***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: Although r and omised trials are important for evidence -based medicine , little is known about their overall characteristics . We assessed the epidemiology and reporting of method ological details for all 519 PubMed -indexed r and omised trials published in December , 2000 ( 383 [ 74 % ] parallel-group , 116 [ 22 % ] crossover ) . 482 ( 93 % ) were published in specialty journals . A median of 80 participants ( 10th-90th percentile 25 - 369 ) were recruited for parallel-group trials . 309 ( 60 % ) were blinded . Power calculation , primary outcomes , r and om sequence generation , allocation concealment , and h and ling of attrition were each adequately described in less than half of publications . The small sample sizes are worrying , and poor reporting of method ological characteristics will prevent reliable quality assessment of many published trials The purpose of this study was to examine the effect of three Therapeutic Touch treatments on the well-being of 20 persons with terminal cancer in palliative care . Participants in the experimental group ( n = 10 ) received three noncontact Therapeutic Touch treatments , the duration of which varied between 15 to 20 minutes . Participants in the control group ( n = 10 ) participated in three rest periods .  Well-being was measured at preintervention time and immediately postintervention time using the Well-Being Scale , a visual analogue scale measuring pain , nausea , depression , anxiety , shortness of breath , activity , appetite , relaxation , and inner peace . The results of the study support the hypothesis that three noncontact Therapeutic Touch treatments increase sensation of well-being in persons with terminal cancer Research suggests that patients with cancer , particularly in the palliative care setting , are increasingly using aromatherapy and massage . There is good evidence that these therapies may be helpful for anxiety reduction for short periods , but few studies have looked at the longer term effects . This study was design ed to compare the effects of four-week courses of aromatherapy massage and massage alone on physical and psychological symptoms in patients with advanced cancer . Forty-two patients were r and omly allocated to receive weekly massages with lavender essential oil and an inert carrier oil ( aromatherapy group ) , an inert carrier oil only ( massage group ) or no intervention . Outcome measures included a Visual Analogue Scale ( VAS ) of pain intensity , the Verran and Snyder-Halpern ( VSH ) sleep scale , the Hospital Anxiety and Depression ( HAD ) scale and the Rotterdam Symptom Checklist ( RSCL ) . We were unable to demonstrate any significant long-term benefits of aromatherapy or massage in terms of improving pain control , anxiety or quality of life . However , sleep scores improved significantly in both the massage and the combined massage ( aromatherapy and massage ) groups . There were also statistically significant reductions in depression scores in the massage group . In this study of patients with advanced cancer , the addition of lavender essential oil did not appear to increase the beneficial effects of massage . Our results do suggest , however , that patients with high levels of psychological distress  respond best to these therapies Much has been written about working with the dying . Few , if any , controlled studies have examined the application of principles set forth . The authors evaluate the effectiveness of working with dying cancer patients by assessing changes in quality of life , physical functioning , and survival .  One‐hundred twenty men with end‐stage cancer were r and omly assigned to experimental or control groups ; the 62 experimental group patients  were seen regularly by a counselor . Patients were assessed before r and om assignment and at one , three , six , nine , and 12 months on quality of life and functional status . Experimental group patients improved significantly more than the control group on quality of life within three months . Functional status and survival did not differ between groups . A sub sample of lung cancer patients provided cross‐validation of findings . Although survival was not expected to differ , it was predicted that functioning would be enhanced if quality of life improved . One interpretation is that little can be done to alter physical function and survival when intervention occurs late in the progression of a fatal disease . This in no way reduces the value of improving overall quality of life , since enhancing the quality of survival for end‐stage cancer patients is a high priority medical goal Sensory environments may potentially provide an atmosphere of calm and refreshment . This small pilot study used a r and omized controlled trial ( RCT ) design and semi-structured interviews to investigate the use of the Snoezelen multisensory environment in palliative day care . Its second aim was to explore the feasibility of the RCT design in advance of a possible larger trial . The study compared Snoezelen with a normal ' quiet room ' setting . Following screening for anxiety , 26 patients were recruited and r and omly assigned to the control of experimental group . Anxiety and depression were assessed using the Hospital Anxiety and Depression scale and quality of life assessed using the European Organisation for Research and Treatment of Cancer Core 30 question naire . A significant reduction in anxiety was seen with the experimental group ( P=0.01 ) but no changes were observed in any of the quality -of-life subscales . However , the results should be viewed with caution , as there were some differences between the groups in two of the quality -of-life subscales . Data from semi-structured interviews suggested Snoezelen might promote relaxation . It is concluded that Snoezelen is feasible for use with this patient group and recommendations are made for further research BACKGROUND Insufficient knowledge about mental illness and its treatment has been shown to constitute a major barrier to its adequate care for mental illness in the lay public ( LP ) . We therefore examined Japanese cancer patients ' ( CP ) ability to recognize depression and their preferences of its treatments . PARTICIPANTS AND METHOD One hundred lung CP and 300 LP were selected at r and om to participate in the study . Structured interviews using a vignette of a person with both cancer and depression were conducted with CP , and those using a vignette of a person with depression were carried out with LP , respectively . RESULTS Only 11 % of CP recognized the presence of depression in the vignette , while 25 % of LP did ( p<0.001 ) . There were few significant differences in the preference for st and ard psychiatric treatments between CP and LP : st and ard treatments such as  antidepressants  ( CP : 39 % , LP : 36 % ) were less often rated as helpful , whereas non-st and ard treatments such as  physical activity  ( CP : 85 % , LP : 66 % ) were most often rated as helpful . CONCLUSIONS The results indicated that cancer patients ' knowledge about mental illness and its treatment were insufficient . Psychological education may reduce patient-related barriers to seek and to utilize optimal mental health care in cancer patients PURPOSE To determine the prevalence of psychiatric disorders during hospitalization for hematopoietic stem-cell transplantation ( SCT ) and to estimate their impact on hospital length of stay ( LOS ) . PATIENTS AND METHODS In a prospect i ve inpatient study conducted from July 1994 to August 1997 , 220 patients aged 16 to 65 years received SCT for hematologic cancer at a single institution . Patients received a  psychiatric assessment  at hospital admission and weekly during hospitalization until discharge or death , yielding a total of 1,062  psychiatric interviews performed . Psychiatric disorders were determined on the basis of the Diagnostic and Statistical Manual of Mental Disorders , Fourth Edition . Univariate and multivariate linear regression analyses were used to identify variables associated with LOS . RESULTS Overall psychiatric disorder prevalence was 44.1 % ; an adjustment disorder was diagnosed in 22.7 % of patients , a mood disorder in 14.1 % , an anxiety disorder in 8.2 % , and delirium in 7.3 % . After adjusting for admission and in-hospital risk factors , diagnosis of any mood , anxiety , or adjustment disorder ( P = .022 ) , chronic myelogenous leukemia ( P = .003 ) , Karnofsky performance score less than 90 at hospital admission ( P = .025 ) , and higher regimen-related toxicity ( P < .001 ) were associated with a longer LOS . Acute lymphoblastic leukemia ( P = .009 ) , non-Hodgkin 's lymphoma ( P = .04 ) , use of peripheral-blood stem cells ( P < .001 ) , second year of study ( P < .001 ) , and third year of study ( P < .001 ) were associated with a shorter LOS . CONCLUSION Our data indicate high psychiatric morbidity and an association with longer LOS , underscoring the need for early recognition and effective treatment To examine the prevalence of depressive symptoms and its relationship with quality -of-life domains in home-care cancer patients at an advanced stage of illness , 86 patients were given psychological tests for depression ( Hospital Anxiety Depression Scale ) ( HAD ) and  quality of life  ( EORTC-QLQ-C30 ) 1 week after admission to the home-care program .  Using a proper cut-off score on the HAD-Depression subscale , depressive symptoms were reported by 45 % of the patients . The quality of life of depressed patients was more affected than non-depressed patients in the social , emotional , cognitive , and physical domains . Significant correlations were found between depression scores and impairment in most quality -of-life areas . These findings support the importance of depression and quality -of-life evaluation in patients with advanced cancer who are followed in a home-care setting . This evaluation is needed to provide patients , their families , and caregivers with appropriate psychosocial interventions Our study belongs to the clinical trials in which the health-related quality of life ( HQL ) evaluation constitutes the primary endpoint . It was carried out with the aim of comparing the impact of three different types of psychological intervention , namely a psychopharmacological treatment alone , the same treatment plus social support carried out by volunteers ( SSV ) and a third treatment modality including “ structured psychotherapy ” ( autogenous training ) , on improving the HQL of elderly cancer patients undergoing antineoplastic therapy with symptoms of anxiety and /or depression related to their disease . The eight question naires used for HQL evaluation were generally . self-rated and multidimensional but unidimensional models were also employed . Seventy-four patients aged over 65 years with either solid tumors in different sites or hematological malignancies , generally in advanced stages ( III – IV ) , were enrolled in the study . Of these patients , 72 ( 42 men and 30 women , mean age 70.68 years , range 66–85 ) were evaluable . Our study high-lighted the usefulness of the pharmacological therapy ( alprazolam + sulpiride ) and of other specific ancillary treatments in reducing the incidence of the main HQL-related side-effects of antineoplastic therapy and the superiority of an “ integrated ” strategy , based both on psychopharmacology and psychosocial interventions , such as SSV with or without structured psychotherapy . The one-way analysis of variance carried out by us did not allow us to draw definitive conclusions about which of the two integrated treatments was to be considered the treatment of choice , as they proved to be almost equally effective This paper describes a pilot study of information giving in an oncology setting . This was achieved by r and omly allocating patients to having their consultation tape-recorded or not . The results suggest that this approach increases the retention of information in patients as well as reducing their levels of anxiety . The method is cheap and easy to use , acceptable to patients and their families , and does not inhibit the consultation process THE SPECIALTY OF PALLIATIVE CARE has experienced substantial growth and development over the past 10 years . Strong clinical palliative care programs are now firmly established in multiple setting s and venues , education in palliative care has seen strong advances with increasing penetration of palliative care content in medical school and residency curricula and continuing medical and nursing education programs , a rigorous certifying board examination for physicians has been developed , and there has been steady growth in the number of physicians who are certified in palliative medicine . Whereas we can point to these many successes in palliative care , palliative care research remains relatively underdeveloped . The evidence base for much of what we do in clinical practice remains sparse compared to more established medical specialties and important research questions in palliative care have yet to be adequately addressed or answered . Dr. Storey ’s poignant account of his difficulties in conducting high- quality rigorous research in palliative care — particularly his difficulty in conducting r and omized controlled trials — is emblematic of the problems facing palliative care research ers . If we are to conduct high- quality research in palliative care ( and indeed we must if the field is to advance ) , then our efforts must be focused equally on answering the important clinical questions of interest ( the what ) and on using the appropriate research instruments , design s , and analytic techniques ( the how ) . In this article , we identify key challenges in each of these three research areas and discuss approaches to overcoming them Two hundred fifteen r and omly accessed cancer patients who were new admissions to three collaborating cancer centers were examined for the presence of formal psychiatric disorder . Each patient was assessed in a common protocol via a psychiatric interview and st and ardized psychological tests . The American Psychiatric Association 's DSM-III diagnostic system was used in making the diagnoses . Results indicated that 47 % of the patients received a DSM-III diagnosis , with 44 % being diagnosed as manifesting a clinical syndrome and 3 % with personality disorders . Approximately 68 % of the psychiatric diagnoses consisted of adjustment disorders , with 13 % representing major affective disorders ( depression ) . The remaining diagnoses were split among organic mental disorders ( 8 % ) , personality disorders ( 7 % ) , and anxiety disorders ( 4 % ) . Approximately 85 % of those patients with a positive psychiatric condition were experiencing a disorder with depression or anxiety as the central symptom . The large majority of conditions 
    Output:
    
AUTHORS ' CONCLUSIONS Evidence from RCTs of moderate quality suggest that psychotherapy is useful for treating depressive states in advanced cancer patients .
However , no evidence supports the effectiveness of psychotherapy for patients with clinical ly diagnosed depression