We have identified efforts by research ers to investigate interventions which seek to improve information delivery and consideration of information to enhance  informed consent .
The interventions used consistently improve patient knowledge , an important prerequisite for informed consent .
This is encouraging and these measures could be widely employed although we are not able to say with confidence which types of interventions are preferable .
Our results should be interpreted with caution due to the high levels of heterogeneity associated with many of the main analyses although we believe there is broad evidence of beneficial outcomes for patients with the pragmatic application of interventions .
BACKGROUND Achieving informed consent is a core clinical procedure and is required before any surgical or invasive procedure is undertaken .
However , it is a complex process which requires patients be provided with information which they can underst and and retain , opportunity to consider their options , and to be able to express their opinions and ask questions .
There is evidence that at present some patients undergo procedures without informed consent being achieved .
OBJECTIVES To assess the effects on patients , clinicians and the healthcare system of interventions to promote informed consent for patients undergoing surgical and other invasive healthcare treatments and procedures .
AUTHORS ' CONCLUSIONS Informed consent is an important ethical and practical part of patient care .
Improvement of the Educational Process by Computer-based Visualization of Procedures: Randomized Controlled Trial
Background Before any invasive procedure , physicians have a legal obligation to inform patients . Traditionally , this involves a discussion with a physician , supplemented by written leaflet information directed at the specific procedure . Objective Comparison of the use and effectiveness of computer-based visualization opposed to st and ardized conversation for providing patients with information of forthcoming procedures ( coronary catheters or endoscopy procedures ) . Methods Prospect i ve , r and omized trial with 56 participants allocated in two different groups : Visualization Group ( st and ardized information supported by a tool for displaying two-dimensional pictures to explain medical facts as well as informative leaflet ) or Control Group ( st and ardized information and informative leaflet only ) . Detailed information was given about the indication , the probable complications and the details of the forthcoming procedures ( coronary catheters or endoscopy procedures ) . All participants had to reach a Karnofsky Score of 70 points and be able to underst and German or English . Main outcome measures were patient 's satisfaction with physician-patient conversation , patient 's acquired knowledge and duration of the intervention as described above . Results Patients of the Visualization Group were more satisfied with the conversation and had higher knowledge scores after the conversation . A Mann-Whitney-U-Test between the two groups showed that these differences in satisfaction ( P<0.001 ) and knowledge ( P=<0.006 ) were statistically significant . Length of time needed for the conversation was slightly higher in the Visualization Group , but this difference was not statistically significant ( 25 versus 23 min ; P= 0.441 ) . No differences could be found due to differing age or educational level in the results of the Visualization and the Control Group . Conclusions Using computerized visualization increased the satisfaction and knowledge of the patients . The presentation of the visualized information in the Visualization Group did not dem and significantly more time than the st and ard conversation in the Control Group
We have identified efforts by research ers to investigate interventions which seek to improve information delivery and consideration of information to enhance  informed consent .
The interventions used consistently improve patient knowledge , an important prerequisite for informed consent .
This is encouraging and these measures could be widely employed although we are not able to say with confidence which types of interventions are preferable .
Our results should be interpreted with caution due to the high levels of heterogeneity associated with many of the main analyses although we believe there is broad evidence of beneficial outcomes for patients with the pragmatic application of interventions .
BACKGROUND Achieving informed consent is a core clinical procedure and is required before any surgical or invasive procedure is undertaken .
However , it is a complex process which requires patients be provided with information which they can underst and and retain , opportunity to consider their options , and to be able to express their opinions and ask questions .
There is evidence that at present some patients undergo procedures without informed consent being achieved .
OBJECTIVES To assess the effects on patients , clinicians and the healthcare system of interventions to promote informed consent for patients undergoing surgical and other invasive healthcare treatments and procedures .
AUTHORS ' CONCLUSIONS Informed consent is an important ethical and practical part of patient care .