***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: CONTEXT Previous studies indicate that industry-sponsored trials tend to draw proindustry conclusions . OBJECTIVE To explore whether the association between funding and conclusions in r and omized drug trials reflects treatment effects or adverse events . DESIGN Observational study of 370 r and omized drug trials included in meta-analyses from Cochrane review s selected from the Cochrane Library , May 2001 . From a r and om sample of 167 Cochrane review s , 25 contained eligible meta-analyses ( assessed a binary outcome ; pooled at least 5 full-paper trials of which at least 1 reported adequate and 1 reported inadequate allocation concealment ) . The primary binary outcome from each meta- analysis was considered the primary outcome for all trials included in each meta- analysis . The association between funding and conclusions was analyzed by logistic regression with adjustment for treatment effect , adverse events , and additional confounding factors ( method ological quality , control intervention , sample size , publication year , and place of publication ) . MAIN OUTCOME MEASURE Conclusions in trials , classified into whether the experimental drug was recommended as the treatment of choice or not . RESULTS The experimental drug was recommended as treatment of choice in 16 % of trials funded by nonprofit organizations , 30 % of trials not reporting funding , 35 % of trials funded by both nonprofit and for-profit organizations , and 51 % of trials funded by for-profit organizations ( P<.001 ; chi2 test ) . Logistic regression analyses indicated that funding , treatment effect , and double blinding were the only significant predictors of conclusions . Adjusted analyses showed that trials funded by for-profit organizations were significantly more likely to recommend the experimental drug as treatment of choice ( odds ratio , 5.3 ; 95 % confidence interval , 2.0 - 14.4 ) compared with trials funded by nonprofit organizations . This association did not appear to reflect treatment effect or adverse events . CONCLUSIONS Conclusions in trials funded by for-profit organizations may be more positive due to biased interpretation of trial results . Readers should carefully evaluate whether conclusions in r and omized trials are supported by data CONTEXT The Consoli date d St and ards for Reporting of Trials ( CONSORT ) statement was developed to help improve the quality of reports of r and omized controlled trials ( RCTs ) . To date , a paucity of data exists regarding whether it has achieved this goal . OBJECTIVE To determine whether use of the CONSORT statement is associated with improvement in the quality of reports of RCTs . DESIGN AND SETTING Comparative before- and -after evaluation in which reports of RCTs published in 1994 ( pre-CONSORT ) were compared with RCT reports from the same journals published in 1998 ( post-CONSORT ) . We included 211 reports from BMJ , JAMA , and The Lancet ( journals that adopted CONSORT ) as well as The New Engl and Journal of Medicine ( a journal that did not adopt CONSORT and was used as a comparator ) . MAIN OUTCOME MEASURES Number of CONSORT items included in a report , frequency of unclear reporting of allocation concealment , and overall trial quality score based on the Jadad scale , a 5-point quality assessment instrument . RESULTS Compared with 1994 , the number of CONSORT checklist items in reports of RCTs increased in all 4 journals in 1998 , and this increase was statistically significant for the 3 adopter journals ( pre-CONSORT , 23.4 ; mean change , 3.7 ; 95 % confidence interval [ CI ] , 2.1 - 5.3 ) . The frequency of unclear reporting of allocation concealment decreased for each of the 4 journals , and this change was statistically significant for adopters ( pre-CONSORT , 61 % ; mean change , -22 % ; 95 % CI , -38 % to -6 % ) . Similarly , 3 of the 4 journals showed an improvement in the quality score for reports of RCTs , and this increase was statistically significant for adopter journals overall ( pre-CONSORT , 2.7 ; mean change , 0.4 ; 95 % CI , 0.1 - 0.8 ) . CONCLUSION Use of the CONSORT statement is associated with improvements in the quality of reports of RCTs UNLABELLED Although two pegylated interferons ( Peg-IFN ) are available to treat chronic hepatitis C virus ( HCV ) infection , no head-to-head comparative studies have been published . We aim to compare the efficacy and safety of PEG IFN alfa-2b ( PEG 2b ) versus PEG IFN alfa-2a ( PEG 2a ) , plus ribavirin ( RBV ) . A prospect i ve , r and omized , multi-center , open-label clinical trial including 182 human immunodeficiency virus (HIV)-hepatitis C virus ( HCV ) patients naïve for HCV therapy was performed . Patients were assigned to PEG 2b ( 80 - 150 mug/week ; n = 96 ) or PEG 2a ( 180 mug/week ; n = 86 ) , plus RBV ( 800 - 1200 mg/day ) for 48 weeks . The primary endpoint was sustained virological response ( SVR : negative HCV-RNA 24 weeks after completion of treatment ) . At baseline , both groups were well balanced : 73 % male ; 63 % HCV genotype 1 or [ corrected ] 4 ; 29 % had fibrosis index of 3 or greater . The overall SVR was 44 % ( 42 % PEG 2b versus 46 % PEG 2a , P = 0.65 ) . Among genotypes 1 or [ corrected ] 4 , SVRs were 28 % versus 32 % ( P = 0.67 ) and 62 % versus 71 % ( P = 0.6 ) in genotypes 2 or [ corrected ] 3 for PEG 2b and PEG 2a , respectively . Early virological response ( EVR ; > or=2 log reduction from baseline or negative HCV-RNA at week 12 ) was 70 % in the PEG 2b group and 80 % in the PEG 2a group ( P = 0.13 ) , reaching a positive predictive value of SVR of 64 % and a negative predictive value of 100 % in both arms . Side effects were present in 96 % of patients but led to treatment discontinuation in 10 % of patients ( 8 % on PEG 2b and 13 % on PEG 2a , P = 0.47 ) . CONCLUSION In patients with HIV , HCV therapy with PEG 2b or PEG 2a plus RBV had no significant differences in efficacy and safety BACKGROUND / AIMS To compare the pharmacokinetics , pharmacodynamics , and antiviral activity of  peginterferon alfa-2b and peginterferon alfa-2a in patients with chronic hepatitis C virus genotype 1 . METHODS Thirty-six patients were r and omised to peginterferon alfa-2b ( 1.5 microg/kg/week ) or peginterferon alfa-2a ( 180 microg/week ) for 4 weeks , then in combination with ribavirin ( 13 mg/kg/day ) for a further 4 weeks . The pharmacokinetic profile of both peginterferons , mRNA expression of a selected group of interferon-induced gene transcripts , and serum HCV-RNA levels were assessed . RESULTS Patients receiving peginterferon alfa-2b had significantly greater up-regulation of interferon-alfa response genes compared with those receiving peginterferon alfa-2a . Correspondingly , patients treated with peginterferon alfa-2b also had a significantly greater log10 maximum and log10 time-weighted average decrease in serum HCV-RNA . A greater proportion of peginterferon alfa-2b patients achieved a > or = 2.0 log10 reduction in serum HCV-RNA levels by week 8 ( 72 % vs 44 % of peginterferon alfa-2a patients , P = 0.09 ) . There was an approximately 16-fold greater exposure to peginterferon in the serum of patients treated with peginterferon alfa-2a . CONCLUSIONS These findings suggest that the biological activity , measured by early interferon-induced gene transcripts and early antiviral responsiveness , may have been greater in patients treated with peginterferon alfa-2b despite their lower exposure to the drug compared with patients treated with peginterferon alfa-2a CONTEXT Controversy and uncertainty ensue when the results of clinical research on the effectiveness of interventions are subsequently contradicted . Controversies are most prominent when high-impact research is involved . OBJECTIVES To underst and how frequently highly cited studies are contradicted or find effects that are stronger than in other similar studies and to discern whether specific characteristics are associated with such refutation over time . DESIGN All original clinical research studies published in 3 major general clinical journals or high-impact-factor specialty journals in 1990 - 2003 and cited more than 1000 times in the literature were examined . MAIN OUTCOME MEASURE The results of highly cited articles were compared against subsequent studies of comparable or larger sample size and similar or better controlled design s. The same analysis was also performed comparatively for matched studies that were not so highly cited . RESULTS Of 49 highly cited original clinical research studies , 45 cl aim ed that the intervention was effective .  Of these , 7 ( 16 % ) were contradicted by subsequent studies , 7 others ( 16 % ) had found effects that were stronger than those of subsequent studies , 20 ( 44 % ) were replicated , and 11 ( 24 % ) remained largely unchallenged . Five of 6 highly-cited nonr and omized studies had been contradicted or had found stronger effects vs 9 of 39 r and omized controlled trials ( P = .008 ) . Among r and omized trials , studies with contradicted or stronger effects were smaller ( P = .009 ) than replicated or unchallenged studies although there was no statistically significant difference in their early or overall citation impact . Matched control studies did not have a significantly different share of refuted results than highly cited studies , but they included more studies with " negative " results . CONCLUSIONS Contradiction and initially stronger effects are not unusual in highly cited research of clinical interventions and their outcomes . The extent to which high citations may provoke contradictions and vice versa needs more study . Controversies are most common with highly cited nonr and omized studies , but even the most highly cited r and omized trials may be challenged and refuted over time , especially small ones BACKGROUND The efficacy and tolerability of Peg-Interferon alpha-2a ( Peg-IFNalpha-2a ) versus Peg-Interferon alpha-2b ( Peg-IFNalpha-2b ) were compared in a patient cohort with hepatitis C virus (HCV)-related active chronic hepatitis , unresponsive to previous antiviral treatment with st and ard IFN ( 6 MU three times/week ) plus ribavirin ( 10.6 mg/kg/day ) for a period of at least 3 months . PATIENTS AND METHODS A total of 143 patients were enrolled and r and omized into two treatment groups ( A-B ) . Group A ( 71 patients ) received one vial of Peg-IFNalpha-2a weekly ( 180 microg ) subcutaneously whereas Group B ( 72 patients ) received 1.5 microg/kg of Peg-IFNalpha-2b weekly subcutaneously . Interferon was combined with ribavirin ( 15 mg/kg/day ) in both groups and all patients who demonstrated nondetectable HCV-RNA or a > or=2(log ) reduction in viral load at week 12 , were treated for 48 weeks , with a 24-week follow up . RESULTS Group A ( 10/71 ) and Group B ( 8/72 ) patients discontinued treatment due to severe side effects . At the end of therapy , HCV-RNA was undetectable in 17/71 ( 23.9 % ) Group A and in 19/72 ( 26.4 % ) of Group B patients . When terminating follow up , a sustained virological response was observed in 14/71 in Group A ( 19.7 % ) and 13/72 in Group B ( 18.0 % ) . CONCLUSIONS Within the limits of the relatively small sample size , Peg-IFNalpha-2a and Peg-IFNalpha-2b demonstrated nonstatistically significant differences in effectiveness in patients nonresponsive to previous antiviral treatment UNLABELLED The overall mortality of patients infected with hepatitis C virus ( HCV ) has not been fully eluci date d. This study analyzed mortality in subjects positive for antibody to HCV ( anti-HCV ) in a community-based , prospect i ve cohort study conducted in an HCV hyperendemic area of Japan . During a 10-year period beginning in 1995 , 1125 anti-HCV-seropositive residents of Town C were enrolled into the study and were followed for mortality through 2005 . Cause of death was assessed by death certificates . Subjects with detectable HCV core antigen ( HCVcAg ) or HCV RNA were considered as having hepatitis C viremia and were classified as HCV carriers ; subjects who were negative for both HCVcAg and HCV RNA ( i.e. , viremia-negative ) were considered as having had a prior HCV infection and were classified as HCV noncarriers . Among the anti-HCV-positive subjects included in the analysis , 758 ( 67.4 % ) were HCV carriers , and 36 
    Output:
    
Current evidence suggests that peginterferon alpha-2a is associated with higher SVR than peginterferon alfa-2b .
However , the paucity of evidence on adverse events curbs the decision to definitively recommend one peginterferon over the other , because any potential benefit must outweigh the risk of harm