***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: We did a prospect i ve study of women with singleton viable pregnancies at 10 - 13 weeks ' gestation who requested first-trimester fetal karyotyping because of advanced maternal age , parental anxiety , or family history of chromosomal abnormality . Women were counselled as to the available options of non-invasive screening or invasive testing by mid-trimester amniocentesis , early amniocentesis ( EA ) , or chorionic villus sampling ( CVS ) , or r and omisation to EA or CVS at 10 - 13 weeks . EA was done in 731 patients ( 493 by choice and 238 by r and omisation ) and CVS in 570 ( 320 by choice and 250 by r and omisation ) . Both procedures were done by transabdominal ultrasound-guided insertion of a 20-gauge needle . The rate of successful sampling was the same for both procedures ( 97.5 % ) . Spontaneous loss ( intrauterine or neonatal death ) was significantly higher after EA ( total group mean = 5.3 % , 95 % CI 3.8 - 7.2 ; r and omised subgroup mean = 5.9 % , 3.3 - 9.7 ) than after CVS ( total group : mean = 2.3 % , 1.2 - 3.9 ; r and omised subgroup : mean = 1.2 % , 0.3 - 3.5 ) . The gestation at delivery and birthweight of the infants after EA and CVS were similar . In the EA group the incidence of talipes equinovarus ( 1.63 % ) , was higher than in the CVS group ( 0.56 % ) , but this difference was not significant Objective To compare the effectiveness and acceptability of  outpatient polypectomy with inpatient polypectomy .  Design Pragmatic multicentre r and omised controlled non-inferiority study . Setting Outpatient hysteroscopy clinics in 31 UK National Health Service hospitals . Participants 507 women who attended as out patients for diagnostic hysteroscopy because of abnormal uterine bleeding and were found to have uterine polyps . Interventions Participants were r and omly assigned to either outpatient uterine polypectomy under local anaesthetic or inpatient uterine polypectomy under general anaesthesia . Data were collected on women ’s self reported bleeding symptoms at baseline and at 6 , 12 , and 24 months . Data were also collected on pain and acceptability of the procedure at the time of polypectomy . Main outcome measures The primary outcome was successful treatment , determined by the women ’s assessment of bleeding at six months , with a prespecified non-inferiority margin of 25 % . Secondary outcomes included generic ( EQ-5D ) and disease specific ( menorrhagia multi-attribute scale ) quality of life , and feasibility and acceptability of the procedure . Results 73 % ( 166/228 ) of women in the outpatient group and 80 % ( 168/211 ) in the inpatient group reported successful treatment at six months ( intention to treat relative risk 0.91 , 95 % confidence interval 0.82 to 1.02 ; per protocol relative risk 0.92 , 0.82 to 1.02 ) . Failure to remove polyps was higher ( 19 % v 7 % ; relative risk 2.5 , 1.5 to 4.1 ) and acceptability of the procedure was lower ( 83 % v 92 % ; 0.90 , 0.84 to 0.97 ) in the outpatient group Quality of life did not differ significantly between the groups . Four uterine perforations , one of which necessitated bowel resection , all occurred in the inpatient group . Conclusions Outpatient polypectomy was non-inferior to inpatient polypectomy . Failure to remove a uterine polyp was , however , more likely with outpatient polypectomy and acceptability of the procedure was slightly lower . Trial registration International Clinical Trials Registry 65868569 OBJECTIVE To determine whether IVF or a st and ard infertility treatment algorithm results in better outcome and /or lower cost when used as first-line therapy for couples with infertility . DESIGN Prospect i ve , r and omized clinical study . SETTING University-affiliated infertility clinic . PATIENT(S ) Couples with newly diagnosed infertility and no prior treatment . INTERVENTION(S ) Couples were r and omized to undergo either IVF ( group 1 , n = 46 ) or a st and ard infertility treatment algorithm ( group 2 , n = 50 ) as initial therapy for infertility . MAIN OUTCOME MEASURE(S ) Pregnancy rates and costs per couple , per month of treatment , and per pregnancy . RESULT ( S ) Pregnancy rates were higher in group 2 than in group 1 . Costs per couple were not statistically different , although a trend toward higher costs was apparent in group 1 , reflected by a higher median cost per clinical pregnancy established and a higher cost per month of treatment . Whereas cost differences between the groups diminished over time , pregnancy rates remained the same . CONCLUSION ( S ) In vitro fertilization currently does not represent an appropriate first-line treatment option for couples with infertility . The use of a st and ard infertility treatment algorithm results in a higher pregnancy rate and lower cost and therefore should be the preferred treatment approach OBJECTIVE We attempted to compare the use of low-dose heparin with a st and ard dose of 40 mg prednisone daily ( both plus low-dose aspirin ) for treatment of pregnant women with antiphospholipid antibody-associated recurrent fetal loss with respect to maternal and perinatal morbidity and efficacy in prevention of fetal death . STUDY DESIGN A multicenter r and omized trial included 20 patients . Generalizability of results from r and omized patients was evaluated by means of additional data from 13 women refusing and 12 women ineligible for r and omization . Data from study groups were compared with Fisher 's exact test , and generalizability was evaluated with a chi 2 test for trend . RESULTS Live birth rates were the same ( 75 % ) with either treatment , but " serious " maternal morbidity and the frequency of preterm delivery were significantly higher among women r and omly assigned to prednisone ( p = 0.02 vs p = 0.006 ) . Preterm delivery among prednisone-treated women was usually associated with premature rupture of the membranes or preeclampsia . These results could be generalized to the other groups of women ascertained during the course of the study . CONCLUSIONS Low-dose heparin should be preferred to prednisone when treatment is indicated for high-risk pregnant women with antiphospholipid antibodies Overwhelming evidence shows the quality of reporting of r and omised controlled trials ( RCTs ) is not optimal . Without transparent reporting , readers can not judge the reliability and validity of trial findings nor extract information for systematic review s. Recent method ological analyses indicate that inadequate reporting and design are associated with biased estimates of treatment effects . Such systematic error is seriously damaging to RCTs , which are considered the gold st and ard for evaluating interventions because of their ability to minimise or avoid bias . A group of scientists and editors developed the CONSORT ( Consoli date d St and ards of Reporting Trials ) statement to improve the quality of reporting of RCTs . It was first published in 1996 and up date d in 2001 . The statement consists of a checklist and flow diagram that authors can use for reporting an RCT . Many leading medical journals and major international editorial groups have endorsed the CONSORT statement . The statement facilitates critical appraisal and interpretation of RCTs . During the 2001 CONSORT revision , it became clear that explanation and elaboration of the principles underlying the CONSORT statement would help investigators and others to write or appraise trial reports . A CONSORT explanation and elaboration article was published in 2001 alongside the 2001 version of the CONSORT statement . After an expert meeting in January 2007 , the CONSORT statement has been further revised and is published as the CONSORT 2010 Statement . This up date improves the wording and clarity of the previous checklist and incorporates recommendations related to topics that have only recently received recognition , such as selective outcome reporting bias . This explanatory and elaboration document-intended to enhance the use , underst and ing , and dissemination of the CONSORT statement-has also been extensively revised . It presents the meaning and rationale for each new and up date d checklist item providing examples of good reporting and , where possible , references to relevant empirical studies . Several examples of flow diagrams are included . The CONSORT 2010 Statement , this revised explanatory and elaboration document , and the associated website ( www.consort-statement.org ) should be helpful re sources to improve reporting of r and omised trials Objective : To examine the representativeness of participants attending a lifestyle intervention study addressing obese pregnant women . Methods : Retrospective comparison of baseline data , attendance to oral glucose tolerance test ( OGTT ) during pregnancy , and pregnancy outcome in eligible women stratified according to study participation . Of 750 eligible women with a self-reported BMI > 30 kg/m2 , and a live singleton pregnancy , 510 were eligible for inclusion and 425 were r and omized to either active intervention ( n= 284 ) or to st and ard obstetric care ( n= 141 ) including two st and ard OGTT . The 85 women who declined participation or were excluded due to competing diseases and 240 women who did not respond to the initial invitation received the same st and ard care . Results : The r and omized women had similar BMI but a lower parity and age , and were more frequently non-smokers , born in Denmark and married or cohabitating with their partner than the non- participants . Women participating in the trial had a higher compliance to the second OGTT compared to non- participants , also after correcting for age and nationality . There was no difference in pregnancy outcome , i.e. , fetal weight and length , gestational age as well as mode of delivery . Conclusion : Women declining participation in a r and omized  lifestyle intervention study in pregnancy have characteristics indicating they are those who might benefit the most from lifestyle intervention Objective To evaluate the effects of postmenopausal hormone therapy ( HT ) with or without the addition of folic acid ( FA ) on serum homocysteine levels in a r and omized , placebo-controlled design . Additionally , a non-r and omized control group with no treatment was included . Methods Forty non-hysterectomized healthy postmenopausal women were r and omly allocated to receive either oral continuous combined HT ( 0.625 mg conjugated equine estrogen with 2.5 mg medroxyprogesterone acetate daily ) and oral folic acid ( 5 mg/day , n = 20 ) or HT and placebo ( n = 20 ) for 3 months . A control group ( n = 15 ) did not receive any study medication and was followed in the same manner . The fasting total serum homocysteine level was measured by fluorescence polarization immunoassay with a sensitivity of < 0.5 μmol/l . Serum levels of folate , estrogen and lipid profile were also followed . Results The mean age of the postmenopausal women was 52 ± 6 years . Baseline homocysteine level was the highest in the HT + FA group ( 9.96 ± 2.82 μmol/l ) , compared to HT + placebo ( 9.64 ± 1.89 μmol/l ) and control groups ( 9.01 ± 1.83 μmol/l ) ( ANCOVA , p = 0.022 ) . Low baseline folate and vitamin B12 levels contributed significantly to the high level of baseline homocysteine in the HT + FA group . The addition of FA to HT led to a significant decrease in the serum homocysteine level from the baseline level of 9.96 ± 2.82 μmol/l to the final level of 8.92 ± 2.53 μmol/l ( p = 0.023 ) . On the other h and , HT alone ( HT + placebo group ) significantly increased the serum homocysteine level from 9.64 ± 1.89 μmol/l to 10.22 ± 1.77 μmol/l without a decline in serum folate level ( p = 0.045 ) . The serum homocysteine level in the control group did not change significantly ( from 9.01 ± 1.83 μmol/l to 9.58 ± 2.05 μmol/l , p = 0.29 ) . Conclusions Three months of oral continuous combined HT  increased the fasting total serum homocysteine level without affecting the serum folate level . Lowering the homocysteine level in postmenopausal woman on HT is achievable by folic acid supplementation AIMS To evaluate whether the treatment based on urodynamics ( UDS ) leads to better treatment response compared to where the treatment is based on symptoms alone . STUDY DESIGN , MATERIAL S AND METHODS All patients referred with lower urinary tract symptoms ( LUTS ) were offered the opportunity to participate in this patient preference trial . Patients were asked to complete a Kings Health Question  naire ( KHQ ) and a 3-day bladder diary . The patients were then offered treatment based on their preference for conservative therapy based on either symptoms alone or with additional UDS or r and omization to the same two alternatives , if they had no preference . The primary outcomes studied were improvement in KHQ and reduction in 
    Output:
    
Women participating in RCTs on average experienced better outcomes compared with those outside trials .
TWEETABLE ABSTRACT Participants in obstetric and gynaecology RCTs experience better outcomes compared with non- participants