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 .
Informed consent in otologic surgery: prospective randomized study comparing risk recall with an illustrated handout and a nonillustrated handout.
OBJECTIVE Following consent , do pictures in a h and out improve  patients ' recall of otologic surgical risks ? STUDY DESIGN Prospect i ve , r and omized trial in a tertiary care centre . METHODS Patients undergoing otologic surgery were consented with a st and ardized checklist of risks by two surgeons . They were r and omized ( stratified by educational level ) to receive either a pure text or a text and pictures h and out outlining the risks of surgery . A telephone interview tested recall at a mean of 19 days . Twenty-six patients were re sample d at 1 year . MAIN OUTCOME MEASURES Recall was analyzed with respect to type of h and out , age , sex , and level of education . A subset of 31 patients was analyzed for the effects of which surgeon consented , previous otologic surgery , and actually reading the h and out . RESULTS Fifty-one patients completed the study . The overall risk recall was 43 % , with 45 % in the pictorial group and 42 % in the pure text group ( p = .84 ) . The illustrated h and out did not improve the recall of any individual surgical risk either . Higher education improved risk recall from 36 to 54 % ( p = .009 ) . Age , consenting surgeon , previous otologic surgery , and even reading the h and out did not improve risk recall . A subgroup of 26 patients was followed up 1 year later , and their recall fell from 41 to 35 % . The illustrated h and out did not improve long-term recall ( p = .674 ) . CONCLUSION Pictorial cues do not improve recall of surgical risks , but education level does
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 .