***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 Following male circumcision for HIV prevention , a high proportion of men fail to return for their scheduled seven-day post-operative visit . We evaluated the effect of short message service ( SMS ) text messages on attendance at this important visit . Methodology We enrolled 1200 participants > 18 years old in a two-arm , parallel , r and omized controlled trial at 12 sites in Nyanza province , Kenya . Participants received daily SMS text messages for seven days ( n = 600 ) or usual care ( n = 600 ) . The primary outcome was attendance at the scheduled seven-day post-operative visit . The primary analysis was by intention-to-treat . Principal Findings Of participants receiving SMS , 387/592 ( 65.4 % ) returned , compared to 356/596 ( 59.7 % ) in the control group ( relative risk [ RR ] = 1.09 , 95 % confidence interval [ CI ] 1.00–1.20 ; p = 0.04 ) . Men who paid more than US$ 1.25 to travel to clinic were at higher risk for failure to return compared to those who spent ≤US$1.25 ( adjusted relative risk [ aRR ] 1.35 , 95 % CI 1.15–1.58 ; p<0.001 ) . Men with secondary or higher education had a lower risk of failure to return compared to those with primary or less education ( aRR 0.87 , 95 % CI 0.74–1.01 ; p = 0.07 ) . Conclusions Text messaging result ed in a modest improvement in attendance at the 7-day post-operative clinic visit following adult male circumcision . Factors associated with failure to return were mainly structural , and included transportation costs and low educational level . Trial Registration Clinical Trials.gov OBJECTIVE Regular follow-up is essential to successful management of childhood cataract . We sought to assess whether a mobile phone short message service ( SMS ) for parents of children with cataract could improve follow-up adherence and the proportion of procedures performed in timely fashion . DESIGN R and omized , controlled trial . This trial is registered with Clinical Trials.gov , NCT01417819 . PARTICIPANTS We included 258 parent-child pairs involved in the Childhood Cataract Program of the Chinese Ministry of Health . METHODS Participants were r and omized ( 1:1 ) to a mobile phone SMS intervention or st and ard follow-up appointments .  All participants were scheduled to attend ≥ 4 follow-up appointments according to the protocol . Parents in the intervention group received SMS automated reminders before scheduled appointments . The  control group parents did not receive SMSs or any alternative reminder of scheduled appointments . Regular ocular examinations and analyses were performed by investigators masked to group allocation ; however , study participants and the manager in charge of r and omization and sending SMSs were not masked . MAIN OUTCOME MEASURES Number of follow-up appointments attended , additional surgeries , laser treatments , changes in eyeglasses prescription , and occurrence of secondary ocular hypertension . RESULTS Among parent-child participants , 135 were r and omly assigned to the SMS intervention and 123 to st and ard appointments . Attendance rates for the SMS group ( first visit , 97.8 % ; second , 91.9 % ; third , 92.6 % ; fourth , 83 % ) were significantly higher than those for the control group ( first visit , 87.8 % ; second , 69.9 % ; third , 56.9 % ; fourth , 33.3 % ) . The increase in attendance rate for total number of follow-up visits with SMS reminders was 47.2 % ( relative risk [ RR ] for attendance , 1.47 ; 95 % confidence interval [ CI ] , 1.16 - 1.78 ; P = 0.003 ) . The number needed to remind ( NNR ) to gain 1 additional visit by 1 child was 3 ( 95 % CI , 1.8 - 4.2 ) . A total of 247 clinical interventions were carried out in the SMS group and 134 in the control group ( RR , 1.68 ; 95 % CI , 1.37 - 1.99 ; P = 0.007 ) . The NNR to result in 1 additional clinical intervention was 5 ( 95 % CI , 3.5 - 6.5 ) . CONCLUSIONS The SMS reminders significantly improved follow-up adherence in pediatric cataract treatment . Using readily available mobile phone re sources may be an effective and economic strategy to improve management of childhood cataract in China . FINANCIAL DISCLOSURE(S ) The authors have no proprietary or commercial interest in any of the material s discussed in this article Background Missed appointments are known to interfere with appropriate care and to misspend medical and administrative re sources . The aim of this study was to test the effectiveness of a sequential intervention reminding patients of their upcoming appointment and to identify the profile of patients missing their appointments . Methods We conducted a r and omised controlled study in an urban primary care clinic at the Geneva University Hospitals serving a majority of vulnerable patients . All patients booked in a primary care or HIV clinic at the Geneva University Hospitals were sent a reminder 48 hrs prior to their appointment according to the following sequential intervention : 1 . Phone call ( fixed or mobile ) reminder ; 2 . If no phone response : a Short Message Service ( SMS ) reminder ; 3 . If no available mobile phone number : a postal reminder . The rate of missed appointment , the cost of the intervention , and the profile of patients missing their appointment were recorded . Results 2123 patients were included : 1052 in the intervention group , 1071 in the control group . Only 61.7 % patients had a mobile phone recorded at the clinic . The sequential intervention significantly reduced the rate of missed appointments : 11.4 % ( n = 122 ) in the control group and 7.8 % ( n = 82 ) in the intervention group ( p < 0.005 ) , and allowed to reallocate 28 % of cancelled appointments . It also proved to be cost effective in providing a total net benefit of 1846 . - EUR/3 months . A satisfaction survey conducted with 241 patients showed that 93 % of them were not bothered by the reminders and 78 % considered them to be useful . By multivariate analysis , the following characteristics were significant predictors of missed appointments : younger age ( OR per additional decade 0.82 ; CI 0.71 - 0.94 ) , male gender ( OR 1.72 ; CI 1.18 - 2.50 ) , follow-up appointment > 1year ( OR 2.2 ; CI : 1.15 - 4.2 ) , substance abuse ( 2.09 , CI 1.21 - 3.61 ) , and being an asylum seeker ( OR 2.73 : CI 1.22 - 6.09 ) . Conclusion A practical reminder system can significantly increase patient attendance at medical outpatient clinics . An intervention focused on specific patient characteristics could further increase the effectiveness of appointment reminders BACKGROUND Psychiatric clinics have high non-attendance rates and failure to attend may be a sign of deteriorating mental health . AIMS To investigate why psychiatric out- patients fail to attend , and the outcome of attenders and non-attenders . METHOD Prospect i ve cohort study of r and omly selected attenders and non-attenders at general adult psychiatric out-patient clinics . Subjects were interviewed at recruitment and severity of mental disorder and degree of social adjustment were measured . Six and 12 months later their engagement with the clinic and any psychiatric admissions were ascertained . RESULTS Of the 365 patients included in the study , 30 were untraceable and 224 consented to participate . Follow-up patients were more psychiatrically unwell than new patients . For follow-up patients , non-attenders had lower social functioning and more severe mental disorder than those who attended . At 12-month follow-up patients who missed their appointment were more likely to have been admitted than those who attended . CONCLUSIONS Those who miss psychiatric follow-up out-patient appointments are more unwell and more poorly socially functioning than those who attend . They have a greater chance of drop-out from clinic contact and subsequent admission Background Telephone or text-message reminders have been shown to significantly reduce the rate of missed appointments in different medical setting s. Since text-messaging is less re source -dem and ing , we tested the hypothesis that text-message reminders would be as effective as telephone reminders in an academic primary care clinic . Methods A r and omized controlled non-inferiority trial was conducted in the academic primary care division of the Geneva University Hospitals between November 2010 and April 2011 . Patients registered for an appointment at the clinic , and for whom a cell phone number was available , were r and omly selected to receive a text-message or a telephone call reminder 24 hours before the planned appointment . Patients were included each time they had an appointment . The main outcome was the rate of unexplained missed appointments . Appointments were not missed if they were cancelled or re-scheduled before or independently from the intervention . We defined non-inferiority as a difference below 2 % in the rate of missed appointments and powered the study accordingly . A satisfaction survey was conducted among a r and om sample of 900 patients ( response rate 41 % ) . Results 6450 patients were included , 3285 in the text-message group and 3165 in the telephone group . The rate of missed appointments was similar in the text-message group ( 11.7 % , 95 % CI : 10.6 - 12.8 ) and in the telephone group ( 10.2 % , 95 % CI : 9.2 - 11.3 p = 0.07 ) . However , only text message reminders were cost-effective . No patient reported any disturbance by any type of reminder in the satisfaction survey . Three quarters of surveyed patients recommended its regular implementation in the clinic . Conclusions Text-message reminders are equivalent to telephone reminders in reducing the proportion of missed appointments in an academic primary care clinic and are more cost-effective . Both types of reminders are well accepted by patients BACKGROUND Text messaging is a dominant form of communication in our society . However , little research has been conducted to evaluate its effectiveness as an appointment reminder in the dental setting . METHODS From the patient pool of the pediatric dentistry clinic at the University of Washington , Seattle , the authors invited 543 caregiver/child dyads who met eligibility criteria to participate in this study . They r and omly assigned 318 pairs ( 59 percent response ) to receive a short message service ( SMS ) text message ( n = 158 ) or a voice message ( control group ) ( n = 160 ) as an appointment reminder . RESULTS Younger caregivers were more likely to be nonattendees than were older caregivers ( P = .02 ) . Participants in the voice message group had a lower no-show attendance ( 8.2 percent ) than did those in the text message group ( 17.7 percent ) ( P = .01 ) . The unadjusted odds ratio ( OR ) for type of appointment reminder and no-show attendance was 2.41 ( P = .01 ) . After the authors adjusted for the caregiver 's age , the OR was 2.12 ( P = .04 ) . CONCLUSIONS SMS text messages were not as effective as voice reminders for patients in a dental school pediatric dentistry clinic . Future studies should investigate the effect of text message reminders when limited to patients who self-select that type of reminder and in patient population s outside the university setting . CLINICAL IMPLICATION S Text messaging may not be the preferable method of reminding patients about appointments in a university pediatric dental clinic BACKGROUND As healthcare services become progressively more stretched , there is increasing discussion of ways in which technological adjuncts may be used to deliver more cost-efficient services . Before widespread implementation , however , the use of these adjuncts requires proper scrutiny of their effects on psychological practice . AIMS This research examined the effectiveness of  SMS reminders on client appointment attendance and dropout in a psychological treatment setting . It was predicted that the reminders would result in increased initial appointment attendance , increased total appointment attendance , and decreased client dropout . METHOD A r and omized controlled trial investigated the impact of  SMS appointment reminders  ( two levels : present or absent ) on client attendance ( three levels : attended , rescheduled , or did not attend ) and dropout ( two levels : completed treatment or terminate early ) . Participants ( N = 140 ) at an outpatient psychology clinic were r and omly allocated to either receive an SMS appointment reminder one day before their scheduled appointment , or to receive no reminder . RESULTS No significant differences were found between the SMS and no SMS conditions in relation to appointment attendance . There were more client dropouts in the SMS compared to the no SMS condition . CONCLUSIONS The SMS appointment reminders were not effective at increasing appointment attendance . The current research suggests that there is more to client non-attendance in psychological setting s than the simple forgetting of appointments . Technological adjuncts may be useful in increasing the cost-efficiency of current services ; however , this research highlights the importance of underst and ing the effects of technology before widespread implementation BACKGROUND Non-attendance is common in primary care and previous studies have reported that reminders were useful in reducing broken appointments . OBJECTIVE To determine the effectiveness of a text messaging reminder in improving attendance in primary care . DESIGN Multicentre three-arm r and omized controlled trial . SETTING Seven primary care clinics in Malaysia . Participants . Patients ( or their caregivers ) who required follow-up at the clinics between 48 hours and 3 months from the recruitment date 
    Output:
    
OUTCOME MEASURES Primary outcomes were rate of attendance/non-attendance at healthcare appointments .
Multiple notifications were significantly more effective at improving attendance than single notifications .
Voice notifications appeared more effective than text notifications at improving attendance .
CONCLUSIONS Electronic text notifications improve attendance and reduce no shows across healthcare setting s. Sending multiple notifications could improve attendance further