***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 Mobile phone-based psychological interventions enable real time self-monitoring and self-management , and large-scale dissemination . However , few studies have focussed on mild-to-moderate symptoms where public health need is greatest , and none have targeted work and social functioning . This study reports outcomes of a CONSORT-compliant r and omised controlled trial ( RCT ) to evaluate the efficacy of myCompass , a self-guided psychological treatment delivered via mobile phone and computer , design ed to reduce mild-to-moderate depression , anxiety and stress , and improve work and social functioning . Method Community-based volunteers with mild-to-moderate depression , anxiety and /or stress ( N = 720 ) were r and omly assigned to the myCompass program , an attention control intervention , or to a waitlist condition for seven weeks . The interventions were fully automated , without any human input or guidance . Participants ’ symptoms and functioning were assessed at baseline , post-intervention and 3-month follow-up , using the Depression , Anxiety and Stress Scale and the Work and Social Adjustment Scale . Results Retention rates at post-intervention and follow-up for the study sample were 72.1 % ( n = 449 ) and 48.6 % ( n = 350 ) respectively . The myCompass group showed significantly greater improvement in symptoms of depression , anxiety and stress and in work and social functioning relative to both control conditions at the end of the 7-week intervention phase ( between-group effect sizes ranged from d = .22 to d = .55 based on the observed means ) . Symptom scores remained at near normal levels at 3-month follow-up . Participants in the attention control condition showed gradual symptom improvement during the post-intervention phase and their scores did not differ from the myCompass group at 3-month follow-up . Conclusions The myCompass program is an effective public health program , facilitating rapid improvements in symptoms and in work and social functioning for individuals with mild-to-moderate mental health problems . Trial registration Australian New Zeal and Clinical Trials Registry ACTRN Background Heart failure ( HF ) is a chronic condition affecting nearly 5.7 million Americans and is a leading cause of morbidity and mortality . With an aging population , the cost associated with managing HF is expected to more than double from US $ 31 billion in 2012 to US $ 70 billion by 2030 . Readmission rates for HF patients are high—25 % are readmitted at 30 days and nearly 50 % at 6 months . Low medication adherence contributes to poor HF management and higher readmission rates .  Remote telehealth monitoring programs aim ed at improved medication management and adherence may improve HF management and reduce readmissions . Objective The primary goal of this r and omized controlled pilot study is to compare the MedSentry remote medication monitoring system versus usual care in older HF adult patients who recently completed a HF telemonitoring program .  We hypothesized that remote medication monitoring would be associated with fewer unplanned hospitalizations and emergency department ( ED ) visits , increased medication adherence , and improved health-related quality of life ( HRQoL ) compared to usual care . Methods Participants were r and omized to usual care or use of the remote medication monitoring system for 90 days . Twenty-nine participants were enrolled and the final analytic sample consisted of 25 participants . Participants completed question naires at enrollment and closeout to gather data on medication adherence , health status , and HRQoL. Electronic medical records were review ed for data on baseline classification of heart function and the number of unplanned hospitalizations and ED visits during the study period . Results Use of the medication monitoring system was associated with an 80 % reduction in the risk of all-cause hospitalization and a significant decrease in the number of all-cause hospitalization length of stay in the intervention arm compared to usual care . Objective device data indicated high adherence rates ( 95%-99 % ) among intervention group participants despite finding no significant difference in self-reported adherence between study arms . The intervention group had poorer heart function and HRQoL at baseline , and HRQoL declined significantly in the intervention group compared to controls . Conclusions The MedSentry medication monitoring system is a promising technology that merits continued development and evaluation . The MedSentry medication monitoring system may be useful both as a st and alone system for patients with complex medication regimens or used to complement existing HF telemonitoring interventions . We found significant reductions in risk of all-cause hospitalization and the number of all-cause length of stay in the intervention group compared to controls . Although HRQoL deteriorated significantly in the intervention group , this may have been due to the poorer HF-functioning at baseline in the intervention group compared to controls . Telehealth medication adherence technologies , such as the MedSentry medication monitoring system , are a promising method to improve patient self-management , the quality of patient care , and reduce health care utilization and expenditure for patients with HF and other chronic diseases that require complex medication regimens . Trial Registration Clinical Trials.gov NCT01814696 ; https:// clinical trials.gov/ct2/show/ study /NCT01814696 ( Archived by WebCite ® at http://www.webcitation.org/6giqAVhno Background The use of mobile apps  for health and well being promotion has grown exponentially in recent years . Yet , there is currently no app- quality assessment tool beyond “ star”-ratings . Objective The objective of this study was to develop a reliable , multidimensional measure for trialling , classifying , and rating the quality of mobile health apps . Methods A literature search was conducted to identify articles containing explicit Web or app quality rating criteria published between January 2000 and January 2013 . Existing criteria for the assessment of app quality were categorized by an expert panel to develop the new Mobile App Rating Scale ( MARS ) subscales , items , descriptors , and anchors . There were sixty well being apps that were r and omly selected using an iTunes search for MARS rating . There were ten that were used to pilot the rating procedure , and the remaining 50 provided data on interrater reliability . Results There were 372 explicit criteria for assessing Web or app quality that were extracted from 25 published papers , conference proceedings , and Internet re sources . There were five broad categories of criteria that were identified including four objective quality scales : engagement , functionality , aesthetics , and information quality ; and one subjective quality scale ; which were refined into the 23-item MARS . The MARS demonstrated excellent internal consistency ( alpha = .90 ) and interrater reliability intraclass correlation coefficient ( ICC = .79 ) . Conclusions The MARS is a simple , objective , and reliable tool for classifying and assessing the quality of mobile health apps . It can also be used to provide a checklist for the design and development of new high quality health apps Background Systematic review s of the effects of healthcare interventions frequently include non-r and omized studies . These are subject to confounding and a range of other biases that are seldom considered in detail when synthesizing and interpreting the results . Our aims were to assess the reliability and usability of a new Cochrane risk of bias ( RoB ) tool for non-r and omized studies of interventions and to determine whether restricting analysis to studies with low or moderate RoB made a material difference to the results of the review s. Methods and Findings We selected two systematic review s of population -based , controlled non-r and omized studies of the relationship between the use of thiazolidinediones ( TZDs ) and cyclooxygenase-2 ( COX-2 ) inhibitors and major cardiovascular events . Two epidemiologists applied the Cochrane RoB tool and made assessment s across the seven specified domains of bias for each of 37 component studies . Inter-rater agreement was measured using the weighted Kappa statistic . We grouped studies according to overall RoB and performed statistical pooling for ( a ) all studies and ( b ) only studies with low or moderate RoB. Kappa scores across the seven bias domains ranged from 0.50 to 1.0 . In the COX-2 inhibitor review , two studies had low overall RoB , 14 had moderate RoB , and five had serious RoB. In the TZD review , six studies had low RoB , four had moderate RoB , four had serious RoB , and two had critical RoB. The pooled odds ratios for myocardial infa rct ion , heart failure , and death for rosiglitazone versus pioglitazone remained significantly elevated when analyses were confined to studies with low or moderate RoB. However , the estimate for myocardial infa rct ion declined from 1.14 ( 95 % CI 1.07–1.24 ) to 1.06 ( 95 % CI 0.99–1.13 ) when analysis was confined to studies with low RoB. Estimates of pooled relative risks of cardiovascular events with COX-2 inhibitors compared with no nonsteroidal anti-inflammatory drug changed little when analyses were confined to studies with low or moderate RoB. The exception was a rise in the relative risk associated with ibuprofen from 1.07 ( 95 % CI 0.97–1.18 ) to 1.14 ( 95 % CI 1.03–1.26 ) . The main limitation of our study was testing the instrument on a narrow range of pharmacoepidemiological studies ; we can not assume our findings extend to a broader range of interventions and setting s. Conclusions The Cochrane RoB tool highlighted a wide range of risks of bias in studies included in two widely cited review s and had the potential to change the conclusions of the review s. Systematic review s that incorporate non-r and omized studies of medical interventions should include a detailed assessment of RoB for each included study Background Telemonitoring of patients with chronic heart failure ( CHF ) is an emerging concept to detect early warning signs of impending acute decompensation in order to prevent hospitalization . Objective The goal of the MOBIle TELemonitoring in Heart Failure Patients Study ( MOBITEL ) was to evaluate the impact of home-based telemonitoring using Internet and mobile phone technology on the outcome of heart failure patients after an episode of acute decompensation . Methods Patients were r and omly allocated to pharmacological treatment ( control group ) or to pharmacological treatment with telemedical surveillance for 6 months ( tele group ) . Patients r and omized into the tele group were equipped with mobile phone – based patient terminals for data acquisition and data transmission to the monitoring center . Study physicians had continuous access to the data via a secure Web portal . If transmitted values went outside individually adjustable borders , study physicians were sent an email alert . Primary endpoint was hospitalization for worsening CHF or death from cardiovascular cause . Results The study was stopped after r and omization of 120 patients ( 85 male , 35 female ) ; median age was 66 years ( IQR 62 - 72 ) . The control group comprised 54 patients ( 39 male , 15 female ) with a median age of 67 years ( IQR 61 - 72 ) , and the tele group included 54 patients ( 40 male , 14 female ) with a median age of 65 years ( IQR 62 - 72 ) . There was no significant difference between groups with regard to baseline characteristics . Twelve tele group patients were unable to begin data transmission due to the inability of these patients to properly operate the mobile phone ( “ never beginners ” ) . Four patients did not finish the study due to personal reasons . Intention-to-treat analysis at study end indicated that 18 control group patients ( 33 % ) reached the primary endpoint ( 1 death , 17 hospitalizations ) , compared with 11 tele group patients ( 17 % , 0 deaths , 11 hospitalizations ; relative risk reduction 50 % , 95 % CI 3 - 74 % , P = .06 ) . Per- protocol analysis revealed that 15 % of tele group patients ( 0 deaths , 8 hospitalizations ) reached the primary endpoint ( relative risk reduction 54 % , 95 % CI 7 - 79 % , P= .04 ) . NYHA class improved by one class in tele group patients only ( P < .001 ) . Tele group patients who were hospitalized for worsening heart failure during the study had a significantly shorter length of stay ( median 6.5 days , IQR 5.5 - 8.3 ) compared with control group patients ( median 10.0 days , IQR 7.0 - 13.0 ; P= .04 ) . The event rate of never beginners was not higher than the event rate of control group patients . Conclusions Telemonitoring using mobile phones as patient terminals has the potential to reduce frequency and duration of heart failure hospitalizations . Providing elderly patients with an adequate user interface for daily data acquisition remains a challenging component of such a concept Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more Background Poor adherence to evidence -based medications in heart failure ( HF ) is a major cause of avoidable hospitalizations , disability , and death . To test the feasibility of improving medication adherence , we performed a r and omized proof-of-concept study of a self-management intervention in high-risk patients with HF . Methods Patients with HF who screened positively for poor adherence ( < 6 Morisky Medication Adherence Scale 8-item ) were r and omized to either the intervention or attention control group . In the intervention group ( n=44 ) , a nurse conducted self-management training prior to discharge that focused on identification of medication goals , facilitation of medication-symptom associations , and use of a symptom-response plan . The attention control group ( n=42 ) received usual care ; both groups received follow-up calls at 1 week . However , the content of follow-up calls for the attention control group was unrelated to HF medications or sympt 
    Output:
    
This review on the commercially available apps demonstrated many incomplete apps , many apps with bugs , and several apps with low quality .
Although the heart failure-related outcomes reported in this review vary , they demonstrated trends toward making an impact and offer a potentially cost-effective solution with 24/7 access to symptom monitoring as a point of care solution , promoting patient engagement in their own home care