JAMA Network Open最新文献

{"title":"Encouraging the Registration of Observational Studies.","authors":"Jesse A Berlin, Stephan D Fihn","doi":"10.1001/jamanetworkopen.2025.24181","DOIUrl":"https://doi.org/10.1001/jamanetworkopen.2025.24181","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2524181"},"PeriodicalIF":10.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Department Use Prior to Cancer Diagnosis and Mortality.","authors":"Keerat Grewal, Andrew Calzavara, Shelley L McLeod, Antoine Eskander, David W Savage, Cameron Thompson, Bjug Borgundvaag, Howard Ovens, Sheldon Cheskes, Kerstin de Wit, Jonathan C Irish, Monika K Krzyzanowska, Rachel Walsh, Venkatesh Thiruganasambandamoorthy, Rinku Sutradhar","doi":"10.1001/jamanetworkopen.2025.22585","DOIUrl":"10.1001/jamanetworkopen.2025.22585","url":null,"abstract":"<p><strong>Importance: </strong>The emergency department (ED) is a common yet understudied route to cancer diagnosis. It has been reported that over 1 in 3 patients in Ontario, Canada, used the ED prior to cancer diagnosis.</p><p><strong>Objective: </strong>To examine the association between ED use in the 90 days prior to cancer diagnosis and subsequent mortality.</p><p><strong>Design, setting, and participants: </strong>This matched, retrospective, population-based cohort study used administrative health data from Ontario, Canada. Adults (aged ≥18 years) diagnosed with cancer between January 1, 2014, and December 31, 2021, were included. Patients were followed from index diagnosis until death, 7 years, or end of the study (March 31, 2024). To create the cohort, patients with and without ED use prior to diagnosis were matched 1:1 on sex and year of diagnosis, and then were propensity score matched.</p><p><strong>Exposure: </strong>Any ED visit in the 90 days prior to diagnosis.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was all-cause mortality after cancer diagnosis. A Cox proportional hazards regression model was used to estimate mortality risk. Interaction with time using restricted cubic splines was included to model the time-varying relationship between ED use and mortality. Results were stratified by hospitalization on the ED visit vs discharge from the ED.</p><p><strong>Results: </strong>A total of 205 060 (89.3%) patients with ED use prior to cancer diagnosis were matched to patients without ED use prior to diagnosis. Of the 410 120 total patients included, the mean (SD) age was 67.4 (15.0) years, and 106 681 (52.0%) per group were male. Overall mortality was 49.7%: 61.7% in patients with an ED visit vs 37.8% in patients without an ED visit. Patients with ED use prior to diagnosis had statistically significantly higher risk of mortality compared with those without ED use, which decreased with time but persisted through the 7-year follow-up (hazard ratio [HR] at 30 days: 4.49 [95% CI, 4.40-4.58]; HR at 1 year: 1.85 [95% CI, 1.82-1.88]; HR at 3 years: 1.48 [95% CI, 1.46-1.50]; HR at 7 years: 1.05 [95% CI, 1.01-1.09]). In stratified analysis, the increased hazard of death among patients with ED use was even higher among those admitted to the hospital vs the overall model, which persisted over the follow-up time (HR at 30 days: 5.83 [95% CI, 5.69-5.99]; HR at 1 year: 2.23 [95% CI, 2.19-2.27]; HR at 3 years: 1.74 [95% CI, 1.70-1.77]; HR at 7 years: 1.30 [95% CI, 1.23-1.37]). Patients discharged from the ED also had a greater hazard of mortality vs those without ED use, which persisted to 3 years of follow-up (HR at 30 days: 2.68 [95% CI, 2.59-2.77]; HR at 1 year: 1.81 [95% CI, 1.76-1.86]; HR at 3 years: 1.38 [95% CI, 1.34-1.41]; HR at 7 years: 1.03 [95% CI, 0.98-1.10]).</p><p><strong>Conclusions and relevance: </strong>In this cohort study of patients diagnosed with cancer, those with ED use prior to cancer diagnosis","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2522585"},"PeriodicalIF":9.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12284740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive Modeling of Heterogeneous Treatment Effects in RCTs: A Scoping Review.","authors":"Joe V Selby, Carolien C H M Maas, Bruce H Fireman, David M Kent","doi":"10.1001/jamanetworkopen.2025.22390","DOIUrl":"10.1001/jamanetworkopen.2025.22390","url":null,"abstract":"<p><strong>Importance: </strong>The Predictive Approaches to Treatment Effect Heterogeneity (PATH) Statement of 2020 proposed predictive modeling for identifying heterogeneity in treatment effects (HTE) in randomized clinical trials (RCTs). It described 2 approaches: risk modeling, which develops a multivariable model predicting individual baseline risk of study outcomes and then examines treatment effects across strata of predicted risk, and effect modeling, which develops a model that directly predicts individual treatment effects using a variety of regression and machine learning methods.</p><p><strong>Objective: </strong>To identify, describe, and evaluate findings from reports that cited the PATH Statement and presented predictive modeling of HTE in RCTs.</p><p><strong>Evidence review: </strong>Reports were identified using PubMed, Google Scholar, Web of Science, and SCOPUS through July 5, 2024. Using double review with adjudication, reports were assessed for consistency with PATH Statement recommendations, credibility of HTE findings (applying criteria adapted from the Instrument to Assess Credibility of Effect Modification Analyses), and clinical importance of credible findings.</p><p><strong>Findings: </strong>A total of 65 reports (presenting 31 risk models and 41 effect models) analyzing 162 RCTs were identified, with credible, clinically important HTE in 24 reports (37%). Contrary to PATH Statement recommendations, only 25 of 48 studies with positive overall findings included a risk model. Most effect models were exploratory, including multiple predictors with little prior evidence for HTE. Claims of HTE were noted in 23 risk modeling and 31 effect modeling reports but were more likely to meet credibility criteria with risk modeling (20 of 23 reports [87%]) than effect modeling (10 of 31 reports [32%]). For effect modeling, validation of HTE findings in external datasets was critical in establishing credibility. Credible HTE from either approach was usually judged clinically important (24 of 30 reports [80%]). In the 19 reports from RCTs suggesting overall treatment benefits, modeling identified subgroups of 5% to 67% of patients predicted to experience no benefit or net treatment harm. In the 5 reports that found no overall benefit, subgroups of 25% to 60% of patients were nevertheless predicted to benefit.</p><p><strong>Conclusions and relevance: </strong>This scoping review of 65 reports of multivariable predictive modeling of HTE in RCTs identified credible, clinically important HTE in 37%. Risk modeling was more likely than effect modeling to find credible HTE, but external validation of HTE findings served to increase the credibility of findings from exploratory effect models.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2522390"},"PeriodicalIF":9.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12284745/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer Labeling, Risk Perception, and Treatment Choices in Clonal Cytopenia of Undetermined Significance.","authors":"Benjamin Chin-Yee, Andrew J Latham, Somogy Varga","doi":"10.1001/jamanetworkopen.2025.23733","DOIUrl":"10.1001/jamanetworkopen.2025.23733","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2523733"},"PeriodicalIF":9.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Perspectives on Prior Authorization for Cancer Care.","authors":"Bridgette Thom, Sonia Persaud, Lauren V Ghazal, Fumiko Chino","doi":"10.1001/jamanetworkopen.2025.23807","DOIUrl":"10.1001/jamanetworkopen.2025.23807","url":null,"abstract":"<p><strong>Importance: </strong>Health insurance companies may require prior authorization at any stage in the cancer care continuum, leading to the potential for denials and/or delays of diagnosis, treatment, or survivorship care. Patient experiences with prior authorization are largely unexplored, with most surveys focused on clinicians.</p><p><strong>Objective: </strong>To characterize prior authorization for cancer care from the perspective of patients with cancer, using their own words.</p><p><strong>Design, setting, and participants: </strong>This qualitative study provided a secondary thematic analysis of an online survey created in collaboration with patient advocates. Data were collected from July to October 2022. The survey was offered through a secure online platform. Participants included a convenience sample of patients with cancer, who self-reported being older than 18 years and having previous experience with prior authorization, recruited from social media, email lists, and word of mouth. Data were coded in May 2023, with initial themes constructed in September 2023.</p><p><strong>Main outcome and measures: </strong>Responses to the open-ended prompt were coded inductively by trained members of the research team, and themes were developed by the study team through discussion.</p><p><strong>Results: </strong>Of 178 respondents in the parent quantitative survey, 89 (50%) provided free-text responses. Most respondents to the open-ended question were women (79 [89%]) and aged 18 to 39 (35 [39%]) or 40 to 54 (31 [35%]). Codes from responses related to patient experiences, views of the process, and perception of the role of the health care team. Four interconnected themes were created from the codes: blinded navigation, intersecting burdens, interference with care, and a broken system.</p><p><strong>Conclusions and relevance: </strong>In this qualitative secondary analysis of patient experiences with prior authorization, themes centered on how, from the patient perspective, prior authorization was a confusing process that added to the administrative, psychosocial, and financial burdens of cancer care. Intersecting burdens amplified the negative impact of prior authorization on patients. Patients voiced concerns that highlighted the broken, profit-driven nature of the United States health care system. Advocacy efforts are needed to promote reform to ensure patients receive timely access to recommended care, and policy considerations toward this reform must center the patient experience.</p>","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2523807"},"PeriodicalIF":9.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Well-Being in Clinical Research Coordinators.","authors":"Regina M Longley, M Tim Song, Daniel A Schaefer, Annabella C Boardman, Emma P Keane, Isabella S Larizza, Emma D Wolfe, Michelle Guo, Joseph Wu, Janet Abrahm, Hermioni L Amonoo","doi":"10.1001/jamanetworkopen.2025.23985","DOIUrl":"10.1001/jamanetworkopen.2025.23985","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2523985"},"PeriodicalIF":9.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308445/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation, Overlap, and Stability in Defining Safety Net Hospitals.","authors":"Paula Chatterjee, Joshua M Liao, Kano Amagai, Yueming Zhao, Torrey Shirk, Amol S Navathe","doi":"10.1001/jamanetworkopen.2025.23923","DOIUrl":"10.1001/jamanetworkopen.2025.23923","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;The lack of universally accepted definitions for safety net hospitals (SNHs) has made it difficult to effectively design policies to support these hospitals and the populations they serve.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the overlap, variation, and consistency across different definitions for SNH status.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This retrospective cohort study used a hospital year-level dataset on short-term acute care US hospitals from 2014 to 2022. Hospital-level and area-level measures were used to define SNHs. Hospital characteristics under each definition, overlap across definitions, and stability of SNH samples produced by each definition from were described. Data analyses were performed from August 2024 to June 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposure: &lt;/strong&gt;Nine hospital-level and 4 area-level SNH definitions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Hospital characteristics under each definition, overlap across definitions, and stability of SNH samples over time. Hospital-level definitions included Medicare Disproportionate Share Hospital (DSH) index, Medicare inpatient day share, dual-eligible or low-income subsidy (DLIS) inpatient day share, Medicaid inpatient day share, Medicare Safety-Net Index, teaching status, public ownership, uncompensated care share, and operating margins. Area-level measures included Area Deprivation Index, Social Vulnerability index, proportion Hispanic population, and proportion Black population. Safety net status was assigned based on quartiles defined nationally (or within a state for Medicaid-specific definitions). For a subset of measures, this quartile-based approach was compared between the absolute number of inpatient days attributed to each patient group and the relative number (or share) of inpatient days.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 4531 short-term acute care hospitals, between 992 (21.9%) and 1326 (29.3%) were SNHs in 2022, depending on definition. SNHs defined based on the absolute level of inpatient days or absolute level of DLIS populations were often large (51% [242 of 476] or 67% [537 of 801]) and were not often rural (9% [45 of 476] or 2% [17 of 801]). Meanwhile, SNHs defined based on relative level of Medicaid inpatient days or relative level of DLIS patients were more often small (63% [298 of 476] and 82% [660 of 801]) and rural (48% [228 of 476] and 69% [555 of 801]) hospitals. The largest overlap across definitions was between a hospital's Medicaid inpatient day share and Medicare DSH index (55% overlap [808 of 1466 hospitals]), which tended to represent large, teaching hospitals. Public ownership, teaching status, and Medicare DSH index produced the most stable definitions of SNHs over time from 2014 to 2022, with 83% (862 of 1043), 74% (1000 of 1354), and 60% (809 of 1358) of similar hospitals, respectively, meeting safety net criteria. The least stable definitions were based on low operating margi","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2523923"},"PeriodicalIF":9.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12311695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variations in the Use of Outpatient Surgery.","authors":"Chi Zhang, Kristine Hanson, Lindsey Sangaralingham, Holly K Van Houten, Zhi Fong, Yu-Hui Chang, Michael Kendrick, David Etzioni, Elizabeth Habermann, Cornelius Thiels","doi":"10.1001/jamanetworkopen.2025.24165","DOIUrl":"10.1001/jamanetworkopen.2025.24165","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Identification of factors associated with variation in outpatient surgery may further quality improvement efforts to safely reduce postoperative hospital length of stay nationally.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To explore variation in the use of outpatient surgery, incorporating patient, geographic, and hospital factors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This retrospective cross-sectional study used deidentified administrative claims data from OptumLabs Data Warehouse. Participants included adults who underwent 1 of 10 general, urological, or gynecological operations between January 1, 2015, and June 30, 2021, in the US. Patients who underwent combined procedures or reoperations or had at least 15 Elixhauser comorbidities were excluded. Data were analyzed from July 26 to December 16, 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposure: &lt;/strong&gt;Inpatient or outpatient surgical procedures.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Multilevel logistic regression assessed variation in the use of outpatient surgery rates by hospital characteristics (bed size, presence of trainees, and rural referral center status) and hospital census division, adjusting for patient factors (age, sex, number of Elixhauser comorbidities, year, and rural-urban commuting area). This multilevel model allowed for the sources of variability to be quantitatively attributed to patient characteristics, geography, and hospital characteristics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 330 424 (72.3%) of 456 954 included patients underwent outpatient surgery. The median age was 54 (IQR, 41-67) years, and of those with data available, most patients were female (268 692 of 414 193 [64.9%]). The likelihood of outpatient surgery varied significantly by hospital census division for all 10 operations (eg, MIS salpingo-oophorectomy range, 29.6%-58.8%; P &lt; .001). Variation in hospital census division contributed most to outpatient surgery for 8 of 10 operations compared with other patient and hospital characteristics. Hospital census division contributed the greatest degree to the variation in outpatient simple mastectomy (20.6%) and the least to outpatient open ventral hernia repair (0.7%). Multivariable analysis showed that the odds of outpatient surgery for patients from metropolitan areas were higher for minimally invasive salpingo-oophorectomy (odds ratio [OR], 1.62; 95% CI, 1.34-1.95) and open ventral hernia repair (OR, 1.16; 95% CI, 1.09-1.24). Hospitals with 400 or more beds were independently associated with decreased odds of outpatient surgery compared with hospitals with 50 to 199 beds for 4 of 7 operations (MIS paraesophageal hernia repair [OR, 0.58; 95% CI, 0.47-0.71; P &lt; .001]; MIS cholecystectomy [OR, 0.73; 95% CI, 0.68-0.78; P &lt; .001]; open ventral hernia [OR, 0.51; 95% CI, 0.46-0.57; P &lt; .001]; MIS ventral hernia repair [OR, 0.66; 95% CI, 0.56-0.77; P &lt; .001]). The presence of a residency training program was independently","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2524165"},"PeriodicalIF":9.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12314726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Youths Experiencing Parental Death Due to Cancer.","authors":"Alexandra L Potter, Benjamin-Samuel Schlüter, Monica J Alexander, Chi-Fu Jeffrey Yang, Mathew V Kiang","doi":"10.1001/jamanetworkopen.2025.19106","DOIUrl":"10.1001/jamanetworkopen.2025.19106","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2519106"},"PeriodicalIF":10.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Care Utilization and the Affordability of Care for Indian Health Service Beneficiaries.","authors":"Matthew Tobey","doi":"10.1001/jamanetworkopen.2025.22045","DOIUrl":"10.1001/jamanetworkopen.2025.22045","url":null,"abstract":"","PeriodicalId":14694,"journal":{"name":"JAMA Network Open","volume":"8 7","pages":"e2522045"},"PeriodicalIF":10.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12281227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}