***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: ABSTRACT Despite increased interest among the public in breast cancer genetic risk and genetic testing , there are limited services to help women make informed decisions about genetic testing . This study , conducted with female callers ( N = 279 ) to the National Cancer Institute 's ( NCI 's ) Atlantic Region Cancer Information Service ( CIS ) , developed and evaluated a theory-based , educational intervention design ed to increase callers ' underst and ing of the following : ( a ) the kinds of information required to determine inherited risk ; ( b ) their own personal family history of cancer ; and ( c ) the benefits and limitations of genetic testing . Callers requesting information about breast/ovarian cancer risk , risk assessment services , and genetic testing were r and omized to either : ( 1 ) st and ard care or ( 2 ) an educational intervention . Results show that the educational intervention reduced intention to obtain genetic testing among women at average risk and increased intention among high-risk women at 6 months . In addition , high monitors , who typically attend to and seek information , demonstrated greater increases in knowledge and perceived risk over the 6-month interval than low monitors , who typically are distracted from information . These findings suggest that theoretically design ed interventions can be effective in helping women underst and their cancer risk and appropriate risk assessment options and can be implemented successfully within a service program like the CIS Abstract Objective : To investigate the feasibility of improving screening for carriers of haemoglobin disorders in general practice by using a nurse facilitator to work with primary care teams and the relevant haematology laboratories ; to identify problems in communication between all those involved in delivering the service , and to implement solutions . Design : Two year , practice based r and omised controlled trial . Setting : North London area where 29 % of residents and 43 % of births are in ethnic groups at risk for haemoglobin disorders . Subjects : 26 of the 93 practice s using the services of the area 's haematology laboratory agreed to take part and were r and omly divided into control and intervention practice s. Main outcome measure : Change in number of requests for screening tests for haemoglobin disorders made by control and intervention practice s in baseline and intervention years . Results : The number of screening tests requested varied from 0 - 150 in the 93 practice s in the baseline year . Study practice s tended to have made a moderate number of requests ( 10 - 50 ) during this period . During the intervention year intervention practice s made 292 more requests ( 99 % increase ) and control practice s made 74 fewer requests ( 23 % decrease ; P=0.001 for difference in median change ) . Four practice s , three of which were singleh and ed , accounted for 75 % of the increase . The number of requests from intervention practice s , adjusted for baseline requests , was 3.2 times higher than control practice s ( P<0.0001 ) . Conclusion : General practitioners and practice nurses are willing to undertake a new genetic screening service ( or exp and an existing one ) if they are persuaded that it benefits the health of a significant proportion of their practice population . They need appropriate tools ( for example , information material s for carriers and groups at risk ) , and the laboratory must be sensitive to their needs . Preconceptional carrier screening and counselling need to be coupled with antenatal screening OBJECTIVE Genetic testing is increasingly part of routine clinical care for women with a family history of breast cancer . Given their substantially elevated risk for breast cancer , BRCA1/BRCA2 mutation carriers must make the difficult decision whether or not to opt for risk reducing mastectomy . To help BRCA1/2 carriers make this decision , the authors developed a computer-based interactive decision aid that was tested against usual care in a r and omized controlled trial . DESIGN After the completion of genetic counseling , 214 female ( aged 21 - 75 ) BRCA1/BRCA2 mutation carriers were r and omized to Usual Care  ( UC ; N = 114 ) or Usual Care plus Decision Aid ( DA ; N = 100 ) arms . UC participants received no additional intervention . DA participants were sent the CD-ROM DA to view at home . MAIN OUTCOME MEASURES The authors measured final management decision , decisional conflict , decisional satisfaction , and receipt of risk reducing mastectomy at 1- , 6- , and 12-months postr and omization . RESULTS Longitudinal analyses revealed that the DA was effective among carriers who were initially undecided about how to manage their breast cancer risk . Within this group , the DA led to an increased likelihood of reaching a management decision ( OR = 3.09 , 95 % CI = 1.62 , 5.90 ; p < .001 ) , decreased decisional conflict ( B = -.46 , z = -3.1 , p < 002 ) , and increased satisfaction ( B = .27 , z = 3.1 , p = .002 ) compared to UC . Among carriers who had already made a management decision by the time of r and omization , the DA had no benefit relative to UC . CONCLUSION These results demonstrate that BRCA1/BRCA2 mutation carriers who are having difficulty making a breast cancer risk management decision can benefit from adjunct decision support PURPOSE To evaluate the predictors of and time taken for the translation of highly promising basic research into clinical experimentation and use . METHODS We identified 101 articles , published between 1979 and 1983 in six major basic science journals , which clearly stated that the technology studied had novel therapeutic or preventive promises . Each case was evaluated for whether the promising finding result ed in relevant r and omized controlled trials and clinical use . Main outcomes included the time to published trials , time to published trials with favorable results ( " positive " trials ) , and licensed clinical use . RESULTS By October 2002 , 27 of the promising technologies had result ed in at least one published r and omized trial , 19 of which had led to the publication of at least one positive r and omized trial . Five basic science findings are currently licensed for clinical use , but only has been used extensively for the licensed indications . Promising technologies that did not lead to a published human study within 10 to 12 years were unlikely to be tested in humans subsequently . Some form of industry involvement in the basic science publication was the strongest predictor of clinical experimentation , accelerating the process by about eightfold ( 95 % confidence interval : 3 to 19 ) when an author had industry affiliations . CONCLUSION Even the most promising findings of basic research take a long time to translate into clinical experimentation , and adoption in clinical practice is rare PURPOSE Markers of genetic susceptibility to tobacco-related cancers could personalize harms of smoking and motivate cessation . Our objective was to assess whether a multicomponent intervention that included feedback about genetic susceptibility to lung cancer increased risk perceptions and rates of smoking cessation compared with a st and ard cessation intervention . EXPERIMENTAL DESIGN Our design was a two-arm trial with eligible smokers r and omized in a 1:2 ratio to Enhanced Usual Care or Biomarker Feedback ( BF ) .  Surveys were conducted at baseline , 6 , and 12 months later . The setting was an inner city community health clinic . African-American patients who were current smokers ( n = 557 ) were identified by chart abstract ion and provider referral . All smokers received a self-help manual and , if appropriate , nicotine patches . Smokers in the BF arm also were offered a blood test for genotyping the GST(3 ) gene ( GSTM1 ) , sent a test result booklet , and called up to four times by a health educator . Prevalent abstinence was assessed by self-report of having smoked no cigarettes in the prior 7 days at the 6- and 12-month follow-ups and sustained abstinence , i.e. , not smoking at either follow-up or in-between . RESULTS Smoking cessation was greater for the BF arm than the Enhanced Usual Care arm ( 19 % versus 10 % , respectively ; P < 0.006 ) at 6 months but not at 12 months . CONCLUSIONS Smokers agreed to genetic feedback as part of a multicomponent cessation program . Although the program increased short-term cessation rates compared with st and ard intervention , genetic feedback of susceptibility may not benefit smokers with high baseline risk perceptions Prenatal diagnosis ( PND ) is offered routinely as part of pregnancy care to a large number of women at increased risk of fetal anomalies . Despite an extraordinary growth in the use of PND and significant re source allocation , few studies have examined outcomes of PND counseling , and virtually no research has evaluated the relative efficacy of various approaches to genetic counseling . This study was a r and omized trial that compared which counseling methods – individual , group , and use of a decision aid – are effective in PND counseling for women of advanced maternal age ( ≥35 years ) and their partners . Three hundred and fifty‐two women and 225 partners completed pre‐ and post‐intervention question naires assessing changes in knowledge , decisional conflict , state anxiety , satisfaction , use of PND , and pregnancy outcomes . All participants showed a significant increase in knowledge and a decrease in decisional conflict post intervention . Those in the group intervention showed a significantly greater increase in knowledge than those in the individual counseling intervention . While high levels of satisfaction were reported by all , those in individual counseling were significantly more satisfied than those receiving group counseling or the decision aid . This study has shown unique benefits with each type of intervention such that women and their partners preferred individual genetic counseling , while they learned best in group‐counseling sessions , and experienced the least decisional conflict regarding genetic testing with a decision aid OBJECTIVES (1)To compare an interactive multimedia decision aid ( IMDA ) with a leaflet and a video to give information about prenatal screening for Down syndrome and ( 2 ) to determine the women 's acceptance of IMDA . METHODS Two hundred and one women were recruited from the prenatal clinic of a university teaching hospital and r and omised into the intervention group ( IMDA , video , and information leaflet ) or the control group ( video and information leaflet ) . RESULTS There were no significant differences in the initial decision for and the final uptake of the prenatal screening test between the control and intervention groups . The proportion of women who were undecided was less than 10 % in both groups . Of the women in the intervention group , 86.6 % and 78.9 % agreed that IMDA was user-friendly and acceptable , respectively . Significantly more women aged < 35 ( 88.1 % ) accepted IMDA than women aged > or = 35 ( 68.3 % ) ( P = 0.030 ) , but the logistic regression analysis did not confirm this finding after adjusting for other factors ( computer knowledge and usage of computer ) . CONCLUSION The use of IMDA did not affect the women 's overall uptake rate of the prenatal screening test for Down syndrome . More women less than 35 years accepted IMDA probably because they used computer more frequently and had more computer knowledge BACKGROUND In response to the isolation of the BRCA1 gene , a breast-ovarian cancer-susceptibility gene , biotechnology companies are already marketing genetic tests to health care providers and to the public . Initial studies indicate interest in BRCA1 testing in the general public and in population s at high risk . However , the optimal strategies for educating and counseling individuals have yet to be determined . PURPOSE Our goal was to evaluate the impact of alternate strategies for pretest education and counseling on decision-making regarding BRCA1 testing among women at low to moderate risk who have a family history of breast and /or ovarian cancer . METHODS A r and omized trial design was used to evaluate the effects of education only ( educational approach ) and education plus counseling ( counseling approach ) , as compared with a waiting-list ( control ) condition ( n = 400 for all groups combined ) . The educational approach review ed information about personal risk factors , inheritance of cancer susceptibility , the benefits , limitations , and risks of BRCA1 testing , and cancer screening and prevention options . The counseling approach included this information , as well as a personalized discussion of experiences with cancer in the family and the potential psychological and social impact of testing . Data on knowledge of inherited cancer and BRCA1 test characteristics , perceived risk , perceived benefits , limitations and risks of BRCA1 testing , and testing intentions were collected by use of structured telephone interviews at baseline and at 1-month follow-up . Provision of a blood sample for future testing served as a proxy measure of intention to be tested ( in the education and counseling arms of the study ) . The effects of intervention group on study outcomes were evaluated by use of hierarchical linear regression modeling and logistic regression modeling ( for the blood sample outcome ) . All P values are for two-sided tests . RESULTS The educational and counseling approaches both led to significant increases in knowledge , relative to the control condition ( P < .001 for both ) . The counseling approach , but not the educational approach , was superior to the control condition in producing significant increases in perceived limitations and risks of BRCA1 testing ( P < .01 ) and decreases in perceived benefits ( P < .05 ) . However , neither approach produced changes in intentions to have BRCA1 testing . Prior to and following both education only and education plus counseling , approximately one half of the participants stated that they intended to be tested ; after the session , 52 % provided a blood sample . CONCLUSIONS St and ard educational approaches may be equally effective as exp and ed counseling approaches in enhancing knowledge . Since knowledge is a key aspect of medical decision-making , st and ard education may be adequate in situations where genetic testing must be streamlined . On the other h and , it has been argued that optimal decision-making requires not only knowledge , but also a reasoned evaluation of the positive and negative consequences of alternate decisions . Although the counseling approach is more likely to achieve this goal , it may not diminish interest in testing , even among women at low to moderate risk . Future research should focus on the merits of these alternate approaches for subgroups of individuals with different background s who are being counseled in the variety of setting s where BRCA1 testing is likely to be offered This trial tests the hypothesis that confirm 
    Output:
    
CONCLUSIONS More research on the effectiveness of KT interventions regarding genetic testing in the clinical context may contribute to patients making informed value-based decisions and drawing the maximum benefit from clinical applications of genetic and genomic innovations