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 .
Use of a Low-Literacy Informed Consent Form to Improve Women's Understanding of Tubal Sterilization: A Randomized Controlled Trial
OBJECTIVE : To estimate whether the Medicaid-Title XIX Sterilization Consent Form ( SCF ) format—“st and ard ” compared with “ low-literacy”—is associated with women 's underst and ing of tubal sterilization . METHODS : This study was a r and omized trial that took place in an obstetrics and gynecology residency clinic in the southeastern United States . Women , aged 21 to 45 years , were r and omly allocated to receive a copy of either the st and ard or the low-literacy Medicaid-Title XIX SCF . A research assistant assessed women 's sociodemographic characteristics , health-literacy skills , and underst and ing of sterilization using items from the Postpartum Tubal Sterilization Knowledge question naire . Women were also queried regarding their preferences for either version of the Medicaid-Title XIX SCF . RESULTS : We included 201 women in the study . Compared with women in the st and ard group ( n=99 ) , women in the low-literacy group ( n=102 ) with no additional counseling better understood the length of time required between signing the form and undergoing sterilization ( 23.6 % difference between groups , P<.01 ) , the time interval until the form expired ( 33.7 % difference between groups , P<.01 ) , permanence of sterilization ( 15.7 % difference between groups , P=.01 ) , and that nonpermanent contraceptive options as effective as sterilization are available ( 8.2 % difference between groups , P=.02 ) . When given the choice to select either Medicaid-Title XIX SCF , 189 ( 94 % ) preferred the low-literacy version . CONCLUSION : Our results support replacing the st and ard Medicaid-Title XIX SCF with the low-literacy version to foster increased underst and ing of sterilization . LEVEL OF EVIDENCE :
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 .