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 .
[3-dimensional computer animation--a new medium for supporting patient education before surgery. Acceptance and assessment of patients based on a prospective randomized study--picture versus text].
INTRODUCTION The rigorous implementation of clear preoperative information is m and atory for the patient 's underst and ing , acceptance and written informed consent to all diagnostic and surgical procedures . In the present study , I evaluated whether new media are suitable for conveying basic information to patients ; I analysed the merits of computerized animation to illustrate a difficult treatment process , i.e. , the progressive steps of a thyroid operation , in comparison to the use of conventional flyers . METHODS 3D animation software was employed to illustrate the basic anatomy of the thyroid and the larnyx ; the principle of thyroidectomy was explained by visualizing the surgical procedure step by step . Finally , the possible complications that may result from the intraoperative manipulations were also visually explained . Eighty patients entered a prospect i ve r and omisation : on the day before surgery , group 1 watched the computer animation , whereas group 2 was given the identical information in a written text (= st and ard flyer ) . The evaluation included a question naire with scores of 1 - 5 , rating the patients ' underst and ing , subjective and objective knowledge , emotional factors like anxiety and trust , and the willingness to undergo an operation . RESULT Underst and ing of and subjective knowledge about the surgical procedure and possible complications , the degree of trust in professional treatment , the reduction in anxiety and readiness for the operation were significantly better after watching the computer animation than after reading the text . However , active knowledge did not improve significantly . The interest in the preoperative information was high in both groups . The benefit of  computer animation  was enhanced in a second inquiry ; patients who had only read the text had a significant improvement in parameters after an additional exposure to the video animation . CONCLUSION Preoperative surgical information can be optimized by presenting the operative procedure via computer animation . Nowadays , several types of new media such as the world wide web , CD , DVD , and digital TV are readily available and --as shown here -- suitable for effective visual explanation . Most patients are familiar with acquiring new information by one of these means . An appropriately design ed 3D repre-sentation is met with a high level of acceptance , as the present study clearly shows . Modern patient-based information systems are necessary . They can no longer be the sole responsibility of the medical profession , but must be on the agenda of hospital managements and of medical care systems as well
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 .