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:
Ginkgo biloba for Dementia
Abstract 1:
Abstract Objective : To systematic ally review the clinical evidence of Ginkgo biloba preparations as a symptomatic treatment for  dementia .  Methods : Computerised literature search es were performed to identify all double-blind , r and omised , placebo-controlled trials assessing clinical end-points of Ginkgo biloba extract as a treatment for dementia . Data bases included Medline , Embase , Biosis and the Cochrane Library . There were no restrictions regarding the language of publication . Data were extracted in a st and ardised , predefined fashion , independently by both authors . Results : Nine double-blind , r and omised , placebo-controlled trials met the inclusion criteria and were review ed . These studies are of varying method ological quality . They collectively suggest that Ginkgo biloba extract is more effective for dementia than placebo . However , a number of caveats pertain . Few , generally mild , adverse effects were reported . Conclusion : These findings are encouraging and warrant independent , large scale confirmatory and comparative trials


Title 2:
Valerian for insomnia: a systematic review of randomized clinical trials.
Abstract 2:
Objective : To systematic ally review the evidence for the effects of the herb valerian ( Valeriana officinalis ) on  insomnia  , based on r and omized , placebo-controlled , double-blind trials . Background : Valerian has long been advocated and used for promoting sleep but until quite recently evidence was solely anecdotal . However , during the last two decades a number of clinical trials have been conducted . Material s and methods : Systematic literature search es were performed to locate r and omized , placebo-controlled , double-blind trials measuring the effect of  valerian monopreparations on sleep in human participants . Data were extracted in a st and ardized manner and method ological quality was assessed by the Jadad score . Results : Nine trials were located meeting the selection criteria . The findings of the studies were contradictory and there was great inconsistency between trials in terms of patients , experimental design and procedures and method ological quality . Conclusion : The evidence for valerian as a treatment for  insomnia  is inconclusive . There is a need for rigorous trials to determine its efficacy


Title 3:
Plants with hypoglycemic activity in humans.
Abstract 3:
More than 400 plants with suspected glucose-lowering potential are known . In most cases , the evidence for this action is based purely on animal experiments or traditional use . This , however , provides only limited information about its clinical usefullness . Therefore this paper review s direct evidence from clinical trials . A systematic literature search identified 22 such papers . The majority reported positive effects . However , much of the data are of poor method ological quality . Only five r and omised controlled trials were found , and even these do not convincingly demonstrate the usefulness of the remedies in question . It is concluded that the use of hypoglycemic plant remedies is not supported by results from rigorous clinical trials and requires further investigation


Title 4:
Immunomodulation with echinacea - a systematic review of controlled clinical trials.
Abstract 4:
We performed a systematic review of controlled clinical trials to check the evidence for the immunomodulatory efficacy of preparations containing extracts of Echinacea . Trials were search ed by on-line search es in Medline and Embase , a search in the private data base Phytodok , contacts with research ers and drug companies , and by checking references in available articles . All available historically and prospect ively controlled trials investigating the prophylactic or therapeutic immunomodulatory activity of preparations of Echinacea alone or in combination with other plant extracts or homeopathic dilutions  in humans were included . Study characteristics , results , and conclusions of primary authors were analyzed using st and ardized evaluation forms and method ological quality assessment using a predefined score system . A total of 26 controlled clinical trials ( 18 r and omized , 11 double-blind ) were identified ; 6 of these involved testing three different mono-extracts , and 20 involved testing three different preparations also containing other ingredients . Nineteen trials studied the efficacy of the prophylactic or curative treatment of infections ; 4 trials the reduction of side-effects of antineoplastic therapies and 3 trials the modulation of various laboratory immune parameters . The primary authors cl aim ed that 30 of the 34 treatment strategies showed a superior efficacy to those of the control groups . The method ological quality of most studies was low and only 8 trials scored more than half of the maximum possible score points . 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 . Further method ologically sound , r and omized clinical trials should be conducted


Title 5:
Do cabbage leaves prevent breast engorgement? A randomized, controlled study.
Abstract 5:
A r and omized , controlled trial was conducted to evaluate the effect of cabbage leaves on mothers ' perceptions of breast engorgement and the influence of this treatment on breastfeeding practice s. The subjects , 120 breastfeeding women 72 hours postpartum , were r and omly allocated to an experimental group who received application of cabbage leaves to their breasts , or to a control group who received routine care . The experimental group tended to report less breast engorgement , but this trend was not statistically significant . At six weeks , women who received the cabbage leaf application were more likely to be breastfeeding exclusively , 76 and 58 percent ( 35/46 vs 29/50 ; P = 0.09 ) , and their mean duration of exclusive breastfeeding was longer ( 36 vs 30 days ; P = 0.04 ) . The greater breastfeeding success in the experimental group may have been due to some beneficial effect of cabbage leaf application , or may have been secondary to reassurance and improved confidence and self-esteem in these mothers


Title 6:
Mistletoe treatment for cancer review of controlled trials in humans.
Abstract 6:
This review assesses the evidence of the efficacy of mistletoe extracts in cancer patients from controlled clinical trials in humans . We used a list of predefined criteria for good methodology to select the trials which had the highest quality and interpreted the results with emphasis on the quality . An extensive search of the literature yielded 11 controlled trials in which at least an attempt was made for unbiased allocation into the contrasted treatment groups . The average quality of the trials appeared to be disappointingly poor . It concerned trials for bronchus carcinoma , colorectal carcinoma , mamma carcinoma , gastric cancer and female genital cancer . In the trials the results were in favour of mistletoe treatment ; the principle endpoint was mostly survival time . Only one trial could not show a beneficial effect , but this was the trial with the highest method ological score . Well performed r and omized , double-blind clinical trials on carefully chosen patient population s are needed in order to make assessment s of any efficacy . Further evidence should also consist of a more solid demonstration of the mechanisms of action from laboratory studies . St and ardization methods on active substances should be improved as there are apparent component variations between , but also within the preparations which were used in clinical trials . Considering the state of affairs we can not recommend the use of mistletoe extracts in the treatment of cancer patients with an exception for patients involved in clinical trials
Conclusions : Systematic review s are available on a broad range of herbal preparations prescribed for defined conditions .
There is very little evidence on the effectiveness of herbalism as practice d by specialist herbalists who combine herbs and use unconventional diagnosis