***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: OBJECTIVES To evaluate a paging system design ed to improve independence in people with memory problems and executive deficits . METHODS After a successful pilot study , a r and omised control trial was conducted involving a crossover design with 143 people aged between 8 and 83 years . All had one or more of the following : memory , planning , attention , or organisation problems . Most had sustained a traumatic head injury or a stroke although a few had developmental learning difficulties or other conditions . The crossover design ensured that some people received a pager after a 2 week baseline whereas others were required to wait for 7 weeks after the baseline before receiving the pager . Participants were assessed at three time periods — namely , at baseline , 7 weeks , and at 14 weeks postbaseline . RESULTS More than 80 % of those who completed the 16 week trial were significantly more successful in carrying out everyday activities ( such as self care , self medication , and keeping appointments ) when using the pager in comparison with the baseline period . For most of these , significant improvement was maintained when they were monitored 7 weeks after returning the pager . CONCLUSIONS This particular paging system significantly reduces everyday failures of memory and planning in people with brain injury To comprehend the results of a r and omised controlled trial ( RCT ) , readers must underst and its design , conduct , analysis , and interpretation . That goal can be achieved only through total transparency from authors . Despite several decades of educational efforts , the reporting of RCTs needs improvement . Investigators and editors developed the original CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to help authors improve reporting by use of a checklist and flow diagram . The revised CONSORT statement presented here incorporates new evidence and addresses some criticisms of the original statement . The checklist items pertain to the content of the Title , Abstract , Introduction , Methods , Results , and Discussion . The revised checklist includes 22 items selected because empirical evidence indicates that not reporting this information is associated with biased estimates of treatment effect , or because the information is essential to judge the reliability or relevance of the findings . We intended the flow diagram to depict the passage of participants through an RCT . The revised flow diagram depicts information from four stages of a trial ( enrolment , intervention allocation , follow- up , and analysis ) . The diagram explicitly shows the number of participants , for each intervention group , included in the primary data analysis . Inclusion of these numbers allows the reader to judge whether the authors have done an intention- to-treat analysis . In sum , the CONSORT statement is intended to improve the reporting of an RCT , enabling readers to underst and a trial 's conduct and to assess the validity of its results A memory-training program previously used effectively upon persons with head-injury ( HI ) was conducted upon eight subjects with multiple sclerosis ( MS ) . The program involved computer-assisted teaching of imagery-based mnemonic strategies for recall of lengthy lists of words , and for associating names with faces . Results were similar to those found in individuals with HI , but the MS subjects learned the strategies quickly , and did not appear to require the lengthy training needed by persons with HI . It was concluded that memory training of those with MS may sometimes only require teaching of mnemonic strategies without extensive practice Summary BACKGROUND : One aim of this project was to investigate the efficacy of a specific training programme for MS patients which also contained compensation strategies and relaxation exercises relevant to everyday life . The other aim was to check the programme 's relevance to everyday life . METHOD : 19 patients , r and omised into two groups , took part in the study . The participants in the treated group completed a specific neurological training programme which began immediately after the basic testing ( visit 1 ) and lasted 4 weeks , with a total of 12 sessions . The monitoring test was done immediately after the training programme ( at visit 2 ) and the follow-up was 3 months later ( visit 3 ) . Both study groups were fully comparable as regards clinical and socio-demographic data and baseline intelligence level . RESULTS : The results of the cognitive training programme were especially evident in the significant improvements in executive functions ( CKV ) and spatial-constructional abilities ( HAWIE-R ) . Comparison between the treated and the control group showed no significant difference in the fatigue values ( MFIS ) . However , when the treated group was examined over the three times of measurements , the symptoms of fatigue had diminished significantly . Regarding memory , comparison of the groups showed no changes ; within the treated group ; however , the verbal ( VLT ) and nonverbal learning and memory ( NVLT ) improved significantly . The results for sustained attention improved in both groups over time . It must be assumed that a learning effect had occurred here . The depression values ( BDI ) also improved in both study groups . The follow-up question naire showed that 60 % ( 6 ) attributed an average to above-average benefit to the training . CONCLUSION : To summarise , it is apparent that MS patients with mild to moderate cognitive impairment are able to profit from even a fairly brief neuropsychological training programme and to integrate much of it into their everyday lives . In view of this , it would seem appropriate to offer such a programme as st and ard , associated with medication . ZusammenfassungHINTERGRUND : Das Ziel dieses Projekts war es einerseits die Effizienz eines spezifischen Trainings , das auch alltagsrelevante Kompensationsstrategien und Entspannungsübungen beinhaltet , bei MS-Patienten zu untersuchen und and ererseits auch dessen Alltagsrelevanz zu überprüfen . METHOD E : 19 PatientInnen , r and omisiert in zwei Gruppen , nahmen an der Untersuchung teil . Die Teilnehmer der Versuchsgruppe absolvierten ein spezifisches neuropsychologisches Trainingsprogramm , das unmittelbar nach der Basistestung ( visit 1 ) begann und 4 Wochen dauerte , wobei insgesamt 12 Sitzungen stattf and en . Unmittelbar nach dem Training erfolgte die Kontrolltestung ( visit 2 ) und nach den darauf folgenden 3 Monaten das Follow-up ( visit 3 ) . Beide Untersuchungsgruppen waren bezüglich ihrer klinischen und soziodemografischen Date n und bezüglich des intellektuellen Ausgangsniveaus gut mitein and er vergleichbar . ERGEBNISSE : Die Erfolge des kognitiven Trainingsprogramms zeigten sich vor allem in den signifikanten Verbesserungen der Exekutivfunktionen ( CKV ) und der räumlich-konstruktiven Fähigkeiten ( HAWIE-R ) . I m Vergleich zwischen Versuchsgruppe und Kontrollgruppe zeigte sich kein signifikanter Unterschied in den Fatigue-Werten ( Ermüdungswerten ) ( MFIS ) . Bei Betrachtung der Therapiegruppe über die Dauer der drei Messzeitpunkte , nahmen die Ermüdungserscheinungen jedoch signifikant ab . Die Änderungen i m Gedächtnisbereich konnten i m Gruppenvergleich nicht nachgewiesen werden , innerhalb der Trainingsgruppe verbesserten sich die verbalen ( VLT ) und nonverbalen Lern- und Gedächtnisleistungen ( NVLT ) jedoch signifikant . Die Daueraufmerksamkeitsleistungen ( Daueraufmerksamkeit ) besserten sich in beiden Gruppen über die Zeit hinweg . Es ist anzunehmen , dass es dabei zu einem Lerneffekt gekommen ist . Die Depressionswerte ( BDI ) verbesserten sich ebenfalls in beiden Untersuchungsgruppen . Der Nachbefragungsbogen ergab , dass 60 % ( 6 ) dem Training einen durchschnittlich bis überdurchschnittlich hohen Gewinn beimaßen . SCHLUSSFOLGERUNG : Zusammenfassend zeigt sich , dass MS-Patienten mit einer leichten bis mittelgradigen kognitiven Störung auch von einem relativ kurzen neuropsychologischen Trainingsprogramms profitieren und vieles davon in ihren Alltag integrieren können . Insofern wäre es sinnvoll , ein derartiges Programm in Kombination mit einer medikamentösen Beh and lung st and ardmäßig anzubieten Background : There is preliminary evidence on the positive effects of neuropsychological rehabilitation on cognition in multiple sclerosis ( MS ) , but the generalisability of the findings is limited by method ological problems . Objective : The aim of the present study was to determine the effects of strategy -oriented neuropsychological rehabilitation on MS . Methods : A total of 102 relapsing – remitting MS patients with subjective and objective attentional deficits were r and omised into an intervention and a control group .  Neuropsychological assessment  s were performed at baseline , at three months immediately after the intervention , and at six months . Patients in the intervention group received neuropsychological rehabilitation once a week in 60-minute sessions for 13 consecutive weeks . The control group received no intervention . Results : Neuropsychological rehabilitation including computer-based attention and working memory retraining , psychoeducation , strategy learning and psychological support did not improve cognitive performance but had a positive effect on perceived cognitive deficits . The intervention group perceived significantly fewer deficits than the control group both immediately after the intervention and at six months . The personal rehabilitation goals were also well achieved . Conclusions : Strategy -oriented neuropsychological rehabilitation did not improve cognitive performance but reduced perceived cognitive deficits in MS Objective : To explore the feasibility and effects of a computer-assisted cognitive rehabilitation intervention –  Memory , Attention , and Problem Solving Skills for Persons with Multiple Sclerosis ( MAPSS-MS ) – for persons with multiple sclerosis on cognitive performance , memory strategy use , self-efficacy for control of symptoms and neuropsychological competence in activities of daily living ( ADL ) . Design : A r and omized controlled single-blinded trial with treatment and wait list control groups . Setting : Southwestern United States . Subjects : Convenience sample of 61 persons ( 34 treatment , 27 wait list control ) with multiple sclerosis ( mean age 47.9 years , SD 8.8 ) . Intervention : The eight-week MAPSS-MS intervention program included two components : ( a ) eight weekly group sessions focused on building efficacy for use of cognitive compensatory strategies and ( b ) a computer-assisted cognitive rehabilitation program with home-based training . Outcome measures : A neuropsychological battery of performance tests comprising the Minimal Assessment of Cognitive Function in Multiple Sclerosis ( MACFIMS ) and self-report instruments ( use of memory strategies , self-efficacy for control of multiple sclerosis and neuropsychological competence in ADL ) were completed at baseline , two months ( after classes ) , and at five months . Results : Both groups improved significantly ( P < 0.05 ) over time on most measures in the MACFIMS battery as well as the measures of strategy use and neuropsychological competence in ADL . There was a significant group-by-time interaction for scores on the measures of verbal memory and the use of compensatory strategies . Conclusions : The MAPSS-MS intervention was feasible and well-accepted by participants . Given the large relative increase in use of compensatory strategies by the intervention group , it holds promise for enhancing cognitive function in persons with multiple sclerosis Recent literature suggests a revival of interest in  single-case methodology  ( e.g. , the r and omised n-of-1 trial is now considered Level 1 evidence for treatment decision purpose s by the Oxford Centre for Evidence -Based Medicine ) . Consequently , the availability of tools to critically appraise single-case reports is of great importance . We report on a major revision of our method quality instrument , the Single-Case Experimental Design Scale . Three changes result ed in a radically revised instrument , now entitled the Risk of Bias in N-of-1 Trials ( RoBiNT ) Scale : ( i ) item content was revised and increased to 15 items , ( ii ) two subscales were developed for internal validity ( IV ; 7 items ) and external validity and interpretation ( EVI ; 8 items ) , and ( iii ) the scoring system was changed from a 2-point to 3-point scale to accommo date currently accepted st and ards . Psychometric evaluation indicated that the RoBiNT Scale showed evidence of construct ( discriminative ) validity . Inter-rater reliability was excellent , for pairs of both experienced and trained novice raters . Intraclass correlation coefficients of summary scores for individual ( experienced ) raters : ICCTotalScore = .90 , ICCIVSubscale = .88 , ICCEVISubscale = .87 ; individual ( novice ) raters : ICCTotalScore = .88 , ICCIVSubscale = .87 , ICCEVISubscale = .93 ; consensus ratings between experienced and novice raters ( ICCTotalScore = .95 , ICCIVSubscale = .93 , ICCEVISubscale = .93 . The RoBiNT Scale thus shows sound psychometric properties and provides a comprehensive yet efficient examination of important features of single-case methodology Objectives : Cognitive problems in multiple sclerosis are common but any possible benefits of treatment remain uncertain . The aim of the study was to evaluate the benefits of providing a psychology service , including cognitive assessment and intervention , to patients with multiple sclerosis . Method : The study was a single blind r and omised controlled trial . A total of 240 patients with clinical ly definite , laboratory supported , or clinical ly probable multiple sclerosis were recruited from an multiple sclerosis management clinic and assessed on a brief screening battery . They were r and omised into three groups . The control group received no further intervention . The assessment group received a  detailed cognitive assessment  , the result of which was fed back to staff involved in the patients ' care . The treatment group received the same detailed cognitive assessment and a treatment programme design ed to help reduce the impact of their cognitive problems . Patients were followed up 4 and 8 months later on the general health question naire ( GHQ-28 ) , extended activities of daily living scale , SF-36 , everyday memory question naire , dysexecutive syndrome question naire , and memory aids question naire . Results : The three groups were compared on the outcome measures at 4 and 8 months after recruitment . There were few significant differences between the groups and those that occurred favoured the control group . Overall , the results showed no effect of the interventions on mood , quality of life , subjective cognitive impair 
    Output:
    
There is insufficient evidence to support or refute the effectiveness of  external memory aids  for improving memory function in people with MS