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: Purpose The purpose of this study was to examine the effects of a r and omized controlled trial ( RCT ) of treatment summaries and survivorship care plans coupled with a nurse counseling session , primarily on physician implementation of and secondarily on patient adherence to recommended survivorship care , among a low-income population of breast cancer survivors ( survivors ) . Methods We recruited 212 low-income , predominantly Latina ( 72.6 % ) survivors with stage 0 to III breast cancer , with an average age of 53 years , from two Los Angeles County public hospitals into an RCT of a survivorship care nurse counseling session coupled with the provision of individualized treatment summaries and survivorship care plans to patients and their health care providers from December 2012 to July 2014 . One hundred seven survivors received the experimental intervention  , and 105 survivors received usual care . Multiple linear regression analyses were performed to assess intervention effects on physician implementation of and patient adherence to recommended survivorship care . Scales that served as covariables were Knowledge of Survivorship Issues , Perceived Efficacy in Patient-Physician Interactions , and Satisfaction With Care and Information . Results Survivors in the intervention group reported greater physician implementation of recommended breast cancer survivorship care , for example , treatment of depression or hot flashes , than did those in the control group ( adjusted difference , 16 ± 5.3 ; P = .003 ) . Baseline Satisfaction With Care and Information was positively associated with physician implementation ( coefficient , 5.2 ± 2.2 ; P = .02 ) . Being married/partnered ( -11.8 ± 4.0 ; P = .004 ) and age ( -0.5 ± 0.2 ; P = .028 ) were negatively associated with patient adherence . Conclusion To our knowledge , this is the first RCT of survivorship care plans to show benefits in clinical outcomes , in this case , showing increased physician implementation of recommended breast cancer survivorship care in the intervention group , compared with the control group Purpose Numerous organizations recommend that patients with cancer receive a survivorship care plan ( SCP ) comprising a treatment summary and follow-up care plans . Among current barriers to implementation are providers ' concerns about the strength of evidence that SCPs improve outcomes . This systematic review evaluates whether delivery of SCPs has a positive impact on health outcomes and health care delivery for cancer survivors . Methods R and omized and nonr and omized studies evaluating  patient-reported outcomes , health care use , and disease outcomes after delivery of  SCPs were identified by search ing MEDLINE , Embase , PsycINFO , Cumulative Index to Nursing and Allied Health Literature , and Cochrane Library . Data extracted by independent raters were summarized on the basis of qualitative synthesis . Results Eleven nonr and omized and 13 r and omized studies met inclusion criteria . Variability was evident across studies in cancer types , SCP delivery timing and method , SCP recipients and content , SCP-related counseling , and outcomes assessed . Nonr and omized study findings yielded descriptive information on satisfaction with care and reactions to SCPs . R and omized study findings were generally negative for the most commonly assessed outcomes ( ie , physical , functional , and psychological well-being ) ; findings were positive in single studies for other outcomes , including amount of information received , satisfaction with care , and physician implementation of recommended care . Conclusion Existing research provides little evidence that SCPs improve health outcomes and health care delivery . Possible explanations include heterogeneity in study design s and the low likelihood that SCP delivery alone would influence distal outcomes . Findings are limited but more positive for proximal outcomes ( eg , information received ) and for care delivery , particularly when SCPs are accompanied by counseling to prepare survivors for future clinical encounters . Recommendations for future research include focusing to a greater extent on evaluating ways to ensure SCP recommendations are subsequently acted on as part of ongoing care OBJECTIVE The aim of this study was to assess the long-term impact of an automatically generated Survivorship Care Plan ( SCP ) on patient reported outcomes in ovarian cancer in routine clinical practice . Outcome measures included satisfaction with information provision and care , illness perceptions and health care utilization . METHODS In this pragmatic cluster r and omized trial , twelve hospitals in the South of the Netherl and s were r and omized to ' SCP care ' or ' usual care ' . All newly diagnosed ovarian cancer patients in the ' SCP care ' arm received an SCP that was automatically generated by the oncology provider , by clicking a button in the web-based Registration system Oncological GYnecology ( ROGY ) .  Ovarian cancer patients ( N=174 , mean age 63.3 , SD=11.4 ; all stages ) completed question naires directly after initial treatment and after 6 , 12 and 24months . RESULTS First question naires were returned from 61 ( 67 % ) ovarian cancer patients in the ' SCP care ' arm and 113 ( 72 % ) patients in the ' usual care ' arm . In the ' SCP care ' arm , 66 % ( N=41 ) of the patients reported receipt of an SCP . No overall differences were observed between the trial arms on satisfaction with information provision , satisfaction with care or health care utilization . Regarding illness perceptions , patients in the ' SCP care ' arm had lower beliefs that the treatment would help to cure their disease ( overall , 6.7 vs. 7.5 , P<0.01 ) . CONCLUSIONS SCPs did not increase satisfaction with information provision or care in ovarian cancer patients . Our trial results suggest that ovarian cancer patients may not benefit from an SCP . TRIAL REGISTRATION clinical trials.gov Identifier : NCT01185626 In 2006 , the IOM released a report citing the importance of “ survivorship plans ” to improve quality of life and care coordination for cancer survivors , but little has been done to evaluate their efficacy . Women with early-stage breast cancer were r and omized within 6 weeks of completing adjuvant therapy to a survivorship intervention group ( SI ) or control group ( CG ) . All subjects were given the NCI publication , “ Facing Forward : Life after Cancer Treatment . ” The SI also met with a nurse/nutritionist to receive a treatment summary , surveillance , and lifestyle recommendations . Both groups completed question naires on the impact of cancer ( IOC ) , patient satisfaction ( FACIT-TS-PS ) , and assessment of survivor concerns ( ASC ) at baseline , 3 and 6 months . Within and between group t tests and linear regression analyses were performed . Among 126 women ( 60 CG , 66 SI ) , mean age was 54 years , 48 % were Hispanic , and the groups were well-balanced by baseline characteristics . No significant differences between the CG and SI on the FACIT-TS-PS or IOC at 3 and 6 months were seen . The ASC health worry subscale was lower ( less worry ) in the SI compared to CG ( p = 0.02 ) . At all time-points , Hispanic women had higher ( worse ) health worry ( p = 0.0008 ) , social-life interference ( p = 0.009 ) , and meaning of cancer scales ( p = 0.0004 ) , and more trust in medical professionals ( p = 0.03 ) compared to non-Hispanic women . While the SI did not lead to significant improvements in most patient-reported outcomes , it was associated with decreased health worry . Future interventions should determine the most efficient and effective method for delivering survivorship care plans PURPOSE Endometrial cancer is the sixth most common female cancer worldwide . There is little evidence that routine hospital surveillance increases survival or decreases morbidity following treatment . Gynaecology Oncology clinical nurse specialists ( CNSs ) are ideally placed to provide the care , information and support to enable women with a gynaecological cancer to self-manage and live well . A multi-centre r and omised controlled trial ( RCT ) compared hospital follow-up ( HFU ) with telephone follow-up ( TFU ) by CNSs . The structured telephone intervention focused on information provision to meet patients psychosocial and information needs . This study aim ed to explore the views of women who had received TFU and the CNS 's who had delivered the service . METHOD A qualitative study to complement the RCT using semi-structured interviews was conducted . Twenty-five patients were r and omly selected from participants in the TFU arm stratified by study site . Seven CNSs were interviewed . RESULTS Patient and CNS regarded TFU positively ; Three themes emerged from the patient interviews ; Convenient Care , Discrete Personalised Care , Confidence and Reassurance . Themes arising from the CNS interviews were Patient Centred Care , Holistic Care and , Confidence and Skills . Patients found that TFU with CNS 's was convenient and enabled discussion of issues and information provision at time-points relevant to them . The CNS 's found the structured format of TFU enabled them to utilise their skills and knowledge to identify and meet patients holistic needs . CONCLUSIONS Alternative models of care such as TFU provided by CNSs provides the care , information and support to enable women treated for endometrial cancer to self-manage and live well Survivorship Care Plans ( SCPs ) may facilitate long-term care for cancer survivors , but their effectiveness has not been established in hematopoietic cell transplantation recipients . We evaluated the impact of individualized SCPs on patient-reported outcomes among transplant survivors . Adult ( ≥18 years at transplant ) survivors who were 1 - 5 years post transplantation , proficient in English , and without relapse or secondary cancers were eligible for this multicenter r and omized trial . SCPs were developed based on risk-factors and treatment exposures using patient data routinely su bmi tted by transplant centers to the Center for International Blood and Marrow Transplant Research and published guidelines for long-term follow up of transplant survivors . Phone surveys assessing patient-reported outcomes were conducted at baseline and at 6 months . The primary end point was confidence in survivorship information , and secondary end points included cancer and treatment distress , knowledge of transplant exposures , health care utilization , and health-related quality of life . Of 495 patients enrolled , 458 completed a baseline survey and were r and omized ( care plan=231 , st and ard care=227 ) ; 200 ( 87 % ) and 199 ( 88 % ) completed the 6-month assessment s , respectively . Patients ’ characteristics were similar in the two arms . Participants on the care plan arm reported significantly lower distress scores at 6 months and an increase in the Mental Component Summary quality of life score assessed by the Short Form 12 ( SF-12 ) instrument . No effect was observed on the end point of confidence in survivorship information or other secondary outcomes . Provision of individualized SCPs generated using registry data was associated with reduced distress and improved mental domain of quality of life among 1 - 5 year hematopoietic cell transplantation survivors . Trial registered at clinical trials.gov 02200133 Survivorship care plans ( SCPs ) and care‐planning sessions have been recommended for over a decade , yet evidence for their benefit remains mixed . In a r and omized trial , changes in survivor knowledge and satisfaction before and after the receipt of an SCP were assessed PURPOSE Post-treatment follow-up for lymphoma potentially fails to address the supportive care needs of survivors . A nurse-led lymphoma survivorship model of care was developed and tested in a phase II pilot pragmatic r and omised controlled trial ( RCT ) . The intervention comprised three face-to-face appointments , delivery of tailored re sources and an individualised survivorship care plan and treatment summary ( SCPTS ) , shared with the general practitioner ( GP ) . METHOD Three months ' post-treatment completion , eligible lymphoma patients were r and omised 1:1 to usual care ( control ) or usual care plus intervention .  Survivorship unmet needs ( Short-Form Survivor Unmet Needs Survey ) , distress ( Depression Anxiety Stress Scale 21 ) , adjustment to cancer ( Mini-Mental Adjustment to Cancer scale ) and self-empowerment ( Patient Empowerment Scale ) were assessed at baseline , three and six months . Univariate and multivariate analyses examined changes within and between groups at the three time points . A GP evaluation survey sought information on the perceived utility of the SCPTS . RESULTS Statistical significance was set at 0.05 ( 2-tailed ) . Although not statistically significant , by study completion , intervention participants ( n = 30 ) , reported less unmet needs ( M = 21.41 vs M = 25.72 , p = .506 ) , less distress ( ( M = 13.03 vs M = 15.14 , p = .558 ) and an increase in empowerment ( M = 50.21 vs M = 47.21 , p = .056 ) compared with control participants ( n = 30 ) . The SCPTS was rated good to very good by a majority of GPs ( n = 13 , 81 % ) . CONCLUSIONS The nurse-led lymphoma survivorship model of care may be a helpful intervention for lymphoma patients who had completed treatment . Survivors require individualised and tailored support and re sources . A tailored SCPTS may promote survivor self-management and increase GP engagement 
    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: Purpose The purpose of this study was to examine the effects of a r and omized controlled trial ( RCT ) of treatment summaries and survivorship care plans coupled with a nurse counseling session , primarily on physician implementation of and secondarily on patient adherence to recommended survivorship care , among a low-income population of breast cancer survivors ( survivors ) . Methods We recruited 212 low-income , predominantly Latina ( 72.6 % ) survivors with stage 0 to III breast cancer , with an average age of 53 years , from two Los Angeles County public hospitals into an RCT of a survivorship care nurse counseling session coupled with the provision of individualized treatment summaries and survivorship care plans to patients and their health care providers from December 2012 to July 2014 . One hundred seven survivors received the experimental intervention  , and 105 survivors received usual care . Multiple linear regression analyses were performed to assess intervention effects on physician implementation of and patient adherence to recommended survivorship care . Scales that served as covariables were Knowledge of Survivorship Issues , Perceived Efficacy in Patient-Physician Interactions , and Satisfaction With Care and Information . Results Survivors in the intervention group reported greater physician implementation of recommended breast cancer survivorship care , for example , treatment of depression or hot flashes , than did those in the control group ( adjusted difference , 16 ± 5.3 ; P = .003 ) . Baseline Satisfaction With Care and Information was positively associated with physician implementation ( coefficient , 5.2 ± 2.2 ; P = .02 ) . Being married/partnered ( -11.8 ± 4.0 ; P = .004 ) and age ( -0.5 ± 0.2 ; P = .028 ) were negatively associated with patient adherence . Conclusion To our knowledge , this is the first RCT of survivorship care plans to show benefits in clinical outcomes , in this case , showing increased physician implementation of recommended breast cancer survivorship care in the intervention group , compared with the control group Purpose Numerous organizations recommend that patients with cancer receive a survivorship care plan ( SCP ) comprising a treatment summary and follow-up care plans . Among current barriers to implementation are providers ' concerns about the strength of evidence that SCPs improve outcomes . This systematic review evaluates whether delivery of SCPs has a positive impact on health outcomes and health care delivery for cancer survivors . Methods R and omized and nonr and omized studies evaluating  patient-reported outcomes , health care use , and disease outcomes after delivery of  SCPs were identified by search ing MEDLINE , Embase , PsycINFO , Cumulative Index to Nursing and Allied Health Literature , and Cochrane Library . Data extracted by independent raters were summarized on the basis of qualitative synthesis . Results Eleven nonr and omized and 13 r and omized studies met inclusion criteria . Variability was evident across studies in cancer types , SCP delivery timing and method , SCP recipients and content , SCP-related counseling , and outcomes assessed . Nonr and omized study findings yielded descriptive information on satisfaction with care and reactions to SCPs . R and omized study findings were generally negative for the most commonly assessed outcomes ( ie , physical , functional , and psychological well-being ) ; findings were positive in single studies for other outcomes , including amount of information received , satisfaction with care , and physician implementation of recommended care . Conclusion Existing research provides little evidence that SCPs improve health outcomes and health care delivery . Possible explanations include heterogeneity in study design s and the low likelihood that SCP delivery alone would influence distal outcomes . Findings are limited but more positive for proximal outcomes ( eg , information received ) and for care delivery , particularly when SCPs are accompanied by counseling to prepare survivors for future clinical encounters . Recommendations for future research include focusing to a greater extent on evaluating ways to ensure SCP recommendations are subsequently acted on as part of ongoing care OBJECTIVE The aim of this study was to assess the long-term impact of an automatically generated Survivorship Care Plan ( SCP ) on patient reported outcomes in ovarian cancer in routine clinical practice . Outcome measures included satisfaction with information provision and care , illness perceptions and health care utilization . METHODS In this pragmatic cluster r and omized trial , twelve hospitals in the South of the Netherl and s were r and omized to ' SCP care ' or ' usual care ' . All newly diagnosed ovarian cancer patients in the ' SCP care ' arm received an SCP that was automatically generated by the oncology provider , by clicking a button in the web-based Registration system Oncological GYnecology ( ROGY ) .  Ovarian cancer patients ( N=174 , mean age 63.3 , SD=11.4 ; all stages ) completed question naires directly after initial treatment and after 6 , 12 and 24months . RESULTS First question naires were returned from 61 ( 67 % ) ovarian cancer patients in the ' SCP care ' arm and 113 ( 72 % ) patients in the ' usual care ' arm . In the ' SCP care ' arm , 66 % ( N=41 ) of the patients reported receipt of an SCP . No overall differences were observed between the trial arms on satisfaction with information provision , satisfaction with care or health care utilization . Regarding illness perceptions , patients in the ' SCP care ' arm had lower beliefs that the treatment would help to cure their disease ( overall , 6.7 vs. 7.5 , P<0.01 ) . CONCLUSIONS SCPs did not increase satisfaction with information provision or care in ovarian cancer patients . Our trial results suggest that ovarian cancer patients may not benefit from an SCP . TRIAL REGISTRATION clinical trials.gov Identifier : NCT01185626 In 2006 , the IOM released a report citing the importance of “ survivorship plans ” to improve quality of life and care coordination for cancer survivors , but little has been done to evaluate their efficacy . Women with early-stage breast cancer were r and omized within 6 weeks of completing adjuvant therapy to a survivorship intervention group ( SI ) or control group ( CG ) . All subjects were given the NCI publication , “ Facing Forward : Life after Cancer Treatment . ” The SI also met with a nurse/nutritionist to receive a treatment summary , surveillance , and lifestyle recommendations . Both groups completed question naires on the impact of cancer ( IOC ) , patient satisfaction ( FACIT-TS-PS ) , and assessment of survivor concerns ( ASC ) at baseline , 3 and 6 months . Within and between group t tests and linear regression analyses were performed . Among 126 women ( 60 CG , 66 SI ) , mean age was 54 years , 48 % were Hispanic , and the groups were well-balanced by baseline characteristics . No significant differences between the CG and SI on the FACIT-TS-PS or IOC at 3 and 6 months were seen . The ASC health worry subscale was lower ( less worry ) in the SI compared to CG ( p = 0.02 ) . At all time-points , Hispanic women had higher ( worse ) health worry ( p = 0.0008 ) , social-life interference ( p = 0.009 ) , and meaning of cancer scales ( p = 0.0004 ) , and more trust in medical professionals ( p = 0.03 ) compared to non-Hispanic women . While the SI did not lead to significant improvements in most patient-reported outcomes , it was associated with decreased health worry . Future interventions should determine the most efficient and effective method for delivering survivorship care plans PURPOSE Endometrial cancer is the sixth most common female cancer worldwide . There is little evidence that routine hospital surveillance increases survival or decreases morbidity following treatment . Gynaecology Oncology clinical nurse specialists ( CNSs ) are ideally placed to provide the care , information and support to enable women with a gynaecological cancer to self-manage and live well . A multi-centre r and omised controlled trial ( RCT ) compared hospital follow-up ( HFU ) with telephone follow-up ( TFU ) by CNSs . The structured telephone intervention focused on information provision to meet patients psychosocial and information needs . This study aim ed to explore the views of women who had received TFU and the CNS 's who had delivered the service . METHOD A qualitative study to complement the RCT using semi-structured interviews was conducted . Twenty-five patients were r and omly selected from participants in the TFU arm stratified by study site . Seven CNSs were interviewed . RESULTS Patient and CNS regarded TFU positively ; Three themes emerged from the patient interviews ; Convenient Care , Discrete Personalised Care , Confidence and Reassurance . Themes arising from the CNS interviews were Patient Centred Care , Holistic Care and , Confidence and Skills . Patients found that TFU with CNS 's was convenient and enabled discussion of issues and information provision at time-points relevant to them . The CNS 's found the structured format of TFU enabled them to utilise their skills and knowledge to identify and meet patients holistic needs . CONCLUSIONS Alternative models of care such as TFU provided by CNSs provides the care , information and support to enable women treated for endometrial cancer to self-manage and live well Survivorship Care Plans ( SCPs ) may facilitate long-term care for cancer survivors , but their effectiveness has not been established in hematopoietic cell transplantation recipients . We evaluated the impact of individualized SCPs on patient-reported outcomes among transplant survivors . Adult ( ≥18 years at transplant ) survivors who were 1 - 5 years post transplantation , proficient in English , and without relapse or secondary cancers were eligible for this multicenter r and omized trial . SCPs were developed based on risk-factors and treatment exposures using patient data routinely su bmi tted by transplant centers to the Center for International Blood and Marrow Transplant Research and published guidelines for long-term follow up of transplant survivors . Phone surveys assessing patient-reported outcomes were conducted at baseline and at 6 months . The primary end point was confidence in survivorship information , and secondary end points included cancer and treatment distress , knowledge of transplant exposures , health care utilization , and health-related quality of life . Of 495 patients enrolled , 458 completed a baseline survey and were r and omized ( care plan=231 , st and ard care=227 ) ; 200 ( 87 % ) and 199 ( 88 % ) completed the 6-month assessment s , respectively . Patients ’ characteristics were similar in the two arms . Participants on the care plan arm reported significantly lower distress scores at 6 months and an increase in the Mental Component Summary quality of life score assessed by the Short Form 12 ( SF-12 ) instrument . No effect was observed on the end point of confidence in survivorship information or other secondary outcomes . Provision of individualized SCPs generated using registry data was associated with reduced distress and improved mental domain of quality of life among 1 - 5 year hematopoietic cell transplantation survivors . Trial registered at clinical trials.gov 02200133 Survivorship care plans ( SCPs ) and care‐planning sessions have been recommended for over a decade , yet evidence for their benefit remains mixed . In a r and omized trial , changes in survivor knowledge and satisfaction before and after the receipt of an SCP were assessed PURPOSE Post-treatment follow-up for lymphoma potentially fails to address the supportive care needs of survivors . A nurse-led lymphoma survivorship model of care was developed and tested in a phase II pilot pragmatic r and omised controlled trial ( RCT ) . The intervention comprised three face-to-face appointments , delivery of tailored re sources and an individualised survivorship care plan and treatment summary ( SCPTS ) , shared with the general practitioner ( GP ) . METHOD Three months ' post-treatment completion , eligible lymphoma patients were r and omised 1:1 to usual care ( control ) or usual care plus intervention .  Survivorship unmet needs ( Short-Form Survivor Unmet Needs Survey ) , distress ( Depression Anxiety Stress Scale 21 ) , adjustment to cancer ( Mini-Mental Adjustment to Cancer scale ) and self-empowerment ( Patient Empowerment Scale ) were assessed at baseline , three and six months . Univariate and multivariate analyses examined changes within and between groups at the three time points . A GP evaluation survey sought information on the perceived utility of the SCPTS . RESULTS Statistical significance was set at 0.05 ( 2-tailed ) . Although not statistically significant , by study completion , intervention participants ( n = 30 ) , reported less unmet needs ( M = 21.41 vs M = 25.72 , p = .506 ) , less distress ( ( M = 13.03 vs M = 15.14 , p = .558 ) and an increase in empowerment ( M = 50.21 vs M = 47.21 , p = .056 ) compared with control participants ( n = 30 ) . The SCPTS was rated good to very good by a majority of GPs ( n = 13 , 81 % ) . CONCLUSIONS The nurse-led lymphoma survivorship model of care may be a helpful intervention for lymphoma patients who had completed treatment . Survivors require individualised and tailored support and re sources . A tailored SCPTS may promote survivor self-management and increase GP engagement 
    Output:
    