***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: BACKGROUND Men with prostate cancer face preference-sensitive decisions when choosing among treatments with similar survival outcomes but different procedures , risks and potential complications . A decision-support intervention , ' Decision Navigation ' assists men with prostate cancer to prepare a question list ( consultation plan ) for their doctors and provides them with a consultation summary and audio recording . A r and omised controlled trial of Decision Navigation showed advantages over usual care on quantitative measures including confidence in decision-making and regret . OBJECTIVE The aim of this study was to gain a qualitative underst and ing of patient 's and doctor 's perspectives on Decision Navigation . METHODS Six patients who received Decision Navigation were purposively selected for interview out of 62 r and omised controlled trial participants . All four doctors who consulted Navigated patients were interviewed . Interview data was analysed using framework analysis . RESULTS Patients reported that planning for the consultation helped them to frame their questions , enabling them to participate in consultations and take responsibility for making decisions . They reported feeling more confident in the decisions made , having a written report of the key information and an audio recording . Patients considered routine information relating to side effects was inadequate . Doctors reported that consultation plans made them aware of patients ' concerns and ensured comprehensive responses to questions posed . Doctors also endorsed implementing Decision Navigation as part of routine care . CONCLUSION Results suggest that Decision Navigation facilitated patients ' involvement in treatment decision-making . Prostate patients engaging in preference-sensitive decision-making welcomed this approach to personalised tailored support 155 Background : The objectives of this implementation study were to 1 ) identify and address the evidentiary , context ual , and facilitative mechanisms that serve to retard or promote the transfer and uptake of consultation recording use in oncology practice , and 2 ) follow patients during the first few days following receipt of the consultation recording to document , from the patient 's perspective , the benefits realized from listening to the recording . METHODS Nine medical and 9 radiation oncologists from cancer centers in three Canadian cities ( Calgary , Vancouver , Winnipeg ) recorded their primary treatment consultations for 228 patients newly diagnosed with prostate or breast cancer . The Digital Recording Use Semi-Structured Interview ( DRUSSI ) was conducted at two days post-consultation and at 1-week post-consultation . Each oncologist was given a feedback letter summarizing the consultation recording benefits reported by their patients . RESULTS Sixty-nine percent of patients listened to at least a portion of the recording within the first week following the consultation . Consultation recording favourableness ratings were high : 93.6 % rated the intervention between 75 - 100 on a 100-point scale . Four main areas of benefit were reported : 1 ) Anxiety reduction ; 2 ) Enhanced retention of information ; 3 ) Better informed decision making ; and 4 ) Improved communication with family members . Eight fundamental components of successful transfer and uptake of consultation recording practice  were identified . CONCLUSIONS Implementation research and additional r and omized trials are needed to facilitate the transfer and uptake of consultation recording use so that far more patients and significant others may realize the associated benefits Abstract Background . Patient information in cancer clinical trial is challenging . The value of audio-recording interventions for patients considering participating in clinical trials is unclear . The primary aim of this r and omized study was to investigate effects of audio-recorded information on knowledge and underst and ing in patients considering participation in a clinical trial . Material and methods . Patients scheduled for information about a phases 2 or 3 trial by one of the 13 participating oncologists at the Department of Oncology during the study period ( 2008–2013 ) were eligible . The intervention consisted of an audio-recording on compact disc ( CD ) of the information at the medical consultation in which the patients were informed about a trial . Knowledge and underst and ing was measured by the question naire , Quality of Informed Consent . Results . A total of 130 patients were r and omized , 70 % of the calculated sample size ( n = 186 ) . Sixty-seven patients were r and omized to the intervention . In total , 101 patients ( 78 % ) completed question naires . No statistical significant differences were found between the groups with respect to knowledge and underst and ing . The level of knowledge was relatively high , with the exceptions of the risks associated with , and the unproven nature of , the trial . Overall , patients who declined participation scored statistically significant lower on knowledge . Conclusion . The present study was underpowered and the results should therefore be interpreted with caution . Still , 130 patients were included with a response rate of 78 % . A CD including the oral information about a clinical trial did not show any effects on knowledge or underst and ing . However , the levels of knowledge were high , possible due to the high levels of education in the study group . Information on risks associated with the trial is still an area for improvement For many clinicians , it is possible that some of their patients are recording their office visit , with or without permission . In a cross-sectional survey administered to the general public in the United Kingdom , 19 of 128 respondents ( 15 % ) indicated that they had secretly recorded a clinic visit , and 14 of 128 respondents ( 11 % ) were aware of someone covertly recording a clinic visit.1 Because every smartphone can record conversations , this may become even more commonplace . The motivation is often reasonable : patients want a recording to listen to again , improve their recall and underst and ing of medical information , and share the information with family members.2 A review identified 33 studies ( including 18 r and omized trials ) of patient use of audio-recorded clinic-visit information . Audio recordings were highly valued ; across the studies , 72 % of patients listened to their recordings , 68 % shared them with a caregiver , and individuals receiving recordings reported greater underst and ing and recall of medical information.3 In the few health care organizations in the United States that offer patients recordings of office visits , clinicians and patients report benefits . In addition , liability insurers maintain that the presence of a recording Purpose To examine the patient 's role in the decision-making process in a tertiary adult ocular oncology service . Methods A prospect i ve study was carried out of patients attending for follow-up at the Liverpool ocular oncology centre ( LOOC ) , a tertiary adult ocular oncology service . Participants were patients who attended the clinic between September and October 2003 . Through supervised completion of question naires , the main factors observed were : patients ' preferred level of participation , patients ' perceived level of participation , sources of information used by patients , and which sources they found most useful . Results In all , 39 patients were included in the study . The majority of patients ( 69.2 % ) would have preferred to make a shared decision with the doctor  ( 10.3 % preferring an active role , 20.5 % preferring a passive role ) , while 48.7 % perceived having had a shared role ( 25.6 % felt they had had an active role , 25.6 % a passive one ) . Outside the LOOC , general ophthalmologists were the most frequently cited source of information from health professionals , and were also scored as the most useful . Family and friends were the most common source of informal information , followed by use of the Internet . Tape recordings of the consultations were reported as the most popular re source provided by the LOOC . Conclusions Patients attending the LOOC have a strong desire for involvement in the decision-making process . Patients receive little formal or informal information outside this tertiary centre . Further work is required to assess the effectiveness of physicians ' communication skills and the influence of their recommendations on patient choice OBJECTIVES To investigate the effects on  patients ' outcome of the consultations when provided with : a Digital Audio Recording ( DAR ) of the consultation and a Question Prompt List ( QPL ) . METHODS This is a three-armed r and omised controlled cluster trial . One group of patients received st and ard care , while the other two groups received either the QPL in combination with a recording of their consultation or only the recording .  Patients from four outpatient clinics participated : Paediatric , Orthopaedic , Internal Medicine , and Urology . The effects were evaluated by patient-administered question naires . RESULTS A total of 4349 patients participated in the study . DAR significantly increased the probability of fulfilling the participants ' self-perceived information needs by 4.1 % to 6.3 % , particularly with regard to test results ( OR=1.41 , 95%CI : 1.14 - 1.74 , p=0.001 ) and treatment options ( OR=1.39 , 95%CI : 1.13 - 1.71 , p=0.002 ) . Additionally , the interventions positively influenced the participants ' satisfaction with the treatment , their relationship with the health professional , and their experience of being involved in the decision-making . CONCLUSION Providing out patients with a QPL and DAR of their consultation positively influences the patients ' perception of having adequate information after the consultation . PRACTICE IMPLICATION S The implementation of a QPL and audio recording of consultations should be considered in routine practice PURPOSE Women with breast cancer were provided with an audiotape of their primary adjuvant treatment consultation , and the following patient outcomes were measured at 12 weeks postconsultation : perceived degree of information provision , audiotape satisfaction and use , communication satisfaction with oncologist , mood state , and cancer-specific quality of life . PATIENTS AND METHODS Participants included 628 women newly diagnosed with breast cancer and 40 oncologists from six cancer centers in Canada . The patients were block r and omized to one of four consultation groups : st and ard care control , not audiotaped ; audiotaped , no audiotape given ; audiotaped , patient given audiotape ; and audiotaped , patient offered choice of receiving audiotape or not . RESULTS Patients receiving the consultation audiotape had significantly better recall of having discussed side effects of treatment than patients who did not receive the audiotape . Audiotape benefit was not significantly related to patient satisfaction with communication , mood state , or quality of life at 12 weeks postconsultation , and was not significantly affected by choice of receiving the audiotape . Patients rated the audiotape intervention positively , with an average score of 83.9 of 100 . CONCLUSION Audiotape provision benefits patients by facilitating their perception of being informed about treatment side effects , but does not significantly influence patient satisfaction with communication , mood state , or quality of life OBJECTIVE To determine whether providing mothers of babies in neonatal intensive care units with audiotapes of their conversations with a neonatologist improves recall of information and psychological wellbeing . DESIGN R and omised , single blinded trial . SETTING Neonatal intensive care unit , North Queensl and , Australia . PARTICIPANTS 200 mothers of babies in a neonatal intensive care unit . INTERVENTIONS Mothers given ( n=102 ) or not given ( n=98 ) audiotapes of their conversations with a neonatologist . MAIN OUTCOME MEASURES Recall of information , attitudes to and use of the tape , satisfaction with conversations , postnatal depression , anxiety , general health , and stress about parenting , at 10 days and four and 12 months . RESULTS 91 % ( n=93 ) of mothers in the tape group listened to the tape ( once by day 10 , twice by four months , and three times by 12 months ; range 1 - 10 ) . At 10 days and four months , mothers in the tape group recalled significantly more information about diagnosis , treatment , and outcome than mothers in the control group . At four months mothers in the tape group were 75 % more likely to recall all of the information about treatment than mothers in the control group ( 59 % v 34 % ; risk ratio 1.75 , 95 % confidence interval 1.27 to 2.4 ) . Six mothers , all in the control group , could not recall their conversations . No statistically significant differences were found between the groups in satisfaction with conversations ( 10 days ) , postnatal depression and anxiety scores ( 10 days , four and 12 months ) , and stress about parenting ( 12 months ) . CONCLUSION Providing the mothers of babies in neonatal intensive care units with audiotapes of conversations with a neonatologist enhanced their recall of information ( up to four months ) . The taped conversations did not affect the mothers ' wellbeing or satisfaction with the neonatologist . TRIAL REGISTRATION Australian Clinical Trials Registry 12606000478516 OBJECTIVE To evaluate audiotape-recorded consultations at which a new diagnosis of oesophageal or gastric cancer was given to patients with reference to information retention , psychological outcome and socio-economic deprivation . METHODS Fifty-eight patients were r and omised to receive audiotaped consultations or not .  Thirty-one patients received tapes ( 12 oesophageal and 19 gastric cancers ) and were compared with 27 control patients ( 12 oesophageal and 15 gastric cancers ) . All patients were re-interviewed and completed a hospital anxiety and depression ( HAD ) question naire . Socio-economic deprivation scores were calculated using National Indices of Multiple Deprivation . RESULTS Patients r and omised to receive tapes were more likely to retain information ( 31 patients ) than control patients ( 18 patients , p=0.001 ) . Median ( range ) HAD scores were similar in both groups of patients [ HAD A tape 6 ( 0 - 21 ) vs. no tape 5 ( 2 - 14 ) , HAD D tape 3 ( 0 - 23 ) vs. 4 ( 0 - 10 ) , respectively ] . Deprivation correlated significantly with higher HAD A scores in control patients ( p=0.039 ) but was not associated with information retention ( p=0.667 ) . CONCLUSION Taped consultations were associated with significantly better information retention without adverse psychological outcomes . Providing an audiot 
    Output:
    
Most patients found  consultation recordings  beneficial .
Statistically significant evidentiary support was found for the beneficial impact of consultation recordings on the following patient reported outcomes : knowledge , perception of being informed , information recall , decision-making factors , anxiety , and depression .
Implementation barriers included strength of evidence concerns , patient distress , impact of the recording on consultation quality , clinic procedures , medico-legal issues , and re source costs .
Facilitators included comfort with being recorded , clinical champions , legal strategies , efficient recording procedures , and a positive consultation recording experience .
Consultation recordings are valuable to patients and positively associated with patient-reported outcomes .