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: Active participation in the medical consultation has been demonstrated to benefit aspects of patients ’ subsequent psychological well-being . We investigated two interventions promoting patient question -asking behaviour . The first was a question prompt sheet provided before the consultation , which was endorsed and worked through by the clinician . The second was a face to face coaching session exploring the benefits of , and barriers to , question -asking , followed by coaching in question -asking behaviour employing rehearsal techniques .  Sixty patients with heterogeneous cancers , seeing two medical oncologists for the first time , were r and omly assigned to one of three groups : two intervention groups and one control group .  Sociodemographic variables and anxiety were assessed prior to the intervention which preceded the consultation . The consultations were audiotaped and subsequently analysed for question -asking behaviour . Anxiety was assessed again immediately following the consultation . Question naires to assess patient satisfaction , anxiety and psychological adjustment were sent by mail 2 weeks following the consultation . Presentation and discussion of the prompt sheet significantly increased the total number of questions asked and the number of questions asked regarding tests and treatment . Coaching did not add significantly to the effects of the prompt sheet . Psychological outcomes were not different among the groups . We conclude that a question prompt sheet addressed by the doctor is a simple , inexpensive and effective means of promoting patient question asking in the cancer consultation OBJECTIVE The goal of this study was to show that physician communication style of breaking bad news affects how the physician is perceived , how satisfied recipients of bad news are with the consultation , and how they feel after the consultation . METHOD Female participants ( students , N=159 ) were asked to put themselves in the shoes of a patient receiving the bad news of a breast cancer diagnosis . Participants were r and omly assigned to watch one of three prototypical physician communication styles of breaking bad news on videotape : patient- , disease- , or emotion-centered communication . RESULTS Results showed that these three prototypical communication styles were perceived very differently and they determined how satisfied participants were with the consultation and how they felt after the consultation . Participants exposed to the patient-centered communication perceived the physician as most emotional , least dominant , most appropriate when it comes to conveying information , most available and most expressive of hope . Also , they reported to be most satisfied with the visit and they showed the least increase in negative emotions . CONCLUSION A patient-centered communication style has the most positive outcome for recipients of bad news on a cognitive , evaluative , and emotional level . PRACTICE IMPLICATION S Results of this study provide guidelines to physicians on how to convey bad news A r and omised-controlled trial compared outcomes for women recently diagnosed with breast cancer who either received support and information from a multidisciplinary team or used a shared decision-making programme on an interactive video disk ( IVD ) system .  Using the IVD did not have a significant effect on the decisions women made about treatment , yet it was evaluated positively by those who used it . The results suggest that the role of clinical staff is more significant than the form of information provided . Potential benefits for the IVD were apparent such as st and ardising the information received by patients , promoting evidence -based practice and providing a measure for quality assurance PURPOSE Women with breast cancer were provided with an audiotape of their primary adjuvant treatment consultation , and the following patient outcomes were measured at 12 weeks postconsultation : perceived degree of information provision , audiotape satisfaction and use , communication satisfaction with oncologist , mood state , and cancer-specific quality of life . PATIENTS AND METHODS Participants included 628 women newly diagnosed with breast cancer and 40 oncologists from six cancer centers in Canada . The patients were block r and omized to one of four consultation groups : st and ard care control , not audiotaped ; audiotaped , no audiotape given ; audiotaped , patient given audiotape ; and audiotaped , patient offered choice of receiving audiotape or not . RESULTS Patients receiving the consultation audiotape had significantly better recall of having discussed side effects of treatment than patients who did not receive the audiotape . Audiotape benefit was not significantly related to patient satisfaction with communication , mood state , or quality of life at 12 weeks postconsultation , and was not significantly affected by choice of receiving the audiotape . Patients rated the audiotape intervention positively , with an average score of 83.9 of 100 . CONCLUSION Audiotape provision benefits patients by facilitating their perception of being informed about treatment side effects , but does not significantly influence patient satisfaction with communication , mood state , or quality of life The purpose of this study was to determine the helpfulness of a prompt sheet versus a general information sheet for patient communication with physicians . Sixty women with breast cancer attending their first outpatient consultation with a breast medical oncologist were r and omized to receive either a prompt sheet ( PS ) or a general information ( GI ) sheet regarding breast cancer . Analysis of the results found that helpfulness of the written material was rated higher in the PS group ( 8.5 + /- 2 ) than the GI group ( 6.2 + /- 3.6 ) , P = 0.005 . The mean score of helpfulness in communicating with physicians was 7.9 + /- 2.4 and 5.7 + /- 3.8 , respectively , P = 0.01 . There were no significant differences between the groups in the average total number of questions asked by the patients or average physician or patient speaking time . We conclude that a disease-specific prompt sheet provided before medical encounters may assist in communication between patients and physicians 8009 Background : Previously we reported on the benefits of providing audiotapes of primary adjuvant treatment consultations to women with newly diagnosed breast cancer ( Hack et al ; Proc ASCO 2001 ) . The purpose of this multi-site , r and omized controlled trial was to use similar methods to examine the efficacy of providing men with prostate cancer with an audiotape of their primary adjuvant treatment consultation . METHODS A total of 429 men and 15 oncologists from cancer centres in three Canadian cities participated . The men were block r and omized to 1 of 4 consultation groups : 1 . St and ard Care Control Group - Consultation not audiotaped ( n=113 ) ; 2 . Patient not given audiotape ( n=98 ) ; 3 . Patient given audiotape ( n=120 ) ; and 4 . Patient offered choice of receiving the audiotape ( n=94 accepted tape , n=4 declined tape ) . Patients completed the Decisional Role Preferences Scale ( Degner ) before and after the consultation , a measure of communication satisfaction post-consultation , and measures of decisional role , audiotape use , information recall , communication satisfaction , mood disturbance ( Profile of Mood States ) , and prostate cancer-specific quality of life ( FACT-P ) at 3 months post-consultation . A feedback question naire was mailed to all participating oncologists . RESULTS Analyses of covariance showed that patients who received the consultation audiotape reported having had significantly more discussion about treatment side effects ( p<.01 ) , treatment alternatives ( p<.05 ) , and treatment and disease information in general ( p<.05 ) than patients who did not receive the audiotape . Patients rated the audiotape intervention positively , with an average score of 83.0 out of 100 . Fifty-six percent of oncologists stated that most , if not all , patients should be provided with an audiotape of their primary adjuvant treatment consultations . CONCLUSIONS Audiotapes of primary adjuvant treatment consultations are rated beneficial by prostate cancer patients and their oncologists , and aid patients by facilitating perception of being informed of treatment alternatives and treatment side effects . No significant financial relationships to disclose BACKGROUND The purpose of this investigation was to systematic ally examine the efficacy of providing men with prostate cancer with an audiotape of their primary treatment consultation . METHOD Participants included 425 men newly diagnosed with prostate cancer and 15 radiation oncologists from 4 cancer centers in Canada . Patients were block r and omized to one of four consultation groups : 1 . St and ard care control -- not audio-taped ; 2 . Audio-taped -- no audiotape given ; 3 . Audio-taped -- patient given audiotape ; and 4 . Audio-taped -- patient offered choice of receiving audiotape or not ( 4 patients declined ; 94 accepted ) . Patient outcomes were measured at 12 weeks post-consultation : perceived degree of information provision ; audiotape satisfaction and use ; communication satisfaction with oncologist ; mood state ; and cancer-specific quality of life . RESULTS Patients receiving the consultation audiotape reported having been provided with significantly more disease and treatment information in general ( p=0.04 ) , and more information about treatment alternatives ( p=0.04 ) and treatment side effects ( p=0.01 ) in particular , than patients who did not receive the audiotape . Audiotape benefit was not significantly related to patient satisfaction with communication , mood state or quality of life at 12 weeks post-consultation , and was not significantly affected by choice of receiving the audiotape . Patients rated the audiotape intervention positively , with an average score of 83.0 out of 100 . CONCLUSION Consultation audiotapes are rated highly by men with prostate cancer , and these audiotapes help to enhance their perception of having been provided with critical disease- and treatment-related information PURPOSE To measure the prevalence of communication barriers between breast cancer patients and their physicians and to present the results of a study evaluating the impact of two visit preparation techniques on communication and satisfaction for breast cancer patients and their physicians . PATIENTS AND METHODS We recruited 132 breast cancer patients from two outpatient cancer centers in a sequential , controlled trial . Ninety-four consented and completed the trial . Patients were assigned to one of two visit preparation interventions before their appointment with either a surgeon or a medical oncologist . In the control intervention , called Productive Listening , a research er listened to and prompted patients to reflect on their experiences communicating with physicians . In the experimental intervention , called Consultation Planning , a research er elicited questions and concerns , generated a printed agenda for the upcoming consultation , and engaged patients in techniques to improve communication with their physicians . Valid and reliable surveys measured communication barriers , satisfaction with the intervention , and patients ' and physicians ' satisfaction with the consultation . RESULTS Sixty-four percent of the patients reported three or more communication barriers . Patients reported a significant reduction in communication barriers after both the intervention and the control session . Patients reported significantly higher satisfaction after the Consultation Planning sessions . Physicians reported significantly higher satisfaction with those patients who had participated in a Consultation Planning session . CONCLUSION Visit preparation sessions help patients prepare for medical consultations and reduce barriers to communication .  Consultation Planning sessions , in which a research er solicited the patient 's agenda , were more satisfying to patients and physicians than the Productive Listening sessions The feasibility of a r and omized clinical trial to implement and compare the effectiveness of three components of an intervention for women with breast cancer and their partners was tested . The intervention components , st and ardized education by videotape ( SE ) , telephone counseling ( TC ) , and education with telephone counseling ( SE + TC ) , were design ed with a complementary approach to disease management of breast cancer at each of four phases of the breast cancer experience : diagnostic , postsurgery , adjuvant therapy , and ongoing recovery . A st and ardized Telephone Counseling Training Manual was developed . A nonprobability sample of 12 patient-partner pairs was accrued . Four pairs were r and omly assigned to each of the three intervention components . A set of question naires was completed by each patient and partner at baseline and following each intervention for assessment of emotional , physical , and social adjustment , and perceived support . Attrition was minimal and return rate for the completed question naires at all five data - collection points was high . Validation of the SE and the TC , one of the objectives , was by data from the preliminary descriptive study ( Hoskins , 1990–1994 ) , pretests and posttests for st and ardized education , audiotapes for each phase-specific telephone counseling session , and evaluation forms for each intervention session . The positive findings included significant changes from pre- to postmeasurement in patients ' and partners ' scores for the st and ardized education in each of the four phases . Even with the limited statistical power , the effects were marked , lending support for a full-scale r and omized clinical trial , to underst and better the relative treatment efficacy and differential benefit of one or some interventions over others Data from a ' limited prospect i ve ' study on life events and breast cancer were tested whether they were biased by knowledge of the prospect i ve diagnosis or by related mood states . Data were gathered by semi-structured and tape-recorded interviews . Event classifications were made according to Brown and Harris ' Life Events and Difficulties Scale , an interviewer-based rating method . Ratings were performed before the interviewer learned the final diagnosis . Among the women coming to hospital with a suspicious breast lump , 33 had a malignant and 59 had a benign diagnosis . For comparison for mood effects two more control groups ( women prior to gall stone surgery and healthy women interviewed at home ) were included . Although artifacts may in general play a role for reporting events in ' limited prospect i ve ' design s , the present study could not document a sizeable effect of presumed confounding variables on response behaviour BACKGROUND Active participation and asking questions are important ways in which patients can ensure they underst and what the doctor has said . This study evaluated a question prompt sheet design ed to encourage patients to ask questions in the cancer consultation . PATIENTS AND METHODS Patients ( n = 142 ) were r and omised to receive ( i ) a question prompt sheet or ( ii ) a general sheet informing patients of services available through the regional Cancer Council . Recall of information was assessed in a structured interview 4 - 20 days after the consultation . Question naires to assess patient satisfaction and adjustment to cancer were sent by mail . RESULTS The question prompt sheet had a significant effect in one content area : prognosis . Thirty-five percent of patients who received the question h and out asked questions about prognosis compared to 16 % of those receiving the information h and out . The prompt sheet did not increase the mean number of questions asked overall . Age , in 
    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: Active participation in the medical consultation has been demonstrated to benefit aspects of patients ’ subsequent psychological well-being . We investigated two interventions promoting patient question -asking behaviour . The first was a question prompt sheet provided before the consultation , which was endorsed and worked through by the clinician . The second was a face to face coaching session exploring the benefits of , and barriers to , question -asking , followed by coaching in question -asking behaviour employing rehearsal techniques .  Sixty patients with heterogeneous cancers , seeing two medical oncologists for the first time , were r and omly assigned to one of three groups : two intervention groups and one control group .  Sociodemographic variables and anxiety were assessed prior to the intervention which preceded the consultation . The consultations were audiotaped and subsequently analysed for question -asking behaviour . Anxiety was assessed again immediately following the consultation . Question naires to assess patient satisfaction , anxiety and psychological adjustment were sent by mail 2 weeks following the consultation . Presentation and discussion of the prompt sheet significantly increased the total number of questions asked and the number of questions asked regarding tests and treatment . Coaching did not add significantly to the effects of the prompt sheet . Psychological outcomes were not different among the groups . We conclude that a question prompt sheet addressed by the doctor is a simple , inexpensive and effective means of promoting patient question asking in the cancer consultation OBJECTIVE The goal of this study was to show that physician communication style of breaking bad news affects how the physician is perceived , how satisfied recipients of bad news are with the consultation , and how they feel after the consultation . METHOD Female participants ( students , N=159 ) were asked to put themselves in the shoes of a patient receiving the bad news of a breast cancer diagnosis . Participants were r and omly assigned to watch one of three prototypical physician communication styles of breaking bad news on videotape : patient- , disease- , or emotion-centered communication . RESULTS Results showed that these three prototypical communication styles were perceived very differently and they determined how satisfied participants were with the consultation and how they felt after the consultation . Participants exposed to the patient-centered communication perceived the physician as most emotional , least dominant , most appropriate when it comes to conveying information , most available and most expressive of hope . Also , they reported to be most satisfied with the visit and they showed the least increase in negative emotions . CONCLUSION A patient-centered communication style has the most positive outcome for recipients of bad news on a cognitive , evaluative , and emotional level . PRACTICE IMPLICATION S Results of this study provide guidelines to physicians on how to convey bad news A r and omised-controlled trial compared outcomes for women recently diagnosed with breast cancer who either received support and information from a multidisciplinary team or used a shared decision-making programme on an interactive video disk ( IVD ) system .  Using the IVD did not have a significant effect on the decisions women made about treatment , yet it was evaluated positively by those who used it . The results suggest that the role of clinical staff is more significant than the form of information provided . Potential benefits for the IVD were apparent such as st and ardising the information received by patients , promoting evidence -based practice and providing a measure for quality assurance PURPOSE Women with breast cancer were provided with an audiotape of their primary adjuvant treatment consultation , and the following patient outcomes were measured at 12 weeks postconsultation : perceived degree of information provision , audiotape satisfaction and use , communication satisfaction with oncologist , mood state , and cancer-specific quality of life . PATIENTS AND METHODS Participants included 628 women newly diagnosed with breast cancer and 40 oncologists from six cancer centers in Canada . The patients were block r and omized to one of four consultation groups : st and ard care control , not audiotaped ; audiotaped , no audiotape given ; audiotaped , patient given audiotape ; and audiotaped , patient offered choice of receiving audiotape or not . RESULTS Patients receiving the consultation audiotape had significantly better recall of having discussed side effects of treatment than patients who did not receive the audiotape . Audiotape benefit was not significantly related to patient satisfaction with communication , mood state , or quality of life at 12 weeks postconsultation , and was not significantly affected by choice of receiving the audiotape . Patients rated the audiotape intervention positively , with an average score of 83.9 of 100 . CONCLUSION Audiotape provision benefits patients by facilitating their perception of being informed about treatment side effects , but does not significantly influence patient satisfaction with communication , mood state , or quality of life The purpose of this study was to determine the helpfulness of a prompt sheet versus a general information sheet for patient communication with physicians . Sixty women with breast cancer attending their first outpatient consultation with a breast medical oncologist were r and omized to receive either a prompt sheet ( PS ) or a general information ( GI ) sheet regarding breast cancer . Analysis of the results found that helpfulness of the written material was rated higher in the PS group ( 8.5 + /- 2 ) than the GI group ( 6.2 + /- 3.6 ) , P = 0.005 . The mean score of helpfulness in communicating with physicians was 7.9 + /- 2.4 and 5.7 + /- 3.8 , respectively , P = 0.01 . There were no significant differences between the groups in the average total number of questions asked by the patients or average physician or patient speaking time . We conclude that a disease-specific prompt sheet provided before medical encounters may assist in communication between patients and physicians 8009 Background : Previously we reported on the benefits of providing audiotapes of primary adjuvant treatment consultations to women with newly diagnosed breast cancer ( Hack et al ; Proc ASCO 2001 ) . The purpose of this multi-site , r and omized controlled trial was to use similar methods to examine the efficacy of providing men with prostate cancer with an audiotape of their primary adjuvant treatment consultation . METHODS A total of 429 men and 15 oncologists from cancer centres in three Canadian cities participated . The men were block r and omized to 1 of 4 consultation groups : 1 . St and ard Care Control Group - Consultation not audiotaped ( n=113 ) ; 2 . Patient not given audiotape ( n=98 ) ; 3 . Patient given audiotape ( n=120 ) ; and 4 . Patient offered choice of receiving the audiotape ( n=94 accepted tape , n=4 declined tape ) . Patients completed the Decisional Role Preferences Scale ( Degner ) before and after the consultation , a measure of communication satisfaction post-consultation , and measures of decisional role , audiotape use , information recall , communication satisfaction , mood disturbance ( Profile of Mood States ) , and prostate cancer-specific quality of life ( FACT-P ) at 3 months post-consultation . A feedback question naire was mailed to all participating oncologists . RESULTS Analyses of covariance showed that patients who received the consultation audiotape reported having had significantly more discussion about treatment side effects ( p<.01 ) , treatment alternatives ( p<.05 ) , and treatment and disease information in general ( p<.05 ) than patients who did not receive the audiotape . Patients rated the audiotape intervention positively , with an average score of 83.0 out of 100 . Fifty-six percent of oncologists stated that most , if not all , patients should be provided with an audiotape of their primary adjuvant treatment consultations . CONCLUSIONS Audiotapes of primary adjuvant treatment consultations are rated beneficial by prostate cancer patients and their oncologists , and aid patients by facilitating perception of being informed of treatment alternatives and treatment side effects . No significant financial relationships to disclose BACKGROUND The purpose of this investigation was to systematic ally examine the efficacy of providing men with prostate cancer with an audiotape of their primary treatment consultation . METHOD Participants included 425 men newly diagnosed with prostate cancer and 15 radiation oncologists from 4 cancer centers in Canada . Patients were block r and omized to one of four consultation groups : 1 . St and ard care control -- not audio-taped ; 2 . Audio-taped -- no audiotape given ; 3 . Audio-taped -- patient given audiotape ; and 4 . Audio-taped -- patient offered choice of receiving audiotape or not ( 4 patients declined ; 94 accepted ) . Patient outcomes were measured at 12 weeks post-consultation : perceived degree of information provision ; audiotape satisfaction and use ; communication satisfaction with oncologist ; mood state ; and cancer-specific quality of life . RESULTS Patients receiving the consultation audiotape reported having been provided with significantly more disease and treatment information in general ( p=0.04 ) , and more information about treatment alternatives ( p=0.04 ) and treatment side effects ( p=0.01 ) in particular , than patients who did not receive the audiotape . Audiotape benefit was not significantly related to patient satisfaction with communication , mood state or quality of life at 12 weeks post-consultation , and was not significantly affected by choice of receiving the audiotape . Patients rated the audiotape intervention positively , with an average score of 83.0 out of 100 . CONCLUSION Consultation audiotapes are rated highly by men with prostate cancer , and these audiotapes help to enhance their perception of having been provided with critical disease- and treatment-related information PURPOSE To measure the prevalence of communication barriers between breast cancer patients and their physicians and to present the results of a study evaluating the impact of two visit preparation techniques on communication and satisfaction for breast cancer patients and their physicians . PATIENTS AND METHODS We recruited 132 breast cancer patients from two outpatient cancer centers in a sequential , controlled trial . Ninety-four consented and completed the trial . Patients were assigned to one of two visit preparation interventions before their appointment with either a surgeon or a medical oncologist . In the control intervention , called Productive Listening , a research er listened to and prompted patients to reflect on their experiences communicating with physicians . In the experimental intervention , called Consultation Planning , a research er elicited questions and concerns , generated a printed agenda for the upcoming consultation , and engaged patients in techniques to improve communication with their physicians . Valid and reliable surveys measured communication barriers , satisfaction with the intervention , and patients ' and physicians ' satisfaction with the consultation . RESULTS Sixty-four percent of the patients reported three or more communication barriers . Patients reported a significant reduction in communication barriers after both the intervention and the control session . Patients reported significantly higher satisfaction after the Consultation Planning sessions . Physicians reported significantly higher satisfaction with those patients who had participated in a Consultation Planning session . CONCLUSION Visit preparation sessions help patients prepare for medical consultations and reduce barriers to communication .  Consultation Planning sessions , in which a research er solicited the patient 's agenda , were more satisfying to patients and physicians than the Productive Listening sessions The feasibility of a r and omized clinical trial to implement and compare the effectiveness of three components of an intervention for women with breast cancer and their partners was tested . The intervention components , st and ardized education by videotape ( SE ) , telephone counseling ( TC ) , and education with telephone counseling ( SE + TC ) , were design ed with a complementary approach to disease management of breast cancer at each of four phases of the breast cancer experience : diagnostic , postsurgery , adjuvant therapy , and ongoing recovery . A st and ardized Telephone Counseling Training Manual was developed . A nonprobability sample of 12 patient-partner pairs was accrued . Four pairs were r and omly assigned to each of the three intervention components . A set of question naires was completed by each patient and partner at baseline and following each intervention for assessment of emotional , physical , and social adjustment , and perceived support . Attrition was minimal and return rate for the completed question naires at all five data - collection points was high . Validation of the SE and the TC , one of the objectives , was by data from the preliminary descriptive study ( Hoskins , 1990–1994 ) , pretests and posttests for st and ardized education , audiotapes for each phase-specific telephone counseling session , and evaluation forms for each intervention session . The positive findings included significant changes from pre- to postmeasurement in patients ' and partners ' scores for the st and ardized education in each of the four phases . Even with the limited statistical power , the effects were marked , lending support for a full-scale r and omized clinical trial , to underst and better the relative treatment efficacy and differential benefit of one or some interventions over others Data from a ' limited prospect i ve ' study on life events and breast cancer were tested whether they were biased by knowledge of the prospect i ve diagnosis or by related mood states . Data were gathered by semi-structured and tape-recorded interviews . Event classifications were made according to Brown and Harris ' Life Events and Difficulties Scale , an interviewer-based rating method . Ratings were performed before the interviewer learned the final diagnosis . Among the women coming to hospital with a suspicious breast lump , 33 had a malignant and 59 had a benign diagnosis . For comparison for mood effects two more control groups ( women prior to gall stone surgery and healthy women interviewed at home ) were included . Although artifacts may in general play a role for reporting events in ' limited prospect i ve ' design s , the present study could not document a sizeable effect of presumed confounding variables on response behaviour BACKGROUND Active participation and asking questions are important ways in which patients can ensure they underst and what the doctor has said . This study evaluated a question prompt sheet design ed to encourage patients to ask questions in the cancer consultation . PATIENTS AND METHODS Patients ( n = 142 ) were r and omised to receive ( i ) a question prompt sheet or ( ii ) a general sheet informing patients of services available through the regional Cancer Council . Recall of information was assessed in a structured interview 4 - 20 days after the consultation . Question naires to assess patient satisfaction and adjustment to cancer were sent by mail . RESULTS The question prompt sheet had a significant effect in one content area : prognosis . Thirty-five percent of patients who received the question h and out asked questions about prognosis compared to 16 % of those receiving the information h and out . The prompt sheet did not increase the mean number of questions asked overall . Age , in 
    Output:
    