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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Musculoskeletal Disorders 1/2015

Internet based patient education improves informed consent for elective orthopaedic surgery: a randomized controlled trial

BMC Musculoskeletal Disorders > Ausgabe 1/2015
Andrew Fraval, Janan Chandrananth, Yew M Chong, Phong Tran, Lillian S Coventry
Wichtige Hinweise
Andrew Fraval, Janan Chandrananth, Yew M Chong, Phong Tran and Lilian S Coventry contributed equally to this work.
An erratum to this article is available at http://​dx.​doi.​org/​10.​1186/​s12891-015-0660-9.

Competing interests

The authors declare that they have no competing interests. Some of the authors of this study did contribute to the patient education website being utilised. This includes Andrew Fraval, Andrew Fraval, Janan Chandranath, Yew M Chong, Phong Tran. None of the authors have benefited financially from either the website or this research in any way.

Authors’ contributions

AF Participated in the design and implementation of the study as well as the statistical analysis for this investigation. He also wrote the manuscipt. JC Participated in the design of this study and contributed to the orthoanswer website. YMC Participated in the design of this study and contributed to the orthoanswer website. PT conceived of the study, and participated in its design and coordination. He also helped to edit the manuscript. LC provided assistance with data collection for this study and helped with the logistics of running the trial. All authors read and approved the final manuscript.



Obtaining informed consent is an essential step in the surgical pathway. Providing adequate patient education to enable informed decision making is a continued challenge of contemporary surgical practice. This study investigates whether the use of a patient information website, to augment patient education and informed consent for elective orthopaedic procedures is an effective measure.


A randomised controlled trial was conducted comparing the quality of informed consent provided by a standard discussion with the treating surgeon compared to augmentation of this discussion with an online education resource (www.​orthoanswer.​org). Participants were recruited from orthopaedic outpatient clinics. Patients undergoing five common orthopaedic procedures were eligible to participate in the trial. The primary outcome measure was knowledge about their operation. Satisfaction with their informed consent and anxiety relating to their operation were the secondary outcome measures.


There was a statistically significant increase in patient knowledge for the intervention arm as compared to the control arm (p < 0.01). Patients in the intervention arm, had an average score of 69.25% (SD 14.91) correct answers as compared to 47.38% (SD 17.77) in the control arm. Satisfaction was also improved in the intervention arm (p = 0.043). There was no statistically significant difference between the control and intervention arm relating to their anxiety scores (p = 0.195).


The use of a patient education website as an augment to informed consent improves patient knowledge about their planned operation as well as satisfaction with the consent process whilst not increasing their anxiety levels. We recommend that all patients be directed to web based education tools to augment their consent.

Trial registration

Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12614001058​662.
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