***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 To examine the prevalence of outcome reporting bias — the selection for publication of a subset of the original recorded outcome variables on the basis of the results — and its impact on Cochrane review s. Design A nine point classification system for missing outcome data in r and omised trials was developed and applied to the trials assessed in a large , unselected cohort of Cochrane systematic review s. Research ers who conducted the trials were contacted and the reason sought for the non-reporting of data . A sensitivity analysis was undertaken to assess the impact of outcome reporting bias on review s that included a single meta- analysis of the review primary outcome . Results More than half ( 157/283 ( 55 % ) ) the review s did not include full data for the review primary outcome of interest from all eligible trials . The median amount of review outcome data missing for any reason was 10 % , whereas 50 % or more of the potential data were missing in 70 ( 25 % ) review s. It was clear from the publications for 155 ( 6 % ) of the 2486 assessable trials that the research ers had measured and analysed the review primary outcome but did not report or only partially reported the results . For reports that did not mention the review primary outcome , our classification regarding the presence of outcome reporting bias was shown to have a sensitivity of 88 % ( 95 % CI 65 % to 100 % ) and specificity of 80 % ( 95 % CI 69 % to 90 % ) on the basis of responses from 62 trialists . A third of Cochrane review s ( 96/283 ( 34 % ) ) contained at least one trial with high suspicion of outcome reporting bias for the review primary outcome . In a sensitivity analysis undertaken for 81 review s with a single meta- analysis of the primary outcome of interest , the treatment effect estimate was reduced by 20 % or more in 19 ( 23 % ) . Of the 42 meta-analyses with a statistically significant result only , eight ( 19 % ) became non-significant after adjustment for outcome reporting bias and 11 ( 26 % ) would have overestimated the treatment effect by 20 % or more . Conclusions Outcome reporting bias is an under-recognised problem that affects the conclusions in a substantial proportion of Cochrane review s. Individuals conducting systematic review s need to address explicitly the issue of missing outcome data for their review to be considered a reliable source of evidence . Extra care is required during data extraction , review ers should identify when a trial reports that an outcome was measured but no results were reported or events observed , and contact with trialists should be encouraged Depression is common in individuals with multiple sclerosis ( MS ) . While psychotherapy is an effective treatment for depression , not all individuals benefit . We examined whether baseline social support might differentially affect treatment outcome in 127 participants with MS and depression r and omized to either Telephone-administered Cognitive-Behavioral Therapy ( T-CBT ) or Telephone-administered Emotion-Focused Therapy ( T-EFT ) . We predicted that those with low social support would improve more in T-EFT , since this approach emphasizes the therapeutic relationship , while participants with strong social networks and presumably more emotional re sources might fare better in the more structured and dem and ing T-CBT . We found that both level of received support and satisfaction with that support at baseline did moderate treatment outcome . Individuals with high social support showed a greater reduction in depressive symptoms in the T-CBT as predicted , but participants with low social support showed a similar reduction in both treatments . This suggests that for participants with high social support , CBT may be a more beneficial treatment for depression compared with EFT Objective : To evaluate the cost effectiveness of a psychological adjustment group shown to be clinical ly effective in comparison with usual care for people with multiple sclerosis . Design : R and omized controlled trial with comparison of costs and calculation of incremental cost effectiveness ratio . Setting : Community . Participants : People with multiple sclerosis were screened on the General Health Question naire 12 and Hospital Anxiety and Depression Scale , and those with low mood were recruited . Interventions : Participants r and omly allocated to the adjustment group received six group treatment sessions . The control group received usual care , which did not include psychological interventions . Main measures : Outcomes were assessed four and eight months after r and omization , blind to group allocation . The costs were assessed from a service use question naire and information provided on medication . Quality of life was assessed using the EQ-5D . Results : Of the 311 patients identified , 221 ( 71 % ) met the criteria for having low mood . Of these , 72 were r and omly allocated to receive treatment and 79 to usual care . Over eight months follow-up there was a decrease in the combined average costs of £ 378 per intervention respondent and an increase in the costs of £ 297 per patient in the control group , which was a significant difference ( p=0.03 ) . The incremental cost-effectiveness ratio indicated that the cost per point reduction on the Beck depression inventory – II was £ 118 . Conclusion : In the short term , the adjustment group programme was cost effective when compared with usual care , for people with multiple sclerosis presenting with low mood .  The longer-term costs need to be assessed This study sought to compare the sensitivity and precision of Embase , Medline and PsycINFO bibliographic data base search es for r and omized controlled trials of  cognitive therapy for depression . Search es in each data base combined with a h and search in five selected journals formed the total pool against which each search was assessed . Sensitivities of st and ard search es ( index terms only ) were 68 % , 84 % and 38 % in Embase , Medline and PsycINFO respectively . Sensitivities of expert search es ( index and free text terms ) were 76 % , 97 % and 65 % for Embase , Medline and PsycINFO respectively . Medline appears to be the most efficient at identifying articles describing psychological treatment evaluation The majority of people affected by Multiple Sclerosis ( paMS ) experience severe and disabling fatigue . A recent r and omised controlled trial ( RCT ) showed that cognitive behaviour therapy with a clinical psychologist was an effective treatment for MS fatigue . An Internet-based version of this intervention , MS Invigor8 , was developed for the current study using agile design and input from paMS . MS Invigor8 includes eight tailored , interactive sessions . The aim was to test the feasibility and potential efficacy and cost-effectiveness of the programme in a pilot RCT . 40 patients were r and omised to MS Invigor8 ( n=23 ) or st and ard care ( n=17 ) . The MS Invigor8 group accessed sessions over 8 - 10 weeks and received up to three 30 - 60min telephone support sessions . Participants completed online st and ardised question naires assessing fatigue , mood , quality of life and service use at baseline and 10 weeks follow-up . Large between group treatment effects were found for the primary outcomes of fatigue severity ( d=1.19 ) and impact ( d=1.02 ) . The MS Invigor8 group also reported significantly greater improvements in anxiety , depression and quality -adjusted life years . These data suggest that Internet-based CBT may be a clinical ly and cost-effective treatment for MS fatigue . A larger RCT with longer term follow-up is warranted Background People with multiple sclerosis ( MS ) are at high risk of depression . We undertook a pilot trial of computerised cognitive behavioural therapy ( CCBT ) for the treatment of depression in people with MS to test the feasibility of undertaking a full trial . Methods Participants with a diagnosis of MS and clinical levels of depression were recruited through out-patient clinics and postal screening question naires at two UK centres and r and omised to CCBT or usual care . Clinical outcomes included the Beck Depression Inventory ( BDI-II ) and Multiple Sclerosis Impact Scale ( MSIS-29 ) at baseline , 8 and 21 weeks . Feasibility outcomes included : recruitment rate ; reasons for refusal , withdrawal and dropout ; feasibility and acceptability of the proposed outcome measures ; sample size estimation and variation in and preferences for service delivery . Results Twenty-four participants were recruited . The recruitment rate , calculated as the proportion of those invited to fill in a screening question naire who were consented into the trial , was 4.1 % . Recruitment through out-patient clinics was somewhat slower than through screening question naire mail-out but the overall recruitment yield was similar . Of the 12 patients in the CCBT arm , 9 ( 75 % ) completed at least four , and 6 completed all 8 CCBT sessions . For completers , the median time ( IQR ) to complete all eight CCBT sessions was 15 ( 13 to 20 ) weeks . Participants expressed concern about the face validity of the Beck Depression Inventory II for the measurement of self-reported depression in people with MS . The MSIS-29 was the patient-reported outcome measure which participants felt best reflected their concerns . The estimated sample size for a full trial is between 180 and 390 participants . NHS partners were not delivering CCBT in community facilities and participants preferred to access CCBT at home , with no one expressing a preference for use of CCBT in an alternative location . Conclusions A definitive trial , with a recruitment window of one year , would require the participation of around 13 MS centres . This number of centres could be reduced by exp and ing the eligibility criteria to include either other neurological conditions or people with more severe depression . The MSIS-29 should be used as a patient-important outcome measurement . Trial registration IS RCT N : IS RCT BACKGROUND Several studies have shown that telephone-administered cognitive-behavioral therapy ( T-CBT ) is superior to forms of no treatment controls . No study has examined if the skills-training component to T-CBT provides any benefit beyond that provided by nonspecific factors . OBJECTIVE To test the efficacy of a 16-week T-CBT against a strong control for attention and nonspecific therapy effects . DESIGN R and omized controlled trial including 12-month follow-up . SETTING Telephone administration of psychotherapy with patients in their homes . PARTICIPANTS Participants had depression and functional impairments due to multiple sclerosis . INTERVENTIONS A 16-week T-CBT program was compared with 16 weeks of telephone-administered supportive emotion-focused therapy . MAIN OUTCOME MEASURES Hamilton Depression Rating Scale score , Structured Clinical Interview for DSM-IV diagnosis of major depressive disorder , Beck Depression Inventory score , and Positive Affect scale score of the Positive and Negative Affect Scale . RESULTS Of the 127 participants r and omized , 7 ( 5.5 % ) dropped out of treatment . There were significant improvement during treatment on all outcome measures ( P<.01 for all ) and an increase in Positive Affect Scale score . Improvements over 16 weeks of treatment were significantly greater for T-CBT , compared with telephone-administered supportive emotion-focused therapy , for major depressive disorder frequency ( P = .02 ) , Hamilton Depression Rating Scale score ( P = .02 ) , and Positive Affect Scale score ( P = .008 ) , but not for the Beck Depression Inventory score ( P = .29 ) . Treatment gains were maintained during 12-month follow-up ; however , differences across treatments were no longer evident ( P > .16 for all ) . CONCLUSIONS Patients showed significant improvements in depression and positive affect during the 16 weeks of telephone-administered treatment . The specific cognitive-behavioral components of T-CBT produced improvements above and beyond the nonspecific effects of telephone-administered supportive emotion-focused therapy on evaluator-rated measures of depression and self-reported positive affect . Attrition was low This study examined the efficacy of an 8-week telephone-administered cognitive-behavioral therapy ( CBT ) for the treatment of depressive symptomatology in multiple sclerosis ( MS ) patients . The treatment , Coping with MS ( CMS ) , included a patient workbook design ed to structure the treatment , provide visual aids , and help with homework assignments .  Thirty-two patients with MS , who scored at least 15 on the Profile of Mood States Depression-Dejection scale , were r and omly assigned to either the telephone CMS or to a usual-care control ( UCC ) condition . Depressive symptomatology decreased significantly in the CMS condition compared with the UCC condition . Furthermore , adherence to interferon beta-1a , a disease-modifying medication for the treatment of MS , was significantly better at the 4-month follow-up among patients who received CMS as compared with those in the UCC condition Background : Mood problems affect many people with multiple sclerosis ( MS ) . The aim was to evaluate the effectiveness of a group treatment based on cognitive behavioural principles . Methods : People with MS were screened on the General Health Question naire 12 ( GHQ-12 ) and Hospital Anxiety and Depression Scale ( HAD ) . Those identified with low mood were invited to take part in a r and omized trial comparing the effect of attending an adjustment group with a waiting list control . Patients allocated to the adjustment group received six 2 h group treatment sessions . Outcomes were assessed 4 and 8 months after r and omization , blind to group allocation . Results : Of the 311 patients identified , 221 ( 71 % ) met the criteria for low mood and 151 ( 68 % ) agreed to take part . Hierarchical regression analyses were conducted to compare the two groups , correcting for baseline mood and disability . At 4 months , group allocation alone was a significant predictor of the primary outcome measure , the GHQ-12 . At 8 months , group allocation alone was no longer a significant predictor for GHQ-12 scores , but it was when baseline GHQ-12 and Guy ’s Neurological Disability Scale scores were controlled for . Comparison of the area under the curve revealed significant differences between the groups for GHQ-12 ( p = 0.003 ) , HAD 
    Output:
    
Conclusions CBT can be an effective treatment for depression in MS .