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 .
THE EFFECTIVENESS OF PATIENT VERBALIZATION ON INFORMED CONSENT
OBJECTIVE To determine if preoperative patient verbalization of the risks and benefits of  anterior cruciate ligament ( ACL ) reconstruction  enhances underst and ing of the risks and benefits of that procedure . DESIGN A r and omized clinical trial . SETTING A referral-based outpatient sport medicine clinic . SUBJECTS Twenty patients from the general population with clinical ly diagnosed ACL tears requiring elective reconstruction surgery were r and omly assigned to 2 groups . Twelve patients who made up a control group received a st and ard surgical consultation , consisting of knee models , diagrams , open dialogue and informed consent to surgery . Eight patients in the experimental group were exposed to the same surgical consultation and were required to accurately verbalize the associated risks and benefits before operation . One month after informed consent was obtained , patients answered 3 questions about the risks and benefits of ACL reconstruction . INTERVENTION ACL reconstruction . MAIN OUTCOME MEASURES A 3- question question naire , addressing 2 risks and 1 benefit of ACL reconstruction . MAIN RESULTS Patients in the experimental group were able to answer all 3 questions correctly . In the control group , 4 patients answered all 3 questions correctly , but 1 patient answered all 3 questions incorrectly , and 7 patients answered 1 question incorrectly . There was a statistically significant difference ( p = 0.03 ) between the control group and the experimental group . CONCLUSION Patients who verbalized the risks and benefits during their surgical consultation demonstrated a significantly greater underst and ing of the risks and benefits of an ACL reconstruction procedure
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 .