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:
Evaluation of three methods of symptom reporting in a clinical trial of felodipine
Abstract 1:
Summary 251 patients from 23 primary health care centres were recruited to a clinical trial in which either felodipine or placebo was added to baseline metoprolol treatment . Three methods of symptom reporting were used in 191 patients , namely two previously documented self-administered question naires and an adverse event monitoring system ( spontaneous reports to treating physician).Higher frequencies of symptoms were seen with the question naires compared to spontaneous reporting . However , the overlap between the methods was moderate and they were found to complement one another . The question naires were completed twice during the study and the adverse event monitoring system was applied on five occasions . The rate of application had consequences for the ability of each method to detect transient , dose-related symptoms , e.g. headache and dizziness . Regardless of method , the possibility of detecting dose-related symptoms was enhanced when symptoms were measured not only during active treatment but also during a run-in or other baseline period , and both phases were considered in the analyses


Title 2:
Evaluation des effets secondaires chez les nevrotiques-un essai avec la mesoridazine et le placebo.
Abstract 2:
Introduction Lors de I'analyse de la portee clinique d'un nouveau medicament , Ie praticien doit en determiner les vertus therapeutiques par rapport aux effets secondaires ( 7 ) . Ce jugement prend une importance accrue lorsqu'il s'agit d'un nouveau psychotrope , et surtout dans Ie traitement de nevrotiques ou les effets secondaires peuvent exercer un effet therapeutique negatif d ' importance . Selon Ie sexe et Ie niveau de scolarite du malade , certains facteurs tels que la forme et la couleur du medicament peuvent influencer la reaction du sujet a la medication qui'il recoit ( 1 - 4 ) . Les rapports d'etudes cliniques nous orientent parfois sur I'rmportance relative des effets secondaires . Ils nous eclairent mieux que la documentation accompagnant Ie nouveau medicament , puisque cette documentation officielle doit rendre compte de tous les effets secondaires possibles du produit , sans necessairement elaborer la frequence des symptomes . Par contre , les etudes cliniques mettent plus d'emphase sur les effets therapeutiques recherches ( l'effet primaire ) que sur les effets secondaires indesirables . Lorsque les effets secondaires sont colliges , ils peuvent decouler de I ' emploi de method es di verses .


Title 3:
Detection of adverse drug reactions in a clinical trial using two types of questioning.
Abstract 3:
Two methods of assessing adverse drug effects-an open-ended question versus a checklist-were compared in a clinical study involving 515 patients being treated with bacampicillin for gonorrhea . Results indicate that adverse reactions are reported more frequently if a checklist is used . However , it was also observed that more serious side effects are usually reported in response to an open-ended question rather than a checklist . Thus it was concluded that the optimal procedure for assessing adverse reactions is to record responses to both an open-ended question and a checklist


Title 4:
Adverse nondrug reactions.
Abstract 4:
Abstract Healthy university students and hospital staff taking no medications  were surveyed by question naire to obtain data on the occurrence of many symptoms often listed as side effects of drugs
10 Most Frequently Reported Adverse Events Discussion In this r and omized , controlled trial , we found that a checklist method of identifying adverse events dramatically increased the number of reported events compared with 2 types of open-ended questions .
However , if different drugs used for the same indication are examined in clinical trials that use different methods of identifying adverse events , then it is not valid to compare the reported rate of side effects .
Similarly , a recent systematic review found that published trials of pharmacologic treatments for rheumatoid arthritis were much more likely to report data on harm than trials of nonpharmacologic treatment ( 5 ) , highlighting the difficulty of comparing the safety of different treatments for the same condition .
Because all patients in the current study were taking placebo , probably none of the reported adverse events were true side effects of the study medication but were merely symptoms that commonly occur in adults .