You will be presented with a collection of medical randomized controlled trial (RCT) reports addressing a shared clinical question -- for instance, the efficacy of a medical intervention on a disease or condition. Given the titles and abstracts of these reports, your task is to generate the conclusion of the systematic review article synthesizing the key findings. Your conclusion should be a few sentences long. In your response, include only the conclusion and no other text. The RCT reports are below.



Title 1:
A method for assessing the quality of a randomized control trial.
Abstract 1:
A system has been constructed to evaluate the design , implementation , and analysis of  r and omized control trials ( RCT ) . The degree of quadruple blinding ( the r and omization process , the physicians and patients as to therapy , and the physicians as to ongoing results ) is considered to be the most important aspect of any trial . The analytic techniques are scored with the same emphasis as is placed on the control of bias in the planning and implementation of the studies . Description of the patient and treatment material s and the measurement of various controls of quality have less weight . An index of quality of a RCT is proposed with its pros and cons . If published papers were to approximate these principles , there would be a marked improvement in the quality of r and omized control trials . Finally , a reasonable st and ard design and conduct of trials will facilitate the interpretation of those with conflicting results and help in making valid combinations of undersized trials


Title 2:
An empirical study of the possible relation of treatment differences to quality scores in controlled randomized clinical trials.
Abstract 2:
Meta-analytic investigations sometimes use assessment s of research quality according to a formal protocol as a tool for improving research synthesis . We asked whether a particular  quality scoring system could have a direct use in adjusting the summary estimates of a treatment difference . In an empirical study of the relation of quality scores to treatment differences in published meta-analyses of 7 groups of controlled r and omized clinical trials comprising 107 primary studies , we found no relation between treatment difference and overall quality score . We also found no relation between quality score and variation in treatment difference . The level of quality scores has increased at a rate of 9 % per decade for three decades , averaging 0.51 on a scale of 0 to 1 for the 1980s , and leaving much room for improvement . Nevertheless , attention to quality of studies by editors , review ers , and authors may be raising both the level of research done and quality of the reports


Title 3:
Reporting on methods in clinical trials.
Abstract 3:
A clinical trial can not be adequately interpreted without information about the methods used in the design of the study and the analysis of the results . To determine the frequency of reporting what we consider 11 important aspects of design and analysis , we surveyed all 67 clinical trials published in the New Engl and Journal of Medicine , the Lancet , and the British Medical Journal from July through December 1979 and in the Journal of the American Medical Association from July 1979 through June 1980 . Of all 11 items in the 67 trials published in all four journals , 56 per cent were clearly reported , 10 per cent were ambiguously mentioned , and 34 per cent were not reported at all . At least 80 per cent of the 67 trials reported information about  statistical analyses , statistical methods used , and  r  and  om allocation  of subjects , yet only 19 per cent reported the method of r and omization . Loss to follow-up was discussed in 79 per cent of the articles , treatment complications in 64 per cent , and admission of subjects before allocation in 57 per cent , but eligibility criteria for admission to the trial appeared in only 37 per cent . Although information about whether patients were blind to treatment was given in 55 per cent , information about whether there was blind assessment of outcome was reported in only 30 per cent . The statistical power of the trial to detect treatment effects was discussed in only 12 per cent of the articles . The clinical trials published in The New Engl and Journal of Medicine reported 71 per cent of the 11 items , those in the Journal of the American Medical Association 63 per cent , those in the British Medical Journal 52 per cent , and those in the Lancet 46 per cent . These rates are significantly different ( P less than 0.001 ) . We recommend that editors improve the reporting of clinical trials by giving authors a list of the important items to be reported


Title 4:
[Additional treatment with Esberitox N in patients with chemo-radiotherapy treatment of advanced breast cancer].
Abstract 4:
A study was made at r and om on 70 female patients with advanced mamma carcinoma to find out whether an additional treatment with Esberitox N prevents or diminishes the sideeffects of a combined chemo-radiation therapy . As it could not be excluded that the efficacy of Esberitox N on previous affliction by haematotoxic therapy would probably differ , the study was made on various groups of risk . The parameter to form an opinion were either the peripheral hematosis or the appearance of infections . It turned out , however , that Esberitox N proved only effective if there was only a minor damage of the bonemarrow . The efficacy seems to promote the recuperation of the haemapoetic system . There was no significant frequency of infections by the additional Esberitox N treatment , yet in tendency favourably influenced
Existing controlled clinical trials indicate that preparations containing extracts of Echinacea can be efficacious immunomodulators .
However , the evidence is still insufficient for clear therapeutic recommendations as to which preparation to use and which dose to employ for a specific indication .