***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 Statistical health risk information has been proven confusing and difficult to underst and . While existing research indicates that presenting risk information in frequency formats is superior to relative risk and probability formats , the optimal design of frequency formats is still unclear . The aim of this study was to compare presentation of multi-figure pictographs in consecutive and r and om arrangements regarding accuracy in perception and vulnerability for cognitive bias . METHODS A total of 111 patients with multiple sclerosis were r and omly assigned to two experimental conditions : patient information using 100 figure pictographs in 1 ) unsorted ( UP group ) or 2 ) consecutive arrangement ( CP group).The study experiment was framed as patient information on how risks and benefit could be explained . The information comprised two scenarios of a treatment decision with varying levels of emotional relevance . Primary outcome measure was accuracy of information recall ( errors made when recalling previously presented frequencies of benefits and side effects ) . Cognitive bias was measured as additional error appearing with higher emotional involvement . The uncertainty tolerance scale and a set of items to assess risk attribution were surveyed . RESULTS The study groups did not differ in their accuracy of recalling benefits , but recall of side effects was more accurate in the CP-group . Cognitive bias when recalling benefits was higher in the UP-group than in the CP-group and equal for side effects in both groups . RESULTS were similar in subgroup analyses of patients 1 ) with highly irrational risk attribution 2 ) with experience regarding the hypothetical contents or 3 ) with experience regarding pictograph presentation of frequencies . Overall , benefit was overestimated by more than 100 % and variance of recall was extremely high . CONCLUSIONS Consecutive arrangement as commonly used seems not clearly superior to unsorted arrangement which is more close to reality . General poor performance and the corresponding high variance of recall might have clouded existing effects of the arrangement types . More research is needed with varying proportions and other sample Background : To gain full benefit from disease-modifying therapies such as interferon & bgr;-1b , patients with multiple sclerosis ( MS ) need to adhere to treatment in the long term . Treatment adherence requires high patient satisfaction with treatment and care . Objectives : Our aim was to evaluate the satisfaction of patients with MS receiving interferon & bgr;-1b Extavia  with the  patient care program Extracare .  Efficacy and safety of treatment were evaluated as secondary objectives . Methods : In this prospect i ve , noninterventional 1-year study , data on the satisfaction of 174 patients with MS with Extracare were obtained by question naires  . Disability and symptom severity as well as patients ’ reported activity limitations , quality of life , and fatigue were recorded . Results : We observed high levels of patients ’ satisfaction with MS nurses , telephonic care , and information provided by Extracare ( values ⩽ 1.53 on a Likert scale ranging from 1 [ very good ] to 6 [ insufficient ] ) . Patient reported quality of life ( Patient Reported Indices for MS QoL ) improved from 11.82 ± 11.36 at baseline to 9.74 ± 10.94 at the end of the study ( p = .02 ) , whereas clinical parameters of disease progression remained unchanged . Rate of adverse events was as expected . Conclusions : This study provides the basis for further improvements of care programs to increase treatment adherence of patients with MS Background Presentation of confidence intervals alongside information about treatment effects can support informed treatment choices in people with multiple sclerosis . We aim ed to develop and pilot-test different written patient information material s explaining confidence intervals in people with relapsing-remitting multiple sclerosis . Further , a question naire on comprehension of confidence intervals was developed and piloted . Methods We developed different patient information versions aim ing to explain confidence intervals . We used an illustrative example to test three different approaches : ( 1 ) short version , ( 2 ) “ average weight ” version and ( 3 ) “ worm prophylaxis ” version . Interviews were conducted using think-aloud and teach-back approaches to test feasibility and analysed using qualitative content analysis . To assess comprehension of confidence intervals , a six-item multiple choice question naire was developed and tested in a pilot r and omised controlled trial using the online survey software UNIPARK . Here , the average weight version ( intervention group ) was tested against a st and ard patient information version on confidence intervals ( control group ) . People with multiple sclerosis were invited to take part using existing mailing-lists of people with multiple sclerosis in Germany and were r and omised using the UNIPARK algorithm . Participants were blinded towards group allocation . Primary endpoint was comprehension of confidence intervals , assessed with the six-item multiple choice question naire with six points representing perfect knowledge . Results Feasibility of the patient information versions was tested with 16 people with multiple sclerosis . For the pilot r and omised controlled trial , 64 people with multiple sclerosis were r and omised ( intervention group : n = 36 ; control group : n = 28 ) . More questions were answered correctly in the intervention group compared to the control group ( mean 4.8 vs 3.8 , mean difference 1.1 ( 95 % CI 0.42–1.69 ) , p = 0.002 ) . The question naire ’s internal consistency was moderate ( Cronbach 's alpha = 0.56 ) . Conclusions The pilot-phase shows promising results concerning acceptability and feasibility . Pilot r and omised controlled trial results indicate that the patient information is well understood and that knowledge gain on confidence intervals can be assessed with a set of six questions .Trial registration German Clinical Trials Register : DRKS00008561 . Registered 8th of June 2015 Purpose A patient 's willingness to consent to a procedure may be influenced by various factors , including the patient 's rapport with the physician , nonverbal cues he or she receives during the discussion of risks , and other elements of the discussion of risks . Previous reports address these influences , but the effect of the actual wording used to describe risks is unclear . The purpose of this study was to better underst and how framing the risk involved in a procedure affects a patient 's likelihood to consent to the procedure . Method In a 1997 study at the Clevel and Clinic Foundation , the authors r and omly assigned 116 patients to view one of two short videos describing angioplasty and its associated risks . Sixty-three participants viewed the first video , which framed the procedure as 99 % safe , and 53 viewed the second , which framed the likelihood of complication as 1 in 100 . Participants were then asked to rate their consent to two hypothetical treatment scenarios on a four-point Likert-type scale ( 1 = definitely , 4 = definitely not ) . Results When asked to consent to a treatment scenario that would relieve chest pain but offer no survival benefit , respondents who viewed the first video were more likely to consent than were those who viewed the second ( p < .001 ) . There was no significant difference in the two groups ' likelihoods to consent when the potential health benefit was to reduce the risk of future heart attack . Conclusion This study 's finding provides evidence that how a physician describes a procedure 's risks when obtaining a patient 's informed consent significantly influences the likelihood of consent . This fact should be considered when teaching communication skills , including interviewing and patient education skills , so that patients will be more likely to make health care decisions that are consistent with their own values and beliefs OBJECTIVE To determine the impact of the self-management training program " S.MS " for new multiple sclerosis ( MS ) patients . METHOD Multicenter , prospect i ve , quasi-experimental study with 31 MS patients in the intervention group ( training program ) and 33 participants in the control group ( CG ) ( brochures ) .  Data were collected before , after and 6 months after the interventions . Analysis of change was done by ANCOVA with repeated measurements . RESULTS At baseline , participants in CG were younger at the time of diagnosis , suffered more frequently from relapsing-remitting MS and took more MS-medication on a permanent basis . The intervention had a stable significant effect on each dimension of self-management ability , on total self-management ability ( ES=0.194 , p<0.001 ) , on anxiety ( ES=0.193 , p=0.001 ) , and on disease-specific quality of life ( ES=0.120 , p=0.007 ) . Regarding depression , a significant interaction effect of time and intervention could be observed ( ES=0.106 , p=0.011 ) . No effect was found on disease-specific knowledge . High participant acceptance was reported . CONCLUSION " S.MS " participation was associated with a significant and sustained improvement of self-management abilities , anxiety and disease-specific quality of life in a quasi-experimental study design . Using RCT or CRT- design s would be desirable to further improve the evidence of treatment effectiveness . PRACTICE IMPLICATION S This study provides substantial evidence that " S.MS " fosters patients ' self-management ability BACKGROUND The Cochrane Collaboration is strongly encouraging the use of a newly developed tool , the Cochrane Collaboration Risk of Bias Tool ( CCRBT ) , for all review groups . However , the psychometric properties of this tool to date have yet to be described . Thus , the objective of this study was to add information about psychometric properties of the CCRBT including inter-rater reliability and concurrent validity , in comparison with the Effective Public Health Practice Project Quality Assessment Tool ( EPHPP ) . METHODS Both tools were used to assess the method ological quality of 20 r and omized controlled trials included in our systematic review of the effectiveness of knowledge translation interventions  to improve the management of cancer pain . Each study assessment was completed independently by two review ers using each tool . We analysed the inter-rater reliability of each tool 's individual domains , as well as final grade assigned to each study . RESULTS The EPHPP had fair inter-rater agreement for individual domains and excellent agreement for the final grade . In contrast , the CCRBT had slight inter-rater agreement for individual domains and fair inter-rater agreement for final grade . Of interest , no agreement between the two tools was evident in their final grade assigned to each study . Although both tools were developed to assess ' quality of the evidence ' , they appear to measure different constructs . CONCLUSIONS Both tools performed quite differently when evaluating the risk of bias or method ological quality of studies in knowledge translation interventions for cancer pain . The newly introduced CCRBT assigned these studies a higher risk of bias . Its psychometric properties need to be more thoroughly vali date d , in a range of research fields , to underst and fully how to interpret results from its application BACKGROUND People with multiple sclerosis ( MS ) are confronted with a number of important uncertainties concerning many aspects of the disease . These include diagnosis , prognosis , disease course , disease-modifying therapies , symptomatic therapies , and non-pharmacological interventions , among others . While people with MS dem and adequate information to be able to actively participate in medical decision making and to self manage their disease , it has been shown that patients ' disease-related knowledge is poor , therefore guidelines recommend clear and concise high- quality information at all stages of the disease . Several studies have outlined communication and information deficits in the care of people with MS . However , only a few information and decision support programmes have been published . OBJECTIVES The primary objectives of this up date d review was to evaluate the effectiveness of information provision interventions  for people with MS that aim to promote informed choice and improve patient-relevant outcomes , Further objectives were to evaluate the components and the developmental processes of the complex interventions used , to highlight the quantity and the certainty of the research evidence available , and to set an agenda for future research . SEARCH METHODS For this up date , we search ed the Cochrane Multiple Sclerosis and Rare Diseases of the Central Nervous System Group Specialised Register , which contains trials from CENTRAL ( the Cochrane Library 2017 , Issue 11 ) , MEDLINE , Embase , CINAHL , LILACS , PEDro , and clinical trials registries ( 29 November 2017 ) as well as other sources . We also search ed reference lists of identified articles and contacted trialists . SELECTION CRITERIA R and omised controlled trials ( RCTs ) , cluster-r and omised controlled trials , and quasi-r and omised trials comparing information provision for people with MS or suspected MS ( intervention groups ) with usual care or other types of information provision ( control groups ) were eligible . DATA COLLECTION AND ANALYSIS Two review authors independently assessed the retrieved articles for relevance and method ological quality and extracted data . Critical appraisal of studies addressed the risk of selection bias , performance bias , attrition bias , and detection bias . We contacted authors of relevant studies for additional information . MAIN RESULTS We identified one new RCT ( 73 participants ) , which when added to the 10 previously included RCTs result ed in a total of 11 RCTs that met the inclusion criteria and were analysed ( 1387 participants overall ; mean age , range : 31 to 51 ; percentage women , range : 63 % to 100 % ; percentage relapsing-remitting MS course , range : 45 % to 100 % ) . The interventions addressed a variety of topics using different approaches for information provision in different setting s. Topics included disease-modifying therapy , relapse management , self care strategies , fatigue management , family planning , and general health promotion . The active intervention components included decision aids , decision coaching , educational programmes , self care programmes , and personal interviews with physicians . All studies used one or more components , but the number and extent differed markedly between studies . The studies had a variable risk of bias . We did not perform meta-analyses due to marked clinical heterogeneity . All five studies assessing MS-related knowledge ( 505 participants ; moderate-certainty evidence ) detected significant differences between groups as a result of the interventions , indicating that information provision may successfully increase participants ' knowledge . There were mixed results on decision making ( five studies , 793 participants ; low-certainty evidence ) and quality of life ( six studies , 671 participants ; low-certainty evidence ) . No adverse events were detected in the seven studies reporting this outcome . AUTHORS ' CONCLUSIONS Information provision for people with MS seems to increase disease-related knowledge , with less clear results on decision making and quality of life . The included studies in this review reported no negative side effects of providing disease-related information 
    Output:
    
MS patients favoured the interventions they received .
Underst and ing of overall treatment information and treatment risks specifically , generally improved following interventions .
Yet overestimation of treatment benefits persisted .
There was no conclusive effect on DMD decisions .
No superior intervention was identified .
Interventions design ed to improve underst and ing of DMD risk and benefit information are moderately successful .
PRACTICE IMPLICATION S Additional support provided to MS patients beyond routine healthcare can generally improve underst and ing of the complex risk-benefit profiles of DMDs .