***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 Drawing on previous web-based diabetes management programs based on the Chronic Care Model , we exp and ed an intervention to include care management through mobile phones and a game console web browser . METHODS The pilot intervention enrolled eight diabetes patients from the University of Washington in Seattle into a collaborative care program : connecting them to a care provider specializing in diabetes , providing access to their full electronic medical record , allowing wireless glucose uploads and e-mail with providers , and connecting them to the program 's web services through a game system . To evaluate the study , we conducted qualitative thematic analysis of semistructured interviews . RESULTS Participants expressed frustrations with using the cell phones and the game system in their everyday lives , but liked the wireless system for collaborating with a provider on uploaded glucoses and receiving automatic feedback on their blood sugar trends . A majority of participants also expressed that their participation in the trial increased their health awareness . DISCUSSION Mobile communication technologies showed promise within a web-based collaborative care program for type 2 diabetes . Future intervention design should focus on integrating easy-to-use applications within mobile technologies already familiar to patients and ensure the system allows for sufficient collaboration with a care provider Patient experience was assessed by survey as part of a large , r and omized controlled trial of a secure , practice -linked personal health record called Patient Gateway at Partners HealthCare in Boston , MA . The subjects were patients with Type 2 diabetes who prepared for their upcoming primary care visit using a previsit electronic journal .  The journal generated a diabetes care plan using patient chart information and patient responses to questions in preparation for a scheduled office visit . Review of 37 surveys revealed that a diabetes care plan took 5 - 9 minutes ( modal ) to be created by the patient and helped many patients to feel more prepared for their visit ( 60 % ) and give more accurate information to their provider ( 53 % ) . Study limitations included small numbers of survey participants and a bias toward white , better educated patients with better controlled diabetes . Nevertheless , the electronic journal is a promising tool for visit preparation and process improvement AIM To investigate whether a comprehensive strategy involving both patients and professionals , with the introduction of a diabetes passport as a key component , improves diabetes care . METHODS The first 150 consecutive patients who visited their internist for a diabetes check up at the internal medicine outpatient departments at each of nine Dutch general hospitals were included in this 1 year clustered , r and omised , controlled trial . Health care professionals attended an educational meeting about the use and dissemination of the diabetes passport which is a patient held record . They also received aggregated feedback on baseline data and personal feedback . Educational meetings were also organised for patients . Patient files were used in conjunction with question naires to determine adherence rates . Data were analysed using multilevel regression analysis . RESULTS Small but significant changes were found in mean HbA1c levels . In the intervention group , positive health changes for patients were found ( -0.3 % ) when compared to those in the control group ( + 0.2 % ) . Diastolic blood pressure improved slightly , but no changes were found in systolic blood pressure or cholesterol . Improvements were found with regard to levels of examination of patients ' feet and in patient education . CONCLUSIONS Efforts to improve professional practice involving both professionals and patients led to small improvements in HbA1c and diastolic blood pressure levels . Further study is needed to establish whether a better structured health care delivery , operating in a more supportive environment can enhance these effects A logbook , or patient-dossier , was developed , to improve continuity of information in the treatment and care of head- and -neck cancer patients . It contained information modules on different aspects of care , as well as forms to facilitate communication both between patient and care-professional and between the various care-professionals . The logbook 's  effectiveness was evaluated in two hospitals in Rotterdam , by comparing outcomes for trial and comparison groups of , respectively , 71 and 54 patients and 59 and 35 care-professionals . Trial patients proved to be better informed , to receive more support and to experience fewer psychosocial problems . Professionals who used the logbook were better informed about their patients , and about the care-activities of fellow-professionals than those who did not . They recognised an improvement in their contact with colleagues and in the harmonisation of their respective care-activities Background : Diabetes mellitus is a complex disease with serious complications . Electronic decision support , providing information that is shared and discussed by both patient and physician , encourages timely interventions and may improve the management of this chronic disease . However , it has rarely been tested in community-based primary care . Methods : In this pragmatic r and omized trial , we r and omly assigned adult primary care patients with type 2 diabetes to receive the intervention or usual care .  The intervention involved shared access by the primary care provider and the patient to a Web-based , colour-coded diabetes tracker , which provided sequential monitoring values for 13 diabetes risk factors , their respective targets and brief , prioritized messages of advice . The primary outcome measure was a process composite score . Secondary outcomes included clinical composite scores , quality of life , continuity of care and usability . The outcome assessors were blinded to each patient ’s intervention status . Results : We recruited sequentially 46 primary care providers and then 511 of their patients ( mean age 60.7 [ st and ard deviation 12.5 ] years ) . Mean follow-up was 5.9 months . The process composite score was significantly better for patients in the intervention group than for control patients ( difference 1.27 , 95 % confidence interval [ CI ] 0.79–1.75 , p < 0.001 ) ; 61.7 % ( 156/253 ) of patients in the intervention group , compared with 42.6 % ( 110/258 ) of control patients , showed improvement ( difference 19.1 % , p < 0.001 ) . The clinical composite score also had significantly more variables with improvement for the intervention group ( 0.59 , 95 % CI 0.09–1.10 , p = 0.02 ) , including significantly greater declines in blood pressure ( −3.95 mm Hg systolic and −2.38 mm Hg diastolic ) and glycated hemoglobin ( −0.2 % ) . Patients in the intervention group reported greater satisfaction with their diabetes care . Interpretation : A shared electronic decision-support system to support the primary care of diabetes improved the process of care and some clinical markers of the quality of diabetes care . ( Clinical Trials.gov trial register no. NCT00813085 . Background Diabetes is one of the four main types of noncommunicable or chronic diseases . Iran is among the countries with the highest incidence of diabetic patients . A study demonstrated that the collection of diabetic data is neither organized nor st and ardized . There is currently no instance of electronic personal health records particularly used for diabetic patients in Iran , hence the need for one , which will be useful for self-care of diabetic patients . Objective The objective of the study is to examine the impact of a Web-based diabetic personal health record ( DPHR ) on the self-care status of diabetic patients as compared with the control group . Methods This study is a r and omized control trial , which involves a systematic review of literature of the preferred data elements regarding a DPHR , and reevaluating the results with the opinions of local endocrinologists . Inclusion criteria were as follows : type 2 diabetic patients between 20 - 70 of age who live in the Mashhad City and having the disease for at least one year . The sample size is 72 people that were r and omly assigned to the control and intervention groups . The participants in the intervention group were allowed access to the Web-based DPHR system , while those in the control group will continue to receive the usual care for 4 months . The study primary outcome measures include self-care status of participants and planned visit adherence . Results At the moment , there is an ongoing recruitment of participants , and preliminary results will be published in early 2016 . Conclusions We expect the final DPHR model , developed and tested during this study , to help diabetic patients to actively participate in their care management process , and also to empower the physician in providing more quality informed decisions regarding their patients . Trial Registration i rct .ir I RCT 2013082914522N1 ; http://www.i rct .ir/ search result .php?id=14522&number=1 ( Archived by WebCite at http://www.webcitation.org/6cC4PCcau ) BACKGROUND Web-based personal health records ( PHRs ) have been advocated as a means to improve type 2 diabetes mellitus ( DM ) care . However , few Web-based systems are linked directly to the electronic medical record ( EMR ) used by physicians . METHODS We r and omized 11 primary care practice s. Intervention practice s received access to a DM-specific PHR that imported clinical and medications data , provided patient-tailored decision support , and enabled the patient to author a " Diabetes Care Plan " for electronic su bmi ssion to their physician prior to upcoming appointments . Active control practice s received a PHR to up date and su bmi t family history and health maintenance information . All patients attending these practice s were encouraged to sign up for online access . RESULTS We enrolled 244 patients with DM ( 37 % of the eligible population with registered online access , 4 % of the overall population of patients with DM ) . Study participants were younger ( mean age , 56.1 years vs 60.3 years ; P < .001 ) and lived in higher-income neighborhoods ( median income , $ 53,784 vs $ 49,713 ; P < .001 ) but had similar baseline glycemic control compared with non participants . More patients in the intervention arm had their DM treatment regimens adjusted ( 53 % vs 15 % ; P < .001 ) compared with active controls . However , there were no significant differences in risk factor control between study arms after 1 year ( P = .53 ) . CONCLUSIONS Previsit use of online PHR linked to the EMR increased rates of DM-related medication adjustment . Low rates of online patient account registration and good baseline control among participants limited the intervention 's impact on overall risk factor control . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00251875 Background : Orthopedic injuries are the most common types of injuries . To identify the main causes of injuries , collecting data in a st and ard manner at the national level are needed , which justifies necessity of making a minimum data set ( MDS ) . Objectives : The aim of this study was to develop an MDS of the information management system for orthopedic injuries in Iran . Material s and Methods : This descriptive cross-sectional study was performed in 2013 . Data were collected from hospitals affiliated with Tehran University of Medical Sciences that had orthopedic department , medical documents centers , legal medicine centers , emergency centers , internet access , and library . Investigated documents were orthopedic injury records in 2012 , documents that retrieved from the internet , and printed material s. Records with R and om sampling by S22-S99 categories from ICD-10 were selected and the related internet- source d data were evaluated entirely . Data were collected using a checklist . In order to make a consensus about the data elements , the decision Delphi technique was applied by a question naire . The content validity and reliability of the question naire were assessed by expert ’s opinions and test-retest method , respectively . Results : An MDS of orthopedic injuries were assigned to two categories : administrative category with six classes including 142 data elements , and clinical category with 17 classes including 250 data elements . Conclusions : This study showed that some of the essential data elements included in other country ’s MDS or required for organizations and healthcare providers were not included . Therefore , a complete list of an MDS elements was created . Existence of comprehensive data concerning the causes and mechanisms of injuries informs public health policy-makers about injuries occurrence and enables them to take rationale measures to deal with these problems 
    Output:
    
Together with representative sample of endocrinologist in Iran achieved consensus on a DPHR model to improve self-care for diabetic patients and to facilitate physician decision making