***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: Objective : To assess whether the type of scale used ( scaling effects ) and the severity of outcome ( outcome severity ) influence patients ’ numerical interpretations of verbal probability expressions . Design : Cross-sectional survey of patients in a general medicine clinic . Setting : A university-based Department of Veterans Affairs Medical Center . Participants : 210 patients seen consecutively in a general medicine clinic . Measurements and results : The patients were r and omized to scale  and health outcome ( complications of surgery ) . Two scales ( a long form and a short form ) were used to expressly allow patients to choose probabilities less than 1 % . The long form had a lower bound of “ < 1 out of 1,000,000 ” ; the short form had a lower bound of “ < 1 out of 1,000 . ” Two complications were used : “ death from anesthesia ” and “ severe pneumonia . ” In the context of being told that their surgeon believed that the chance the complication would occur was “ rare , ” patients were asked to give the numerical estimate of that chance . The values elicited on both scales were significantly different for the two outcomes , with the “ rare ” risk of death from anesthesia being characterized as less likely than the “ rare ” risk of severe pneumonia ( F=5.24 , p=0.023 ) . Linear regression and three-factor analysis of variance showed significant differences in the probabilities elicited for scale , outcome , and age , with older patients generally responding with higher probabilities than did younger patients . Conclusions : These findings suggest that the severity of the associated outcome and the scale used to elicit patients ’ numerical estimates of verbal probability  expressions influence patients ’ quantitative interpretations of the verbal probability statement ; and older patients respond with higher probabilities of negative outcomes than do younger patients . Future studies must continue to explore whether verbal probability expressions are adequate for communicating medical risk to patients or whether patients should be provided with numerical estimates of frequency OBJECTIVES The study evaluated the interpretation of , and preferences for , numerical information on side-effect incidence when presented in three different formats . METHODS It used a controlled design , with participants allocated at r and om to receive one of the three formats . Participants were recruited via a pop-up window on the CancerHelp UK website . The sample comprised 129 website users , of whom 96 % were women and 86 % had cancer , who received frequency information on four side effects of tamoxifen  , using one of three risk expressions ( percentages , e.g. ' affects 25 % of people ' ; frequencies , e.g. ' affects 1 in 4 people ' ; combined , e.g. ' affects 1 in 4 people ( 25 % ) ' ) . They then interpreted information on tamoxifen and its effect on health , and estimates of side-effect frequency , and then stated a preference from the three risk expression formats . KEY FINDINGS The results showed that the three formats did not influence participants ' ratings of the information or their side-effect estimates . However , more than half ( 53 % ) the participants preferred the combined ( frequency and percentage ) format . In conclusion , a combined risk expression format performed no worse than percentages or frequencies alone and was preferred by a majority . CONCLUSIONS The three risk expression formats did not differ in their effect on participants ' interpretations . However , the preferred format was the combined ( frequency and percentage ) risk expression OBJECTIVE The objective of this r and omized controlled trial was to evaluate the efficacy of presenting information on the risks of side effects from a medicine , presented in different formats . METHODS A r and omized , parallel-group , single-center controlled trial was conducted among adult users of a training pharmacy . The information was categorized into the following groups : verbal descriptors+percentage range , percentage range and absolute percentage . The main outcomes were gist underst and ing and verbatim underst and ing , classified either as adequate or inadequate . The analyses were performed using ANOVA and Pearson 's chi-square test . RESULTS A total of 393 participants were recruited from June to October 2015 .  Adequate levels of gist underst and ing and verbatim underst and ing were respectively 65.6 % and 53.9 % for the verbal descriptors+percentage range ( n=128 ) , 63.4 % and 44.3 % for percentage range ( n=131 ) , and 62.3 % and 48.5 % for absolute percentage ( n=131 ) , with no statistically significant difference between the groups ( p=0.852 and p=0.299 , respectively ) . CONCLUSION The underst and ing of the information was similar in all three formats , but the percentages of adequate underst and ing were low . PRACTICAL IMPLICATION S The percentage of inadequate underst and ing demonstrated in this study indicates that alternative formats for reporting adverse reactions need to be evaluated Objective : To determine whether the use of verbal descriptors suggested by the European Union ( EU ) such as “ common ” ( 1–10 % frequency ) and “ rare ” ( 0.01–0.1 % ) effectively conveys the level of risk of side effects to people taking a medicine . Design : R and omised controlled study with unconcealed allocation . Participants : 120 adults taking simvastatin or atorvastatin after cardiac surgery or myocardial infa rct ion . Setting : Cardiac rehabilitation clinics at two hospitals in Leeds , UK . Intervention : A written statement about one of the side effects of the medicine ( either constipation or pancreatitis ) . Within each side effect condition half the patients were given the information in verbal form and half in numerical form ( for constipation , “ common ” or 2.5 % ; for pancreatitis , “ rare ” or 0.04 % ) . Main outcome measure : The estimated likelihood of the side effect occurring . Other outcome measures related to the perceived severity of the side effect , its risk to health , and its effect on decisions about whether to take the medicine . Results : The mean likelihood estimate given for the constipation side effect was 34.2 % in the verbal group and 8.1 % in the numerical group ; for pancreatitis it was 18 % in the verbal group and 2.1 % in the numerical group . The verbal descriptors were associated with more negative perceptions of the medicine than their equivalent numerical descriptors . Conclusions : Patients want and need underst and able information about medicines and their risks and benefits . This is essential if they are to become partners in medicine taking . The use of verbal descriptors to improve the level of information about side effect risk leads to overestimation of the level of harm and may lead patients to make inappropriate decisions about whether or not they take the medicine OBJECTIVE To determine whether the public has different expectations of nonprescription medications based on location of sale . DESIGN Cross-sectional , descriptive . SETTING Saskatoon , Saskatchewan , Canada , during the summer of 2003 . PARTICIPANTS 2,102 r and omly selected citizens . INTERVENTION Mail survey . MAIN OUTCOME MEASURES Differences in expectations for potency , safety , adverse effects , effectiveness , and package information of products sold in pharmacies versus convenience stores . RESULTS The response rate was 57.2 % . Most participants ( 81.2 % ) were aware that nonprescription medications could be purchased in convenience stores , but far fewer ( 42.3 % ) had done so . As one potential re source during purchases , pharmacists were held in reasonably high regard . Expectations with the greatest difference were of a merch and ising nature . Respondents expected pharmacies to have a better quality and selection of products and lower prices . For drug-related attributes , differences were minimal but statistically significant . CONCLUSION Location of sale does not appear to have any practical influence on consumer expectations of the drug-related attributes of nonprescription medications . Buyers of such products expect similar properties to be present regardless of location Abstract Background : All licensed medicines in the European Union must be provided with a Patient Information Leaflet that includes a list of all known side effects . Among patients who read the leaflet , the side effects section is the most often read . A UK government regulatory publication recommends providing medicine side effect risk information in a combined format , using verbal descriptors accompanied by numerical information . Objectives : This study , with users of an existing popular patient information website , investigates the effectiveness of presenting medicine side effect risk information in different forms . Design : Participants were r and omly allocated to one of the three formats for representing risk information ( verbal descriptors , e.g. ‘ common ’ ; absolute frequencies , e.g. ‘ less than 1 in 10 people ’ ; and a combination of verbal descriptors and frequency b and s , e.g. ‘ common ( affects less than 1 in 10 people ) ’ . Methods : Participants ( n= 187 ) were recruited from users of the Cancer Research UK patient information website . They were asked to imagine that they had to take a cancer treatment ( tamoxifen ) , estimate the risks of four side effects occurring , and complete Likert scales relating to their satisfaction with the information supplied and perceived likelihood of various outcomes . Results : Those in the absolute frequency format demonstrated greater accuracy in estimating the likelihood of having two of four side effects than the other two formats . They were also more accurate at estimating the likelihood of themselves or the average person having any side effect from taking tamoxifen . Participants in the absolute frequency format rated the risk to health from tamoxifen as lower than those in the other two formats , were more satisfied with the information they received than those in the verbal format , and felt there would be less impact of the information on tamoxifen use than those in the combined format . Conclusions : These findings fail to confirm that the recommended use of combined descriptors for medicine side effects is unequivocally superior to absolute frequency alone . They also add weight to the growing body of research highlighting the deficiencies in using verbal descriptors for conveying side effect risk , and the strength of using absolute frequency descriptors BACKGROUND : Several studies suggest that many parents and research participants have poor underst and ing of the elements of consent , particularly the risks and benefits . However , some data suggest that the format and framing of research risks and benefits may be an important determinant of subject underst and ing . We examined the effect of tabular and graphical presentation of risks and benefits on parents ' underst and ing of a research study . METHODS : Parents of children scheduled to undergo an elective surgical procedure ( n = 408 ) were r and omized to receive information about the risks and benefits of a sham study of postoperative pain control using text , tables , or pictographs and then completed a question naire to examine their gist ( essential ) and verbatim ( actual ) underst and ing of the information . Parent demographics were recorded and their literacy and numeracy skills measured . RESULTS : Parents r and omized to receive information using tables or pictographs had significantly ( P < 0.025 ) greater gist and verbatim underst and ing than did parents who received the information using st and ard text . Tables and pictographs were also superior to text in promoting underst and ing among parents with low numeracy and literacy skills . CONCLUSIONS : Many parents and patients have difficulty in assimilating and interpreting risk/benefit information for both research and treatment . This is due , in part , to the manner in which risks and benefits are communicated and to the literacy and numeracy abilities of the individual . The results of this study suggest a simple and practical method for enhancing underst and ing of risk/benefit statistics for parents with varying numeracy and literacy skills OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity CONTEXT Patients with cancer undergoing similar treatments experience variable severity and frequency of side effects not adequately explained by pharmacological mechanisms , suggesting psychological influence . OBJECTIVES First , this study aim ed to further examine the relationship between patients ' expectations of multiple chemotherapy-related toxicities and experiences . Second , this study aim ed to explore the impact of anxiety and cancer coping styles to aid in informing interventions to lessen such expectations . METHODS A total of 59 eligible , consenting patients with cancer rated their expectations of 20 chemotherapy toxicities on 100-point linear analogue self- assessment indicators before treatment and completed the Spielberger State Anxiety Inventory and the Mental Adjustment to 
    Output:
    
DISCUSSION AND CONCLUSIONS Decreasing unrealistic side-effect expectations may lead to decreased experience of side-effects and increased adherence to medical interventions .