***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: OBJECTIVES To investigate the acceptability and feasibility of using short message services ( SMS ) via cell phones to ensure adherence to management prescriptions by diabetic patients . METHODS Type 2 diabetic patients with 5 or more years of diabetes and having HbA1c between 7.0 % to 10 % were r and omized to the control arm ( n = 105 ) to receive st and ard care and to the intervention arm ( SMS , n = 110 ) . Messages in English on principles of diabetes management were sent once in 3 days , the contents and frequencies varied as per the patients ' preferences . The study duration was 1 year . All participants were advised to report for quarterly clinic visits . A comparative assessment of the clinical , biochemical and anthropometric outcomes was made among the groups at the annual visit . RESULTS Annual review was possible in 71 % of intervention group and 63 % of control group . SMS was acceptable to the patients and the median number requested was 2 per week . HbA1c and plasma lipids improved significantly in the SMS group . CONCLUSIONS The pilot study showed that frequent communication via SMS was acceptable to diabetic patients and it helped to improve the health outcomes A common question in clinical consultations is : “ For this person , what are the likely effects of one treatment compared with another ? ” The central tenet of evidence based medicine is that this task is achieved by using the best evidence combined with consideration of that person 's individual needs.1 A further question then arises : “ What is the best evidence ? ” Two recent studies in the New Engl and Journal of Medicine have caused uproar in the research community by finding no difference in estimates of treatment effects between r and omised controlled trials and non-r and omised trials . The r and omised controlled trial and , especially , systematic review s of several of these trials are traditionally the gold st and ards for judging the benefits of treatments , mainly because it is conceptually easier to attribute any observed effect to the treatments being compared . The role of non-r and omised ( observational ) studies in evaluating treatments is contentious : deliberate choice of the treatment for each person implies that observed outcomes may be caused by differences among people being given the two treatments , rather than the treatments alone . Unrecognised confounding factors can always interfere with attempts to correct for identified differences between groups . These considerations have supported a hierarchy of evidence , with r and omised controlled trials and derivatives at the top , controlled BACKGROUND Non-attendance results in administrative problems and disruption in patient care . Several interventions have been used to reduce non-attendance , with varying degree of success . A relatively new intervention , text messaging , has been shown to be as effective as telephone reminders in reducing non-attendance . However , no study has looked specifically at using text messaging reminders to reduce non-attendance in chronic disease care . AIM To determine if text messaging would be effective in reducing non-attendance in patients on long-term followup , compared with telephone reminders and no reminder . DESIGN OF STUDY A r and omised controlled trial with three arms : text messaging reminder , telephone reminder , and control . SETTING Two primary care clinics in Malaysia . METHOD A total of 931 subjects who had been on at least 6 months of follow-up were r and omised into the three groups . Demographic variables were recorded at the first visit . In the intervention arms , a reminder was sent 24–48 hours prior to the appointment . Non-attendance rate was documented at the second visit . Non-attenders were defined as those who did not attend , attended early , or attended late without rescheduling their appointment . Attenders were defined as participants who had turned up for their scheduled appointment and those who had changed or cancelled their appointment with notification . RESULTS The non-attendance rates in the text messaging group ( odds ratio [ OR ] = 0.62 , 95 % confidence interval [ CI ] = 0.41 to 0.93 , P = 0.020 ) and the telephone reminder group ( OR = 0.53 , 95 % CI = 0.35 to 0.81 ) , P = 0.003 ) were significantly lower than the control group . The absolute non-attendance rate for telephone reminders was lower by 2 % compared to the text messaging group . This difference was not found to be statistically significant ( P = 0.505 ) . CONCLUSION Text messaging was found to be as effective as telephone reminder in reducing non-attendance in patients who required long-term follow-up for their chronic illnesses in this study . It could be used as an alternative to conventional reminder systems Background Adequate antenatal care is important to both the health of a pregnant woman and her unborn baby . Given South Africa ’s high rate of cellphone penetration , mobile health interventions have been touted as a potentially powerful means to disseminate health information . This study aim ed to increase antenatal health knowledge and awareness by disseminating text messages about clinic procedures at antenatal visits , and how to be healthy during pregnancy . Methods Participants recruited were pregnant women attending a primary health care facility in Cape Town . A controlled clinical trial was carried out where the intervention group ( n = 102 ) received text messages staggered according to the week of pregnancy at the time of recruitment . The control group ( n = 104 ) received no text messages . These text messages contained antenatal health information , and were delivered in English , Xhosa or Afrikaans , according to the preference of each participant . A baseline knowledge question naire with nine questions was administered prior to the intervention . The same question naire was used with added health-related behaviour questions for the intervention group at exit . A modified intention-to-treat analysis was done . To compare the control and intervention group ’s knowledge , Fisher ’s exact tests and two- sample t-tests tests were carried out for binary and continuous outcomes , respectively . A focus group of seven participants from the intervention group was then conducted to gain more insight into how the text messages were perceived . Results There was substantial loss to follow-up during the study with only 57 % of the participants retained at exit . No statistically significant difference was detected between the control and intervention group in any of the nine knowledge questions at exit ( all p > 0.05 ) . Responses from the focus group indicated that the text messages acted as a welcome reminder and a source of positive motivation , and were perceived as extended care from the health care provider . Conclusions While the intervention failed to improve antenatal health knowledge , evidence from self-reported behaviour and the focus group suggests that text messages have the potential to motivate change in health-seeking behaviour . One should be mindful of loss to follow-up when rolling out mobile health interventions in developing country setting s . Trial registration Pan African Clinical Trials Registry PACTR201406000841188 . Registered 3 June 2014 OBJECTIVE Hypertension and other noncommunicable diseases represent a growing threat to low/middle-income countries ( LMICs ) . Mobile health technologies may improve noncommunicable disease outcomes , but LMICs lack re sources to provide these services . We evaluated the efficacy of a cloud computing model using automated self-management calls plus home blood pressure ( BP ) monitoring as a strategy for improving systolic BPs ( SBPs ) and other outcomes of hypertensive patients in two LMICs . SUBJECTS AND METHODS This was a r and omized trial with a 6-week follow-up . Participants with high SBPs ( ≥140 mm Hg if nondiabetic and ≥130 mm Hg if diabetic ) were enrolled from clinics in Honduras and Mexico . Intervention patients received weekly automated monitoring and behavior change telephone calls sent from a server in the United States , plus a home BP monitor . At baseline , control patients received BP results , hypertension information , and usual healthcare . The primary outcome , SBP , was examined for all patients in addition to a preplanned subgroup with low literacy or high hypertension information needs . Secondary outcomes included perceived health status and medication-related problems . RESULTS Of the 200 patients recruited , 181 ( 90 % ) completed follow-up , and 117 of 181 had low literacy or high hypertension information needs . The median annual income was $ 2,900 USD , and average educational attainment was 6.5 years . At follow-up intervention patients ' SBPs decreased 4.2 mm Hg relative to controls ( 95 % confidence interval -9.1 , 0.7 ; p=0.09 ) . In the subgroup with high information needs , intervention patients ' average SBPs decreased 8.8 mm Hg ( -14.2 , -3.4 , p=0.002 ) . Compared with controls , intervention patients at follow-up reported fewer depressive symptoms ( p=0.004 ) , fewer medication problems ( p<0.0001 ) , better general health ( p<0.0001 ) , and greater satisfaction with care ( p≤0.004 ) . CONCLUSIONS Automated telephone care management plus home BP monitors can improve outcomes for hypertensive patients in LMICs . A cloud computing model within regional telecommunication centers could make these services available in areas with limited infrastructure for patient-focused informatics support The self-management of asthma can improve clinical outcomes . Recently , mobile telephones have been widely used as an efficient , instant personal communication tool . This study investigated whether a self-care system will achieve better asthma control through a mobile telephone-based interactive programme . This was a prospect i ve , controlled study in outpatient clinics . From 120 consecutive patients with moderate-to-severe persistent asthma , 89 were eventually recruited for the study , with 43 in the mobile telephone group ( with a mobile telephone-based interactive asthma self-care system )  . In the mobile telephone group , mean±sem peak expiratory flow rate significantly increased at 4 ( 378.2±9.3 L·min−1 ; n = 43 ; p = 0.020 ) , 5 ( 378.2±9.2 L·min−1 ; n = 43 ; p = 0.008 ) and 6 months ( 382.7±8.6 L·min−1 ; n = 43 ; p = 0.001 ) compared to the control group . Mean±sem forced expiratory volume in 1 s significantly increased at 6 months ( 65.2±3.2 % predicted ; n = 43 ; p<0.05 ) . Patients in the mobile telephone group had better quality of life after 3 months , as determined using the Short Form-12 ® physical component score , and fewer episodes of exacerbation and unscheduled visits than the control group . Patients in the mobile telephone group significantly increased their mean daily dose of either systemic or inhaled corticosteroids compared with the control group . The mobile telephone-based interactive self-care system provides a convenient and practical self-monitoring and -management of asthma , and improves asthma control OBJECTIVE To determine the effect of mobile phone intervention on HbA1c in type-2 Diabetes Mellitus ( DM ) patients living in rural areas of Pakistan . STUDY DESIGN R and omized controlled trial . PLACE AND DURATION OF STUDY Department of Endocrinology , Liaquat National Hospital , Karachi , from December 2013 to June 2014 . METHODOLOGY A total of 440 patients in intervention and control groups were enrolled . All patients between 18 - 70 years of age , residing in rural areas of Pakistan , HbA1c ³ 8.0 % and having personal functional mobile phone were included . The intervention group patients were called directly on mobile phone after every 15 days for a period of 4 months . They were asked about the self-monitoring blood glucose , intake of medications , physical activity , healthy eating and were physically examined after 4 months . However , the control group was examined initially and after 4 months physically in the clinic and there were no mobile phone contacts with these patients . RESULTS Patients in intervention group showed improvement ( p < 0.001 ) in following diet plan from 17.3 % at baseline to 43.6 % at endline , however , the control group showed insignificant increase ( p=0.522 ) from 13.6 % at baseline to 15.9 % at endline . Intervention group ( RR = 2.71 , 95 % CI = 1.18 - 6.40 ) showed significant positive association with normalization of HbA1c levels . The relationship was adjusted for age , gender , socio-economic status , ethnicity , education , hypertension , medication , BMI , diet , LDL levels and physical activity . Dietary restriction and low LDL levels also showed significant associations with reduced HbA1c levels on multivariate analysis . CONCLUSION Mobile phone technology in rural areas of Pakistan was helpful in lowering HbA1c levels in intervention group through direct communication with the diabetic patients . Lowering LDL and following diabetic diet plan can reduce HbA1c in these patients and help in preventing future complications Please cite this paper as : Lund S , Hemed M , Nielsen B , Said A , Said K , Makungu M , Rasch V. Mobile phones as a health communication tool to improve skilled attendance at delivery  in Zanzibar : a cluster‐r and omised controlled trial . BJOG 2012;119:1256–1264 Home peak expiratory flow ( PEF ) measurement is recommended by asthma guidelines . In a 16-week r and omized controlled study on 16 subjects with asthma ( 24.6 6.5 years old , asthma duration small ze , Cyrillic 6 months ) , we examined Global System for Mobile Communications ( GSM ) mobile telephone short-message service ( SMS ) as a novel means of telemedicine in PEF monitoring . All subjects received asthma education , self-management plan , and st and ard treatment . All measured PEF three times daily and kept a symptom diary . In the study group , therapy was adjusted weekly by an asthma specialist according to PEF values received daily from 
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Except for one study all showed rather positive effects of  mHealth  interventions on reported outcome measures .Furthermore , our results suggest that particular types of mHealth interventions that were found to have positive effects on patients with communicable diseases and for improving maternal care are likely to be effective also for NCDs .