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 pediatric surgery: Do parents understand the risks?
OBJECTIVE To investigate parent underst and ing of the risks of pediatric ear , nose , and throat surgery after counseling with and without the use of informational aids . DESIGN Prospect i ve , r and omized trial . SETTING Academic tertiary care center . PARTICIPANTS Parents of children undergoing ear , nose , and throat surgery . INTERVENTIONS  Parents  were  r and omized  to receive st and ard informed consent with or without detailed informational aids . MAIN OUTCOME MEASURES Parents completed identical question naires testing their general procedure knowledge and their recall of 9 specific surgical risks both immediately after counseling and on the day of surgery . RESULTS Thirty-four parents enrolled in and completed the study ( 18 in the control group and 16 in the test group ) . The mean time from informed consent to surgery was 6.3 days ( range , 1 - 22 days ) . Parents in the test group scored significantly higher on identifying the 9 risks on both the preoperative question naire ( mean score , 6.00 vs 4.44 ; P = .007 , 2-tailed t test ) and the postoperative question naire ( 6.25 vs 4.17 ; P < .001 ) . There was a negative correlation ( inverse relationship ) between parent education score and risk recall , with parents with lower education levels scoring higher on both the preoperative ( Pearson r = -0.36 ; P = .04 ) and the postoperative ( r = -0.35 ; P = .04 ) surveys . The maternal parent recalled risks significantly better than the paternal parent , with surgical risk recall scores of 5.46 out of 9 vs 3.67 out of 9 ( P = .02 , 2-tailed t test ) . CONCLUSIONS Parents of children undergoing ear , nose , and throat surgery recall far less than 100 % of counseled risks . The use of detailed surgical risk counseling improves measured parental underst and ing of surgical risk . Parental educational level and maternal vs paternal parent may affect risk counseling recall
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 .