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: BACKGROUND Brief interventions for  problem drinking  in medical setting s are effective but rarely conducted , mainly due to insufficient time . A stepped care approach ( starting with a very brief intervention and intensifying efforts in case of no success ) could save re sources and enlarge effectiveness ; however , research is lacking . The present study compares a full care brief intervention for patients with at-risk drinking , alcohol abuse or dependence with a stepped care approach in a r and omized controlled trial . METHODS Participants were proactively recruited from general practice s in two northern German cities . In total , 10,803 screenings were conducted ( refusal rate : 5 % ) . Alcohol use disorders according to DSM-IV were assessed with the Munich-Composite International Diagnostic Interview ( M-CIDI ) . Eligible participants were r and omly assigned to one of three conditions : ( 1 ) stepped care ( SC ) : a computerized intervention plus up to three 40-min telephone-based interventions depending on the success of the previous intervention ; ( 2 ) full-care ( FC ) : a computerized intervention plus a fixed number of four 30-min telephone-based interventions that equals the maximum of the stepped care intervention ; ( 3 ) an untreated control group ( CG ) .  Counseling effort in the intervention conditions and quantity/frequency of drinking were assessed at 12-month follow-up . RESULTS SC participants received roughly half of the amount of intervention in minutes compared to FC participants . Both groups did not differ in drinking outcomes . Compared to CG , intervention showed small to medium effect size for at-risk drinkers . CONCLUSIONS Study results reveal that a stepped care approach can be expected to increase cost-effectiveness of brief interventions for individuals with at-risk drinking Background In recent years , interventions that deliver online personalized feedback on alcohol use have been developed and appear to be a feasible way to curb heavy drinking . R and omized controlled trials ( RCTs ) among the general adult population , however , are scarce . The present study offers an RCT of Drinktest.nl , an online personalized feedback intervention in the Netherl and s. Objective The aim of this study was to assess the effectiveness of computer-based personalized feedback  on heavy alcohol use in male adults . Methods R and omization stratified by age and educational level was used to assign participants to either the intervention consisting of online personalized feedback or an information-only control condition . Participants were told as a cover story that they would evaluate newly developed health education material s. Participants were males ( n = 450 ) , aged 18 to 65 years , presenting with either heavy alcohol use ( > 20 units of alcohol weekly ) and /or binge drinking ( > 5 units of alcohol at a single occasion at least 1 day per week ) in the past 6 months . They were selected with a screener from a sampling frame of 25,000 households . The primary outcome measure was the percentage of the participants that had successfully reduced their drinking levels to below the Dutch guideline threshold for at-risk drinking . Results Intention-to-treat analysis showed that in the experimental condition , 42 % ( 97/230 ) of the participants were successful in reducing their drinking levels to below the threshold at the 1-month follow-up as compared with 31 % ( 67/220 ) in the control group ( odds ratio [ OR ] = 1.7 , number needed to treat [ NNT ] = 8.6 ) , which was statistically significant ( χ2 1 = 6.67 , P = .01 ) . At the 6-month follow-up , the success rates were 46 % ( 105/230 ) and 37 % ( 82/220 ) in the experimental and control conditions , respectively ( OR = 1.4 , NNT = 11.9 ) , but no longer statistically significant ( χ2 1 = 3.25 , P = .07 ) . Conclusions Personalized online feedback on alcohol consumption appears to be an effective and easy way to change unhealthy drinking patterns in adult men , at least in the short-term . Trial registration International St and ard R and omized Controlled Trial Number : NTR836 ; http://www.trialregister.nl/trialreg/admin/ rct view.asp?TC=836 ( Archived by WebCite at http://www.webcitation.org/5ytnEz2vp OBJECTIVES This study evaluates a computerized alcohol intervention implemented in a Swedish emergency department ( ED ) with regard to the effectiveness of two different types of tailored brief feedback on patients ' drinking patterns and the reach of the intervention . METHODS The study was a prospect i ve , r and omized controlled trial of ED patients . The design ated target population was the ED population aged 18 - 69 years who registered at the triage room before receiving care . Patients who were categorized as risky drinkers and completed the computerized test  were r and omized to either a long or a short feedback . The feedback was tailored on the basis of the individual patient 's responses to questions on their drinking patterns . RESULTS The computerized intervention reached 41 % of the target population . Those who completed the computerized test and received the feedback were younger than those who did not receive the intervention . Among those who could be followed up , the feedback was effective in reducing the patient 's weekly alcohol consumption and the number of heavy episodic drinking occasions . The long feedback was slightly more effective than the short feedback , but the differences were not statistically significant Background Hazardous alcohol use is associated with an increased risk for development of a substance use disorder , leading to negative outcomes in psychiatric patients . Aims In order to investigate whether psychiatric out patients ’  hazardous alcohol consumption could be reduced by way of a brief intervention by telephone . Method Non-psychotic psychiatric out patients , n = 1,670 , completed a self-rating form concerning alcohol habits ( AUDIT ) . Participants with scores indicating risk consumption ( n = 344 ) were r and omised to intervention ( immediate advice ) or control ( advice after 6 months ) . Results Hazardous alcohol habits occurred among 19 % of the women and 24 % of the men . In the intervention group , half of the patients reduced their alcohol consumption to non-hazardous levels at 6-month follow-up ( ITT analysis ) . In women , 41.5 % in the intervention group had no hazardous consumption at follow-up compared to 24.7 % in the control group ( P = 0.003 ) , corresponding figure for men was 49.1 and 34.0 % . Conclusion Brief intervention seems to be effective to reduce hazardous alcohol consumption in psychiatric out patients Objective : Alcohol consumption has been a growing concern at U.S. colleges , particularly among first-year students , who are at increased risk for problems . This study tested the efficacy of the “ electronic Check-Up to Go ” ( e-CHUG ) , a commercially-available internet program , at reducing drinking among a group of at-risk college freshman . Method : The design was a r and omized controlled trial : 106 freshmen students who reported heavy episodic drinking were r and omly assigned to receive feedback or to assessment only . Assessment measures were completed at baseline , 8 weeks , and 16 weeks . Results : At 8 weeks , the feedback group showed a significant decrease in drinks per week and peak BAC over control . By 16 weeks , the control group also declined to a point where there were no differences between groups . Changes in normative drinking estimates mediated the effect of the intervention . An additional 245 abstainers and light drinkers who were also r and omized to condition did not show any intervention effect . Conclusions : This study provides preliminary support for the efficacy of this intervention at reducing short-term drinking among at-risk students Background Current insights indicate that Web-based delivery may enhance the implementation of brief alcohol interventions . Previous research showed that electronically delivered brief alcohol interventions decreased alcohol use in college students and adult problem drinkers . To date , no study has investigated the effectiveness of Web-based brief alcohol interventions in reducing alcohol use in younger population s. Objective The present study tested 2 main hypotheses , that is , whether an online multicomponent brief alcohol intervention was effective in reducing alcohol use among 15- to 20-year-old binge drinkers and whether inclusion of normative feedback would increase the effectiveness of this intervention . In additional analyses , we examined possible moderation effects of participant ’s sex , which we had not a priori hypothesized . Method A total of 575 online panel members ( aged 15 to 20 years ) who were screened as binge drinkers were r and omly assigned to ( 1 ) a Web-based brief alcohol intervention without normative feedback , ( 2 ) a Web-based brief alcohol intervention with normative feedback , or ( 3 ) a control group ( no intervention ) .  Alcohol use and moderate drinking were assessed at baseline , 1 month , and 3 months after the intervention . Separate analyses were conducted for participants in the original sample ( n = 575 ) and those who completed both posttests ( n = 278 ) . Missing values in the original sample were imputed by using the multiple imputation procedure of PASW Statistics 18 . Results Main effects of the intervention were found only in the multiple imputed data set for the original sample suggesting that the intervention without normative feedback reduced weekly drinking in the total group both 1 and 3 months after the intervention ( n = 575 , at the 1-month follow-up , beta = -.24 , P = .05 ; at the 3-month follow-up , beta = -.25 , P = .04 ) . Furthermore , the intervention with normative feedback reduced weekly drinking only at 1 month after the intervention ( n=575 , beta = -.24 , P = .008 ) . There was also a marginally significant trend of the intervention without normative feedback on responsible drinking at the 3-month follow-up ( n = 575 , beta = .40 , P = .07 ) implying a small increase in moderate drinking at the 3-month follow-up . Additional analyses on both data sets testing our post hoc hypothesis about a possible differential intervention effect for males and females revealed that this was the case for the impact of the intervention without normative feedback on weekly drinking and moderate drinking at the 1-month follow-up ( weekly drinking for n = 278 , beta = -.80 , P = .01 , and for n = 575 , beta = -.69 , P = .009 ; moderate drinking for n = 278 , odds ratio [ OR ] = 3.76 , confidence interval [ CI ] 1.05 - 13.49 , P = .04 , and for n = 575 , OR = 3.00 , CI = 0.89 - 10.12 , P = .08 ) and at the 3-month follow-up ( weekly drinking for n = 278 , beta = -.58 , P = .05 , and for n = 575 , beta = -.75 , P = .004 ; moderate drinking for n = 278 , OR = 4.34 , CI = 1.18 - 15.95 , P = .04 , and for n = 575 , OR = 3.65 , CI = 1.44 - 9.25 , P = .006 ) . Furthermore , both data sets showed an interaction effect between the intervention with normative feedback and participant ’s sex on weekly alcohol use at the 1-month follow-up ( for n = 278 , beta = -.74 , P = .02 , and for n = 575 , beta = -.64 , P = .01 ) and for moderate drinking at the 3-month follow-up ( for n = 278 , OR = 3.10 , CI = 0.81 - 11.85 , P = .07 , and for n = 575 , OR = 3.00 , CI = 1.23 - 7.27 , P = .01 ) . Post hoc probing indicated that males who received the intervention showed less weekly drinking and were more likely to drink moderately at 1 month and at 3 months following the intervention . For females , the interventions yielded no effects : the intervention without normative feedback even showed a small unfavorable effect at the 1-month follow-up . Conclusion The present study demonstrated that exposure to a Web-based brief alcohol intervention generated a decrease in weekly drinking among 15- to 20-year-old binge drinkers but did not encourage moderate drinking in the total sample . Additional analyses revealed that intervention effects were most prominent in males result ing in less weekly alcohol use and higher levels of moderate drinking among 15- to 20-year-old males over a period of 1 to 3 months . Trial Registration IS RCT N50512934 ; http://www.controlled-trials.com/IS RCT N50512934/ ( Archived by WebCite at http://www.webcitation.org/5usICa3Tx AIMS To test the feasibility of online alcohol screening and brief intervention ( BI ) by comparing ( i ) two approaches to inviting all students to be screened , and ( ii ) a minimal versus a more extensive BI . METHODS Freshmen students at one university were r and omized to receive one of two types of email invitations to an online anonymous : ( i ) general health assessment , or ( ii ) alcohol-specific assessment . All were linked to the same alcohol screening survey . Those with unhealthy alcohol use ( AUDIT > or=8 ) were r and omly assigned to minimal or more extensive online alcohol BI . RESULTS In both invitation groups ( 4008 students ) , 55 % of students completed the online screening .  Overall , 37 % of men and 26 % of women had unhealthy alcohol use .  Compared to minimal BI , more extensive BI was associated with intention to seek help among men and with a greater 
    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: BACKGROUND Brief interventions for  problem drinking  in medical setting s are effective but rarely conducted , mainly due to insufficient time . A stepped care approach ( starting with a very brief intervention and intensifying efforts in case of no success ) could save re sources and enlarge effectiveness ; however , research is lacking . The present study compares a full care brief intervention for patients with at-risk drinking , alcohol abuse or dependence with a stepped care approach in a r and omized controlled trial . METHODS Participants were proactively recruited from general practice s in two northern German cities . In total , 10,803 screenings were conducted ( refusal rate : 5 % ) . Alcohol use disorders according to DSM-IV were assessed with the Munich-Composite International Diagnostic Interview ( M-CIDI ) . Eligible participants were r and omly assigned to one of three conditions : ( 1 ) stepped care ( SC ) : a computerized intervention plus up to three 40-min telephone-based interventions depending on the success of the previous intervention ; ( 2 ) full-care ( FC ) : a computerized intervention plus a fixed number of four 30-min telephone-based interventions that equals the maximum of the stepped care intervention ; ( 3 ) an untreated control group ( CG ) .  Counseling effort in the intervention conditions and quantity/frequency of drinking were assessed at 12-month follow-up . RESULTS SC participants received roughly half of the amount of intervention in minutes compared to FC participants . Both groups did not differ in drinking outcomes . Compared to CG , intervention showed small to medium effect size for at-risk drinkers . CONCLUSIONS Study results reveal that a stepped care approach can be expected to increase cost-effectiveness of brief interventions for individuals with at-risk drinking Background In recent years , interventions that deliver online personalized feedback on alcohol use have been developed and appear to be a feasible way to curb heavy drinking . R and omized controlled trials ( RCTs ) among the general adult population , however , are scarce . The present study offers an RCT of Drinktest.nl , an online personalized feedback intervention in the Netherl and s. Objective The aim of this study was to assess the effectiveness of computer-based personalized feedback  on heavy alcohol use in male adults . Methods R and omization stratified by age and educational level was used to assign participants to either the intervention consisting of online personalized feedback or an information-only control condition . Participants were told as a cover story that they would evaluate newly developed health education material s. Participants were males ( n = 450 ) , aged 18 to 65 years , presenting with either heavy alcohol use ( > 20 units of alcohol weekly ) and /or binge drinking ( > 5 units of alcohol at a single occasion at least 1 day per week ) in the past 6 months . They were selected with a screener from a sampling frame of 25,000 households . The primary outcome measure was the percentage of the participants that had successfully reduced their drinking levels to below the Dutch guideline threshold for at-risk drinking . Results Intention-to-treat analysis showed that in the experimental condition , 42 % ( 97/230 ) of the participants were successful in reducing their drinking levels to below the threshold at the 1-month follow-up as compared with 31 % ( 67/220 ) in the control group ( odds ratio [ OR ] = 1.7 , number needed to treat [ NNT ] = 8.6 ) , which was statistically significant ( χ2 1 = 6.67 , P = .01 ) . At the 6-month follow-up , the success rates were 46 % ( 105/230 ) and 37 % ( 82/220 ) in the experimental and control conditions , respectively ( OR = 1.4 , NNT = 11.9 ) , but no longer statistically significant ( χ2 1 = 3.25 , P = .07 ) . Conclusions Personalized online feedback on alcohol consumption appears to be an effective and easy way to change unhealthy drinking patterns in adult men , at least in the short-term . Trial registration International St and ard R and omized Controlled Trial Number : NTR836 ; http://www.trialregister.nl/trialreg/admin/ rct view.asp?TC=836 ( Archived by WebCite at http://www.webcitation.org/5ytnEz2vp OBJECTIVES This study evaluates a computerized alcohol intervention implemented in a Swedish emergency department ( ED ) with regard to the effectiveness of two different types of tailored brief feedback on patients ' drinking patterns and the reach of the intervention . METHODS The study was a prospect i ve , r and omized controlled trial of ED patients . The design ated target population was the ED population aged 18 - 69 years who registered at the triage room before receiving care . Patients who were categorized as risky drinkers and completed the computerized test  were r and omized to either a long or a short feedback . The feedback was tailored on the basis of the individual patient 's responses to questions on their drinking patterns . RESULTS The computerized intervention reached 41 % of the target population . Those who completed the computerized test and received the feedback were younger than those who did not receive the intervention . Among those who could be followed up , the feedback was effective in reducing the patient 's weekly alcohol consumption and the number of heavy episodic drinking occasions . The long feedback was slightly more effective than the short feedback , but the differences were not statistically significant Background Hazardous alcohol use is associated with an increased risk for development of a substance use disorder , leading to negative outcomes in psychiatric patients . Aims In order to investigate whether psychiatric out patients ’  hazardous alcohol consumption could be reduced by way of a brief intervention by telephone . Method Non-psychotic psychiatric out patients , n = 1,670 , completed a self-rating form concerning alcohol habits ( AUDIT ) . Participants with scores indicating risk consumption ( n = 344 ) were r and omised to intervention ( immediate advice ) or control ( advice after 6 months ) . Results Hazardous alcohol habits occurred among 19 % of the women and 24 % of the men . In the intervention group , half of the patients reduced their alcohol consumption to non-hazardous levels at 6-month follow-up ( ITT analysis ) . In women , 41.5 % in the intervention group had no hazardous consumption at follow-up compared to 24.7 % in the control group ( P = 0.003 ) , corresponding figure for men was 49.1 and 34.0 % . Conclusion Brief intervention seems to be effective to reduce hazardous alcohol consumption in psychiatric out patients Objective : Alcohol consumption has been a growing concern at U.S. colleges , particularly among first-year students , who are at increased risk for problems . This study tested the efficacy of the “ electronic Check-Up to Go ” ( e-CHUG ) , a commercially-available internet program , at reducing drinking among a group of at-risk college freshman . Method : The design was a r and omized controlled trial : 106 freshmen students who reported heavy episodic drinking were r and omly assigned to receive feedback or to assessment only . Assessment measures were completed at baseline , 8 weeks , and 16 weeks . Results : At 8 weeks , the feedback group showed a significant decrease in drinks per week and peak BAC over control . By 16 weeks , the control group also declined to a point where there were no differences between groups . Changes in normative drinking estimates mediated the effect of the intervention . An additional 245 abstainers and light drinkers who were also r and omized to condition did not show any intervention effect . Conclusions : This study provides preliminary support for the efficacy of this intervention at reducing short-term drinking among at-risk students Background Current insights indicate that Web-based delivery may enhance the implementation of brief alcohol interventions . Previous research showed that electronically delivered brief alcohol interventions decreased alcohol use in college students and adult problem drinkers . To date , no study has investigated the effectiveness of Web-based brief alcohol interventions in reducing alcohol use in younger population s. Objective The present study tested 2 main hypotheses , that is , whether an online multicomponent brief alcohol intervention was effective in reducing alcohol use among 15- to 20-year-old binge drinkers and whether inclusion of normative feedback would increase the effectiveness of this intervention . In additional analyses , we examined possible moderation effects of participant ’s sex , which we had not a priori hypothesized . Method A total of 575 online panel members ( aged 15 to 20 years ) who were screened as binge drinkers were r and omly assigned to ( 1 ) a Web-based brief alcohol intervention without normative feedback , ( 2 ) a Web-based brief alcohol intervention with normative feedback , or ( 3 ) a control group ( no intervention ) .  Alcohol use and moderate drinking were assessed at baseline , 1 month , and 3 months after the intervention . Separate analyses were conducted for participants in the original sample ( n = 575 ) and those who completed both posttests ( n = 278 ) . Missing values in the original sample were imputed by using the multiple imputation procedure of PASW Statistics 18 . Results Main effects of the intervention were found only in the multiple imputed data set for the original sample suggesting that the intervention without normative feedback reduced weekly drinking in the total group both 1 and 3 months after the intervention ( n = 575 , at the 1-month follow-up , beta = -.24 , P = .05 ; at the 3-month follow-up , beta = -.25 , P = .04 ) . Furthermore , the intervention with normative feedback reduced weekly drinking only at 1 month after the intervention ( n=575 , beta = -.24 , P = .008 ) . There was also a marginally significant trend of the intervention without normative feedback on responsible drinking at the 3-month follow-up ( n = 575 , beta = .40 , P = .07 ) implying a small increase in moderate drinking at the 3-month follow-up . Additional analyses on both data sets testing our post hoc hypothesis about a possible differential intervention effect for males and females revealed that this was the case for the impact of the intervention without normative feedback on weekly drinking and moderate drinking at the 1-month follow-up ( weekly drinking for n = 278 , beta = -.80 , P = .01 , and for n = 575 , beta = -.69 , P = .009 ; moderate drinking for n = 278 , odds ratio [ OR ] = 3.76 , confidence interval [ CI ] 1.05 - 13.49 , P = .04 , and for n = 575 , OR = 3.00 , CI = 0.89 - 10.12 , P = .08 ) and at the 3-month follow-up ( weekly drinking for n = 278 , beta = -.58 , P = .05 , and for n = 575 , beta = -.75 , P = .004 ; moderate drinking for n = 278 , OR = 4.34 , CI = 1.18 - 15.95 , P = .04 , and for n = 575 , OR = 3.65 , CI = 1.44 - 9.25 , P = .006 ) . Furthermore , both data sets showed an interaction effect between the intervention with normative feedback and participant ’s sex on weekly alcohol use at the 1-month follow-up ( for n = 278 , beta = -.74 , P = .02 , and for n = 575 , beta = -.64 , P = .01 ) and for moderate drinking at the 3-month follow-up ( for n = 278 , OR = 3.10 , CI = 0.81 - 11.85 , P = .07 , and for n = 575 , OR = 3.00 , CI = 1.23 - 7.27 , P = .01 ) . Post hoc probing indicated that males who received the intervention showed less weekly drinking and were more likely to drink moderately at 1 month and at 3 months following the intervention . For females , the interventions yielded no effects : the intervention without normative feedback even showed a small unfavorable effect at the 1-month follow-up . Conclusion The present study demonstrated that exposure to a Web-based brief alcohol intervention generated a decrease in weekly drinking among 15- to 20-year-old binge drinkers but did not encourage moderate drinking in the total sample . Additional analyses revealed that intervention effects were most prominent in males result ing in less weekly alcohol use and higher levels of moderate drinking among 15- to 20-year-old males over a period of 1 to 3 months . Trial Registration IS RCT N50512934 ; http://www.controlled-trials.com/IS RCT N50512934/ ( Archived by WebCite at http://www.webcitation.org/5usICa3Tx AIMS To test the feasibility of online alcohol screening and brief intervention ( BI ) by comparing ( i ) two approaches to inviting all students to be screened , and ( ii ) a minimal versus a more extensive BI . METHODS Freshmen students at one university were r and omized to receive one of two types of email invitations to an online anonymous : ( i ) general health assessment , or ( ii ) alcohol-specific assessment . All were linked to the same alcohol screening survey . Those with unhealthy alcohol use ( AUDIT > or=8 ) were r and omly assigned to minimal or more extensive online alcohol BI . RESULTS In both invitation groups ( 4008 students ) , 55 % of students completed the online screening .  Overall , 37 % of men and 26 % of women had unhealthy alcohol use .  Compared to minimal BI , more extensive BI was associated with intention to seek help among men and with a greater 
    Output:
    