***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: OBJECTIVES To assess the influence of the form of presentation of the results of clinical trials on the quantitative perceptions of cardiologists regarding the efficacy of drugs for the primary and secondary prevention of coronary heart disease and their likelihood of prescribing them . METHOD We conducted a survey of 1,408 cardiologists in Spain who were r and omly allocated of three question naires that used different measurements to evaluate the impact of published clinical trials . RESULTS Five-hundred and fifty-nine question naires ( 40 % ) were suitable for analysis . On a scale of 0 to 10 , the following mean efficacy estimates were obtained from question naire items that focused , respectively , on the results of clinical trials in terms of relative risk reduction , absolute risk reduction , and number needed to treat : primary prevention with statins : 6.79 , 6.38 and 5.43 ; primary prevention with aspirin : 6.84 , 5.06 and 4.25 ; secondary prevention with statins : 8.16 , 7.76 and 7.54 ; secondary prevention with ACE inhibitors : 7.11 , 7.81 and 7.19 , and secondary prevention with beta-blockers : 7.22 , 7.43 and 6.98 . The likelihood that a drug treatment would be prescribed was not influenced very much by the form of presentation of the trial results . CONCLUSIONS Presenting the results of clinical trials in the form of relative risk reduction , as compared with presenting results in terms of absolute risk reduction or number needed to treat , led to overestimation of the efficacy of interventions without influencing the likelihood of prescribing a given drug therapy Abstract Objective : To assess whether the way in which the results of a r and omised controlled trial and a systematic review are presented influences health policy decisions . Design : A postal question naire to all members of a health authority within one regional health authority . Setting : Anglia and Oxford regional health authorities . Subjects : 182 executive and non-executive members of 13 health authorities , family health services authorities , or health commissions . Main outcome measures : The average score from all  health authority members in terms of their willingness to fund a mammography programme or cardiac rehabilitation programme  according to four different ways of presenting the same results of research evidence —namely , as a relative risk reduction , absolute risk reduction , proportion of event free patients , or as the number of patients needed to be treated to prevent an adverse event . Results : The willingness to fund either programme was significantly influenced by the way in which data were presented . Results of both programmes when expressed as relative risk reductions produced significantly higher scores when compared with other methods ( P<0.05 ) . The difference was more extreme for mammography , for which the outcome condition is rarer . Conclusions : The method of reporting trial results has a considerable influence on the health policy decisions made by health authority members BACKGROUND Underst and ing pre-test probability and baseline risks helps to interpret the results of diagnostic tests and the benefits of treatment , but how good is the underst and ing of these concepts ? OBJECTIVES Our aim was to assess the ability of GPs and consultant physicians to make accurate estimates and underst and the application of pre-test probability and baseline risk for two common clinical conditions . METHODS A two-stage question naire survey based on case scenarios of patients with angina and congestive heart failure was carried out of 202 physicians , r and omly selected from the members of the Royal College of Physicians in the NW of Engl and , 205 GPs r and omly chosen from the practice list of the NW Health Authorities and 128 MRCGP examiners attending an examiners meeting . A total of 115 , 106 and 81 members of these groups , respectively , responded to the first stage , and 44 , 46 and 64 to the second . The main outcome measures were the stated likelihood of true ischaemic heart disease ( IHD ) being present and the predicted 1-year mortality ; the impact of changing prevalence and baseline risk on these results ; and interpretation of different methods of risk presentation . RESULTS Estimates of pre-test probability of IHD being present ranged from 5 to 100 % and of baseline risk of 1-year mortality from 0 to 86 % . More GP examiners and consultant physicians understood the impact of increasing age on the test result than did the r and om sample of GPs . A majority of each group correctly said that increasing age would reduce the number needed to treat ( NNT ) . Presentation of benefit as relative risk reduction was a greater stimulus to starting treatment than the NNT or measures of population impact . CONCLUSION Clinicians should collect data to allow a better knowledge of the likelihood of disease and of baseline risk in their patient population s. Methods to increase the underst and ing of the influence of pre-test probability on diagnostic test results and of how to quantify and demonstrate the impact of the benefit of interventions should be explored This study was conducted to evaluate willingness to prescribe medication  based on identical data presented in different outcome terms to health professionals of varied discipline , geographic location , and level of training .  Cross-sectional survey using a self-administered question naire was performed in 400 health professionals ( physicians , pharmacists , physicians-in-training , and pharmacy students ) in the United States and Europe . Data reflecting a clinical trial were presented in 6 outcome terms : 3 terms describing identical mortality ( relative risk reduction , absolute risk reduction , and number of patients needed to be treated to prevent 1 death ) ; and 3 distractors ( increased life expectancy , decreased hospitalization rate , and decreased cost ) . Willingness to prescribe and rank order of medication preference assuming willingness to prescribe were measured . The results of the study showed that willingness to prescribe and first choice preference were significantly greater when study results were presented as relative risk reduction than when identical mortality data were presented as absolute risk reduction or number of patients needed to be treated to avoid 1 death ( p < 0.001 ) . Increase in life expectancy was the most influential distractor . In conclusion , this study , performed in the era of " evidence -based medicine , " demonstrates that the method of reporting research trial results has significant influence on health professionals ' willingness to prescribe . The high numerical value of relative risk reduction and the concrete and tangible quality of increased life expectancy exert greater influence on health professionals than other st and ard outcome terms Objective - The objective of the study was to gain better insight into how general practitioners ( GPs ) perceive risk reduction and the way this perception may be influenced by healthcare environment . Design - Question naires with clinical episodes were sent to Danish and Polish GPs , who were r and omised into four groups , each receiving the same case story with differently phrased information about risk reduction achieved through medical treatment . The GPs were asked whether they would recommend medical treatment , knowing the case story and expected risk reduction . Subjects - Danish and Polish GPs . Results - A greater proportion of Polish GPs than Danish GPs would definitely or probably recommend treatment ( 93 % versus 72 % ; p < 0.001 ) . Both groups of doctors were more inclined to recommend treatment when the achievable benefits were presented in terms of relative risk reduction rather than absolute risk reduction or number needed to treat . Conclusion - Neither information on number needed to treat nor relative risk reduction alone provides doctors with all the information they need to recommend treatment or prevention to their patients . The present study showed that the professional h and ling of risk information is affected by differences produced by healthcare cultures CONTEXT Ongoing efforts to improve the quality of reporting for r and omized controlled trials ( RCTs ) include the Consoli date d St and ards of Reporting Trials ( CONSORT ) statement . We examined the frequency of explicit reporting of the number needed to treat ( NNT ) and the absolute risk reduction ( ARR ) in RCTs . METHODS Five frequently cited journals were investigated : Annals of Internal Medicine , BMJ , JAMA , The Lancet , and the New Engl and Journal of Medicine . For each journal , 4 years were evaluated : 1989 , 1992 , 1995 , and 1998 . All issues of each journal for each year were review ed manually . Eligible articles were those in which an RCT was conducted on the use of a medication showing a significant treatment effect . Elements abstract ed from each eligible article were the condition investigated , event being treated or prevented , intervention , study results , and reporting methods ( relative risk reduction , NNT , and ARR ) . RESULTS Of 359 eligible articles , NNT was reported in 8 articles . Six of the 8 studies were from 1998 . Absolute risk reduction was reported in 18 articles , 10 of which were from 1998 . CONCLUSIONS Despite CONSORT recommendations , few authors expressed their findings in terms of NNT or ARR . Consideration should be given to including these values in reports of RCTs OBJECTIVE To compare clinicians ' ratings of therapeutic effectiveness when different trial end points were presented as percent reductions in relative compared with absolute risk and as numbers of patients treated to avoid one adverse outcome . DESIGN Survey , with r and om allocation of two question naires . SETTING Toronto teaching hospitals . RESPONDENTS Convenience sample of 100 faculty and housestaff in internal medicine and family medicine . INTERVENTION One question naire presented results for three end points of the Helsinki Heart Study as separate drug trials using only absolute differences in events ; the other showed the same end points as relative differences . Both question naires included a fourth " trial , " showing person-years of treatment needed to prevent one myocardial infa rct ion . MAIN OUTCOME MEASURE The " trials " were each rated on an 11-point scale , from treatment " harmful " to " very effective . " RESULTS Respondents ' ratings of effectiveness varied with the end point . Controlling for end point , ratings of effectiveness by the 50 participants receiving absolute event data were lower than those by 50 participants responding to relative risk reductions ( P < 0.001 ) ; however , no end-point difference was more than 0.6 scale points . For a " trial " reporting that 77 persons were treated for 5 years to prevent one myocardial infa rct ion , mean ratings were 2.3 or 1.8 scale points lower , respectively ( both P < 0.001 ) , than when the same data were shown as relative or absolute risk reductions . CONCLUSIONS Clinicians ' views of drug therapies are affected by the common use of relative risk reductions in both trial reports and advertisements , by end-point emphasis , and , above all , by underuse of summary measures that relate treatment burden to therapeutic yields in a clinical ly relevant manner OBJECTIVE : To assess the impact of informed consent on elderly patients ’ colorectal cancer ( CRC ) screening preferences . DESIGN : R and omized , controlled trial . SETTING : Four general internal medicine practice s. PATIENTS : We studied 399 elderly patients visiting their primary care provider for routine office visits . INTERVENTIONS : Patients were r and omized to receive either a scripted control message briefly describing CRC screening methods or one of two informational interventions simulating an informed consent presentation about CRC screening . One intervention described CRC mortality risk reduction in relative terms ; the other , in absolute terms . MEASUREMENTS AND MAIN RESULTS : The main outcome measure was intent to begin or continue fecal occult blood testing ( FOBT ) , flexible sigmoidoscopy , or both . There was no difference in screening interest between the control group and the two information groups ( p=.8 ) . The majority ( 63 % ) of patients intended to begin or continue CRC screening . Informed patients were able to gauge more accurately the positive predictive value of screening ( p=.0009 ) . Control patients rated the efficacy of screening higher than did patients receiving relative risk reduction information , who rated it higher than did patients receiving absolute risk reduction information ( p=.0002 ) . CONCLUSIONS : Elderly patients appeared to underst and CRC screening information and use it to gauge the efficacy of screening , but provision of information had no impact on their preferences for screening . In view of the large proportion who preferred not to be screened , we conclude that elderly patients should be involved in the screening decision . However , factors other than provision of information must determine their CRC screening preferences BACKGROUND Evidence -based medicine requires general practitioners ( GPs ) to act upon the results of clinical trials . Clinical trial evidence may be difficult to underst and and apply in practice . AIM To investigate whether GPs were unduly influenced in managing hypertension in the elderly by the ways in which benefits of trial results were presented , and to establish whether their current treatment of an elderly hypertensive patient was broadly in line with recent clinical trial evidence . METHOD Seventy-three GPs attending a refresher course were given a written question naire containing data from one clinical trial of treatment of hypertension  in the elderly presented in four different ways ( absolute risk reduction , relative risk reduction , difference in event-free patients , and number of patients who had to be treated in order to prevent one clinical event ) , as if from four different trials . The effect of each presentation on treatment preferences was assessed using Likert scales . The results were analysed to determine whether the method of presentation of results influenced decision making . A clinical scenario was presented to investigate their current treatment preferences in an elderly hypertensive . RESULTS All GPs returned completed question naires . Relative risk reduction was the only presentation which was significantly different from the others , and was the most likely to influence prescribing . In free-text comments , 75 % of GPs admitted having problems underst and ing statistics commonly found in medical journals . More than 90 % conformed with recent clinical trial evidence for the management of hypertension . CONCLUSION GPs were most influenced by relative risk reduction , and were unaware of how the presentation of research results could affect treatment decisions . Most GPs freely admitted to difficulty in comprehending medical statistics . Almost all of the GPs expressed treatment decisions which were broadly in line with clinical evidence Clinical trials may lead to conflicting results . We studied how different ways of reporting results affected physicians ' recommendations . A question naire distributed to 148 general practitioners presented results of a clinical trial where a reduction of cardiac events and an increase of mortality was reported . Results were shown in four different ways -- relative risk reduction , absolute risk reduction , percentages of event-free patients , number needing to be treated to prevent an event -- as if they 
    Output:
    
The meta- analysis showed that treatments were evaluated more favorably when the relative risk format was used rather than the absolute risk or number needed to treat format .
Although the subgroup analyses revealed smaller effect sizes in the studies conducted on physicians , the metaregression showed that these differences were largely accounted for by other features of the study design .
Most notably , variations in effect sizes were explained by the particular wordings that the studies had chosen to use for the relative risk and absolute risk reductions .
The published literature has consistently demonstrated that relative risk formats produce more favorable evaluations of treatments than absolute risk or number needed to treat formats .
However , the effects are heterogeneous and seem to be moderated by key differences between the method ologies used