***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: Purpose . To conduct a pilot test of a decision aid design ed to help patients choose among currently recommended colorectal cancer screening programs . Methods . R and omized controlled trial comparing a patient decision aid based on multi criteria decision-making theory with a simple educational intervention . Patient population . 96 patients at average risk for colorectal cancer seen in an Internal Medicine practice in Rochester , New York . Outcome measures . The two primary outcome measures were patient decision process and the decision outcome . Patient decision process was assessed using the decisional conflict scale . Decision outcome was defined as the proportion of colorectal cancer screening plans carried out . Results . After controlling for the effects of the physicians in a factorial analysis of variance , patients who used the decision aid had lower decisional conflict regarding colorectal cancer screening decisions ( F ratio6.47 , P = 0.01 ) due to increased knowledge , better clarity of values , and higher ratings of the quality of the decisions they made . There was no difference between the groups in decision outcomes : 52 % of patients in the control group and 49 % in the experimental group completed planned screening tests ( P = 1.0 ) . Conclusions . In a pilot study , a multi criteria -based patient decision aid for colorectal cancer screening improved patients ’ decision-making processes but had no effect on the implementation of screening plans Developing an evidence base for making public health decisions will require using data from evaluation studies with r and omized and nonr and omized design s. Assessing individual studies and using studies in quantitative research syntheses require transparent reporting of the study , with sufficient detail and clarity to readily see differences and similarities among studies in the same area . The Consoli date d St and ards of Reporting Trials ( CONSORT ) statement provides guidelines for transparent reporting of r and omized clinical trials . We present the initial version of the Transparent Reporting of Evaluations with Nonr and omized Design s ( TREND ) statement . These guidelines emphasize the reporting of theories used and descriptions of intervention and comparison conditions , research design , and methods of adjusting for possible biases in evaluation studies that use nonr and omized design BACKGROUND The availability of several effective screening options for colorectal cancer ( CRC ) screening calls for involving patients in decision making about CRC screening . The current study examined ( 1 ) participant characteristics associated with their preferences for participation in CRC screening decision making , ( 2 ) correspondence between participant preferences for decision making and their usual participation in decision making , and ( 3 ) associations between participant decision-making preferences and CRC screening practice s and attitudes . METHODS Data were obtained using a r and om ,  population -based  telephone survey  , conducted during August 2001 and April 2002 , of 2119 community-living adults aged 50 to 75 years ( 56 % female ) residing in Long Isl and , NY . RESULTS Overall , 77 % reported that preferences for CRC screening decision making matched how screening decisions were usually made ( simple kappa coefficient=0.67 [ 0.64 - 0.69 ] ) . Fifteen percent preferred to make  screening decisions themselves , while 25 % preferred to make decisions after considering their physician 's opinion ; nearly 50 % preferred to share decision making , and 16 % preferred that their physician make all screening decisions . Less education was associated with preferring that the physician make all screening decisions . Preferring physician involvement in screening decision making was associated with greater odds of citing no physician recommendation as a barrier to CRC screening , when compared to those who preferred no physician involvement . Preferring no physician involvement in decision making was associated with lower odds of reporting a recent CRC screening exam , as well as lower odds of endorsing positive attitudes and greater odds of endorsing negative attitudes toward CRC screening , when compared to participants who preferred physician involvement in decision making . Their attitudes also reflected intentions not to screen for CRC if they were asymptomatic , as well as the perception that they were not at personal risk for CRC . CONCLUSIONS Several factors were identified as significantly associated with preferences for decision making and deserve further exploration for their application to clinical practice The purpose of this study was to determine if providing men with information about screening for prostate cancer would enable them to assume a more active role in decision making with their family physician , and lower levels of anxiety and decisional conflict .  Men were recruited from one family medical clinic in Winnipeg , Manitoba . One hundred men scheduled for a periodic health examination ( PHE ) were r and omly assigned to receive verbal and written information either prior to the PHE , or following the second interview . Men completed measures of preferred decisional role and anxiety prior to the PHE ; and assumed decisional role , decisional conflict , and anxiety post PHE . Results demonstrated that men who received the information prior to the PHE assumed a significantly more active role in making a screening decision , and had lower levels of decisional conflict post PHE . The two groups did not differ with regard to levels of state anxiety . Providing men with information enables them to make informed screening decisions with their family physicians BACKGROUND We tested an intervention based on social learning theory ( SLT ) to improve colorectal  cancer ( CRC ) screening among Native Hawaiians , a group with low CRC screening rates . METHOD Sixteen Hawaiian civic clubs agreed to r and omization . Eight control clubs received a culturally targeted presentation , a free Fecal Occult Blood Test ( FOBT ) , and a reminder call . Eight experimental clubs also received culturally targeted education and free testing ; but , in line with SLT , education was delivered by a Native Hawaiian physician and Native Hawaiian CRC survivor , and members received an FOBT demo , were challenged to involve a family member in screening , and were telephoned multiple times to address change-related emotions and barriers . RESULTS One hundred twenty-one members age 50 and older from 16 clubs participated . At the club level , screening rates were modestly increased in four experimental clubs and six control clubs . Surprisingly , 64 % of participants reported being up to date with CRC screening at baseline . Only 13 individuals ( five in experimental arm and eight in the control arm ) were screened for the first time through this intervention , increasing the percent screened from 59 % to 67 % in the experimental group and from 69 % to 85 % in the control group . Although individuals in the experimental arm were more likely to rate the intervention as culturally appropriate , both arms realized similar and significant gains in CRC knowledge , attitudes , intent , and self-efficacy . CONCLUSIONS For Native Hawaiian individuals belonging to a network of civic clubs , an intervention based on SLT delivered by a Native Hawaiian physician and CRC survivor was less effective at further increasing compliance than was a culturally targeted educational session delivered by a non-Hawaiian nurse . That CRC screening compliance was high prior to our intervention suggests that we targeted a very health conscious segment of the Native Hawaiian population . Future work should focus on underserved segments of this indigenous group Patient satisfaction measures have previously addressed satisfaction with medical care , satisfaction with providers , and satisfaction with outcomes , but not satisfaction with the health care decision itself . As patients become more involved in health care decisions , it is important to underst and specific dynamics of the decision itself The  Satisfaction with Decision ( SWD ) scale  measures satisfaction with health care decisions . It was developed in the context of postmenopausal hormone-replacement therapy decisions The six-item scale has excellent reliability ( Cronbach 's alpha = 0.86 ) . Discriminant validity , tested by performing principal- components analysis of items pooled from the SWD scale and two conceptually related measures , was good . Correlation of the  SWD scale  with measures of satisfaction with other aspects of the decision-making process showed the  SWD scale  was correlated most highly ( 0.64 ) with " decisional confidence , " and least with " desire to participate in health care de cisions " and " satisfaction with provider " The  SWD  scale predicts decision certainty in this study . Use in an independent study showed that the  SWD scale  was correlated with the likelihood of patients ' intentions to get a flu shot . Further investigation in relation to other health decisions will establish the utility of the  SWD scale  as an outcome measure Key words : patient satisfaction ; medical decision making ; decision support ( Med Decis Making 1996;16:58 - 64 BACKGROUND Studies have shown that a majority of women with a family history of breast cancer have exaggerated perceptions of their own risk of this disease and experience excessive anxiety . In response to the need to communicate more accurate risk information to these women , specialized programs for breast cancer risk counseling have been initiated in medical centers across the United States . PURPOSE Our purpose was 1 ) to evaluate the impact of a st and ardized protocol for individualized breast cancer risk counseling on comprehension of personal risk among first-degree relatives of index breast cancer patients and 2 ) to identify women most and least likely to benefit from such counseling . METHODS This study is a prospect i ve r and omized trial comparing individualized breast cancer risk counseling to general health counseling ( control ) . We studied 200 women aged 35 years and older who had a family history of breast cancer in a first-degree relative . Women with a personal history of cancer were excluded .  Risk comprehension was assessed as the concordance between perceived " subjective " lifetime breast cancer risk and estimated " objective " lifetime risk . RESULTS The results of logistic regression analysis showed that women who received risk counseling were significantly more likely to improve their risk comprehension , compared with women in the control condition ( odds ratio [ OR ] = 3.5 ; 95 % confidence interval [ CI ] = 1.3 - 9.5 ; P = .01 ) . However , in both groups , about two thirds of women continued to overestimate their lifetime risks substantially following counseling . Examination of subjects by treatment interaction effects indicated that risk counseling did not produce improved comprehension among the large proportion of women who had high levels of anxious preoccupation with breast cancer at base line ( P = .02 ) . In addition , white women were less likely to benefit than African-American women ( OR = 0.34 ; 95 % CI = 0.11 - 0.99 ; P = .05 ) . CONCLUSION Efforts to counsel women about their breast cancer risks are not likely to be effective unless their breast cancer anxieties are also addressed . IMPLICATION S Attention to the psychological aspects of breast cancer risk will be critical in the development of risk-counseling programs that incorporate testing for the recently cloned breast cancer susceptibility gene , BRCA1 ( and BRCA2 when that gene has also been cloned ) OBJECTIVE To describe women 's breast screening  knowledge , attitudes , intentions and practice s. DESIGN Telephone survey . PARTICIPANTS R and om population -based sample of 383 women aged 50 to 69 , living in Ottawa-Carleton , and having no history of breast cancer . Participation rates were 81 % . RESULTS Only 47 % reported having had a mammogram within the two years before the survey , and 57 % had received a  physical breast exam  within the previous year . Intentions to arrange screening  were positively correlated to income , previous mammography , encouragement to have a mammogram , knowledge , knowing a person with breast cancer , an absence of negative attitudes ( i.e. , mammograms unnecessary ) , and low decisional conflict . CONCLUSIONS Improvements in participation rates will be achieved only if women are convinced of the need for screening , and physicians encourage them to be screened BACKGROUND Little is known about what information affects men 's decisions about prostate cancer screening . METHODS We developed a four-part decision aid about  prostate cancer screening and tested it in men , ages 45 - 85 , to determine how the information in each part--(1 ) the epidemiology of prostate cancer ; ( 2 ) the PSA test ; ( 3 ) prostate biopsy and treatment options for prostate cancer ; and ( 4 ) balance sheets to aid decision-making -- affected men 's interest in screening . RESULTS One hundred eighty-eight men from one general internal medicine clinic participated in our study ( response rate 65 % ) . Before the decision aid , 76 % were interested in screening ; 8 % were not ; and 16 % were undecided . The decision aid increased the proportion of men who knew the advantages ( + 28 % ; 95 % CI : 21 - 35 ) and disadvantages ( + 55 % ; 95 % CI : 48 - 63 % ) of screening . It also increased the proportion who knew enough to make a decision ( + 24 ; 95 % CI : 16 - 32 % ) . It did not change men 's interest in screening ( P = 0.134 ) . Twenty percent of men , however , did change their interest category . Men who were undecided at baseline were more likely to change than those who were interested or not interested . There were no clinical ly meaningful changes in interest following each component part of the decision aid . CONCLUSION Interest in prostate cancer screening is high and remained high after a 10 min decision aid . The decision aid increased the proportion of men with sufficient information to decide about screening . It also changed 20 % of men 's interest in screening . Because no single piece of information was influential to decision-making in all men , clinicians may want to tailor information to men 's individual needs OBJECTIVES Efforts to educate men about the controversy surrounding prostate cancer screening are well intended but rarely evaluated rigorously . We evaluated an evidence -based ( EB ) booklet for men design ed to promote informed decision-making . We also determined whether men 's preference for involvement in decision-making ( " passive " , " collaborative " or " active " ) modified its impact . SETTING AND METHODS Men aged 40 - 70 years were recruited from the practice s of 13 local general practitioners ( GPs ) in Sydney , Australia . They completed a self-administered question naire before seeing their GP , who , according to pre-r and omised codes , distributed either our EB booklet or conventional information . Post-test question naires were mailed to men three days later . Of the 248 eligible men recruited , 214 ( 86 % response rate ) returned post-test question naires . Knowledge of evidence and of risk of developing and dying from pro 
    Output:
    
Our findings revealed that most studies measured screening ( or intention ) and knowledge ; fewer measured recommended IDM-related constructs and none measured all outcomes proposed for evaluating IDM interventions .