***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: Negative symptoms are considered the most debilitating and refractory aspect of schizophrenia , being associated with poor social , occupational and global outcomes . Conventional antipsychotics have limited efficacy against these symptoms and poor tolerability profiles . Atypical antipsychotics are an alternative treatment , and this 12‐week , r and omised , flexibly dosed study compared the efficacy , safety and tolerability of quetiapine and olanzapine in this regard . Of the 40 patients who entered the study ( 32 male ; 8 female ) , 19 were r and omised to quetiapine  ( mean dose 637 mg/day , mean treatment duration 80 days ) and 21 to  olanzapine  ( mean dose 16 mg/day , mean treatment duration 78 days ) . Quetiapine and olanzapine were similarly effective : in each treatment group significant improvements at Week 12 were observed for negative symptom scores on the SANS and the PANSS , and for subscale scores of affective flattening and alogia on the SANS . Both treatments were well tolerated in this patient population , with no worsening of extrapyramidal symptoms in either case . Anxiety and insomnia were the most common adverse events ( ≥7 % of patients in each group ) , but were not drug‐related . Although this is a small study with limited power , the results support the effectiveness of quetiapine and olanzapine in treating the negative symptoms of schizophrenia . Copyright © 2006 John Wiley & Sons , BACKGROUND Amisulpride is a substituted benzamide with high selectivity for dopamine D2 and D3 receptors . The purpose of the study was to evaluate the effect of 100 mg amisulpride in patients with predominantly negative symptoms of schizophrenia . METHOD This was a multi-centre , r and omised , parallel-group , double-blind study . Patients received either amisulpride ( 100 mg/day ) or placebo over a six-month treatment period . RESULTS A total of 141 patients were included , 69 received amisulpride , 72 placebo .  Fifty-eight patients ( 41 % ) had received neuroleptic treatment prior to inclusion . The percentage of amisulpride patients completing the study ( 55 % ) was significantly higher than that with placebo ( 32 % ) , and drop-out rates due to lack of efficacy were 27 % with amisulpride and 47 % with placebo . All efficacy assessment s were statistically in favour of amisulpride compared with placebo . The overall incidence of extrapyramidal symptoms was comparable in both groups ; only five patients started anti-Parkinsonian treatment during the study ( one in the placebo and four in the amisulpride group ) . CONCLUSION Amisulpride is effective in the medium-term treatment schizophrenic patients with predominantly negative symptoms Background The approximately 1100 medical journals now active in China are publishing a rapidly increasing number of research reports , including many studies identified by their authors as r and omized controlled trials . It has been noticed that these reports mostly present positive results , and their quality and authenticity have consequently been called into question . We investigated the adequacy of r and omization  of clinical trials published in recent years in China to determine how many of them met acceptable st and ards for allocating participants to treatment groups . Methods The China National Knowledge Infrastructure electronic data base was search ed for reports of r and omized controlled trials on 20 common diseases published from January 1994 to June 2005 . From this sample , a subset of trials that appeared to have used r and omization methods was selected . Twenty-one investigators trained in the relevant knowledge , communication skills and quality control issues interviewed the original authors of these trials about the participant r and omization methods and related quality -control features of their trials . Results From an initial sample of 37,313 articles identified in the China National Knowledge Infrastructure data base , we found 3137 apparent r and omized controlled trials . Of these , 1452 were studies of conventional medicine ( published in 411 journals ) and 1685 were studies of traditional Chinese medicine ( published in 352 journals ) . Interviews with the authors of 2235 of these reports revealed that only 207 studies adhered to accepted methodology for r and omization and could on those grounds be deemed authentic r and omized controlled trials ( 6.8 % , 95 % confidence interval 5.9–7.7 ) . There was no statistically significant difference in the rate of authenticity between r and omized controlled trials of traditional interventions and those of conventional interventions . R and omized controlled trials conducted at hospitals affiliated to medical universities were more likely to be authentic than trials conducted at level 3 and level 2 hospitals ( relative risk 1.58 , 95 % confidence interval 1.18–2.13 , and relative risk 14.42 , 95 % confidence interval 9.40–22.10 , respectively ) . The likelihood of authenticity was higher in level 3 hospitals than in level 2 hospitals ( relative risk 9.32 , 95 % confidence interval 5.83–14.89 ) . All r and omized controlled trials of pre-market drug clinical trial were authentic by our criteria . Of the trials conducted at university-affiliated hospitals , 56.3 % were authentic ( 95 % confidence interval 32.0–81.0 ) . Conclusion Most reports of r and omized controlled trials published in some Chinese journals lacked an adequate description of r and omization . Similarly , most so called ' r and omized controlled trials ' were not real r and omized controlled trials owing toa lack of adequate underst and ing on the part of the authors of rigorous clinical trial design . All r and omized controlled trials of pre-market drug clinical trial included in this research were authentic . R and omized controlled trials conducted by authors in high level hospitals , especially in hospitals affiliated to medical universities had a higher rate of authenticity . That so many non-r and omized controlled trials were published as r and omized controlled trials reflected the fact that peer review needs to be improved and a good practice guide for peer review including how to identify the authenticity of the study urgently needs to be developed BACKGROUND Although predominant negative symptoms of schizophrenia can be severe enough to cause persistent impairment , effective treatment options are lacking . We aim ed to assess the new generation antipsychotic cariprazine in adult patients with predominant negative symptoms . METHODS In this r and omised , double-blind , phase 3b trial , we enrolled adults aged 18 - 65 years with long-term ( > 2 year ) , stable schizophrenia and predominant negative symptoms ( > 6 months ) at 66 study centres ( mainly hospitals and university clinics , with a small number of private practice s ) in 11 European countries . Patients were r and omly assigned ( 1:1 ) by an interactive web response system to 26 weeks of monotherapy with fixed-dose oral cariprazine ( 3 mg , 4·5 mg [ target dose ] , or 6 mg per day ) or risperidone ( 3 mg , 4 mg [ target dose ] , or 6 mg per day ) ; previous medication was discontinued over 2 weeks . The primary outcome was change from baseline to week 26 or end of treatment on the Positive and Negative Syndrome Scale factor score for negative symptoms ( PANSS-FSNS ) analysed in a modified intention-to-treat population of patients who had follow-up assessment s within 5 days after last receipt of study drugs with a mixed-effects model for repeated measures . Safety was assessed in all patients who received at least one dose of study drug . This study is registered with EudraCT , number 2012 - 005485 - 36 . FINDINGS Between May 27 , 2013 , and Nov 17 , 2014 , 533 patients were screened and 461 ( 86 % ) patients were r and omised to treatment ( 230 for cariprazine and 231 for risperidone )  ; 460 were included in the safety population ( one patient discontinued before study drug intake ) . 227 ( 99 % ) of 230 patients in the cariprazine group and 229 ( 99 % ) of 230 patients in the risperidone group were included in the modified intention-to-treat population ( 178 [ 77 % ] in each group completed 26 weeks of treatment ) . Mean daily doses were 4·2 mg ( SD 0·6 ) for cariprazine and 3·8 mg ( 0·4 ) for risperidone . Treatment-emergent adverse events ( eg , insomnia , akathisia , worsening of schizophrenia , headache , anxiety ) were reported in 123 ( 54 % ) patients treated with cariprazine and 131 ( 57 % ) patients treated with risperidone . Use of cariprazine led to a greater least squares mean change in PANSS-FSNS from baseline to week 26 than did risperidone ( -8·90 points for cariprazine vs -7·44 points for risperidone ; least squares mean difference -1·46 , 95 % CI -2·39 to -0·53 ; p=0·0022 ; effect size 0·31 ) . One patient in the risperidone group died of a cause regarded as unrelated to treatment . INTERPRETATION Our results support the efficacy of cariprazine in the treatment of predominant negative symptoms of schizophrenia . FUNDING Gedeon Richter Plc The study investigated the non-inferiority of flupentixol compared to risperidone in the treatment of negative symptoms . In addition , the effects of flupentixol on mood and cognitive symptoms were explored . In a r and omized , double-blind multicenter study , 144 non-acute schizophrenia patients with predominant negative symptoms were treated with a flexible dose of either flupentixol ( 4 - 12 mg/d ) or risperidone ( 2 - 6 mg/d ) for up to 25 weeks . In addition to a non-inferiority analysis , a principal component analysis ( PCA ) of the PANSS was performed post hoc . Regarding negative symptoms , flupentixol proved to be non-inferior to risperidone . Both drugs improved depressed mood with effect sizes favoring flupentixol . PCA suggested a five-factor structure . Effect sizes for the cognitive factor were up to 0.74 for flupentixol and up to 0.80 for risperidone .  EPS scores were rather low and Parkinsonism improved in both groups , but anticholinergic drugs were prescribed significantly more frequently in the flupentixol group , which generally showed significantly more adverse events . Results indicate that the 1st generation antipsychotic flupentixol  improves negative , affective and cognitive symptoms in chronic schizophrenia comparable to risperidone . Further studies should confirm the latter using neuropsychological performance tests and should investigate whether tolerability improves with a markedly lower dose range OBJECTIVE To discuss the quality of r and omized controlled trials ( RCTs ) in Chinese herbal medicine ( CHM ) with respect to design and methodology , and provide suggestions for further improvement in future clinical trials . METHODS A search of the Cochrane Library was conducted to identify RCTs of CHM on line in July 2005 .  Quality of the RCTs was assessed using a 11-item checklist modified from the revised CONSORT statement , with 2 items specific to CHM ( i.e. herb preparation form and quality control of herbs ) . RESULTS The search yielded 167 RCTs that were selected for assessment . All trials included statements about the interventions , objectives , primary outcome design , statistical methods , and herb preparation form . Although 163 ( 97.6 % ) trials reported inclusion criteria , exclusion criteria were only reported in 26 ( 15.6 % ) trials . Fewer than 10 % of trials clearly stated the r and om allocation sequence generation methods , and only 2.4 % mentioned allocation concealment . The vast majority ( 86.8 % ) of trials were open-label , while only 13.2 % used blinding . Almost half ( 45.5 % ) administered the CHM intervention as a tea or decoction . Only one trial ( 0.6 % ) reported a sample size calculation , and a single trial ( 0.6 % ) discussed quality control of the CHM intervention . CONCLUSION The overall method ologic quality of RCTs in CHM was poor . It is essential to improve the design of future RCTs in this clinical area . RECOMMENDATIONS ( 1 ) Investigator conducting RCTs should have formal training about clinical trial design ; ( 2 ) A flow chart is recommended to ensure that all essential steps of clinical trial design are included . ( 3 ) Conducting pilot studies prior to RCTs may help improve their design ; ( 4 ) Registration of clinical trials and publishing their protocol s prior to enrollment may reduce publication bias and solicit peer review s of the proposed design ; ( 5 ) Collaboration between CHM investigators and traditional medicine academic research centers interested in integrative medicine may lead to quality improvement of RCTs of CHM BACKGROUND The efficacy of low doses of certain neuroleptics in improving negative symptoms is still controversial . This study assessed the efficacy of amisulpride , a benzamide which increases dopaminergic transmission at low doses via presynaptic dopamine receptor blockade , on negative symptoms of schizophrenia . METHOD The study was design ed as a parallel-group , double-blind , placebo-controlled trial . Patients had to fulfil DSM-III criteria for schizophrenia , And reasen 's criteria for negative schizop 
    Output:
    
Overall , studies in prominent negative symptoms were potentially more confounded by improvements of secondary negative symptoms .
InterpretationAmisulpride is the only antipsychotic that outperformed placebo in the treatment of predominant negative symptoms , but there was a parallel reduction of depression .
Cariprazine was better than risperidone in a large trial that was well-controlled for secondary negative symptoms , but the trial was sponsored by its manufacturer .