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 .
Randomised controlled trial of the effect of standard and detailed risk disclosure prior to bronchoscopy on peri-procedure anxiety and satisfaction
Background : Deciding what risks to disclose before a procedure is often challenging for clinicians . Consecutive patients undergoing elective fibreoptic bronchoscopy  were r and omised to receive simple or more detailed written information about the risks of the procedure and the effects on anxiety and satisfaction levels were compared . Methods : A 100 mm anxiety visual analogue scale ( VAS ) and a modified Amsterdam preoperative anxiety ( scored 4–20 ) scale ( APAIS ) were completed before and after reading the design ated information leaflet . Following bronchoscopy , subjects completed a satisfaction question naire . Results : Of 142 consecutive patients , 122 ( 86 % ) ( mean age 57.8 years , 53 % male ) completed the study . Baseline demographic , clinical and anxiety measures were similar in the two groups . Those who received more detailed risk information had significantly greater increase in anxiety levels than those who received simple information on both the VAS ( mean 14.0 ( 95 % CI 10.1 to 17.9 ) vs 2.5 ( 95 % CI −1.4 to 6.4 ) , p<0.001 ) and the APAIS ( 1.73 ( 95 % CI 1.19 to 2.26 ) vs 0.57 ( 95 % CI 0.05 to 1.10 ) , p<0.001 ) . Almost twice as many of those receiving detailed risk information reported that they felt they had received too much information about complications or that the information they had received about bronchoscopy had been worrying . Conclusions : Provision of more detailed risk information before bronchoscopy may come at the cost of a small but significant increase in anxiety
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 .