***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: ors ( physicians , method ologists , pharmacists , and a nurse ) independently abstract ed data from trials ; a nurse and physician abstract ed data about adverse effects . Data were synthesized descriptively , emphasizing method ologic characteristics of the studies , such as population s enrolled , definitions of selection and outcome criteria , sample sizes , adequacy of r and omization process , interventions and comparisons , co interventions , biases in outcome assessment , and study design s. Evidence tables and graphic summaries , such as funnel plots , Galbraith plots , and forest plots , were used to examine relationships between clinical outcomes , participant characteristics , and method ologic characteristics . Trial outcomes were examined quantitatively in exploratory meta-analyses that used st and ardized mean differences between mean change scores as the effect size measure Objective : To systematic ally review the evidence for the effects of the herb valerian ( Valeriana officinalis ) on  insomnia  , based on r and omized , placebo-controlled , double-blind trials . Background : Valerian has long been advocated and used for promoting sleep but until quite recently evidence was solely anecdotal . However , during the last two decades a number of clinical trials have been conducted . Material s and methods : Systematic literature search es were performed to locate r and omized , placebo-controlled , double-blind trials measuring the effect of  valerian monopreparations on sleep in human participants . Data were extracted in a st and ardized manner and method ological quality was assessed by the Jadad score . Results : Nine trials were located meeting the selection criteria . The findings of the studies were contradictory and there was great inconsistency between trials in terms of patients , experimental design and procedures and method ological quality . Conclusion : The evidence for valerian as a treatment for  insomnia  is inconclusive . There is a need for rigorous trials to determine its efficacy We performed a systematic review of controlled clinical trials to check the evidence for the immunomodulatory efficacy of preparations containing extracts of Echinacea . Trials were search ed by on-line search es in Medline and Embase , a search in the private data base Phytodok , contacts with research ers and drug companies , and by checking references in available articles . All available historically and prospect ively controlled trials investigating the prophylactic or therapeutic immunomodulatory activity of preparations of Echinacea alone or in combination with other plant extracts or homeopathic dilutions  in humans were included . Study characteristics , results , and conclusions of primary authors were analyzed using st and ardized evaluation forms and method ological quality assessment using a predefined score system . A total of 26 controlled clinical trials ( 18 r and omized , 11 double-blind ) were identified ; 6 of these involved testing three different mono-extracts , and 20 involved testing three different preparations also containing other ingredients . Nineteen trials studied the efficacy of the prophylactic or curative treatment of infections ; 4 trials the reduction of side-effects of antineoplastic therapies and 3 trials the modulation of various laboratory immune parameters . The primary authors cl aim ed that 30 of the 34 treatment strategies showed a superior efficacy to those of the control groups . The method ological quality of most studies was low and only 8 trials scored more than half of the maximum possible score points . Existing controlled clinical trials indicate that preparations containing extracts of Echinacea can be efficacious immunomodulators . However , the evidence is still insufficient for clear therapeutic recommendations as to which preparation to use and which dose to employ for a specific indication . Further method ologically sound , r and omized clinical trials should be conducted A r and omized , controlled trial was conducted to evaluate the effect of cabbage leaves on mothers ' perceptions of breast engorgement and the influence of this treatment on breastfeeding practice s. The subjects , 120 breastfeeding women 72 hours postpartum , were r and omly allocated to an experimental group who received application of cabbage leaves to their breasts , or to a control group who received routine care . The experimental group tended to report less breast engorgement , but this trend was not statistically significant . At six weeks , women who received the cabbage leaf application were more likely to be breastfeeding exclusively , 76 and 58 percent ( 35/46 vs 29/50 ; P = 0.09 ) , and their mean duration of exclusive breastfeeding was longer ( 36 vs 30 days ; P = 0.04 ) . The greater breastfeeding success in the experimental group may have been due to some beneficial effect of cabbage leaf application , or may have been secondary to reassurance and improved confidence and self-esteem in these mothers This review assesses the evidence of the efficacy of mistletoe extracts in cancer patients from controlled clinical trials in humans . We used a list of predefined criteria for good methodology to select the trials which had the highest quality and interpreted the results with emphasis on the quality . An extensive search of the literature yielded 11 controlled trials in which at least an attempt was made for unbiased allocation into the contrasted treatment groups . The average quality of the trials appeared to be disappointingly poor . It concerned trials for bronchus carcinoma , colorectal carcinoma , mamma carcinoma , gastric cancer and female genital cancer . In the trials the results were in favour of mistletoe treatment ; the principle endpoint was mostly survival time . Only one trial could not show a beneficial effect , but this was the trial with the highest method ological score . Well performed r and omized , double-blind clinical trials on carefully chosen patient population s are needed in order to make assessment s of any efficacy . Further evidence should also consist of a more solid demonstration of the mechanisms of action from laboratory studies . St and ardization methods on active substances should be improved as there are apparent component variations between , but also within the preparations which were used in clinical trials . Considering the state of affairs we can not recommend the use of mistletoe extracts in the treatment of cancer patients with an exception for patients involved in clinical trials 
    Output:
    
Conclusions Systematic review s are available on a broad range of herbal preparations prescribed for defined conditions .
There is very little evidence on the effectiveness of herbalism as practised by specialist herbalists who combine herbs and use unconventional diagnosis