***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: A series of UK and European audits have revealed that a high proportion of patients remain dissatisfied with the information they received following a diagnosis of cancer . Additional educational aids are often required to facilitate the consent process , and our previous work showed a high level of acceptability for video-directed information for this purpose . In this study a multidisciplinary team of health professionals worked with patients , a documentary film company and experienced television personalities to produce an information film . The aim of this study was to assess the benefits of receiving a cassette to take home following the first consultation and this was evaluated in a r and omised multicentre controlled study among 220 patients receiving chemotherapy or radiotherapy over a 6-month period . There was a significant correlation between satisfaction and reduced treatment-related anxiety overall . In the video group , the mean Hospital Anxiety and Depression ( HAD ) anxiety score was significantly lower during treatment compared with the non-video group ( 4.6+/-3.7 ( range : 0 - 18 ) versus 7.4+/-5.2 ( range : 0 - 20 ) , Chi square test P=0.001 ) . Likewise , the mean HAD depression scores were also significantly lower in the patients prepared for the side-effects of treatment with the video ( 2.9+/-2.9 ( range : 0 - 13 ) versus 5.3+/-4.7 ( range : 0 - 21 ) Chi square test P=0.001 ) . 81 % felt the video was helpful , only 5 % of patients felt this extra information was worrying . Well design ed video cassettes should be regarded as a useful additional information strategy , within routine oncology practice In a r and omised , controlled trial , patients with joint diseases and concomitant treatment with NSAIDs and diuretics received systematic education . The intervention group was given information by a self-conducted , interactive Kodak Photo-CD program in addition to personal drug information and non-commercial drug leaflets . Awareness of drug interactions and encouragement of self-adjustment of treatment was focused on . Control patients received conventional information . Three months after r and omisation , knowledge was tested by means of a question naire . At 3 months there was a significant difference in attained score between the intervention group and the control group . Greater knowledge was achieved , especially on drug interaction , in the intervention group . In conclusion , less than 1 h of systematic education significantly improved  patients ' knowledge on essential issues of concomitant treatment with NSAIDs and diuretics . Knowledge of effects , side-effects and interactions of drugs is essential for self-adjustment of treatment . The method employed , which is st and ardised and produces a reproducible quantity of education , might be applicable to several other medical conditions Asthma self-management programmes have been shown to increase children 's knowledge about asthma and improve their management practice s and health status . However , existing programmes have rarely addressed the unique learning needs of very young children . This study aim ed to develop and assess the effectiveness of a video tape and picture book design ed to teach children about the prevention and management of acute episodes of asthma . The information content of the educational re sources was determined by analysis of relevant medical information and asthma management skills . Social Learning Theory and consideration of the developmental stage of the target population informed the format and style of presentation of the re sources . Eighty children aged between 2 and 5 years who had been diagnosed with asthma by their medical practitioner and who required daily asthma medication participated in a controlled experimental study . The study evaluated the impact of the asthma education re sources on children 's knowledge about asthma , compliance with medication regimens and health status . Children were r and omly allocated to one of three experimental groups . Children in these groups were exposed to either the video tape alone , the book alone or both the video tape and book , or to a control group who viewed material s unrelated to asthma . The results for the three experimental groups were compared with the control group who did not receive exposure to any of the asthma education re sources . The results showed that children in each experimental group had significantly greater gains in asthma-related knowledge than children in the control group and children exposed to both re sources showed the greatest increases in knowledge . Children in each of the three experimental groups also had better compliance and health than children in the control group . These findings indicate that carefully design ed asthma education re sources are useful for providing even the youngest children with information about asthma and its management BACKGROUND Asthma continues to be a substantial cause of morbidity in pediatric population s. New strategies are needed to provide cost-effective educational interventions for children with asthma , particularly those in the inner city . OBJECTIVE To assess the effectiveness of a multimedia educational software program about asthma . SETTING A hospital-based primary care clinic and an affiliated neighborhood health center . DESIGN R and omized , controlled trial . POPULATION Children 3 to 12 years old with physician-diagnosed asthma . INTERVENTION An interactive educational computer program , Asthma Control , design ed to teach children about asthma and its management . Using a graphic display of a child going through simulated daily events , the game emphasizes : 1 ) monitoring ; 2 ) allergen identification ; 3 ) use of medications ; 4 ) use of health services ; and 5 ) maintenance of normal activity . Control group participants review ed printed educational material s with a research assistant . OUTCOMES Acute health care use ( emergency department and outpatient ) was the primary outcome . Secondary outcome measures included maternal report of asthma symptom severity , child functional status and school absences , satisfaction with care , and parental and child knowledge of asthma . RESULTS A total of 137 families were enrolled in the study ( 76 intervention , 61 control ) . Both intervention and control groups showed substantial improvement in all outcomes during the 12-month follow-up period . Aside from improvement in knowledge after use of the computer program , no differences were demonstrated between the 2 groups in primary or secondary outcome measures . Children reported enjoyment of program use . CONCLUSIONS This trial of an educational software program found that it did not produce greater improvement than occurred with review of traditional written material s. Because both groups showed substantial improvement over baseline , computer-based education may be more cost-effective . Alternatively , improvements in illness severity over time may overshadow the effects of such interventions . Rigorous comprehensive evaluations such as this are necessary to assess new interventions intended to improve management and outcomes of asthma Objective . To study the effect of an educational videotape about poliovirus vaccines and choices of schedules for parents/guardians of children starting the polio vaccination series . Design . Prospect i ve , r and omized trial comparing two educational interventions . Setting . Five pediatric offices ( two university-based , two health maintenance organization staff models , and one private practice ) and a local health department immunization clinic in the greater Lansing , MI , area . Participants . A total of 287 parents/guardians of 2- to 3-month-olds presenting for well-child care and due for the first set of immunizations including poliovirus vaccine . Interventions . Parents/guardians were r and omized to read the vaccine information statement ( VIS ) alone or to read the VIS and view a 15-minute videotape about polio vaccination and choices of schedules produced by Michigan State University . The intervention groups were similar by race/ethnicity , education , and relationship to the child . Outcome Measures . Change in knowledge about the risk of poliomyelitis in the United States , transmission of poliomyelitis , characteristics of the two poliovirus vaccines , and choices of polio vaccination schedules ; and parent opinion on effectiveness of the interventions , as measured by pre- and postintervention question naires . Results . Both interventions result ed in increased test scores of knowledge . However , videotape viewers scored significantly higher on their posttest compared with parents/guardians assigned to VIS only . This significant increase was noted across all practice types , two of three major racial/ethnic groups , and educational levels . ( The increase for Hispanic parents/guardians approached significance ) . Reading the VIS did not improve posttest scores for videotape viewers . Reading the VIS did improve posttest scores for those assigned to VIS only , but these scores still were not as high as for videotape viewers who did not read the VIS . Conclusions . This study demonstrated that a complicated discussion of risks/ benefits of two vaccines and their schedules of administration could be communicated effectively via a videotaped presentation . In addition , the videotape was more effective than VIS alone in increasing short-term knowledge , regardless of practice type , race/ethnicity , or educational level . As immunization schedules increase in complexity and parents are asked to make more choices , videotaped information may be a better method to achieve the goal of truly informed consent OBJECTIVE To test a quality improvement intervention , a learning collaborative based on the Institute for Healthcare Improvement 's Breakthrough Series methodology , specifically intended to improve care and outcomes for patients with childhood asthma . DESIGN R and omized trial in primary care practice s. SETTING Practice s in greater Boston , Mass , and greater Detroit , Mich. PARTICIPANTS Forty-three practice s , with 13 878 pediatric patients with asthma , r and omized to intervention and control groups . Intervention Participation in a learning collaborative project based on the Breakthrough Series methodology of continuous quality improvement . MAIN OUTCOME MEASURES Change from baseline in the proportion of children with persistent asthma who received appropriate medication therapy for asthma , and in the proportion of children whose parent received a written management plan for their child 's asthma , as determined by telephone interviews with parents of 631 children . RESULTS After adjusting for state , practice size , child age , sex , and within- practice clustering , no overall effect of the intervention was found . CONCLUSIONS This method ologically rigorous assessment of a widely used quality improvement technique did not demonstrate a significant effect on processes or outcomes of care for children with asthma . Potential deficiencies in program implementation , project duration , sample selection , and data sources preclude making the general inference that this type of improvement program is ineffective . Additional rigorous studies should be undertaken under more optimal setting s to assess the efficacy of this method for improving care Inhaled medication is important in the treatment of chronic obstructive pulmonary disease ( COPD ) . In this paper a comparison of the long-term efficacy of three instruction-models is presented . A total of 152 COPD - patients were r and omized into one of four groups : Personal- , video- , group-instruction and a control group . Inhalation technique was assessed by means of checklists , on which essential inhalation manoeuvres were identified . Up to 9 months later , 148 patients returned for follow-up assessment . Prior to instruction 61 % of patients in the control group had a perfect score on essential actions , compared to 62 , 65 and 53 % for those receiving group- , personal- and video-instruction respectively . At follow-up these percentages were 49 , 97 , 75 and 76 % . For group-(35 % ) and video-instruction ( 24 % ) the increase from baseline was significant . Examining the different inhalers under investigation , it is striking , that only 24 % of all patients with a Metered Dose Inhaler ( MDI ) performed all essential checklist items correctly , versus 96 % for those using a Diskhaler . The fact that for the MDI this percentage improved to 90 % post-instruction , shows that time spent on instruction , is time well spent . We conclude that group instruction seems superior to personal counselling , and equally effective or even better than video instruction . Personal instruction should not be dismissed and a combination with video instruction might prove to be effective as well Abstract Background Low utilization of effective coronary heart disease ( CHD ) prevention strategies may be due to many factors , but chief among them is the lack of patient involvement in prevention decisions . We undertook this study to test the effectiveness of an individually-tailored , computerized decision aid about CHD on patients ' discussion s with their doctor and their plans for CHD prevention . Methods We conducted a pilot r and omized trial in a convenience sample of adults with no previous history of cardiovascular disease to test the effectiveness of an individually-tailored , computerized decision aid about CHD prevention against a risk factor list that patients could present to their doctor . Results We enrolled 75 adults . Mean age was 53 . 59 % were female , 73 % white , and 23 % African-American . 66 % had some college education . 43 % had a 10-year CHD risk of 0–5 % , 25 % a risk of 6–10 % , 24 % a risk of 11–20 % , and 5 % a risk of > 20 % . 78 % had at least one option to reduce their CHD risk , but only 45 % accurately identified the strategies best supported by evidence . 41 patients received the decision aid  , 34 received  usual care . In unadjusted analysis , the decision aid increased the proportion of patients who discussed CHD risk reduction with their doctor from 24 % to 40 % ( absolute difference 16 % ; 95 % CI -4 % to + 37 % ) and increased the proportion who had a specific plan to reduce their risk from 24 % to 37 % ( absolute difference 13 % ; 95 % CI -7 % to + 34 % ) . In pre-post testing , the decision aid also appeared to increase the proportion of patients with plans to intervene on their CHD risk ( absolute increase ranging from 21 % to 47 % for planned medication use and 5 % to 16 % for planned behavioral interventions ) . Conclusion Our study confirms patients ' limited knowledge about their CHD risk and effective risk reduction options and provides preliminary evidence that an individually-tailored decision aid about CHD prevention might be expected to increase patients ' discussion s about CHD prevention with their doctor and their plans for CHD risk reduction . These findings should be replicated in studies with a larger sample size and patients at overall higher risk of CHD . Trial Registration : Clinical Trials.gov OBJECTIVE Adherence to self-care behaviors improves heart failure ( HF )  morbidity and life quality . We examined short-term impact of video education ( VE ) in addition to st and ard education ( SE ) on HF healthcare utilization and self-care behavior adherence . METHODS One hundred and twelve hospitalized patients were r and omly assigned to SE ( n=53 ) or SE plus VE ( n=5 
    Output:
    
This review provides evidence that multimedia education about medications is more effective than usual care ( non-st and ardised education provided by health professionals as part of usual clinical care ) or no education , in improving both knowledge and skill acquisition .
It also suggests that multimedia education is at least equivalent to other forms of education , including written education and education provided by a health professional .
Multimedia education about medications could therefore be considered as an adjunct to usual care but there is inadequate evidence to recommend it as a replacement for written education or education by a health professional .