***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 number of pharmacologic treatments examined in recent r and omized clinical trials ( RCTs ) have failed to show statistically significant superiority to placebo in conditions in which their efficacy had previously been demonstrated . Assuming the validity of previous evidence of efficacy and the comparability of the patients and outcome measures in these studies , such results may be a consequence of limitations in the ability of these RCTs to demonstrate the benefits of efficacious analgesic treatments vs placebo ( “ assay sensitivity ” ) . Efforts to improve the assay sensitivity of analgesic trials could reduce the rate of falsely negative trials of efficacious medications and improve the efficiency of analgesic drug development . Therefore , an Initiative on Methods , Measurement , and Pain Assessment in Clinical Trials consensus meeting was convened in which the assay sensitivity of chronic pain trials was review ed and discussed . On the basis of this meeting and subsequent discussion s , the authors recommend consideration of a number of patient , study design , study site , and outcome measurement factors that have the potential to affect the assay sensitivity of RCTs of chronic pain treatments . Increased attention to and research on method ological aspects of clinical trials and their relationships with assay sensitivity have the potential to provide the foundation for an evidence ‐based approach to the design of analgesic clinical trials and expedite the identification of analgesic treatments with improved efficacy and safety In complex regional pain syndrome ( CRPS ) many clinical symptoms suggest involvement of the central nervous system . Neuropathic pain as the leading symptom is often resistant to therapy . In the present study we investigated the analgesic efficiency of repetitive transcranial magnetic simulation ( rTMS ) applied to the motor cortex contralateral to the CRPS-affected side . Seven out of ten patients reported decreased pain intensities . Pain relief occurred 30 s after stimulation , whereas the maximum effect was found 15 min later . Pain re-intensified increasingly 45 min after rTMS . In contrast , sham rTMS did not alter pain perception . These findings provide evidence that in CRPS I pain perception can be modulated by repetitive motor cortex stimulation The CONSORT statement is used worldwide to improve the reporting of r and omised controlled trials . Kenneth Schulz and colleagues describe the latest version , CONSORT 2010 , which up date s the reporting guideline based on new method ological evidence and accumulating experience . To encourage dissemination of the CONSORT 2010 Statement , this article is freely accessible on bmj.com and will also be published in the Lancet , Obstetrics and Gynecology , PLoS Medicine , Annals of Internal Medicine , Open Medicine , Journal of Clinical Epidemiology , BMC Medicine , and Trials 
    Output:
    
Cossins et al. , ( 2012 ) conclude that there is strong evidence that a number of treatments are effective .
Further , where statistically significant results are robust , the true treatment effect may still be clinical ly trivial .
For example , the authors conclude that there is strong evidence that  repetitive transcranial magnetic stimulation ( rTMS ) is effective .
Indeed , generally , in  chronic  pain , there is reason to doubt that rTMS delivers clinical ly meaningful reductions in pain ( O’Connell et al. , 2010 ) .
In our view , while some treatments hold promise , there is currently no intervention for CRPS that can be considered to be supported by strong evidence of efficacy ; although we agree that the evidence is strong that intravenous regional blockade with guanethidine is ineffective .