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 .
An evaluation of informed consent prior to epidural analgesia for labor and delivery.
This investigation was performed to determine the ability of a parturient to recall the pre-anesthesia discussion with her anesthesiologist and to determine if written consent added to this discussion improves recall . Eighty-two women presenting in labor were r and omized to ' verbal ' and ' verbal plus written ' consent for epidural labor analgesia and were contacted 5 to 7 months after a pre-anesthetic interview . Ten objective questions were posed at this time that addressed issues that were ' true risks ' , ' false risks ' , and ' situational ' issues related to the consent process . These responses were scored on a point scale so that a maximal objective recall score of 100 points was possible . Median recall score was 80 ( 70 - 90 ) in the ' verbal ' group and 90 ( 80 - 100 ) in the ' verbal plus written ' group . This difference was statistically significant ( P < 0.01 ) . In addition , three subjective questions were asked of all women at this time . All but six women ( one ' verbal plus written ' and five ' verbal ' group patients ) expressed that written consent would help them ' remember and appreciate the different anesthetic options , risks , and procedures ' . Four of these same women ( one ' verbal plus written ' and three ' verbal ' group patients ) thought a written consent process was ' alarming ' . Two of these same women ( both ' verbal ' group patients ) reported that they felt unable to give informed consent
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 .