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 .
Assisting informed decision making for labour analgesia: a randomised controlled trial of a decision aid for labour analgesia versus a pamphlet
Background Most women use some method of pain relief during labour . There is extensive research evidence available of pharmacological pain relief during labour ; however this evidence is not readily available to pregnant women . Decision aids are tools that present evidence based information and allow preference elicitation . Methods We developed a labour analgesia decision aid . Using a RCT design women either received a decision aid or a pamphlet .  Eligible women were primiparous , ≥ 37 weeks , planning a vaginal birth of a single infant and had sufficient English to complete the trial material s. We used a combination of affective ( anxiety , satisfaction and participation in decision-making ) and behavioural outcomes ( intention and analgesia use ) to assess the impact of the decision aid , which were assessed before labour . Results 596 women were r and omised ( 395 decision aid group , 201 pamphlet group ) . There were significant differences in knowledge scores between the decision aid group and the pamphlet group ( mean difference 8.6 , 95 % CI 3.70 , 13.40 ) . There were no differences between decisional conflict scores ( mean difference -0.99 ( 95 % CI -3.07 , 1.07 ) , or anxiety ( mean difference 0.3 , 95 % CI -2.15 , 1.50 ) . The decision aid group were significantly more likely to consider their care providers opinion ( RR 1.28 95%CI 0.64 , 0.95 ) . There were no differences in analgesia use and poor follow through between antenatal analgesia intentions and use . Conclusions This decision aid improves women 's labour analgesia knowledge without increasing anxiety . Significantly , the decision aid group were more informed of labour analgesia options , and considered the opinion of their care providers more often when making their analgesia decisions , thus improving informed decision making . Trial Registration Trial registration no : IS RCT
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 .