***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: Introduction Reporting r and omised controlled trials is a key element in order to disseminate research findings . The CONSORT statement was introduced to improve the reporting quality . We assessed the adherence to the CONSORT statement of r and omised controlled trials published 2011 in the top ten ranked journals of critical care medicine ( ISI Web of Knowledge 2011 , Thomson Reuters , London UK ) . Methods Design . We performed a retrospective cross sectional data analysis . Setting . This study was executed at the University Hospital of RWTH , Aachen . Participants . We selected the following top ten listed journals according to ISI Web of Knowledge ( Thomson Reuters , London , UK ) critical care medicine ranking in the year 2011 : American Journal of Respiratory and Critical Care Medicine , Critical Care Medicine , Intensive Care Medicine , CHEST , Critical Care , Journal of Neurotrauma , Resuscitation , Pediatric Critical Care Medicine , Shock and Minerva Anestesiologica . Main outcome measures . We screened the online table of contents of each included journal , to identify the r and omised controlled trials . The adherence to the items of the CONSORT Checklist in each trial was evaluated . Additionally we correlated the citation frequency of the articles and the impact factor of the respective journal with the amount of reported items per trial . Results We analysed 119 r and omised controlled trials and found , 15 years after the implementation of the CONSORT statement , that a median of 61,1 % of the checklist-items were reported . Only 55.5 % of the articles were identified as r and omised trials in their titles . The citation frequency of the trials correlated significantly ( rs = 0,433 ; p<0,001 and r = 0,331 ; p<0,001 ) to the CONSORT statement adherence . The impact factor showed also a significant correlation to the CONSORT adherence ( r = 0,386 ; p<0,001 ) . Conclusion The reporting quality of r and omised controlled trials in the field of critical care medicine remains poor and needs considerable improvement Background Stroke prevention in atrial fibrillation ( AF ) , most commonly with warfarin , requires maintenance of a narrow therapeutic target ( INR 2.0 to 3.0 ) and is often poorly controlled in practice . Poor patient-underst and ing surrounding AF and its treatment may contribute to the patient ’s willingness to adhere to recommendations . Method A theory-driven intervention , developed using patient interviews and focus groups , consisting of a one-off  group session ( 1–6 patients ) utilising an “ expert-patient ” focussed DVD , educational booklet , self-monitoring diary and worksheet , was compared in a r and omised controlled trial ( IS RCT N93952605 ) against usual care , with patient postal follow-ups at 1 , 2 , 6 , and 12-months . Ninety-seven warfarin-naïve AF patients were r and omised to intervention ( n=46 , mean age ( SD ) 72.0 ( 8.2 ) , 67.4 % men ) , or usual care ( n=51 , mean age ( SD ) 73.7 ( 8.1 ) , 62.7 % men ) , stratified by age , sex , and recruitment centre . Primary endpoint was time within therapeutic range ( TTR ) ; secondary endpoints included knowledge , quality of life , anxiety/depression , beliefs about medication , and illness perceptions . Main Findings Intervention patients had significantly higher TTR than usual care at 6-months ( 76.2 % vs. 71.3 % ; p=0.035 ) ; at 12-months these differences were not significant ( 76.0 % vs. 70.0 % ; p=0.44 ) . Knowledge increased significantly across time ( F ( 3 , 47 ) = 6.4 ; p<0.01 ) , but there were no differences between groups ( F ( 1 , 47 ) = 3.3 ; p = 0.07 ) . At 6-months , knowledge scores predicted TTR ( r=0.245 ; p=0.04 ) . Patients ’ scores on subscales representing their perception of the general harm and overuse of medication , as well as the perceived necessity of their AF specific medications predicted TTR at 6- and 12-months . Conclusions A theory-driven educational intervention significantly improves TTR in AF patients initiating warfarin during the first 6-months . Adverse clinical outcomes may potentially be reduced by improving patients ’ underst and ing of the necessity of warfarin and reducing their perception of treatment harm . Improving education provision for AF patients is essential to ensure efficacious and safe treatment . The trial is registered with Current Controlled Trials , IS RCT N93952605 , and details are available at www.controlled-trials.com/IS RCT N93952605 Background Effective and safe management of oral anticoagulant treatment ( OAT ) requires a high level of patient knowledge and adherence . The aim of this study was to assess  patient knowledge about  OAT  and factors associated with patient knowledge . Methods This is a baseline survey of a cluster-r and omized controlled trial in 22 general practice s with an educational intervention for patients or their caregivers . We assessed  knowledge  about  general information on OAT  and key facts regarding  nutrition  , drug-interactions and other safety pre caution s of 345 patients at baseline . Results Participants rated their knowledge about OAT as excellent to good ( 56 % ) , moderate ( 36 % ) or poor ( 8 % ) . However , there was a discrepancy between self-rated knowledge and evaluated actual knowledge and we observed serious knowledge gaps . Half of the participants ( 49 % ) were unaware of dietary recommendations . The majority ( 80 % ) did not know which non-prescription analgesic is the safest and 73 % indicated they would not inform pharmacists about OAT . Many participants ( 35 - 75 % ) would not recognize important emergency situations . After adjustment in a multivariate analysis , older age and less than 10 years education remained significantly associated with lower overall score , but not with self-rated knowledge . Conclusions Patients have relevant knowledge gaps , potentially affecting safe and effective OAT . There is a need to assess patient knowledge and for structured education programs . Trial registration Deutsches Register Klinischer Studien ( German Clinical Trials Register ) : DRKS00000586.Universal Trial Number ( UTN U1111 - 1118 - 3464 ) BACKGROUND The knowledge of warning symptoms and risk factors for stroke has not been studied among patients with stroke in developing countries . AIMS We aim ed to assess the knowledge of stroke among patients with stroke and their relatives . SETTING S AND DESIGN Prospect i ve tertiary referral hospital-based study in Northwest India . MATERIAL S AND METHODS Trained nurses and medical interns interviewed patients with stroke and transient ischemic attack and their relatives about their knowledge of stroke symptoms and risk factors . STATISTICAL ANALYSIS Univariable and multivariable logistic regression were used . RESULTS Of the 147 subjects interviewed , 102 ( 69 % ) were patients and 45 ( 31 % ) were relatives . There were 99 ( 67 % ) men and 48 ( 33 % ) women and the mean age was 59.7+/-14.1 years . Sixty-two percent of respondents recognized paralysis of one side as a warning symptom and 54 % recognized hypertension as a risk factor for stroke . In the multivariable logistic regression analysis , higher education was associated with the knowledge of correct organ involvement in stroke ( OR 2.6 , CI 1.1- 6.1 , P = 0.02 ) , whereas younger age ( OR 2.7 , CI 1.1 - 7.0 , P = 0.04 ) and higher education ( OR 4.1 , CI 1.5 - 10.9 , P = 0.005 ) correlated with a better knowledge regarding warning symptoms of stroke . CONCLUSIONS In this study cohort , in general , there is lack of awareness of major warning symptoms , risk factors , organ involvement and self-recognition of stroke . However younger age and education status were associated with better knowledge . There is an urgent need for awareness programs about stroke in this study cohort OBJECTIVE Previous research has demonstrated that patients with atrial fibrillation ( AF ) possess very little knowledge of their disease , the consequences of AF and the benefits /risks of anti-coagulant therapy . The aim of this pilot study was to examine patient 's knowledge and perceptions of AF and their anticoagulant treatment before and after a brief educational intervention . MATERIAL S AND METHODS Ninety-three patients ( 47 male ; mean ( S.D. ) age 67.3 ( 11.6 ) years ) completed the baseline interview to assess their knowledge and perceptions of AF . All patients were given an information booklet which explained what AF was , associated symptoms , the possible causes and consequences of AF , treatment options and their benefits /risks , what the INR is and what factors may effect it . The booklet was explained to each patient by the research er and given to the patient to take away for reference . Thirty-three ( 35.5 % ) patients ( 12 men ; mean ( S.D. ) age 68.0 ( 13.6 ) years ) completed the follow-up assessment to re-assess their knowledge and perceptions of AF . RESULTS Only 49 % of patients could name their cardiac condition at baseline , although the majority were aware that AF was an arrhythmia ( 80 % baseline vs. 91 % follow-up ) . Only about half the patients perceived AF as a serious condition or were aware that AF predisposes to thromboembolism at baseline . Following the educational intervention there was a non-significant increase in patient knowledge of the risks associated with AF . Of those who completed both question naires , 52 % were aware that anticoagulants prevented blood clots , which increased to 70 % post-intervention . However , few patients were aware of the benefit of stroke prevention associated with anticoagulants at baseline ( 21 % ) or after the educational intervention ( 27 % ) . The intervention had little effect on increasing awareness of the bleeding risks associated with anticoagulants , although three in five people appeared to appreciate these risks . However , the educational intervention significantly improved patient 's knowledge of the target INR range and factors that may affect INR levels ( p=0.001 and p=0.014 , respectively ) for those who completed both question naires . CONCLUSIONS Most patients with AF possess very limited knowledge about their cardiac condition , its consequences , and how anticoagulant treatment can benefit them . This pilot study has demonstrated that a brief educational intervention with an information booklet can help to somewhat improve their knowledge about anticoagulation therapy for AF Of 125 patients aged 65 years or over , with atrial fibrillation taking warfarin for at least 12 months , with a st and ard deviation ( SD ) of prothrombin time , expressed as the International Normalized Ratio ( INR ) > 0·5 over the previous 6 months , 40 were r and omized to continue with usual clinic care and 85 to receive education about warfarin .  Of these , 44 were r and omized to self‐monitor their INR and 41 returned to clinic . Compared with the previous 6 months there was a significant increase in percentage time within the therapeutic range for the 6 months following education [ 61·1 vs. 70·4 ; mean difference 8·8 ; 95 % confidence interval ( CI ) : −0·2–17·8 ; P = 0·054 ] and following education and self‐monitoring ( 57 vs. 71·1 ; mean difference 14·1 ; 95 % CI : 6·7–21·5 ; P < 0·001 ) , compared with those patients following usual clinic care ( 60·0 vs. 63·2 ; mean difference 3·2 ; 95 % CI : −7·3–13·7 ) . Using the same comparative periods , the INR SD fell by 0·24 ( P < 0·0001 ) in the group allocated to education and self‐monitoring , 0·26 ( P < 0·0001 ) in the group receiving education alone and 0·16 ( P = 0·003 ) in the control group . Inter‐group differences were not statistically significant ( intervention groups 0·26 ± 0·30 vs. control 0·16 ± 0·3 , P = 0·10 ) . Quality ‐of‐life measurements and health beliefs about warfarin were unchanged ( apart from emotional role limitation ) with education or education and self‐monitoring .  Patient  education regarding anticoagulation therapy could be a cost‐effective initiative and is worthy of further study 
    Output:
    
Conclusion and Relevance : This systematic review identified several AF patient knowledge gaps about their condition and its treatment that can inform the development of AF patient education programs