***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 
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    Input: Purpose To determine if particular values clarification exercises included in a patient decision aid had discernible impact on postdecisional regret in patients with early-stage prostate cancer . Methods A multicenter r and omized controlled trial compared 2 versions of a computerized patient decision aid : only structured information compared to the structured information plus values clarification exercises . Assessment s were conducted during the decision aid visit ; telephone follow-up interviews were conducted when patients made their decisions with their physician , 3 months after completing treatment , and > 1 year later ( per a mailing ) . Outcome measures included the Decisional Conflict Scale , the Preparation for Decision Making Scale , and the Decision Regret Scale . Results A total of 156 patients participated , 75 provided information only and 81 provided information plus values clarification exercises . The groups did not differ significantly on any outcome evaluated at the decision aid visit ; in both groups , decisional conflict decreased immediately after using the decision aid . Between-group differences emerged after the decision was actually made . The values clarification exercises group reported higher Preparation for Decision Making Scale scores at the decision follow-up and at the > 1-year follow-up . Regret did not differ significantly between groups at the 3-month follow-up but was lower for the values clarification exercises group than for the information group at the > 1-year follow-up . Conclusion The results suggest that the values clarification exercises led to better preparation for decision making and to less regret . The impact , however , only emerged after the decision was made Background : Fertility is a priority for many young women with breast cancer . Women need to be informed about interventions to retain fertility before chemotherapy so as to make good quality decisions . This study aim ed to prospect ively evaluate the efficacy of a fertility-related decision aid ( DA ) . Methods : A total of 120 newly diagnosed early-stage breast cancer patients from 19 Australian oncology clinics , aged 18–40 years and desired future fertility , were assessed on  decisional conflict , knowledge , decision regret , and satisfaction about fertility-related treatment decisions .  These were measured at baseline , 1 and 12 months , and were examined using linear mixed effects models . Results : Compared with usual care , women who received the DA had reduced decisional conflict ( β=−1.51 ; 95%CI : −2.54 to 0.48 ; P=0.004 ) and improved knowledge ( β=0.09 ; 95%CI : 0.01–0.16 ; P=0.02 ) , after adjusting for education , desire for children and baseline uncertainty . The DA was associated with reduced decisional regret at 1 year ( β=−3.73 ; 95%CI : −7.12 to −0.35 ; P=0.031 ) , after adjusting for education . Women who received the DA were more satisfied with the information received on the impact of cancer treatment on fertility ( P<0.001 ) , fertility options ( P=0.005 ) , and rated it more helpful ( P=0.002 ) , than those who received st and ard care . Conclusion : These findings support widespread use of this DA shortly after diagnosis ( before chemotherapy ) among younger breast cancer patients who have not completed their families Background : To examine the impact of race on treatment regret among men with recurrent prostate cancer after surgery or radiation . Methods : The prospect i ve Comprehensive , Observational , Multicenter , Prostate Adenocarcinoma ( COMPARE ) registry was used to study a cohort of 484 men with biochemically recurrent prostate cancer after radical prostatectomy , external beam radiation or brachytherapy . Multivariable logistic regression was used to model the association between race and treatment regret and to determine whether there was an interaction between race and sexual problems after treatment with regards to treatment regret . Results : Black men ( N=78 ) were significantly more likely to have treatment regret when compared with non-black men ( N=406 ; 21.8 % versus 12.6 % ) on univariable analysis ( odds ratio ( OR ) 1.94 ; 95 % confidence interval 1.05–3.56 ; P=0.03 ) . On multivariable analysis , black race trended towards but was no longer significantly associated with an increase in treatment regret ( adjusted OR ( AOR ) 1.84 ( 0.95–3.58 ) ; P=0.071 ) . There was an interaction between race and sexual problems after treatment ( Pinteraction=0.02 ) such that among those without sexual problems , black men had more treatment regret than non-black men ( 26.7 % versus 8.4 % : AOR 4.68 ( 1.73–12.63 ) ; P=0.002 ) , whereas among those with sexual problems , there was no difference in treatment regret between black and non-black men ( 18.8 % versus 17.3 % : AOR 1.04 ( 0.44–2.46 ) ; P=0.93 ) . Conclusions : Among men with recurrent prostate cancer after surgery or radiation , black men were nearly twice as likely to experience treatment regret . Treating physicians should ensure that patients are fully apprised of the pros and cons of all treatment options to reduce the risk of subsequent regret PURPOSE Breast cancer ( BC ) decision aid ( DA ) r and omized studies are limited to DA use in consultations among Western population s and for primary surgery . Their effectiveness beyond consultations , for reconstructive surgery and in other population s , has not been evaluated . We developed a DA administered after consultation for Chinese women deciding on BC surgery and , where relevant , immediate breast reconstruction , which was evaluated in this r and omized controlled trial ( RCT ) . PATIENTS AND METHODS Overall , 276 women considering BC surgery for early-stage BC were r and omly assigned to receive a DA ( take-home booklet ) or the st and ard information booklet ( control condition ) after the initial consultation , wherein surgeons disclosed the diagnosis and discussed treatment options with patients . Using block r and om assignment by week , 138 women were assigned to the DA arm and 138 to the control arm . Participants completed interview-based question naires 1 week after consultation and then 1 , 4 , and 10 months after surgery . Primary outcome measures were decisional conflict , decision-making difficulties , BC knowledge 1 week after consultation , and decision regret 1 month after surgery . Secondary outcome measures were treatment decision , decision regret 4 and 10 months after surgery , and postsurgical anxiety and depression . RESULTS The DA group reported significantly lower decisional conflict scores 1 week after consultation ( P = .016 ) compared with women in the control arm . Women receiving the DA had significantly lower decision regret scores 4 ( P = .026 ) and 10 months ( P = .014 ) after surgery and lower depression scores 10 months after surgery ( P = .001 ) . CONCLUSION This RCT demonstrated DAs may benefit Chinese patients in Hong Kong by reducing decisional conflict and subsequent regret and enhance clinical services for this population PURPOSE Underst and ing the distinctive patterns of treatment-related dysfunction after alternative initial treatments for early prostate cancer ( PC ) may improve patients ' choice of treatment and later help them adjust to its consequences . We characterized the time course of treatment complications while adjusting for potentially confounding pretreatment factors hindering other observational studies . PATIENTS AND METHODS In a prospect i ve cohort study of 417 men we assessed urinary , bowel , and sexual function from before primary treatment to 24 months after . To control for potential confounding , we measured sociodemographic and PC prognostic factors , medical comorbidity , and pretreatment function commonly affected by PC and its treatment . RESULTS Patients who underwent external beam radiotherapy ( EBRT ) , radical prostatectomy ( RP ) , and brachytherapy ( BT )  differed significantly in sociodemographic factors , cancer prognostic factors , and pretreatment symptom status , especially sexual function . Urinary incontinence increased sharply after RP , while bowel problems and urinary irritation/obstruction rose after EBRT and BT . Sexual dysfunction increased in all patients , particularly after radical prostatectomy , and nerve-sparing surgical technique had little apparent benefit . There was no change in urinary function and little change in overall bowel function after 12 months , but the time course of sexual dysfunction varied by treatment and , for bowel function , by symptom . Multiple regression modeling confirmed that treatment influences all 24-month outcomes , but residual confounding persisted . CONCLUSION Pretreatment function and the primary treatment modality for early stage PC strongly predict the affected organ systems and time course of dysfunction . With this information , patients and their physicians may refine their choice of treatment and better anticipate its consequences OBJECTIVE To describe relationships between use of the Personal Patient Profile-Prostate ( P3P ) decision support system and patient characteristics , and perceived preparation for decision making ( PrepDM ) , satisfaction and decisional regret in the context of prostate cancer treatment choice . METHODS 494 men with localized prostate cancer ( LPC ) were r and omized to receive the P3P intervention or usual care and completed pre-treatment , 1-month and 6-month outcome measures . Multivariable linear regression models were fit for each outcome . RESULTS Physician consult visits prior to enrollment , race/ethnicity , and use of clinic-provided books were significant predictors of perceived PrepDM at 1 month . Prior Internet use and PrepDM significantly predicted 6-month decision satisfaction . Decisional regret was significantly predicted by demographics , anxiety , PrepDM score , and EPIC bowel domain score at 6 months . Use of P3P did not predict any outcome . CONCLUSION While the P3P intervention did not significantly affect the outcomes , pre-enrollment information and preparation were strong predictors of the 1- and 6-month outcomes . Decision regret was significantly influenced by personal characteristics and post-treatment symptoms/side effects . PRACTICE IMPLICATION S Information received and used between biopsy and the treatment options consult visit is likely to make a difference in decision satisfaction OBJECTIVE To investigate the effect of including an online decision aid ( DA ) during prostate cancer treatment counseling on decisional regret and information satisfaction in a one-year follow-up . METHODS Within a cluster RCT , 18 Dutch hospitals were r and omized to DA counseling or care-as-usual  , patients ( n = 382 ) initially completed question naires  directly after treatment decision making . Six and twelve months later regret ( Decisional Regret Scale ) and information satisfaction ( SCIP-B ) were assessed . Anxious and depressive symptoms ( HADS ) was included as possible covariate . RESULTS After 12 months , 43 participants ( 15 % ) regretted their treatment choice and 105 participants ( 36 % ) were dissatisfied with the information that was received at the time of decision-making , regardless of being exposed to the DA .  Anxious and depressive symptoms at follow-up were associated with regret and information dissatisfaction . CONCLUSION No long-term benefical effects emerged from DA usage compared to patients who underwent st and ard counseling . PRACTICE IMPLICATION S During PCa treatment counseling , healthcare providers should be aware of anxious and depressive symptoms Effect sizes are the currency of psychological research . They quantify the results of a study to answer the research question and are used to calculate statistical power . The interpretation of effect sizes — when is an effect small , medium , or large ?— has been guided by the recommendations Jacob Cohen gave in his pioneering writings starting in 1962 : Either compare an effect with the effects found in past research or use certain conventional benchmarks . The present analysis shows that neither of these recommendations is currently applicable . From past publications without pre- registration , 900 effects were r and omly drawn and compared with 93 effects from publications with pre- registration  , revealing a large difference : Effects from the former ( median r = 0.36 ) were much larger than effects from the latter ( median r = 0.16 ) . That is , certain biases , such as publication bias or question able research practice s , have caused a dramatic inflation in published effects , making it difficult to compare an actual effect with the real population effects ( as these are unknown ) . In addition , there were very large differences in the mean effects between psychological sub-disciplines and between different study design s , making it impossible to apply any global benchmarks . Many more pre-registered studies are needed in the future to derive a reliable picture of real population effects In this prospect i ve , longitudinal study the authors examined changes in cognitive , emotional , and interpersonal components of prostate cancer-related quality of life in 71 men who underwent robotic-assisted prostatectomy for prostate cancer . They identified significant changes across several quality -of-life domains from presurgery to 3-months and 1-year postsurgery . Although some components of quality of life returned to baseline by one year postsurgery , decrements in sexual intimacy , sexual confidence , and masculine self-esteem were enduring . These data can be used to guide patients in their expectations for quality of life following robotic prostatectomy and highlight the need for multidisciplinary approaches aim ed at improving men 's sexual adjustment after this procedure PURPOSE Hypospadias repair is a commonly performed procedure . Little is known about decisional regret in parents who agree to proceed with this surgical reconstruction . We present data on this previously underexplored issue . MATERIAL S AND METHODS We performed followup analysis of 100 couples prospect ively evaluated after counseling for surgical correction of distal hypospadias in their son with assessment of complications and decisional regret 1 year after surgery . Findings were contrasted with baseline demographics , hypospadias knowledge and decisional conflict at the time of counseling . RESULTS Decisional regret was found in 116 parents , including mild regret in 41.4 % and moderate to severe regret in 8.6 % . There was no statistically significant difference in paired regret analysis between mothers and fathers . Complications were strongly associated with decisional regret ( p < 0.001 ) . On regression analysis postoperative complications ( OR 14.7 , 95 % CI 1.6 - 131. 
    Output:
    
Longitudinal effects can influence the expression of decision regret , yet many studies are not design ed to collect long-term data ; prostate cancer studies may be particularly disadvantaged .