***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 Objective : To evaluate a palliative care home support team based on an inpatient unit . Design : R and omised controlled trial with waiting list . Patients in the study group received the service immediately , those in the control group received it after one month . Main comparison point was at one month . Setting - A city of 300 000 people with a publicly funded home care service and about 200 general practitioners , most of whom provide home care . Main outcome measures : Pain and nausea levels were measured at entry to trial and at one month , as were quality of life for patients and care givers ' health . Results : Because of early deaths , problems with recruitment , and a low compliance rate for completion of question naires , the required sample size was not attained . Conclusion : In design ing evaluations of palliative care services , investigators should be prepared to deal with the following issues : attrition due to early death , opposition to r and omisation by patients and referral sources , ethical problems raised by r and omisation of dying patients , the appropriate timing of comparison points , and difficulties of collecting data from sick or exhausted patients and care givers . Investigators may choose to evaluate a service from various perspectives using different methods : controlled trials , qualitative studies , surveys , and audits . R and omised trials may prove to be impracticable for evaluation of palliative care OBJECTIVE To evaluate the use of a multidisciplinary record held by patients with cancer in the community . DESIGN Pragmatic r and omised controlled trial . SETTING The environs of Swansea in south west Wales . PARTICIPANTS 501 patients under the care of the Department of Oncology , Singleton Hospital , Swansea . INTERVENTION A patient held record used by the patient and healthcare professionals . Main outcome measures -Health related quality of life ( EORTC QLQ-C30 ) measured at entry into the study and at 6 months ; patients ' views at 6 months ; healthcare professionals ' views collected after the completion of patient follow up ; NHS re source and booklet use . RESULTS 1148 patients were eligible for the study ; 501 were recruited ( 44 % ) and 344 completed the study ( 172 in each group ) . There was no significant difference between the two groups in change in quality of life or NHS re source use . The patient held record did not have an impact on communication but was significantly helpful to patients in preparing for appointments , reducing difficulties in monitoring their own progress , and helping them to feel more in control ( p<0.05 ) . Fifty three percent of patients would have preferred not to have a patient held record .  There was a low level of use of the record by healthcare professionals but most of those who remembered using it indicated that they would prefer patients to have it . CONCLUSIONS The patient held record is valued by some patients and professionals but has no significant impact on the quality of life of patients or NHS re source use . It has a positive impact on quality by helping patients feel more in control and prepare for meetings with healthcare staff . Patients who find it useful tend to be younger and have more professionals involved in their care . It is recommended that it should be made available to patients on request and used by them according to need 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 The burden of cancer care in general practice is increasing . Patient-held records may facilitate effective , coordinated care , but no r and omised controlled trials of their use in cancer care have been conducted , and concerns about possible negative effects remain . AIM To evaluate the use of a supplementary patient-held record in cancer care . METHOD Six hundred and fifty radiotherapy out patients with any form of cancer were r and omised either to hold a supplementary record or to receive normal care . It was explained to record holders that the supplementary record was intended to improve communication with health professionals and act as an aide memoire . After three months , patients ' satisfaction with communication and with participation in their own care were assessed . Global health status , emotional functioning , and cognitive functioning were measured using the European Organization for Research and Treatment of Cancer QLQ-C30 question naire . RESULTS There were no significant differences between groups in any of the outcome measures . Patients in both groups expressed a high level of satisfaction with communication and participation in their care . Mean ( SD ) scores in the intervention and control groups were : global health status , 66.8 ( 24.2 ) and 65.3 ( 23.7 ) ; emotional functioning , 75.0 ( 24.6 ) and 77.4 ( 22.8 ) ; cognitive functioning , 84.5 ( 21.0 ) and 84.0 ( 21.3 ) . CONCLUSION A supplementary patient-held record for radiotherapy out patients appears to have no effect on satisfaction with communication , participation in care , or quality of life The objective of this study was to evaluate a patient-held record ( PHR ) for patients with cancer . A r and omized controlled trial ( RCT ) was conducted of a PHR to be used by patients newly diagnosed with lung or colorectal cancer ( hospital ) , patients with cancer at any stage ( community ) and professionals involved in their care , together with surveys of health professionals to gauge views on PHR . Main outcome measures were patient satisfaction with information and communication , and patient and healthcare professionals ' views of PHR .  The only significant difference was 86 % of control compared with 58 % of intervention patients were very satisfied with information received at the end of treatment ( odds ratio 4.4 , 95 % confidence interval 1.2 - 15.6 , P < 0.05 ) . Fifty-three per cent of intervention respondents found the  PHR helpful ( 63 % hospital vs. 38 % community patients ) , and 69 % felt that it would be useful to them in the future . Primary healthcare ( PHC ) professionals found the PHR of more benefit than those working in hospitals ( P < 0.05 ) . The PHR did not improve measures of patient satisfaction with information or communication . Despite its limited use by many health professionals , the PHR was well received by recently diagnosed patients , and those who did not receive negative responses to it from staff involved in their care . It was also positively valued by staff in PHC . An evaluation of a customized record provided at the time of diagnosis is warranted The Patient Care Travelling Record ( PCTR ) is a passport-like health-care summary that , in previous research by the authors , has been found to be a feasible and acceptable tool to convey important clinical information about the palliative care patient . This r and omized controlled trial was conducted to determine the effectiveness and efficiency of this Record in improving patient mood , decreasing uncertainty , improving satisfaction with health care , reducing use of health-care services , and maximizing pain control .  Eligible patients were r and omized to receive or not receive the PCTR ( completed by nurse or physician and review ed jointly with the patient ) . As baseline entry into the study and then at 1 and 2 months , patients completed measures on level of certainty , mood states , satisfaction with care , levels of pain , and health-care services utilization . During the 2-year study period , only 20 % ( N = 61 ) of the patients enrolled in a palliative care program in Southern Ontario were eligible for the trial . Of these patients , 18 died , 15 declined to participate , and 7 were emotionally unable to complete the question naires . Thus 21 patients completed the trial . With the exception of those age 65 years and over , the patients using the Record reported decreased levels of uncertainty on follow-up . There was no additional use of health-care services , no differences in mood states , pain relief , or satisfaction with health care . It is significant that 80 % of palliative patients were not eligible because their physical and psychological status rendered them insufficiently stable to participate in a research study . Because of their vulnerable status , these patients may be ideal for the utilization of the Record in clinical care . Although research in this palliative care population is challenging due to difficulties with recruitment and high dropout rates due to death , the PCTR , which was previously shown to be acceptable and feasible , has now been shown to be effective in reducing patient uncertainty , specifically for adults under 65 years . Indications for future research are described 
    Output:
    
R and omized trials found an absence of effect , non-experimental evaluations shed light on the conditions for its successful use .
Most patients welcomed introduction of a PHR .
Main problems related to its suitability for different patient groups and the lack of agreement between patients and health professionals regarding its function .