***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: OBJECTIVE We sought to develop a valid , reliable assessment of intraoperative judgment by residents during gynecologic surgery based on Script Concordance Theory . STUDY DESIGN This was a multicenter prospect i ve study involving 5 obstetrics and gynecology residency programs . Surgeons from each site generated case scenarios based on common gynecologic procedures . Construct validity was evaluated by correlating scores to training level , in-service examinations , and surgical skill and experience using a Global Rating Scale of Operative Performance and case volumes . RESULTS A final test that included 42 case scenarios was administered to 75 residents .  Internal consistency ( Cronbach alpha = 0.73 ) and test-retest reliability ( Lin correlation coefficient = 0.76 ) were good . There were significant differences between test scores and training levels ( P = .002 ) and test scores correlated with in-service examination scores ( r = 0.38 ; P = .001 ) . There was no association between test scores and total number of cases or technical skills . CONCLUSION The Script Concordance Test appears to be a reliable , valid assessment tool for intraoperative decision-making during gynecologic surgery Aim : To examine which response options children prefer and which they find easiest to use , and to study the relative reliability of the different response options . Methods : A consecutive group of unselected children ( n= 120 ) filled out three question naires in a paediatric outpatient clinic . Each question naire included seven similar questions , but had different response options : the  Likert scale , the  Visual Analogue Scale ( VAS ) and the  numeric VAS .  In general , the questions were not related to the children 's particular diseases , but dealt with the frequency of simple activities , their feelings and opinions . The pages with the three different response options were offered in r and om order . Afterwards , the children rated their preference and ease of use of the different response options on a scale from one to 10 . Results : Children preferred the Likert scale ( median mark 9.0 ) over the numeric VAS ( median mark 8.0 ) and the simple VAS ( median 6.0 ) . They considered the Likert scale easiest to fill out ( median mark 10 vs 9 and 7.5 for the numeric and simple VAS , respectively ) . Results of the different response options correlated strongly with each other ( rho = 0.67–0.90 , p < 0.05 ) Many controlled trials rely on subjective measures of symptoms or quality of life as primary outcomes . The relative merits of different response options for these measures is an important , but largely unexplored , issue . Therefore , we compared the responsiveness of seven-point Likert vs visual analogue scales ( VAS ) in a question naire measuring quality of life in chronic lung disease . The VAS and seven-point scale versions of the question naire were administered to 28 patients before and after completing an inpatient respiratory rehabilitation program of known benefit . For all four dimensions of the question naire ( dyspnea , fatigue , emotional function , and mastery ) the VAS showed a larger improvement than the seven-point scale when both were st and ardized on a scale of 0 - 10 . However , in each case the variability of the improvement was greater using the VAS . The difference in improvement between the two scales was not statistically significant . We conclude that the two methods of presenting response options show comparable responsiveness . The ease of administration and interpretation of the seven-point scale recommend its use in clinical trials OBJECTIVE To report on the creation and administration of an online Script Concordance Test ( SCT ) for ear , nose , and throat ( ENT ) , the ENT-SCT . DESIGN Prospect i ve study . SETTING Two tertiary care university centers . PARTICIPANTS In total , 132 individuals were asked to test an ENT-SCT of 20 cases and 94 questions based on the major educational objectives of the ENT residency program . MAIN OUTCOME MEASURES Three levels of experience were tested : medical students , ENT residents , and board-certified otorhinolaryngologists as the expert panel . The test 's construct validity-whether scores were related to clinical experience-was statistically analyzed . Reliability was estimated by the Cronbach α internal consistency coefficient . Participants ' perception of the test was assessed with the use of a question naire . RESULTS The 65 respondents with usable data were medical students ( n = 21 ) , ENT residents ( n = 22 ) , and experts ( n = 22 ) . Total mean ( SD ) test scores differed significantly : 76.81 ( 3.31 ) for the expert panel , 69.05 ( 4.35 ) for residents , and 58.29 ( 5.86 ) for students . The Cronbach α coefficient was 0.95 . More than two-thirds of the participants found the test to be realistic and relevant for assessing clinical reasoning . The test was also considered fun , interesting , and intuitive . CONCLUSIONS The Web-based ENT-SCT is feasible , reliable , and useful for assessing clinical reasoning . This online assessment tool may have applications for residency programs and continuing medical education 
    Output:
    
Conclusions Although SCT is an interesting test to evaluate clinical decision-making in emergency medicine , our results raise concerns regarding whether the judgments of an expert panel are sufficiently valid as the reference st and ard for this test