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 .
Randomized, controlled trial of an interactive videodisc decision aid for patients with ischemic heart disease
OBJECTIVE : To determine the effect of the Ischemic Heart Disease Shared Decision-Making Program ( IHD SDP ) an interactive videodisc design ed to assist patients in the decision-making process involving treatment choices for ischemic heart disease , on patient decision-making . DESIGN : R and omized , controlled trial . SETTING : The Toronto Hospital , University of Toronto , Toronto , Ontario , Canada . PARTICIPANTS : Two hundred forty ambulatory patients with ischemic heart disease amenable to elective revascularization and ongoing medical therapy . MEASUREMENTS AND MAIN RESULTS : The primary outcome was patient satisfaction with the decision-making process . This was measured using the 12-item Decision-Making Process Question naire that was developed and vali date d in a r and omized trial of the benign prostatic hyperplasia SDP . Secondary outcomes included patient knowledge ( measured using 20 questions about knowledge deemed necessary for an informed treatment decision ) , treatment decision , patient-angiographer agreement on decision , and general health scores . Outcomes were measured at the time of treatment decision and /or at 6 months follow-up . Shared decision-making program scores were similar for the intervention and control group ( 71 % and 70 % , respectively ; 95 % confidence interval [ CI ] for 1 % difference , −3 % to 7 % ) . The intervention group had higher knowledge scores ( 75 % vs 62 % ; 95 % CI for 13 % difference , 8 % to 18 % ) . The intervention group chose to pursue revascularization less often ( 58 % vs 75 % for the controls ; 95 % CI for 17 % difference , 4 % to 31 % ) . At 6 months , 52 % of the intervention group and 66 % of the controls had undergone revascularization ( 95 % CI for 14 % difference , 0 % to 28 % ) . General health and angina scores were not different between the groups at 6 months . Exposure to the IHD SDP result ed in more patient-angiographer disagreement about treatment decisions . CONCLUSIONS : There was no significant difference in satisfaction with decision-making process scores between the IHD SDP and usual practice groups . The IHD SDP  patients were more knowledgeable , underwent less revascularization ( interventional therapies ) , and demonstrated increased patient decision-making autonomy without apparent impact on quality of life
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 .