability level were used for calculating the readability level of consent forms. Results:: Even though elective ICFs are more readable compared to those of emergency procedures according to Bezirci-Yılmaz formulas, this was statistically insignificant (<inline-formula id="IEq1"><alternatives><math><mrow><mi>P</mi><mo>=</mo><mo>.</mo><mn>54</mn></mrow></math><tex-math id="IEq1_TeX">\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$P=.54$$\end{document}</tex-math><inline-graphic href="43441_2019_96_Article_IEq1.gif"></inline-graphic></alternatives></inline-formula>). The readability of elective consent forms was found to be at a significantly more difficult level to read compared to Ateşman, Gunning fog, and Flesch Kincaid formulas (<inline-formula id="IEq2"><alternatives><math><mrow><mi>P</mi><mo>=</mo><mo>.</mo><mn>002</mn></mrow></math><tex-math id="IEq2_TeX">\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$P= .002$$\end{document}</tex-math><inline-graphic href="43441_2019_96_Article_IEq2.gif"></inline-graphic></alternatives></inline-formula>, <inline-formula id="IEq3"><alternatives><math><mrow><mi>P</mi><mo>&lt;</mo><mo>.</mo><mn>001</mn></mrow></math><tex-math id="IEq3_TeX">\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$P &lt; .001$$\end{document}</tex-math><inline-graphic href="43441_2019_96_Article_IEq3.gif"></inline-graphic></alternatives></inline-formula>, <inline-formula id="IEq4"><alternatives><math><mrow><mi>P</mi><mo>&lt;</mo><mo>.</mo><mn>001</mn></mrow></math><tex-math id="IEq4_TeX">\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$P &lt; .001$$\end{document}</tex-math><inline-graphic href="43441_2019_96_Article_IEq4.gif"></inline-graphic></alternatives></inline-formula>, respectively). Conclusion:: Even though the procedure is emergency or elective, a difficult readability level may cause problems for the doctor in legal phases. Readable and understandable consent forms should be available to be able to explain morbidity and mortality and improve prognosis. Education level of our country should also be considered while preparing these consent forms.