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 .
The influence of written information during the consenting process on patients’ recall of operative risks. A prospective randomised study
In a recent article , Leigh ( J Bone Joint Surg [ Br ] 88-B:16–18 , 2006 ) notes that patients do not lay down memory when being counselled as to the risks involved in prospect i ve surgery . In our article we focused on the patients ’ recall of risk factors involved in elective spinal surgery . We assessed the influence of written information provided to the patients during the consenting process on their recall of operative risks . The study was a prospect i ve r and omised study . All patients having elective spinal surgery were included in our study from February 2006 to November 2006 as a consecutive series . Patients were r and omised into two groups , one of which received routine consent with verbal explanations ( group 1 ) , the other received the same information supplemented by a written sheet explaining the risks of the surgery ( group 2 ) . Two weeks later we assessed patients ’ recall of the risk involved in the surgery with a question naire and compared both groups with a Student t-test .  Fifty-three patients ( twenty in group 1 and twenty three in group 2 ) were involved . We noted a significant difference between the two groups in terms of mean number of risks recalled and number of patients recalling each risk ( p < 0.001 and p < 0.005 , respectively ) . The addition of a written sheet given to patients during the consenting process makes a significant difference in terms of their recall of the surgical risks in elective lumbar spine surgery . We advocate the routine use of written booklets during the consenting process . RésuméRappel : dans un article récent , Leigh montre que les patients ne se souviennent pas très bien des indicationsqui leur ont été données en ce qui concerne l’information sur les risques avant une intervention chirurgicale . Nous avons souhaité , dans notre étude mettre l’accent sur les risques pouvant survenir dans la chirurgie rachidienne . Nous avons essayé d’évaluer l ’ importance de l’information écrite lors de la mise en place du consentement éclairé de ces patients . Méthode : cette étude est une étude prospect i ve r and omisée . Tous les patients devant bénéficier d’une chirurgie rachidienne ont été inclus dans notre étude sur une période s’étalant de février 2006 à novembre 2006 . Tous les patients consécutifs ont été r and omisés en deux groupes . Le premier groupe n’ayant que des explications par voie orale , ( groupe 1 ) et le deuxième groupe avec un complément d’informations écrites , ( groupe 2 ) . Deux semaines après , ces patients ont été évalués avec un question naire et les deux groupes ont été comparés . Résultats : 53 patients dans le groupe 1 et 23 dans le groupe 2 ont été pris en compte dans cette étude . Nous avons noté une différence significative entre les deux groupes soit sur le nombre d’informations retenues par le patient ou le nombre de patients ayant pris en compte ces informations . En conclusion : outre l’information orale , une information écrite remise au patient durant le processus de consentement éclairé en chirurgie du rachis lombaire , est nécessaire avec une différence significative entre les deux groupes . Nous recomm and ons cette information écrite de façon routinière
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 .