Royal College of Surgeons in Ireland
Kiernan 2023 - Digital technology in informed consent for surgery - systematic review.pdf (585.22 kB)

Digital technology in informed consent for surgery: systematic review.

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posted on 2023-07-21, 15:54 authored by Aoife KiernanAoife Kiernan, Brian Fahey, Shaista S Guraya, Fiona BolandFiona Boland, Daragh MoneleyDaragh Moneley, Frank DoyleFrank Doyle, Denis HarkinDenis Harkin

Background: Informed consent is an ethical and legal requirement in healthcare and supports patient autonomy to make informed choices about their own care. This review explores the impact of digital technology for informed consent in surgery.

Methods: A systematic search of EBSCOhost (MEDLINE/CINAHL), Embase, Cochrane Central Register of Controlled Trials and Web of Science was performed in November 2021. All RCTs comparing outcomes of both digital and non-digital (standard) consent in surgery were included. Each included study underwent an evaluation of methodological quality using the Cochrane risk of bias (2.0) tool. Outcomes assessed included comprehension, level of satisfaction and anxiety, and feasibility of digital interventions in practice.

Results: A total of 40 studies, across 13 countries and 15 surgical specialties were included in this analysis. Digital consent interventions used active patient participation and passive patient participation in 15 and 25 studies respectively. Digital consent had a positive effect on early comprehension in 21 of 30 (70 per cent) studies and delayed comprehension in 9 of 20 (45 per cent) studies. Only 16 of 38 (42 per cent) studies assessed all four elements of informed consent: general information, risks, benefits, and alternatives. Most studies showed no difference in satisfaction or anxiety. A minority of studies reported on feasibility of digital technology in practice.

Conclusion: Digital technologies in informed consent for surgery were found to have a positive effect on early comprehension, without any negative effect on satisfaction or anxiety. It is recommended that future studies explore the feasibility of these applications for vulnerable patient groups and busy surgical practice.


The Royal College of Surgeons in Ireland, Strategic Academic Research programme together with the Bon Secours Health System (Ireland) are sponsoring the study though research grant DC21139A01



The original article is available at

Published Citation

Kiernan A, et al. Digital technology in informed consent for surgery: systematic review. BJS Open. 2023;7(1):zrac159.

Publication Date

24 January 2023

PubMed ID



  • RCSI Bahrain
  • Data Science Centre
  • Beaumont Hospital
  • Health Psychology
  • School of Population Health
  • Medicine
  • Medical Professionalism

Research Area

  • Health Professions Education
  • Surgical Science and Practice
  • Population Health and Health Services
  • Vascular Biology


Oxford University Press (OUP)


  • Published Version (Version of Record)

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