human
***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: Delay in follow-up after an abnormal mammogram is associated with advanced disease stage , poorer survival , and increased anxiety . Despite the implementation of many patient navigator programs across the country , there are few published , peer- review ed studies documenting its effectiveness . We tested the effectiveness of a patient navigator in improving timeliness to diagnosis , decreasing anxiety , and increasing satisfaction in urban minority women after an abnormal mammogram . Women with suspicious mammograms were r and omly assigned to usual care ( N = 50 ) or usual care plus intervention with a patient navigator ( N = 55 ) . There were no demographic differences between the two groups . Women in the intervention group had shorter times to diagnostic resolution ( mean 25.0 vs. 42.7 days ; p = .001 ) , with 22 % of women in the control group without a final diagnosis at 60 days vs. 6 % in the intervention group . The intervention group also had lower mean anxiety scores ( decrease of 8.0 in intervention vs. increase of 5.8 in control ; p < .001 ) , and higher mean satisfaction scores ( 4.3 vs. 2.9 ; p < .001 ) . Patient navigation is an effective strategy to improve timely diagnostic resolution , significantly decrease anxiety , and increase patient satisfaction among urban minority women with abnormal mammograms Women with breast cancer express the greatest need for counseling at the time of diagnosis and report that the intervention they want is to be able to speak with someone who has the same cancer , but has lived through the crisis of treatment and is leading a ' normal ' life . We conducted an observational study of a 6-month peer-counseling intervention testing outcomes for both newly diagnosed women ( Sojourners ) and peer counselors ( Navigators )  as a first step toward the goal of validating a peer navigator program . Significant improvement in the Sojourners was observed in trauma symptoms , emotional well-being , cancer self-efficacy , and desire for information on breast cancer re sources . Navigators maintained baseline levels of the outcome variables , but increased in dissatisfaction with their interactions with their medical team and increased emotional suppression . Our findings indicate that peer navigation may halt a decline in quality of life that is commonly found in the first year following breast cancer diagnosis . In addition , Navigators were not adversely affected by their experience ; however , careful training and supervision of Navigators is crucial to overall success . R and omized clinical trials are needed to demonstrate the efficacy of peer navigator programs BACKGROUND Underutilization of breast and cervical cancer screening has been observed in many ethnic groups and underserved population s. Effective community-based interventions are needed to eliminate disparities in screening rates and thus to improve prospect s for survival . METHODS The Breast and Cervical Cancer Intervention Study was a controlled trial of three interventions in the San Francisco Bay Area from 1993 to 1996 : ( 1 ) community-based lay health worker outreach ; ( 2 ) clinic-based provider training and reminder system ; and ( 3 ) patient navigator for follow-up of abnormal screening results . Study design and a description of the interventions are reported along with baseline results of a household survey conducted in four language s among 1599 women , aged 40 - 75 . RESULTS Seventy-six percent of women ages 40 and over had had at least one mammogram , and most had had a clinical breast examination ( 88 % ) and Pap smear ( 89 % ) . Rates were significantly lower for non-English-speaking Latinas and Chinese women ( 56 and 32 % , respectively , for mammography ) , and maintenance screening ( three mammograms in the past 5 years ) varied from 7 % ( non-English-speaking Chinese ) to 53 % ( Blacks ) . Pap smear screening in the past 3 years was low among non-English-speaking Latinas ( 72 % ) and markedly lower among non-English-speaking Chinese women ( 24 % ) . The strongest predictors of screening behavior were having private health insurance and frequent use of medical services . Having a regular clinic and speaking English were also important . Race/ethnicity , education , household income , and employment status were , overall , not significant predictors of screening behavior . CONCLUSIONS These baseline results support the importance of cancer screening interventions targeted to persons of foreign origin , particularly those less acculturated Colorectal cancer ( CRC ) is the second leading cause of cancer-related deaths in the United States . Racial disparities in CRC incidence and mortality have been well documented . In addition , lower rates of CRC screening among ethnic minorities have been reported . Therefore , we tested the effectiveness of a patient navigator ( PN ) in increasing compliance with CRC screening in a minority community health setting . Men and women aged 50 or older attending a primary care practice were enrolled if they had not had a fecal occult blood test within the past year , a sigmoidoscopy or barium enema within the past 3–5 years , or a colonoscopy within the past 10 years . Participants were r and omly assigned either to receive navigator services ( PN+ ) or not to receive navigator services ( PN− ) . There were no demographic differences between the two groups . Within 6 months of physician recommendation , 15.8 % in the PN+ group had complied with an endoscopic examination , compared with only 5 % in the PN− group ( P=.019 ) . The PN+ groups also demonstrated higher rates of fecal occult blood test completion ( 42.1 % vs. 25 % , P=.086 ) . Thus , a PN system successfully increases CRC screening rates among a predominantly minority population of low socioeconomic status BACKGROUND A high rate of low-income , ethnic minority women delay or fail to keep appointments following abnormal mammograms . This study was design ed to test the effectiveness of a structured counseling and patient navigation intervention for improving follow-up rates at a large public sector medical center . METHODS This r and omized clinical trial , conducted in Los Angeles 2001 - 2002 , included 204 women with abnormal mammograms referred for follow-up who were then assigned to intervention or usual care .  The primary outcome was the rate of follow-up through diagnostic resolution within eight months . RESULTS The intervention result ed in a significant increase in the rate of adherence to follow-up through diagnostic resolution . The intervention group was much more likely to be adherent through diagnostic resolution than the control group ( 90 % vs. 66 % , OR=4.48 , p<0.001 ) and were more likely to experience timely adherence than UC patients ( 77 % vs. 57 % , OR=2.5 , p=0.01 ) . Intervention effectiveness was not significantly different for women assigned to different levels of service intensity . CONCLUSIONS Patient navigation and counseling driven by a structured clinical algorithm are highly effective strategies to improve diagnostic resolution follow-up among low-income , ethnic minority women with abnormal mammograms . The intervention algorithm and available training material s can be adapted for diverse care systems serving high-risk women to decrease loss to follow-up Rarely has utilization of genetic counseling for Hereditary Breast and Ovarian Cancer ( HBOC ) been studied separately from utilization of testing . At Kaiser Permanente Colorado , consistently only 30 % of all members referred for HBOC attend genetic counseling .  To increase the volume of genetic counseling appointments , a patient navigator approach was pilot tested in a r and omized-controlled trial over 3 months . A total of 125 members were referred for HBOC genetic counseling ( 55 r and omized to PN , 70 r and omized to usual care ) .  Utilization of referrals for Navigator-assisted members was 44 % , compared to 31 % in the usual care arm ( p=0.16 ) . The patient navigator significantly decreased time to appointment , with over 80 % of Navigator-assisted members seen for genetic counseling less than three months from referral date , compared to 32 % in usual care ( p=0.002 ) . patient navigator assistance  shortens time from referral to appointment for HBOC genetic counseling , and may increase utilization of such services Blacks have the highest cancer incidences and mortality rates in the United States . Higher mortality rates appear due to higher incidence in some sites and to later-stage diagnoses in others . To address these problems , exp and ed cancer screening in an inner-city public hospital and a patient navigator intervention were proposed . Patient navigators acted as patient advocates for patients with abnormal screening findings . One thous and thirty-four females and 102 males were screened from July 1990 through November 1992 ; seven breast cancers and one cervical cancer were found .  Patient navigators were significantly more likely to have seen patients with suspicious findings than patients with non-suspicious findings . However , even among those with suspicious findings , almost 70 % were not seen by a patient navigator . Of those navigated , 87.5 % completed recommended breast biopsies , compared with 56.6 % of the non-navigated patients . Among those with a biopsy , navigated patients did so in significantly less time than those not navigated . Navigation is one of three phases proposed to reduce cancer mortality among medically underserved population 
    Output:
    
agent
***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: Delay in follow-up after an abnormal mammogram is associated with advanced disease stage , poorer survival , and increased anxiety . Despite the implementation of many patient navigator programs across the country , there are few published , peer- review ed studies documenting its effectiveness . We tested the effectiveness of a patient navigator in improving timeliness to diagnosis , decreasing anxiety , and increasing satisfaction in urban minority women after an abnormal mammogram . Women with suspicious mammograms were r and omly assigned to usual care ( N = 50 ) or usual care plus intervention with a patient navigator ( N = 55 ) . There were no demographic differences between the two groups . Women in the intervention group had shorter times to diagnostic resolution ( mean 25.0 vs. 42.7 days ; p = .001 ) , with 22 % of women in the control group without a final diagnosis at 60 days vs. 6 % in the intervention group . The intervention group also had lower mean anxiety scores ( decrease of 8.0 in intervention vs. increase of 5.8 in control ; p < .001 ) , and higher mean satisfaction scores ( 4.3 vs. 2.9 ; p < .001 ) . Patient navigation is an effective strategy to improve timely diagnostic resolution , significantly decrease anxiety , and increase patient satisfaction among urban minority women with abnormal mammograms Women with breast cancer express the greatest need for counseling at the time of diagnosis and report that the intervention they want is to be able to speak with someone who has the same cancer , but has lived through the crisis of treatment and is leading a ' normal ' life . We conducted an observational study of a 6-month peer-counseling intervention testing outcomes for both newly diagnosed women ( Sojourners ) and peer counselors ( Navigators )  as a first step toward the goal of validating a peer navigator program . Significant improvement in the Sojourners was observed in trauma symptoms , emotional well-being , cancer self-efficacy , and desire for information on breast cancer re sources . Navigators maintained baseline levels of the outcome variables , but increased in dissatisfaction with their interactions with their medical team and increased emotional suppression . Our findings indicate that peer navigation may halt a decline in quality of life that is commonly found in the first year following breast cancer diagnosis . In addition , Navigators were not adversely affected by their experience ; however , careful training and supervision of Navigators is crucial to overall success . R and omized clinical trials are needed to demonstrate the efficacy of peer navigator programs BACKGROUND Underutilization of breast and cervical cancer screening has been observed in many ethnic groups and underserved population s. Effective community-based interventions are needed to eliminate disparities in screening rates and thus to improve prospect s for survival . METHODS The Breast and Cervical Cancer Intervention Study was a controlled trial of three interventions in the San Francisco Bay Area from 1993 to 1996 : ( 1 ) community-based lay health worker outreach ; ( 2 ) clinic-based provider training and reminder system ; and ( 3 ) patient navigator for follow-up of abnormal screening results . Study design and a description of the interventions are reported along with baseline results of a household survey conducted in four language s among 1599 women , aged 40 - 75 . RESULTS Seventy-six percent of women ages 40 and over had had at least one mammogram , and most had had a clinical breast examination ( 88 % ) and Pap smear ( 89 % ) . Rates were significantly lower for non-English-speaking Latinas and Chinese women ( 56 and 32 % , respectively , for mammography ) , and maintenance screening ( three mammograms in the past 5 years ) varied from 7 % ( non-English-speaking Chinese ) to 53 % ( Blacks ) . Pap smear screening in the past 3 years was low among non-English-speaking Latinas ( 72 % ) and markedly lower among non-English-speaking Chinese women ( 24 % ) . The strongest predictors of screening behavior were having private health insurance and frequent use of medical services . Having a regular clinic and speaking English were also important . Race/ethnicity , education , household income , and employment status were , overall , not significant predictors of screening behavior . CONCLUSIONS These baseline results support the importance of cancer screening interventions targeted to persons of foreign origin , particularly those less acculturated Colorectal cancer ( CRC ) is the second leading cause of cancer-related deaths in the United States . Racial disparities in CRC incidence and mortality have been well documented . In addition , lower rates of CRC screening among ethnic minorities have been reported . Therefore , we tested the effectiveness of a patient navigator ( PN ) in increasing compliance with CRC screening in a minority community health setting . Men and women aged 50 or older attending a primary care practice were enrolled if they had not had a fecal occult blood test within the past year , a sigmoidoscopy or barium enema within the past 3–5 years , or a colonoscopy within the past 10 years . Participants were r and omly assigned either to receive navigator services ( PN+ ) or not to receive navigator services ( PN− ) . There were no demographic differences between the two groups . Within 6 months of physician recommendation , 15.8 % in the PN+ group had complied with an endoscopic examination , compared with only 5 % in the PN− group ( P=.019 ) . The PN+ groups also demonstrated higher rates of fecal occult blood test completion ( 42.1 % vs. 25 % , P=.086 ) . Thus , a PN system successfully increases CRC screening rates among a predominantly minority population of low socioeconomic status BACKGROUND A high rate of low-income , ethnic minority women delay or fail to keep appointments following abnormal mammograms . This study was design ed to test the effectiveness of a structured counseling and patient navigation intervention for improving follow-up rates at a large public sector medical center . METHODS This r and omized clinical trial , conducted in Los Angeles 2001 - 2002 , included 204 women with abnormal mammograms referred for follow-up who were then assigned to intervention or usual care .  The primary outcome was the rate of follow-up through diagnostic resolution within eight months . RESULTS The intervention result ed in a significant increase in the rate of adherence to follow-up through diagnostic resolution . The intervention group was much more likely to be adherent through diagnostic resolution than the control group ( 90 % vs. 66 % , OR=4.48 , p<0.001 ) and were more likely to experience timely adherence than UC patients ( 77 % vs. 57 % , OR=2.5 , p=0.01 ) . Intervention effectiveness was not significantly different for women assigned to different levels of service intensity . CONCLUSIONS Patient navigation and counseling driven by a structured clinical algorithm are highly effective strategies to improve diagnostic resolution follow-up among low-income , ethnic minority women with abnormal mammograms . The intervention algorithm and available training material s can be adapted for diverse care systems serving high-risk women to decrease loss to follow-up Rarely has utilization of genetic counseling for Hereditary Breast and Ovarian Cancer ( HBOC ) been studied separately from utilization of testing . At Kaiser Permanente Colorado , consistently only 30 % of all members referred for HBOC attend genetic counseling .  To increase the volume of genetic counseling appointments , a patient navigator approach was pilot tested in a r and omized-controlled trial over 3 months . A total of 125 members were referred for HBOC genetic counseling ( 55 r and omized to PN , 70 r and omized to usual care ) .  Utilization of referrals for Navigator-assisted members was 44 % , compared to 31 % in the usual care arm ( p=0.16 ) . The patient navigator significantly decreased time to appointment , with over 80 % of Navigator-assisted members seen for genetic counseling less than three months from referral date , compared to 32 % in usual care ( p=0.002 ) . patient navigator assistance  shortens time from referral to appointment for HBOC genetic counseling , and may increase utilization of such services Blacks have the highest cancer incidences and mortality rates in the United States . Higher mortality rates appear due to higher incidence in some sites and to later-stage diagnoses in others . To address these problems , exp and ed cancer screening in an inner-city public hospital and a patient navigator intervention were proposed . Patient navigators acted as patient advocates for patients with abnormal screening findings . One thous and thirty-four females and 102 males were screened from July 1990 through November 1992 ; seven breast cancers and one cervical cancer were found .  Patient navigators were significantly more likely to have seen patients with suspicious findings than patients with non-suspicious findings . However , even among those with suspicious findings , almost 70 % were not seen by a patient navigator . Of those navigated , 87.5 % completed recommended breast biopsies , compared with 56.6 % of the non-navigated patients . Among those with a biopsy , navigated patients did so in significantly less time than those not navigated . Navigation is one of three phases proposed to reduce cancer mortality among medically underserved population 
    Output:
    