***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 Suboptimal hearing aid use extorts significant social , health , and economic costs . The aims of this study were to ( 1 ) test the novel hypothesis that the threat associated with being diagnosed with hearing loss could be ameliorated with a self‐affirmation manipulation and ( 2 ) gauge the feasibility of deploying the manipulation in routine clinical practice . Design Parallel groups r and omized controlled trial with 10‐week follow‐up . Method Fifty people , newly prescribed with a hearing aid , completed either a question naire that included a brief self‐affirming exercise or an identical question naire with no self‐affirming exercise . The main outcome measure was derived from data logging automatically stored by the hearing aid . Perceived threat ( ‘ anxiety about ageing ’ ) , behavioural intention , and self‐efficacy were measured as potential mediators . Results Objective ly measured hours of daily hearing aid use were marginally higher in the intervention group compared with the control group ( between‐group difference = 1.94 hr , 95%CI = −1.24 , 5.12 , d = 0.43 ) . At follow‐up , participants in the intervention group were significantly less anxious about ageing and more accepting of older people than were participants in the control group ( between‐group difference = 0.75 , 95%CI = 0.26 , 1.22 , d = 0.87 ) . There was no statistically significant effect of the intervention on behavioural intention or self‐efficacy . Conclusions Although not statistically significant , the magnitude of the effect of the intervention on hearing aid use ( d = 0.43 ) suggests that it would be worthwhile working towards a fully powered r and omized controlled trial . The ability to reduce anxieties about ageing with this brief intervention could have far‐reaching benefits for multiple patient and general population groups . Statement of contribution What is already known on this subject ? Hearing impairment is more disabling than diabetes , yet hearing aid use is suboptimal . Anxieties about ageing may undermine hearing aid use . What does this study add ? The study tests a brief theory‐based psychological intervention to reduce anxiety about ageing and promote hearing aid use . Results show that the brief psychological intervention  reduced anxiety and marginally increased objective hearing aid use . Further work is required to identify other situations in which anxieties about ageing undermine behaviour change efforts . The very brief , flexible nature of the intervention means it could be adapted and deployed in numerous other health care setting In systematic review s , evidence -based practice and journal clubs critical appraisal tools are used to rate research papers . However , little evidence exists on whether the critical appraisal tool , subject matter knowledge or research design knowledge affect the appraisal of research papers . A match paired r and omised trial was conducted in August/September 2010 in the Faculty of Medicine , Health and Molecular Science , James Cook University , Australia . Ten participants in total were r and omly assigned to two groups using either an informal appraisal of research ( IA group ) or the Crowe Critical Appraisal Tool ( CCAT group )  , a general critical appraisal tool . Participant independently appraised five research papers , where each paper had a different research design . The scores allocated to the papers by each group were analysed . The intraclass correlation coefficient for absolute agreement was 0.76 for the informal appraisal group and 0.88 for the Crowe Critical Appraisal Tool group . The G study showed that in the informal appraisal group 24 % of variance in scores was attributable to either the rater or paper × rater interactions , whereas this was 12 % in the Crowe Critical Appraisal Tool group . Analysis of covariance showed that there were statistically significant results in the informal appraisal group for subject matter knowledge ( F(1,18 ) = 7.03 , P < 0.05 1 tailed , partial η² = 0.28 ) and rater ( F(4,18 ) = 4.57 , P < 0.05 1 tailed , partial η² = 0.50 ) . Kendall 's tau correlation coefficient also showed a significant weak positive relationship ( τ = 0.38 , P = 0.03 ) between total score and subject matter knowledge for the informal appraisal group . The Crowe  Critical Appraisal Tool was more reliable than an informal appraisal of the research papers . In the informal appraisal group , there were significant effects for rater and subject matter knowledge , whereas the Crowe Critical Appraisal Tool almost eliminated the rater effect , and no subject matter knowledge effect was apparent . There was no research design knowledge effect in either group . The Crowe Critical Appraisal Tool provided much better score reliability and should help readers with different levels and types of knowledge to reach similar conclusions about a research paper Abstract Objectives : The aim of this study was to evaluate the feasibility of conducting a r and omized controlled trial ( RCT ) on the effect of motivational interviewing ( MI ) on hearing-aid use . Design : This was a pilot single-blind , r and omized parallel-group study conducted in the UK . Study sample : Thirty-seven adult patients who reported using their hearing aid(s ) less than four hours per day were r and omized to MI combined with St and ard Care ( MISC ) ( n = 20 ) , and St and ard Care only ( SC ) ( n = 17 ) . Results : Of 220 patients invited , 37 were enrolled giving the recruitment rate  of 17 % . One participant withdrew giving the retention rate of 97 % . It was feasible to combine MI with SC for facilitating hearing-aid use and deliver the intervention with high fidelity in an audiology setting . The measure on hearing-aid use ( data logging ) one month after interventions favoured the MISC group . Conclusions : This pilot study suggests that conducting an RCT on using MI for facilitating hearing-aid use in people who do not use their hearing aids is feasible , and that MI combined with SC may have more positive effects on hearing-aid use compared to SC only BACKGROUND Motivational interviewing ( MI ) has been used in consultation setting s to motivate hearing aid users to increase hearing aid usage . However , the effect of MI on those who use their hearing aids only rarely or not at all has not been explored . PURPOSE The aims of this pilot study were to evaluate the effect of MI counseling with elderly hearing aid recipients found to have low hearing aid use at a six-month follow-up appointment and to describe clients ' subjective assessment s of their perceived need for hearing aids three months after MI counseling . RESEARCH DESIGN The study had a within-subjects pretest-posttest design . STUDY SAMPLE Forty seven hearing aid recipients who had used their new hearing aids , an average of < 90 min/day , were recruited at a follow-up appointment six months after hearing aid fitting . INTERVENTION Thirty minutes of MI counseling was provided at the six-month follow-up appointment . If needed , hearing aid adjustments and technical support were also provided . DATA COLLECTION AND ANALYSIS The effect of MI counseling in combination with adjustments and technical support was assessed in relation to data logged hearing aid use , which was assessed immediately before ( at the six-month follow-up ) and three months after ( at the nine-month follow-up ) the intervention . Hearing aid experiences were also assessed three months after MI . RESULTS Thirty seven participants ( 79 % ) returned for the nine-month follow-up visit and had modest but significant increases in data logged hearing aid use in the three months following MI counseling . Of the 37 participants who returned , 51 % had increased their hearing aid use to at least 2 h/day after the MI counseling . Most of the 37 participants who attended the nine-month follow-up reported increased need for ( 59 % ) or increased benefit and contentment with ( 57 % ) their hearing aid three months after MI ; these participants also had significantly higher data logged hearing aid use following MI . CONCLUSIONS These findings suggest that follow-up appointments using MI counseling in conjunction with technical support may be useful for increasing hearing aid usage among low-users , and a r and omized controlled trial is warranted Abstract Objective : To assess ( 1 ) the feasibility of incorporating the Ida Institute ’s Motivation Tools into a UK audiology service , ( 2 ) the potential benefits of motivational engagement in first-time hearing aid users , and ( 3 ) predictors of hearing aid and general health outcome measures . Design : A feasibility study using a single-centre , prospect i ve , quasi-r and omized controlled design with two arms . The Ida Institute ’s Motivation Tools formed the basis for motivational engagement . Study sample : First-time hearing aid users were recruited at the initial hearing assessment appointment . The intervention arm underwent motivational engagement ( M+ , n = 32 ) , and a control arm ( M- , n = 36 ) received st and ard care only . Results : The M+ group showed greater self-efficacy , reduced anxiety , and greater engagement with the audiologist at assessment and fitting appointments . However , there were no significant between-group differences 10-weeks post-fitting . Hearing-related communication scores predicted anxiety , and social isolation scores predicted depression for the M+ group . Readiness to address hearing difficulties predicted hearing aid outcomes for the M- group . Hearing sensitivity was not a predictor of outcomes . Conclusions : There were some positive results from motivational engagement early in the patient journey . Future research should consider using qualitative methods to explore whether there are longer-term benefits of motivational engagement in hearing aid users 
    Output:
    
Most studies of clinicians ' behaviours were descriptive , with very little research linking clinician behaviour to patient outcomes .