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 .
Influence of supplemental written information on adolescent anxiety, motivation and compliance in early orthodontic treatment.
OBJECTIVES To test the null hypotheses that supplementation of verbal information with written information when obtaining consent to orthodontic treatment has no effect on ( 1 ) anxiety , motivation and apprehension related to treatment and ( 2 ) compliance in the early stages of fixed appliance therapy . MATERIAL S AND METHODS Seventy-six adolescents who were due to start fixed appliance therapy were r and omly allocated to receive verbal information only or verbal and written information before orthodontic treatment . Participants ' anxiety , motivation , and apprehension were assessed using a question naire that was completed prior to meeting the orthodontic clinician ( T1 ) , following consent to treatment ( T2 ) , and after 12 weeks of treatment ( T3 ) . Appointment attendance , appliance breakages , and periodontal scores were used as measures of patient compliance . RESULTS Sixty participants completed the study . At T2 there was no change in anxiety scores for either group ( P = .412 ) ; however , increased motivation was detected in the group that had been given both written and verbal information ( P = .049 ) . At T3 both groups demonstrated similar reductions in anxiety ( P = .311 ) and apprehension ( P = .790 ) and similar levels of motivation ( P = .756 ) . A reduction in periodontal scores ( P = .065 ) , better appointment attendance ( P = .732 ) , and fewer breakages ( P = .525 ) were reported in the group that was given additional information , although these changes were not statistically significant . CONCLUSIONS Supplementation of verbal information with written information result ed in improved motivation for orthodontic treatment but had no statistically significant effect on anxiety , apprehension , or patient compliance
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 .