***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: OBJECTIVE This study examined the impact of a brief pain communication/education intervention on patient outcomes in breast cancer . We hypothesized that our intervention would improve patient communication and reduce misconceptions ( " Barriers " ) concerning pain management , and that patients with lower Barriers , or who perceived their physician as being more facilitative and receptive , would report better outcomes . METHODS Female breast cancer patients with persistent pain ( n=89 ) were r and omly assigned to either a 30-min in-person pain education/communication intervention or control condition and followed for 12 weeks . RESULTS Intervention group patients reported a significant decrease in pain Barriers but not in other outcomes . Overall , patients with lower barrier scores reported less distress and better emotional well-being . Patients who scored higher in active communication ( e.g. , asking questions , giving information ) reported fewer Barriers and better pain relief . Individuals who perceived their physicians as being more receptive reported better pain management while those who perceived their physicians as being both more receptive and facilitative were more satisfied with their health care . CONCLUSION A brief education/communication intervention reduced patients '  Barriers to pain management but did not impact other patient outcomes . PRACTICAL IMPLICATION S Pain outcomes may be improved by addressing patients ' pain misconceptions and emphasizing a receptive and responsive communication style This quasi-experimental longitudinal study documented the impact of a comprehensive cancer informational intervention using information technology on healthcare service use among individuals newly diagnosed with cancer . Women with breast cancer ( n = 205 ) and men with prostate cancer ( n = 45 ) were recruited within 8 weeks of diagnosis at 4 university teaching hospitals in Montreal , Quebec , Canada . The intervention group ( n = 148 ) received a 1-hour training on information technology use , a CD-ROM on cancer , and a list of reputable cancer-related Web sites . The intervention material was available for a period of 8 weeks . The control group ( n = 102 ) received usual care .  Self-reported question naires were completed at T1 ( baseline ) , T2 ( 1 week after intervention ) , and T3 ( 3 months after intervention ) . Using multivariate statistics , the experimental group reported significantly more satisfaction with cancer information received compared to the control group . No significant differences were found between experimental and control groups in their reliance on healthcare services . However , women as opposed to men spent more time with nurses , were more satisfied with cancer information received , and relied more heavily on health services . Future research would explore whether the latter observations reflect genuine sex differences or are more contingent on the specific cancer diagnosis OBJECTIVE The purpose of this trial was to compare usual patient education plus the Internet-based Personal Patient Profile-Prostate , vs. usual education alone , on conflict associated with decision making , plus explore time-to-treatment , and treatment choice . METHODS A r and omized , multi-center clinical trial was conducted with measures at baseline , 1- , and 6 months . Men with newly diagnosed localized prostate cancer ( CaP ) who sought consultation at urology , radiation oncology , or multi-disciplinary clinics in 4 geographically-distinct American cities were recruited . Intervention group participants used the Personal Patient Profile-Prostate , a decision support system comprised of customized text and video coaching regarding potential outcomes , influential factors , and communication with care providers . The primary outcome , patient-reported decisional conflict , was evaluated over time using generalized estimating equations to fit generalized linear models . Additional outcomes , time-to-treatment , treatment choice , and program acceptability/usefulness , were explored . RESULTS A total of 494 eligible men were r and omized ( 266 intervention ; 228 control ) . The intervention reduced adjusted decisional conflict over time compared with the control group , for the uncertainty score ( estimate -3.61 ; ( confidence interval , -7.01 , 0.22 ) , and values clarity ( estimate -3.57 ; confidence interval ( -5.85,-1.30 ) . Borderline effect was seen for the total decisional conflict score ( estimate -1.75 ; confidence interval ( -3.61,0.11 ) . Time-to-treatment was comparable between groups , while undecided men in the intervention group chose brachytherapy more often than in the control group . Acceptability and usefulness were highly rated . CONCLUSION The Personal Patient Profile-Prostate is the first intervention to significantly reduce decisional conflict in a multi-center trial of American men with newly diagnosed localized CaP. Our findings support efficacy of P3P for addressing decision uncertainty and facilitating patient selection of a CaP treatment that is consistent with the patient values and preferences OBJECTIVE To evaluate an entertainment-based patient decision aid for early stage breast cancer surgery in low health literacy patients . METHODS Newly diagnosed female patients with early stage breast cancer from two public hospitals were r and omized to receive an entertainment-based decision aid for breast cancer treatment along with usual care ( intervention arm ) or to receive usual care only ( control arm ) . Pre-decision ( baseline ) , pre-surgery , and 1-year follow-up assessment s were conducted . RESULTS Patients assigned to the intervention arm of the study were more likely than the controls to choose mastectomy rather than breast-conserving surgery ;  however , they appeared better informed and clearer about their surgical options than women assigned to the control group . No differences in satisfaction with the surgical decision or the decision-making process were observed between the patients who viewed the intervention and those assigned to the control group . CONCLUSIONS Entertainment education may be a desirable strategy for informing lower health literate women about breast cancer surgery options . PRACTICE IMPLICATION S Incorporating patient decision aids , particularly computer-based decision aids , into st and ard clinical practice remains a challenge ; however , patients may be directed to view programs at home or at public locations ( e.g. , libraries , community centers ) There are a number of impulses towards public participation in health care decision making including instrumentalist , communitarian , educative and expressive impulses and the desire for increased accountability . There has , however , been little research looking systematic ally at the public 's preferences for being involved in particular types of rationing decisions , nor indeed , has there been a critical examination of the degree of involvement desired by the public . The research reported here uses findings from focus groups and in-depth interviews to explore these questions . Eight focus groups were conducted with a total of 57 informants , four amongst r and omly selected members of the public and four with informants from health and non-health related organisations . Nineteen interviews were conducted to allow the elaboration of focus group comments , to probe views more deeply and to pursue emerging themes . The findings show variations in the willingness of members of the public to be involved in health care decisions and consistency across the different forms of the public as represented by the focus groups with r and omly selected citizens and pre-existing organisations . There was a strong desire in all the groups for the public to be involved both at the system and programme levels , with much less willingness to be involved at the individual level . At the system and programme levels informants generally favoured consultation , without responsibility for decisions , but with the guarantee that their contribution would be heard and that decisions taken following consultation would be explained . At the patient level informants felt that the public should participate only by setting criteria for deciding between potential beneficiaries of treatment . The public has much to contribute , particularly at the system and programme levels , to supplement the inputs of health care professionals OBJECTIVE To determine the effectiveness of a pictorial ' mind map ' together with the Arthritis Research Campaign ( ARC ) booklet for imparting knowledge to participants with rheumatoid arthritis ( RA ) . Also , we wished to relate this to their reading ability . METHODS We studied 363 participants with RA . Reading ability was assessed using the REALM , and knowledge was assessed using the Knowledge Scale Question naire ( KSQ ) . Information on educational attainment , disease state and levels of anxiety and depression was also collected . Participants were r and omly assigned to receive either the ARC booklet alone or the booklet and the mind map together . RESULTS A significant minority ( 15 % ) of participants were functionally illiterate .  There was a statistically significant increase in knowledge across both groups from baseline to re assessment after they were given the literature , but there was no difference in attainment between the groups . The more literate participants gained more knowledge regardless of the information they were given . They were also significantly less anxious and less depressed . CONCLUSIONS The ARC booklet with or without the mind map was associated with a significant increase in knowledge .  Poor readers had poor educational attainment and poor knowledge acquisition . The information on the mind map was not more accessible to them . Different educational strategies will be necessary to educate these patients OBJECTIVE Previous studies suggest that poorer knowledge and expectations about surgical outcomes may be responsible for low rates of total knee replacement ( TKR ) among African American males . The goal of this study was to pilot test the scope , acceptability , and efficacy of an educational videotape and tailored TKR decision aid design ed to reduce disparities in TKR knowledge and expectations . METHODS African American and Caucasian male veteran volunteers ages 55 - 85 years with moderate to severe knee osteoarthritis ( OA ) were recruited . During group meetings , patients viewed a video about knee OA treatments and were provided a personalized arthritis report that presented predicted patient outcomes should they decide to undergo TKR . Patients completed baseline and postintervention question naires that included an adapted Western Ontario and McMaster Universities Osteoarthritis Index ( WOMAC ) instrument to measure post-TKR expectations ( 0 - 100 scale with higher scores reflecting poorer outcomes ) . RESULTS A total of 102 patients ( 54 African American , 48 Caucasian ) completed the baseline survey and 64 patients attended the intervention . There were no significant differences by race between patients completing and those dropping out of the study . At baseline ( n = 102 ) , African American patients expressed lower expectations about post-TKR outcomes than did Caucasian patients for both pain ( WOMAC score 41 versus 34 ; P = 0.18 ) and physical function expectations ( WOMAC score 38 versus 30 ; P = 0.13 ) . Among African Americans who underwent the intervention , expected pain and physical function improved to 31 ( P = 0.04 versus baseline ) and 30 ( P = 0.09 versus baseline ) , respectively . Caucasian patients ' expectations changed little . CONCLUSION Disparities in baseline knowledge and expectations about TKR may be improved with the combined educational video and tailored decision aid A r and omized posttest-only double blind design was used to pilot test the effect of a virtual practitioner pain communication coach on older adults ' communication of their osteoarthritis pain . Baseline pain intensity and pain interference with activities were measured using the Brief Pain Inventory Short Form .  Thirty older adults watched a video of a practitioner describing important osteoarthritis pain information followed by either a virtual practitioner coach , a video practitioner coach , or no coach . Participants were next asked , via a videotaped health care practitioner , to orally describe their pain as if speaking to their own practitioner . The amount of important distinctive pain information described by the older adults was audiotaped , transcribed , content analyzed , and summed using a priori criteria from the American Pain Society osteoarthritis pain management guidelines . Older adults described M=6.3 ( SD=3.17 ) , M=3.0 ( SD=2.08 ) , and M=5.2 ( SD=2.40 ) items of important pain information as a result of the virtual coach , video coach , and no coach conditions , respectively ; F(2,25)=3.17 , p=.06 , η²=.01 . Older adults who practice d talking with the virtual coach described more than one additional item of important pain information . The clinical ly significant group difference supports the need to test the intervention in a r and omized clinical trial . The virtual coaching and education intervention might enable older adults to communicate their pain management information more effectively to their practitioners PURPOSE Breast cancer ( BC ) decision aid ( DA ) r and omized studies are limited to DA use in consultations among Western population s and for primary surgery . Their effectiveness beyond consultations , for reconstructive surgery and in other population s , has not been evaluated . We developed a DA administered after consultation for Chinese women deciding on BC surgery and , where relevant , immediate breast reconstruction , which was evaluated in this r and omized controlled trial ( RCT ) . PATIENTS AND METHODS Overall , 276 women considering BC surgery for early-stage BC were r and omly assigned to receive a DA ( take-home booklet ) or the st and ard information booklet ( control condition ) after the initial consultation , wherein surgeons disclosed the diagnosis and discussed treatment options with patients . Using block r and om assignment by week , 138 women were assigned to the DA arm and 138 to the control arm . Participants completed interview-based question naires 1 week after consultation and then 1 , 4 , and 10 months after surgery . Primary outcome measures were decisional conflict , decision-making difficulties , BC knowledge 1 week after consultation , and decision regret 1 month after surgery . Secondary outcome measures were treatment decision , decision regret 4 and 10 months after surgery , and postsurgical anxiety and depression . RESULTS The DA group reported significantly lower decisional conflict scores 1 week after consultation ( P = .016 ) compared with women in the control arm . Women receiving the DA had significantly lower decision regret scores 4 ( P = .026 ) and 10 months ( P = .014 ) after surgery and lower depression scores 10 months after surgery ( P = .001 ) . CONCLUSION This RCT demonstrated DAs may benefit Chinese patients in Hong Kong by reducing decisional conflict and subsequent regret and enhance clinical services for this population OBJECTIVE Studies have shown that patients with knee pain are not well informed of their potential treatment options and that patient preferences are often discordant with physician practice s. The objective of this pilot study was to test the efficacy of a computer tool to improve informed decision-making for patients with knee pain in an outpatient primary care clinic setting . M 
    Output:
    
Conclusions Single interventions involving print material achieved beneficial outcomes as did more complex interventions .