***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: STUDY OBJECTIVE Emergency department ( ED ) -based clinical research has the potential to include patient population s that are typically underrepresented in clinical research . The objective of this study is to assess how emergency clinical care and research processes , informed consent , and patient demographic factors ( age , sex , and ethnicity/race ) affect enrollment and consent in clinical research in the ED . METHODS This was an analysis of prospect ively collected data of all patients ( aged 2 to 101 years ) eligible for one of 7 clinical research studies from February 2005 to April 2007 in an academic ED . We measured rates of enrollment and consent in the clinical studies . RESULTS One thous and two hundred two of the 4418 patients screened for participation in 7 clinical studies were clinical ly eligible for enrollment . Of the 868 patients who were able to provide a voluntary decision regarding consent  , 639 ( 73.6 % ) agreed to participate ; an overall enrollment rate of 53.2 % . The mean age of patients enrolled was 51.8 years ( range 3 to 98 years ) . Black patients ( 49.2 % enrollment ) and Latino patients ( 18.4 % enrollment ) were less likely to be enrolled in comparison with white patients ( 58.3 % enrollment ) ( adjusted odds ratio [ OR ] of enrollment for blacks=0.64 ; 95 % confidence interval [ CI ] 0.50 to 0.82 ; adjusted OR of enrollment for Latinos=0.16 ; 95 % CI 0.08 to 0.33 ) . Enrollment rates were lower among pediatric ( 40.0 % ) and geriatric patients ( 49.1 % ) in comparison with adult patients ages 18 to 64 years ( 55.5 % ) ( adjusted OR of enrollment for pediatric patients = 0.70 , 95 % CI 0.34 to 1.43 ; adjusted OR of enrollment for geriatric patients = 0.69 , 95 % CI 0.53 to 0.90 ) . Unique issues contributing to underenrollment included challenges in consent among pediatric and elderly patients , language issues in Latino patients , reduced voluntary consent rates among black patients , and perhaps underuse of minimal risk waivers . CONCLUSION In a large academic ED , minority , pediatric , and geriatric patients were less likely to be enrolled in acute care clinical research studies than middle-aged whites . Enrollment and consent strategies design ed to enhance research participation in these important patient population s may be necessary to address disparities in the development and application of evidence -based emergency and acute care Background Concerns have been raised about low participation rates of people from minority ethnic groups in clinical trials . However , the evidence is unclear as many studies do not report the ethnicity of participants and there is insufficient information about the reasons for in eligibility by ethnic group . Where there are data , there remains the key question as to whether ethnic minorities more likely to be ineligible ( e.g. due to language ) or decline to participate . We have addressed these questions in relation to the Birmingham Rehabilitation Uptake Maximisation ( BRUM ) study , a r and omized controlled trial ( RCT ) comparing a home-based with a hospital-based cardiac rehabilitation programme in a multi-ethnic population in the UK . Methods Analysis of the ethnicity , age and sex of presenting and recruited subjects for a trial of cardiac rehabilitation in the West-Midl and s , UK . Participants : 1997 patients presenting post-myocardial infa rct ion , percutaneous transluminal coronary angioplasty or coronary artery bypass graft surgery .  Data collected : exclusion rates , reasons for exclusion and reasons for declining to participate in the trial by ethnic group . Results Significantly more patients of South Asian ethnicity were excluded ( 52 % of ' South Asian ' v 36 % ' White European ' and 36 % ' Other ' , p < 0.001 ) . This difference in eligibility was primarily due to exclusion on the basis of language ( i.e. the inability to speak English or Punjabi ) . Of those eligible , similar proportions were recruited from the different ethnic groups ( white , South Asian and other ) . There was a marked difference in eligibility between people of Indian , Pakistani or Bangladeshi origin . Conclusion Once eligible for this trial , people from different ethnic groups were recruited in similar proportions . The reason for in eligibility in the BRUM study was the inability to support the range of minority language PURPOSE Well-conducted cancer clinical trials are essential for improving patient outcomes . Unfortunately , only 3 % of new cancer patients participate in clinical trials . Barriers to patient accrual in cancer clinical trials must be identified and overcome to increase patient participation . MATERIAL S AND METHODS We prospect ively tracked factors that potentially affected patient accrual into cancer clinical trials at the University of California Davis Cancer Center . Oncologists seeing new out patients were asked to complete question naires regarding patient characteristics and the physician 's decision-making on patient eligibility , protocol availability , and patient opinions on participation . Statistical analysis was performed to correlate these parameters with subsequent protocol accrual . RESULTS There were 276 assessable patients . At the initial visits , physicians did not consider clinical trials in 38 % ( 105/276 ) of patients principally because of a perception of protocol unavailability and poor performance status . Physicians considered 62 % ( 171/276 ) of patients for participation in clinical trials . Of these , only 53 % ( 91/171 ) had an appropriate protocol available for site and stage of disease . Seventy-six of 90 patients ( 84 % ) with available protocol s met eligibility criteria for a particular study . Only 39 of 76 patients ( 51 % ) agreed to participate in cancer clinical trials , for an overall accrual rate of 14 % ( 39/276 ) . The remainder ( 37/76 , 49 % ) declined trial participation despite meeting eligibility criteria . The most common reasons were a desire for other treatment ( 34 % ) , distance from the cancer center ( 13 % ) , patient refusal to disclose reason ( 11 % ) , and insurance denial ( 8 % ) . Patients with private insurance were less likely to enroll in clinical trials compared to those with government-funded insurance ( OR , 0.34 ; P = .03 ; 95 % CI , 0.13 to 0.9 ) . CONCLUSION Barriers to cancer clinical trial accrual can be prospect ively identified and addressed in the development and conduct of future studies , which may potentially lead to more robust clinical trials enrollment . Investigation of patient perceptions regarding the clinical trials process and the role of third party-payers is warranted Background / Aims : Asian Americans have been underrepresented in cancer research . The purpose of this study was to evaluate the efficacy of a multiple arm recruitment approach in improving Asian recruitment into the Cancer Genetics Network ( CGN ) . Methods : 1,096 potential participants , identified through cancer registries located at University of California , Irvine ( UCI ) and Fred Hutchinson Cancer Research Center ( FHCRC ) , were r and omly assigned to receive one of four recruitment approaches . Results : A 6.2 % gain in Asian participation into the CGN was achieved over a 2-year period at FHCRC and UCI , which contributed a 2 % CGN-wide increase in overall Asian enrollment . Site-specific differences in recruitment success by study arm were observed . Conclusion : Novel recruitment approaches can assist in improving recruitment of Asian population s into cancer genetic research studies PURPOSE R and om assignment to clinical trials involving different treatment modalities can be difficult . We describe our experience with the Surgical Prostatectomy Versus Interstitial Radiation Intervention Trial ( SPIRIT ; ACOSOG Z0070 NCIC PR10 ) , a r and omized trial for early-stage prostate cancer comparing radical prostatectomy ( RP ) , and brachytherapy ( BT ) . A multidisciplinary educational session was developed to improve patient underst and ing of treatment options and to facilitate accrual . PATIENTS AND METHODS Prostate cancer referrals were screened and men who met favorable risk criteria ( T1c/T2a , prostate-specific antigen [ PSA ] < 10 ng/mL , Gleason < or = 6 ) were invited to a structured education session before a specialty consultation . Men and their partners viewed the SPIRIT informed-consent video and heard from a cancer patient who described his participation in a r and omized trial . Then , a urologist and radiation oncologist together compared and contrasted RP and BT to establish the rationale for the trial . RESULTS In May 2002 , SPIRIT opened for accrual and was endorsed by the University Health Network urologists and radiation oncologists . The first 27 eligible patients were approached about SPIRIT , consulted both specialties , and viewed an educational video . No patients consented . The multidisciplinary education session was then introduced . Forty-seven education sessions with 263 patients result ed in 34 consents . Of 203 patients who were suitable for the study but declined r and om assignment , 62 chose surgery , 94 chose brachytherapy , three patients chose external radiotherapy , and 11 chose no treatment .  Consent rates for eligible and suitable patients were one in six . CONCLUSION Men who underst and their treatment options and trial rationale as presented jointly by representative specialists from competing treatment modalities may be better equipped to make an informed decision and are more likely to consent to r and om assignment Purpose Writing scientific articles is a daunting task for novice research ers . In this qualitative study carried out in 2007 , the authors evaluated the experiences of a group of novice research ers engaged in the writing process , to eluci date the main difficulties and sources of encouragement they encountered . Method Sixteen novice research ers were interviewed . Most were women ( 10 ) , and most were enrolled in programs of medicine ( 9 ) , followed by nursing ( 4 ) and physical therapy ( 3 ) . These were drawn via convenience sampling from a r and omized control trial in which 48 of them were equally assigned to either an online or a  face-to-face course of instruction . On completion , interviews were conducted in focus groups of four students each . The interviews were transcribed and read independently by two of the authors , who then encoded the material based on the principles of grounded theory . Initial categories were converted to major emerging themes , which were vali date d when participants were asked to review the findings . Triangulation of results was carried out by discussing the emerging themes in an online forum with five specialists in college writing education . Results Classifying the diverse responses of participants led to the emergence of four major themes : cognitive burden , group support and mentoring , difficulty in distinguishing between content and structure , and backward design of manuscripts . Conclusions The themes produced by this study provide some insight into the challenges faced by novice research ers in their early attempts at scientific writing . Remedies that address these challenges are needed to substantially improve scientific writing instruction PURPOSE To investigate patients ' willingness to participate ( WTP ) in a r and omized controlled trial ( RCT ) comparing intensity-modulated radiotherapy ( IMRT ) with proton beam therapy ( PBT ) for prostate cancer ( PCa ) . METHODS AND MATERIAL S We undertook a qualitative research study in which we prospect ively enrolled patients with clinical ly localized PCa . We used purposive sampling to ensure a diverse sample based on age , race , travel distance , and physician . Patients participated in a semi-structured interview in which they review ed a description of a hypothetical RCT , were asked open-ended and focused follow-up questions regarding their motivations for and concerns about enrollment , and completed a question naire assessing characteristics such as demographics and prior knowledge of IMRT or PBT . Patients ' stated WTP was assessed using a 6-point Likert scale . RESULTS Forty-six eligible patients ( 33 white , 13 black ) were enrolled from the practice s of eight physicians . We identified 21 factors that impacted patients ' WTP , which largely centered on five major themes : altruism/desire to compare treatments , r and omization , deference to physician opinion , financial incentives , and time dem and s/scheduling . Most patients ( 27 of 46 , 59 % ) stated they would either " definitely " or " probably " participate . Seventeen percent ( 8 of 46 ) stated they would " definitely not " or " probably not " enroll , most of whom ( 6 of 8) preferred PBT before their physician visit . CONCLUSIONS A substantial proportion of patients indicated high WTP in a RCT comparing IMRT and PBT for PCa Study objectives The emergency department ( ED ) provides an arena for patient enrolment into a variety of research studies even for non-critically ill patients . Given the types of illness , time constraints and sense of urgency that exists in the ED environment , concern exists about whether research subjects in the ED can provide full consent for participation . We sought to identify enrolled research subjects ' perspectives on the informed consent process for research conducted in the ED . Methods This was a prospect i ve , observational study of ED subjects , 18 years or older , who had been approached to participate in research in the ED and who were judged to have decision-making capacity . Exclusions were critical illness and refusal to participate . Subjective were followed up within 1 week after enrolling using structured phone interviews by trained interviewers . Results During the study period , 229 eligible patients were approached to participate in both a target study and this study . Of these , 66 % ( 150/229 ) agreed to participate in this study , at least to the extent of allowing us access to their demographic data . The study participant group was similar in terms of gender to this particular ED 's patient population but had significantly more African-Americans and persons older than 45 . Conclusion Despite rigorous time constraints and rapid throughput times , the 
    Output:
    
Conclusions / Significance Chinese heritage clinical research participants value personal benefit , financial incentives , the ability to help others , recommendations of others , advertisements , and convenience when considering clinical research participation .