***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 Based on the two legal st and ards of informed consent currently in use , the Medical Practice St and ard and the Reasonable Person St and ard , two disclosures containing information about the risks and benefits of the anticonvulsant , Carbamazepine , were empirically derived . One of these two disclosures was r and omly given to a sample of 39 seizure patients and the parents of pediatric seizure patients prescribed this drug . Subjects were interviewed either immediately after disclosure and at followup , or at followup only . The results provide no evidence for the hypothesized negative effects — anxiety , treatment refusal , reduced compliance and increased side effects — of providing patients with extensive disclosures about prescription drugs Objective : To determine whether the use of verbal descriptors suggested by the European Union ( EU ) such as “ common ” ( 1–10 % frequency ) and “ rare ” ( 0.01–0.1 % ) effectively conveys the level of risk of side effects to people taking a medicine . Design : R and omised controlled study with unconcealed allocation . Participants : 120 adults taking simvastatin or atorvastatin after cardiac surgery or myocardial infa rct ion . Setting : Cardiac rehabilitation clinics at two hospitals in Leeds , UK . Intervention : A written statement about one of the side effects of the medicine ( either constipation or pancreatitis ) . Within each side effect condition half the patients were given the information in verbal form and half in numerical form ( for constipation , “ common ” or 2.5 % ; for pancreatitis , “ rare ” or 0.04 % ) . Main outcome measure : The estimated likelihood of the side effect occurring . Other outcome measures related to the perceived severity of the side effect , its risk to health , and its effect on decisions about whether to take the medicine . Results : The mean likelihood estimate given for the constipation side effect was 34.2 % in the verbal group and 8.1 % in the numerical group ; for pancreatitis it was 18 % in the verbal group and 2.1 % in the numerical group . The verbal descriptors were associated with more negative perceptions of the medicine than their equivalent numerical descriptors . Conclusions : Patients want and need underst and able information about medicines and their risks and benefits . This is essential if they are to become partners in medicine taking . The use of verbal descriptors to improve the level of information about side effect risk leads to overestimation of the level of harm and may lead patients to make inappropriate decisions about whether or not they take the medicine Abstract Objective : To assess whether provision of educational leaflets or questions on contraception improves knowledge of contraception in women taking the combined contraceptive pill . Design : R and omisation of women into three groups according to type of  educational leaflet on contraceptive information . These groups were subdivided into two on the basis of questions on contraception asked by the doctor or practice nurse . The women were followed up by postal question naire 3 months later . Setting : 15 general practice s in South and West region . Subjects : 636 women attending check up appointment for repeat prescription of the combined contraceptive pill . Main outcome measures : Knowledge of : factors causing pill failure , subsequent action , emergency contraception , and all the rules ( pill rules ) that apply to the contraceptive pill . Results : 523 women returned completed question naires ( response rate 82 % ) . Knowledge of contraception with no intervention was low with only 10 ( 12 % ) women knowing all the pill rules . Educational intervention had a highly significant effect on knowledge of : factors causing pill failure ( likelihood ratio χ2=22 ) ; subsequent action ( 21 ) ; emergency contraception ( 24 ) ; and all the pill rules ( 22 ) ( P<0.01 in all cases ) . Improvement in knowledge of all the pill rules occurred with provision of the summary leaflet ( 28 % knew all the rules , adjusted odds ratio 4.04 , 95 % confidence interval 1.68 to 9.75 ) , the Family Planning Association 's leaflet ( 27 % , 3.43 , 1.45 to 8.09 ) , and asking questions ( 26 % , 3.03 , 1.30 to 7.00 ) . Asking questions in addition to provision of leaflets improved knowledge of contraception further for the summary leaflet ( 39 % , 6.81 , 2.85 to 16.27 ) but not for the Family Planning Association leaflet ( 21 % , 2.58 , 1.07 to 6.18 ) . Conclusion : Women attending check ups for repeat prescriptions of the contraceptive pill should be provided with educational leaflets on contraception or asked relevant questions to help improve their knowledge of contraception . Asking questions in addition to providing a summary leaflet is time consuming , but results in the most knowledge gained . Key messages It is very important to most women who take the contraceptive pill to avoid pregnancy Poor knowledge of contraception is common in women taking the contraceptive pill and associated with unwanted pregnancy No r and omised trials have been conducted of educational interventions to improve knowledge of contraception Providing leaflets or asking questions both improve knowledge of contraception The largest effect on knowledge of contraception is from asking questions and providing a summary This paper reports the findings of a study of information given to rheumatology patients using non-steroidal anti-inflammatory drugs . One hundred and twenty patients were r and omized to three groups . Group A received an information leaflet , Group B received both a leaflet and a verbal explanation and Group C received only a verbal explanation . Information was gathered on demography , knowledge base , sources of information , satisfaction with the leaflet and further information requirements . Data were collected by question naires which were completed before r and omization and 8 - 12 weeks later . Analysis indicates the potential benefits of giving information to patients although the full implication s of these benefits are not clear and further research is indicated in this important area OBJECTIVES To develop three tools for assessing the quality of written information provided with new prescriptions in community pharmacies and to identify pharmacy , pharmacist , and patient characteristics associated with the dissemination and quality of that information . DESIGN Observational study . Regression techniques were used to analyze the influence of pharmacy , pharmacist , and shopper ( acting as patient ) characteristics on outcome measures . PARTICIPANTS Trained shoppers ( acting as patients ) visited 306 r and omly selected pharmacies in 8 states . Each shopper presented three prescriptions , answered questions according to a st and ard scenario , accepted the information offered , and paid for the prescriptions . MAIN OUTCOME MEASURES Percentage of shoppers receiving any written information ; quality of written information as judged by an expert panel using explicit criteria . RESULTS Shoppers received an information leaflet with 87 % of the 918 prescriptions dispensed . Although most leaflets provided unbiased information , leaflet length and quality of information varied greatly . A majority of leaflets did not include adequate information about contraindications , pre caution s , and how to avoid harm . Shoppers were more likely to receive leaflets in chain pharmacies and pharmacies with more staff . Information quality also was higher in chain pharmacies . Shopper and pharmacist demographic characteristics were unrelated to the level or quality of written information after controlling for other factors . CONCLUSION The provision of patient leaflets is becoming a routine practice in the states studied . However , most leaflets do not meet quality criteria . It is important for pharmacists to become familiar with criteria for evaluating these leaflets and to take necessary action to improve their quality OBJECTIVES The authors determined patients ' report of prescription drug counseling activities after withdrawal of the pilot program to require patient package inserts in 1980 and implementation of Omnibus Budget Reconciliation Act of 1990 counseling requirements in 1993 . METHODS Four cross-sectional national telephone surveys were conducted in the fall of 1982 , 1984 , 1992 , and 1994 . Telephone households were chosen by r and om-digit dialing . Subjects had obtained a new prescription for themselves or for a family member at a retail pharmacy during the previous 4 weeks .  Verbal counseling rates at physician offices and pharmacies for five information categories and the distribution of written information at those locations were determined . RESULTS Spontaneous  verbal counseling  at the physician 's office has increased slightly , with the largest increases focused on the delivery of side effect and pre caution ary information . Slightly larger increases in pharmacy-delivered information regarding directions for use and pre caution s have occurred . Patient question ing has remained at single digit levels at both sites . The percentage of patients receiving any written information has increased from 5 % to 15 % at the physician 's office and from 16 % to 59 % at the pharmacy . CONCLUSIONS The data indicate small increases in  verbal counseling  but larger increases in the delivery of written information provided at the pharmacy . In light of Healthy People : 2000 goals for patient counseling and legislation encouraging private-sector initiatives , these data should help to refocus attention on the continuing need for effective patient education interventions OBJECTIVE : To investigate whether patients are influenced by the order in which they learn the risks and benefits of a treatment and whether this effect is attenuated by a treatment ’s associated risk and /or benefit . DESIGN : Subjects were r and omized to review 1 of 6 medical treatment information brochures . SETTING : Waiting rooms of primary care physicians at an academic health center . PARTICIPANTS : Six hundred eighty-five subjects , ages 18 to 70 years . INTERVENTION : Subjects review ed 1 of 3 treatments for symptomatic carotid artery disease . The first ( aspirin ) was low-risk/low-benefit , the second ( carotid endarterectomy surgery ) was high-risk/high-benefit , and the third ( extracranial-to-intracranial bypass surgery ) was high-risk but of unknown benefit . Patients were also r and omized to receive information about risk either before or after benefit . Patients were asked to rate the favorability of the treatment on a scale of 0 to 100 and whether they would consent . Finally , subjects rated how their decisions were influenced by the risk and benefit information . MAIN RESULTS : Subjects evaluating aspirin therapy were influenced by the order of the risk/benefit information . Those learning about risks after benefits had a greater drop in their favorability ratings than subjects learning about risks before benefits ( −10.9 vs −5.2 on a 100-point scale ; P=.02 ) and were less likely to consent ( odds ratio , 2.27 ; P=.04 ) . In contrast , subjects evaluating carotid endarterectomy and extracranial-to-intracranial bypass were not influenced by information order . When subjects were influenced by the order of information , they also reported that the treatment ’s risk had less influence on their decision making ( P<.01 ) . CONCLUSIONS : When patients evaluate low-risk medical interventions , they may form less favorable impressions of the treatment and be less likely to consent to the treatment when they learn about the risks after the benefits . Order effects were not observed with high-risk treatments regardless of potential benefits Insulin/sulphonylurea-treated diabetics attending a busy university diabetic clinic were studied to determine whether issuing drug information sheets and /or age influenced underst and ing and behaviour regarding their disease and its treatment , especially with respect to avoiding hypoglycaemia . Patients were each asked 10 basic questions ( each correct answer scoring 1 ) , stratified by age ( 20 were less than or equal to 45 years and 91 greater than 45 years ) . According to a single-blind r and omised protocol , they were issued or not issued with drug information sheets ( providing information to correctly answer all 10 questions ) . After 2 - 3 months , 107 ( 88 aged greater than 45 years ) were retested and asked whether they recalled an information sheet , read it themselves or had it read to them . Whether or not patients received sheets , corresponding mean aggregate scores were very similar in both age groups and there was no correlation with age . Second test scores yielded clinical ly and statistically significant increments in both the sheet and no sheet groups , respective mean aggregate scores increasing from 4.48 to 5.80 and 5.14 to 6.27 ( P less than 0.001 ) . Among patients issued with sheets , 32 who recalled reading them achieved the greatest improvement in mean scores ( 4.53 to 6.16 , P less than 0.001 ) . Active interaction/communication ( participation in first test , recall and reading of information sheet ) had a favourable educational impact irrespective of age , but merely issuing drug information sheets had no benefit 1 . Cardiologists and pharmacists at the University Hospital of Wales collaborated to write 20 individual leaflets incorporating guidelines for a range of drugs used in the treatment of cardiology patients . The Plain English Campaign advised on the intelligibility and presentation of the information . 2 . One hundred and twenty-five patients from the Regional Cardiology Unit , University Hospital of Wales were r and omly allocated to receive usual verbal counselling about their drug treatment with or without an individualised drug information wallet . Two weeks after discharge from hospital patients completed a postal question naire to determine their satisfaction with the information about their drug treatment and their underst and ing of it . Forty-nine question naires were returned from the leaflet group and 52 from the control group . 3 . The provision of written guidelines result ed in significant improvements in patients ' satisfaction with their drug treatment ( chi 2 = 33.3 , P less than 0.001 ) and their underst and ing of it ( P less than 0.001 , Mann-Whitney test ) . Overall , patients who received leaflets were more likely to be aware of the potential side effects of their drugs but less likely to be apprehensive about them . Succinct guidelines concerning drug therapy can be assimilated by cardiology patients and provide them with a permanent record for future reference 1 . Prescription information leaflets ( PILs ) giving information about non-steroidal anti-inflammatory drugs ( NSAIDs ) , beta-adrenoceptor antagonists and inhaled bronchodilators were evaluated in three small Hampshire towns , while a fourth , in which no leaf 
    Output:
    
REVIEW METHODS Data from selected studies were tabulated and the results were qualitatively synthesis ed along with findings from the information design and stakeholder workshop str and s. RESULTS Most people do not value the written information they receive .
They had concerns about the use of complex language and poor visual presentation and in most cases the research showed that the information did not increase knowledge .
The research showed that patients valued written information that was tailored to their individual circumstances and illness , and that contained a balance of harm and benefit information .
Most patients wanted to know about any adverse effects that could arise .
Patients did not want written information to be a substitute for spoken information from their prescriber .
While not everyone wanted written information , those who did wanted sufficient detail to meet their need .
Some health professionals thought that written information for patients should be brief and simple , with concerns about providing side-effect information .
They saw increasing compliance as a prime function , in contrast to patients who saw an informed decision not to take a medicine as an acceptable outcome .
There is a gap between currently provided leaflets and information which patients would value and find more useful .