***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: Background and Aim : Chronic abdominal pain ( AP ) is common in children .  Recall of symptoms is used clinical ly to determine management , to assess treatment progress , and in drug studies to assess outcomes . Limited data exist on accuracy of AP recall in children . The aim of the present study was to assess ability to accurately recall AP  in children . Methods : The study was a secondary analysis of data obtained from a double-blind , r and omized , placebo-controlled trial , evaluating amitriptyline in children with functional gastrointestinal disorders . Children ages 8 to 17 years with AP predominant functional gastrointestinal disorders based on Rome II criteria were recruited from 6 centers . Those with evidence of organic disease were excluded . Patients maintained AP diary daily for 1 month ( presence , frequency , and intensity ) . At the end of the study , patients reported the number of days of AP  during previous month . Agreement between daily pain reports and recalled pain was assessed . Univariate analysis was conducted with Spearman rank correlations . Results : We recruited 63 children ( 45 girls , mean age 12.8 years ) . Sixteen percent children had perfect agreement on number of days of AP . Fifty-four percent of children recalled fewer episodes of pain . The average number of days with AP by recall was 17.7/month , whereas by diary it was 23.5/month ( P = 0.001 ) . Correlation between patient recall of the last week of symptoms ( r = 0.47 ) was no better than correlation between recall of the last 30 days of symptoms ( r = 0.48 ) . On comparing AP recall versus various pain intensities , reported AP did not reflect only AP of greater severity . Higher correlation of recall of symptoms was seen in children 11 years or younger ( r = 0.59 ) as compared with children older than 11 years ( r = 0.26 ) . Conclusions : Few children can accurately recall the episodes of AP . Children commonly recall a lower frequency of AP than that assessed by prospect i ve diary reports . Reported recall does not reflect a shorter re collection period . Recall is not related to intensity of pain . Adolescents have worse recall of symptoms Objective : Aerophagia is a functional gastrointestinal disorder characterised by repetitive air swallowing , abdominal distension , belching , and flatulence . In severe cases , it can lead to pneumoperitonium , volvulus of the colon , and intestinal perforation . Little is known about the epidemiology and clinical profile of affected children . The main objective of the present study was to assess the epidemiology of aerophagia in 10- to 16-year-olds in Sri Lanka . Methods : A school-based cross-sectional survey was conducted in 8 r and omly selected schools in 4 r and omly selected provinces in Sri Lanka . Data were collected using a pretested , self-administered question naire , which was distributed in an examination setting and collected on the same day . Trained research assistants were present during completion of the question naire , for any required clarification . Aerophagia was diagnosed using the Rome III criteria . Results : In the present study , aerophagia was seen in 163 ( 7.5 % ) of the 2163 children evaluated . The prevalence was higher in older children ( 10.5 % in 15-year-olds ) and no sex difference was observed ( boys 8.2 % vs girls 6.8 % , P > 0.05 ) . Intestinal-related ( abdominal pain , nausea , and anorexia ) and extraintestinal symptoms ( headache , limb pain , sleeping difficulty , photophobia , and lightheadedness ) were more prevalent among affected children ( P < 0.05 ) . A higher percentage of affected children were found to be exposed to stressful events when compared with controls ( P < 0.05 ) . Conclusions : The present study highlights the high prevalence of aerophagia among Sri Lankan children and adolescents . This condition is more common in those exposed to emotional stress . Intestinal-related symptoms and extraintestinal somatic symptoms are frequently seen in affected children AIM To evaluate the clinical presentation , response to prophylactic therapy and outcome of children with cyclic vomiting syndrome ( CVS ) in Shiraz , Iran . METHODS During a period of 11 years ( March 1994 to March 2005 ) , 181 consecutive children with a final diagnosis of CVS were evaluated , treated and followed in our center . Patients were r and omized to receive either amitriptyline or propranolol as prophylactic treatments . RESULTS There were 88 boys and 93 girls with mean age of onset of symptoms of 4.9 + /- 3.3 years ( range , neonatal period to 14 years ) , the mean age at final diagnosis was 6.9 years ( range , 1.5 to 14 ) , and the mean duration between the onset of the first attack  and the final diagnosis of CVS was 2 + /- 1.81 years ( range , 1/6 to 8) . The mean duration of each attack was 4.26 days ( range , from few hours to 10 d ) and the mean interval between the attacks was 1.8 mo ( range , 1 wk to 12 mo ) . The time of onset of the attacks was midnight to early morning in about 70 % of cases . Amitriptyline was effective in 46 out of 81 ( 56 % ) patients ( P < 0.001 ) . Propranolol appeared to have a superior action and was effective in 74 out of 83 ( 92 % ) patients ( P < 0.0001 ) . CONCLUSION There is a significant lag time between the onset of clinical symptoms and the final diagnosis of CVS in our area . In patients with typical clinical presentations of CVS , who are examined by an experienced physician , invasive workup is not necessary . Propranolol appears more effective than amitriptyline for prophylactic use in children with CVS BACKGROUND To date , no patient reported outcomes ( PRO ) instrument is available for evaluation of treatment efficacy in functional dyspepsia (FD)/postpr and ial distress syndrome ( PDS ) . The aim of our study was to perform focus group interviews for the development of a new question naire for assessing symptom pattern and severity in PDS . METHODS R and om ambulatory patients diagnosed with FD/PDS based on Rome III criteria and no predominant gastro-esophageal reflux disease ( GERD ) symptoms were invited to participate . Focus group sessions were organized where patients reported and discussed their symptoms , facilitated by an experienced physician . After reaching saturation of identified symptom items , questions for a pilot PRO instrument were drafted and evaluated in cognitive interviews for relevance , clarity , and consistency . KEY RESULTS Of 225 screened patients , 26 patients were diagnosed with PDS without overlapping GERD as single final diagnosis . Fifteen of these ( 87 % female , 48 ± 3.2 years ) participated in one of three focus groups . All ( 100 % ) confirmed experiencing symptoms that were triggered or aggravated by ingestion of a meal , corresponding to early satiation ( 100 % ) , and postpr and ial fullness ( 100 % ) . In addition reported gastroduodenal symptoms were nausea ( 40 % , postpr and ial in all , interpr and ial in 20 % ) , upper abdominal bloating ( 33 % ) , excessive belching ( 27 % ) , and vomiting ( 13 % ) . Epigastric pain and burning were present in respectively 20 % and 13 % . Non-gastroduodenal symptoms that patients reported included heartburn ( 33 % , but mostly sporadic ) , weight loss ( 93 % , on average 5.0 ± 1.7 kg ) , and fatigue ( 67 % ) . Questions evaluating these symptoms were vali date d in 15 cognitive interviews . CONCLUSIONS & INFERENCES This focus group study confirms symptoms corresponding to postpr and ial fullness and early satiation as the key items for developing a PRO for PDS Most systematic review s rely substantially on the assessment of the method ological quality of the individual trials . The aim of this study was to obtain consensus among experts about a set of generic core items for quality assessment of r and omized clinical trials ( RCTs ) . The invited participants were experts in the field of quality assessment of RCTs . The initial item pool contained all items from existing criteria lists . Subsequently , we reduced the number of items by using the Delphi consensus technique . Each Delphi round comprised a question naire , an analysis , and a feedback report . The feedback report included staff team decisions made on the basis of the analysis and their justification . A total of 33 international experts agreed to participate , of whom 21 completed all question naires . The initial item pool of 206 items was reduced to 9 items in three Delphi rounds . The final criteria list ( the Delphi list ) was satisfactory to all participants . It is a starting point on the way to a minimum reference st and ard for RCTs on many different research topics . This list is not intended to replace , but rather to be used alongside , existing criteria lists AIM To look at predictors of consulting behaviour among children with recurrent abdominal pain in a rural community in Malaysia . SUBJECTS AND METHODS A sample of 1462 school-children aged between 9 and 15 years were r and omly selected from all schools in Kuala Langat , a rural district in Malaysia . Those with recurrent abdominal pain , defined according to Apley 's criteria , were recruited and divided into consulters and non-consulters . A consulter was defined as a child who had sought the help of a medical practitioner at least once in the past year for recurrent abdominal pain . A detailed clinical , social and family history was obtained in all recruited children . RESULTS A total of 161 children were recruited : 78 ( 48.4 % ) consulters , 83 ( 51.6 % ) non-consulters . Of the consulters , 40 were boys , 38 were girls ( male : female ratio = 1.1:1 ) . The two sexes did not show a significant difference in prevalence of consulters [ p=0.189 ) . Of the ethnic groups , only Indians had a significantly higher likelihood to consult a doctor ( Indians , p=0.006 ; Malays , p=0.742 ; Chinese , p=0.050 ] . Younger children ( under 12 years ) had a significantly higher chance of having been brought to see a medical practitioner ( p=0.014 ) . Children in whom age of onset of abdominal pain was below ten years were also more likely to have been seen by a doctor ( p=0.012 ) . Children who had consulted a doctor were more likely to be missing school because of abdominal pain ( p<0.001 ) . Pain severity was not a significant factor ( p=0.429 ) . Multiple logistic regression analysis revealed that the only variable that remained significantly associated with health-care consultation  was school absence ( p<0.001 ) . CONCLUSIONS Children who saw their doctors for recurrent abdominal pain were also more likely to be those who missed school on account of abdominal pain . Following multiple regression analysis , other factors were no longer significant OBJECTIVES : Functional GI disorders ( FGIDs ) are common in clinical practice , but little is known about the epidemiology of these disorders in the general population . We aim ed to determine the prevalence , association with psychological morbidity , and health care seeking behavior of FGIDs in the population . METHODS : A r and om sample of subjects ( n = 4500 ) aged ≥18 yr and representative of the Australian population were mailed a vali date d question naire . For these subjects we measured all Rome I GI symptoms and physician visits over the past 12 months , as well as neuroticism , anxiety , depression , and somatic distress . RESULTS : The response rate for the study was 72 % . The prevalence of any FGID was 34.6 % , and 62.1 % of these subjects had consulted a physician . There was considerable overlap of the FGIDs ( 19.2 % had more than two disorders ) . Independent predictors for an FGID diagnosis were neuroticism , somatic distress , anxiety , bowel habit disturbance , abdominal pain frequency , and increasing age . However , psychological morbidity did not independently discriminate between consulters and nonconsulters with an FGID . CONCLUSIONS : More than one third of the general population have one or more FGIDs . There seems to be a modest link between psychological morbidity and FGIDs , although other unknown factors seem to be more important in explaining health care seeking for these disorders Objectives : Irritable bowel syndrome is a multisymptom construct , with abdominal pain ( AP ) acting as the driving symptom of patient-reported severity . The Food and Drug Administration considers a > 30 % decrease in AP as satisfactory improvement , but this has not been vali date d in children . We investigated the correspondence of 2 measures for AP assessment , ≥30 % improvement in AP and global assessment of improvement . Methods : Secondary analysis of data from 72 children who completed a r and omized clinical trial for abdominal pain – associated functional gastrointestinal disorders . Children completed daily assessment of AP intensity , functional disability inventory ( FDI ) , question regarding pain 's interference with activities , and 2 global assessment questions . We measured the extent to which ≥30 % improvement of AP and global assessment questions correlated with each other and with disability . Results : The global questions correlated with each other ( r = 0.74 ; P < 0.0001 ) and with a ≥30 % improvement in AP ( P < 0.01 ) . Global outcomes were satisfaction with treatment was inversely related to the child 's report of interference with activities ( P < 0.01 ) and symptom relief was positively associated with ≥3 
    Output:
    
CONCLUSIONS Different outcome measures are used in therapeutic trials on functional disorders of the upper gastrointestinal tract .