***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: PURPOSE By means of a r and omized double-blind study , the effect of providing taped initial consultations on cancer patients '  satisfaction , recall , and quality of life was investigated . PATIENTS AND METHODS Consecutive cancer patients referred to either the gynecology or medical oncology outpatient clinic were eligible .  Initial consultations were audiotaped . Patients were either provided with the tape ( experimental group ) or not ( control group ) . Baseline variables included sociodemographics , preferences for information , coping styles , and clinical characteristics . Follow-up ( after 1 week and 3 months ) variables included attitudes toward the intervention , satisfaction , recall , and quality of life . Assessment s took place through mailed question naires and telephone interviews . RESULTS Two hundred one patients were included ( response , 71 % ) , 105 in the experimental group and 96 in the control group . Most patients ( 75 % ) listened to the tape , the majority of which ( 73 % ) listened with others . Almost all patients , both in the experimental group ( 96 % ) and control group ( 98 % ) were positive about the intervention . Expectations were confirmed ; patients provided with the tape were more satisfied ( P < .05 ) and recalled more information ( P < .01 ) than patients without the tape . The intervention did not have an effect on quality of life . An interaction effect was found between the intervention and patients ' age on satisfaction with the taped consultation ( P < .01 ) and recall of diagnostic information ( P < .01 ) ; access to tapes seems more helpful in enhancing satisfaction in younger patients and recall of diagnostic information in older patients . CONCLUSION Cancer patients and their families value the taped initial consultation . This intervention enhances their satisfaction and improves their recall of information . Tapes seem more helpful in enhancing satisfaction in younger patients and recall of diagnostic information in older patients Objective : To assess the effectiveness of nurse led follow up in the management of patients with lung cancer . Design : R and omised controlled trial . Setting : Specialist cancer hospital and three cancer units in southeastern Engl and Participants : 203 patients with lung cancer who had completed their initial treatment and were expected to survive for at least 3 months . Intervention : Nurse led follow up of out patients compared with conventional medical follow up . Outcome measures : Quality of life , patients ' satisfaction , general practitioners ' satisfaction , survival , symptom-free survival , progression-free survival , use of re sources , and comparison of costs . Results : Patient acceptability of nurse led follow up was high : 75 % ( 203/271 ) of eligible patients consented to participate . Patients who received the intervention had less severe dyspnoea at 3 months ( P=0.03 ) and had better scores for emotional functioning ( P=0.03 ) and less peripheral neuropathy ( P=0.05 ) at 12 months . Intervention group patients scored significantly better in most satisfaction subscales at 3 , 6 , and 12 months ( P<0.01 for all subscales at 3 months ) . No significant differences in general practitioners ' overall satisfaction were seen between the two groups . No differences were seen in survival or rates of objective progression , although nurses recorded progression of symptoms sooner than doctors ( P=0.01 ) . Intervention patients were more likely to die at home rather than in a hospital or hospice ( P=0.04 ) , attended fewer consultations with a hospital doctor during the first 3 months ( P=0.004 ) , had fewer radiographs during the first 6 months ( P=0.04 ) , and had more radiotherapy within the first 3 months ( P=0.01 ) . No other differences were seen between the two groups in terms of the use of re sources . Conclusion : Nurse led follow up was acceptable to lung cancer patients and general practitioners and led to positive outcomes This study reports results from a r and omised controlled trial of nurse-led care and was design ed to determine whether nurse-led follow up improved patients morbidity and satisfaction with care in men treated with radical radiotherapy for prostate and bladder cancer . The aim was to compare outcomes in terms of toxicity , symptoms experienced , quality of life , satisfaction with care and health care costs , between those receiving nurse-led care and a group receiving st and ard care .  The study population was of men prescribed radical radiotherapy ( greater than 60 Gy ) .  Participants completed self- assessment question naires for symptoms and quality of life within the first week of radiotherapy treatment , at week 3 , 6 and 12 weeks from start of radiotherapy .  Satisfaction with clinical care was also assessed at 12 weeks post-treatment . Observer-rated RTOG toxicity scores were recorded pre-treatment , weeks 1 , 3 , 6 and 12 weeks from start of radiotherapy . The results presented in this paper are on 115 of 132 ( 87 % ) of eligible men who agreed to enter the r and omised trial . 6 men ( 4 % ) refused and 11 ( 8 % ) were missed for inclusion in the study . Data were analysed as a comparison at cross-sectional time points and as a general linear model using multiple regression . There was no significant difference in maximum symptom scores over the time of the trial between nurse-led follow-up care and conventional medical care . Differences were seen in scores in the initial self assessment of symptoms ( week 1 ) that may have been as a result of early nursing intervention . Those men who had received nurse-led care were significantly more satisfied ( P < 0.002 ) at 12 weeks and valued the continuity of the service provided . There were also significant ( P < 0.001 ) cost benefits , with a 31 % reduction in costs with nurse-led , compared to medically led care . Evidence from this study suggests that a specialist nurse is able to provide safe follow up for men undergoing radiotherapy . The intervention focused on coping with symptoms , and provided continuity of care and telephone support . Further work is required to improve the management of patients during and after radiotherapy . © 2001 Cancer Research Campaign Objective : To determine the effect of a shared care programme on the attitudes of newly referred cancer patients towards the healthcare system and their health related quality of life and performance status , and to assess patients ’ reports on contacts with their general practitioner ( GP ) . Setting : Department of Oncology at Aarhus University Hospital and general practice s. Design : R and omised controlled trial in which patients completed question naires at three time points . The shared care programme included transfer of knowledge from the oncologist to the GP , improved communication between the parties , and active patient involvement . Participants : 248 consecutive cancer patients recently referred to the department . Main outcome measures : Patients ’ attitudes towards the healthcare services , their health related quality of life , performance status , and reports on contacts with their GPs . Results : The shared care programme had a positive effect on patient evaluation of cooperation between the primary and secondary healthcare sectors . The effect was particularly significant in men and in younger patients ( 18–49 years ) who felt they received more care from the GP and were left less in limbo . Young patients in the intervention group rated the GP ’s knowledge of disease and treatment significantly higher than young patients in the control group . The number of contacts with the GP was significantly higher in the intervention group . The EORTC quality of life question naire and performance status showed no significant differences between the two groups . Conclusions : An intersectoral shared care programme in which GPs and patients are actively involved has a positive influence on patients ’ attitudes towards the healthcare system .  Young patients and men particularly benefit from the programme Goals of workTo investigate whether increased contact with the patient ’s general practitioner ( GP ) soon after cancer treatment can increase patient quality of life ( QoL ) and satisfaction with follow-up . Patients and methods A r and omised controlled study with 91 patients from one Norwegian municipality . The intervention group got a 30-min invited consultation with the patient ’s GP and an invitation to further GP follow-up .  Quality of life and patient satisfaction with diagnosis , treatment and overall care were measured with vali date d instruments . Main results Relatives ’ satisfaction with care increased over 6 months in the intervention group ( P=0.018 ) , but otherwise , there was no difference between the intervention and control groups concerning QoL , satisfaction with care or number of consultations . Patient satisfaction with care showed a tendency to increase when treatment intent was curative . Some functional QoL measures and satisfaction tended to increase during the first 6 months after treatment . Free text comments suggested that some patients appreciated the contact with their GP . ConclusionS ome cancer patients benefit from follow-up by their GP . The way to perform this kind of follow-up in primary care , and who these cancer patients are , should be further studied . Short follow-up time and an urban setting may have contributed to the lack of group differences in our study , but patients treated for cancer may have limited need for follow-up as long as they feel well and the situation remains stable BACKGROUND Routine follow-up of breast cancer patients in specialist clinics is st and ard practice in most countries . Follow-up involves regularly scheduled breast cancer check-ups during the disease-free period . The aims of follow-up are to detect breast cancer recurrence and to provide psychosocial support to the patient ; however , little is known about patients ' views on breast cancer follow-up . AIM To assess the effect on patient satisfaction of transferring primary responsibility for follow-up of women with breast cancer in remission from hospital outpatient clinics to general practice . METHOD R and omized controlled trial with 18 months ' follow-up in which women received routine follow-up either in hospital outpatient clinics or from their own general practitioner . Two hundred and ninety-six women with breast cancer in remission receiving regular follow-up care at two district general hospitals in Engl and were included in the study . Patient satisfaction was measured by means of a self-administered question naire supplied three times during the 18-month study period . RESULTS The general practice group selected responses indicating greater satisfaction than did the hospital group on virtually every question . Furthermore , in the general practice group there was a significant increase in satisfaction over baseline ; a similar significant increase in satisfaction over baseline was not found in the hospital group . CONCLUSION Patients with breast cancer were more satisfied with follow-up in general practice than in hospital outpatient departments . When discussing follow-up with breast cancer patients , they should be provided with complete and accurate information about the goals , expectations , and limitations of the follow-up programme so that they can make an informed choice Patient participation in medical consultations has been demonstrated to benefit their subsequent psychological well being . Question asking is one way in which patients can be active . We investigated 2 means of promoting cancer patient  question asking . One was the provision of a question prompt sheet to patients prior to their initial consultation with their oncologist .  The second was the active endorsement and systematic review of the question prompt sheet by their oncologist . 318 patients with heterogeneous cancers , seeing one of 5 medical and 4 radiation oncologists for the first time , were r and omised to either receive or not receive a question prompt sheet . Doctors were r and omised to either proactively address or passively respond to the question prompt sheet in the subsequent consultation . Anxiety was assessed prior to the consultation . Consultations were audiotaped and content analysed . Anxiety was assessed again immediately following the consultation . Within the next 10 days patients completed question naires assessing information needs , anxiety and satisfaction and were given a structured telephone interview assessing information recall . Patients provided with a question prompt sheet asked more questions about prognosis compared with controls and oncologists gave significantly more prognostic information to these patients . Provision of the question prompt sheet prolonged consultations and increased patient anxiety ; however , when oncologists specifically addressed the prompt sheet , anxiety levels were significantly reduced , consultation duration was decreased and recall was significantly improved . A patient question prompt sheet , used proactively by the doctor , is a powerful addition to the oncology consultation . © 2001 Cancer Research Campaign The provision of adequate information in a clear and sensitive manner can improve cancer patients ' experience of care . Satisfaction with the cancer consultation may impact on satisfaction with care in general and adjustment to the disease . This study aims to identify factors that influence patient and clinician satisfaction  with the cancer consultation and whether satisfaction can be improved with communication skills training . 160 doctors from 34 UK cancer centres participated . Half were r and omized to attend a communication skills training course .  Patient satisfaction data are presented at baseline and following a communication skills course or in the case of the control doctors , three months after baseline . Clinicians also rated their satisfaction with the consultations . Overall patient satisfaction was not related to the speciality , seniority or sex of the clinician or patient , site of primary cancer or type of treatment . Satisfaction was related to patients ' age , psychological morbidity and , most significantly , satisfaction with the length of wait in clinic . Clinician satisfaction was not related to age , sex or cancer site but clinicians were less satisfied following consultations with patients being treated palliatively . Communication skills training had a non-significant positive effect on patient satisfaction . The subtle benefits of improved communication may be overshadowed by practical problems such as waiting too long to see the doctor , which have an adverse effect on satisfaction OBJECTIVE To evaluate the use of a multidisciplinary record held by patients with cancer in the community . DESIGN Pragmatic r and omised controlled trial . SETTING The environs of Swansea in south west Wales . PARTICIPANTS 501 patients under the care of the Department of Oncology , Singleton Hospital , Swansea . INTERVENTION A patient held record used by the patient and healthcare professionals . Main outcome measures -Health related quality of life ( EORTC QLQ-C30 ) measured at entry into the study and at 6 months ; patients ' views at 6 months ; healthcare professionals ' views collected after the completion of patient follow up ; NHS re source and booklet use . RESULTS 1148 patients were eligible for the study ; 501 were recruited ( 44 % ) and 344 completed the study ( 172 in each group ) . There was no significant difference between the two groups in change in quality of life or NHS re source use . The patient held record did not have an impact on communication but was significantly helpful to patients in preparing for appointments , reducing difficulties in monitoring their own progress , and helping them to feel more in control ( p<0.05 ) . Fifty three percent of patients would have preferred not to have a patient held record .  There was a low level of use of the record by healthcare profession 
    Output:
    
Effective interventions to improve patient-centredness are the ' provision of an audiotape of the consultation to the patient '  , ' provision of information to patients ' and ' use of a decision aid ' .
Effective interventions to improve the organization of care can be ' follow-up ' and ' case management ' , especially by nurses and ' one-stop clinics ' .