Journal of evaluation in clinical practice最新文献

{"title":"Use and impact of clinical pathways across various healthcare settings: A protocol for an umbrella review of global evidence.","authors":"Rishita Chandra, Maria Unwin, Viet Tran, Amanda Neil","doi":"10.1111/jep.14201","DOIUrl":"https://doi.org/10.1111/jep.14201","url":null,"abstract":"<p><strong>Aim: </strong>The proposed umbrella review aims to assess the use and impact of clinical pathways on professional practice, patient outcomes, length of hospital stay, hospital costs, patient satisfaction, and hospital staff satisfaction through a synthesis of existing systematic reviews and meta-analyses.</p><p><strong>Methods: </strong>Following PRIOR guidelines, a systematic search will be conducted in MEDLINE, Epistemonikos, and the Cochrane Library to identify relevant systematic reviews and meta-analyses, from inception till March 2024. Two reviewers will independently screen titles and abstracts, with a third resolving any disagreements. Full-text articles considered potentially relevant will be assessed for eligibility by the same process. The data extraction form will cover information about the review methods, characteristics of the included primary studies, the types of interventions evaluated, and the reported outcomes. This standardized data extraction form will be piloted by the review team on five to ten articles to ensure all relevant information is recorded. The quality of included systematic reviews and meta-analyses will be evaluated using AMSTAR 2. PROSPERO registration number is CRD42024529371.</p><p><strong>Results: </strong>The study will present a narrative synthesis of the findings, addressing the clinical and methodological heterogeneity and assessing the impact of clinical pathways on various healthcare outcomes.</p><p><strong>Conclusion and implications: </strong>This umbrella review will provide evidence-based insights into the effectiveness, challenges, and best practices of clinical pathways, guiding healthcare decision-making and identifying areas for future research. Results will be disseminated widely to inform policy and improve healthcare service delivery.</p><p><strong>Patient or public contribution: </strong>No patient or public contribution, as this paper is a protocol of an umbrella review.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The equivalence of a high-stakes objective structured clinical exam adapted to suit a virtual delivery format","authors":"Karen Coetzee MA,&nbsp;Luxshi Amirthalingam BSc,&nbsp;Tabasom Eftekari BComm,&nbsp;Sandra Monteiro PhD","doi":"10.1111/jep.14167","DOIUrl":"10.1111/jep.14167","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The COVID-19 pandemic necessitated rapid adaptation of clinical competence assessments, including the transition of Objective Structured Clinical Examinations (OSCE) from in-person to virtual formats. This study investigates the construct equivalence of a high-stakes OSCE, originally designed for in-person delivery, when adapted for a virtual format.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted using OSCE scores from the Internationally Educated Nurse Competency Assessment Program (IENCAP®). Data were collected from 15 exam administrations between January 2018 and June 2022, encompassing 2021 examinees (1936 in-person, 85 virtual). The Many-Facet Rasch Measurement (MFRM) model was employed to analyze the invariance of examinee ability, case difficulty, and criteria difficulty across in-person and virtual formats.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results revealed overall examinee ability estimates remained invariant regardless of the OSCE format, while invariant violations were identified in only three of the 15 cases (<i>N</i> = 20%) adapted to suit the virtual format. The most significant adaptation, namely the use of a verbal physical examination to suit the virtual context achieved equivalence to its hands-on in-person counterpart given evidence of invariance across criteria estimates. Interestingly, criteria scores in invariant violated cases displayed a higher level of stability or consistency across the virtual OSCE formats versus their in-person counterpart highlighting a potential benefit of the virtual versus in-person format and potentially linked to the verbal physical examination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study found that while examinee ability and case difficulty estimates exhibited some invariance between in-person and virtual OSCE formats, criteria involving physical assessments faced challenges in maintaining construct equivalence. These findings highlight the need for careful consideration in adapting high-stakes clinical assessments to virtual formats to ensure fairness and reliability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jep.14167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Misconceptions about randomisation harm validity of randomised controlled trials.","authors":"Wolfgang Mastnak","doi":"10.1111/jep.14224","DOIUrl":"https://doi.org/10.1111/jep.14224","url":null,"abstract":"<p><strong>Rationale: </strong>The coherence theory of truth, the epistemology of evidence-based medicine, mathematical statistics, and axiomatic mathematics.</p><p><strong>Aims and objectives: </strong>To explore mathematical misconceptions inhering in randomised controlled trial designs, suggest improvements, encourage meta-methodological discussions and call for further interdisciplinary studies.</p><p><strong>Method: </strong>Mathematical-statistical analyses and science-philosophical considerations.</p><p><strong>Results: </strong>Randomisation does not (necessarily) generate equal samples, ergo, outcomes of usual RCTs are not as reliable as they claim. Moreover, ignoring initial sample discrepancies may cause inaccuracies similar to type I and type II errors. Insufficient awareness of these flaws harms final RCT statements about significance and evidence levels, hence their loss of trustworthiness. Statistical parameters such as the standard error of the mean may help to estimate the expected distinction between random samples.</p><p><strong>Conclusion: </strong>Researchers in EBM should be aware of systemic misconceptions in RCT standards. Pre-measurement can reduce shortcomings, e.g. through calculation how sample differences impact on usual RCT processing, or randomisation is given up in favour of mathematical minimisation of sample differences, i.e. optimising statistical sample equality. Moreover, the promising future of dynamic simulation models is highlighted.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The compassionate care framework plus quality control group improves the quality of postoperative nursing management for patients in anorectal surgery: An observational study.","authors":"Peiyao Li, Jieping Liu, Dan Li, Lin Wang, Guoshuang Yu","doi":"10.1111/jep.14168","DOIUrl":"https://doi.org/10.1111/jep.14168","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the effectiveness of the joint application of the compassionate care framework (CCF) and a quality control (QC) team in improving the quality of postoperative nursing management for patients in anorectal surgery.</p><p><strong>Methods: </strong>Patients who underwent anorectal surgery at the China-Japan Friendship Hospital between May 2022 and December 2022 were selected by convenience sampling. A digital random generator was used for random grouping. The odd numbers entered the control group (n = 53) and the even numbers entered the study group (n = 53). The control group received postoperative traditional nursing, and the study group received postoperative nursing and QC team management. A questionnaire survey was used to analyse patients' satisfaction with nursing. The two groups were compared for nursing quality scores, patient satisfaction with nursing care and incidence of complications.</p><p><strong>Results: </strong>After management, compared with the control group, the study group scored significantly higher for the nursing process, environmental management, emergency response and safety protection (p < 0.05 for all). The study group also exhibited higher satisfaction scores with the nursing process, nurse-patient relationship and service attitude compared with the control group (p < 0.05 for all). The complication incidence rate in the study group was significantly lower than in the control group (p < 0.05).</p><p><strong>Conclusion: </strong>The combined use of the CCF and a QC team can effectively improve the quality of postoperative nursing management for patients in anorectal surgery, reduce the incidence of complications and enhance patient satisfaction with nursing care, thus holding significant potential for wider application.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotions and difficulties experienced by parents of children with autism: A qualitative study.","authors":"Gülzade Uysal, Atiye Karakul, Duygu Sönmez Düzkaya","doi":"10.1111/jep.14207","DOIUrl":"https://doi.org/10.1111/jep.14207","url":null,"abstract":"<p><strong>Rationale: </strong>This study was performed to determine the difficulties experienced by the parents of children with autism.</p><p><strong>Methods: </strong>A qualitative method was used to determine the difficulties experienced by the parents. The sample of the study consisted of parents with 24 children with autism who met the inclusion criteria. The data were analysed by the MAXQDA qualitative data analysis programme in accordance with Colaizzi's seven-stage method.</p><p><strong>Results: </strong>Total of 5 themes and 29 codes were gathered in line with the data obtained from the interviews. Five main themes of the interviews emerged; emotions experienced by parents; adaptation to family life; difficulty in social relationships; limited opportunity for entertainment/activity and financial difficulty. Parents whose income were less than or equal to their expenses particularly stated that they had economic difficulties in the transportation of their children to places such as hospitals/schools/special education.</p><p><strong>Conclusion: </strong>In accordance with the findings of this study, it was determined that almost all of the parents with a child diagnosed with autism experienced sadness, denial, shock, depression, self-blame in the period when their children were first diagnosed, and later accepted the disease. In addition, it was detected that parents had difficulties in family relations, social relations, entertainment/activity and economic aspects.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of social support and parental monitoring on glycaemic control in adolescents with type 1 diabetes mellitus.","authors":"Ayla İrem Aydın, Gülay Öztaş, Meryem Atak, Nurcan Özyazıcıoğlu, Halil Sağlam","doi":"10.1111/jep.14190","DOIUrl":"https://doi.org/10.1111/jep.14190","url":null,"abstract":"<p><strong>Rationale: </strong>Glycaemic control is a crucial aspect of managing type 1 diabetes mellitus (T1DM). Strict glycaemic control has been proven to reduce the long-term complications of the disease.</p><p><strong>Aims: </strong>The aim of this study was to investigate the effect of parental involvement in diabetes care and social support on glycaemic control in adolescents with T1DM.</p><p><strong>Methods: </strong>In this cross-sectional study, 94 adolescents and their parents admitted to a university hospital between January and July 2023 were included in the study. The Multidimensional Scale of Perceived Social Support (PMDC-R) and Parental Monitoring Scale (MSPSS) in Diabetes Care of Adolescents with T1DM were used as data collection tools.</p><p><strong>Results: </strong>Females constituted 63.8% of the adolescents who participated in the study and the glycaemic control of females was significantly lower than males (p < 0.05). The mean HbA1c of the adolescents was 8.65 + 1.57. In the study, PMDC-R and MSPSS scores of adolescents with good and poor glycaemic control were compared. The PMDC-R of the good control group were statistically significantly higher than the poor control group (p < 0.05), but there was no significant difference between the MSPSS scores.</p><p><strong>Conclusion: </strong>Parental supervision plays a protective role in adolescents, and glycaemic control is better as parental supervision increases. Paediatric nurses should collaborate with parents in diabetes management. This approach may help adolescents to be more successful in diabetes management.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Findings from the 'Ask Me About PrEP' HIV Pre-Exposure Prophylaxis Awareness Programme in England.","authors":"Jonny Edwards, Sara Paparini, Will Nutland, Marc Thompson, Phil Samba","doi":"10.1111/jep.14163","DOIUrl":"https://doi.org/10.1111/jep.14163","url":null,"abstract":"<p><strong>Rationale: </strong>HIV incidence has decreased in England by over a third since 2019. Despite the early success of HIV Pre-Exposure Prophylaxis (PrEP) in reducing HIV transmission in the United Kingdom, many people who could benefit from HIV PrEP do not yet know about it, or know how to access it.</p><p><strong>Aims and objectives: </strong>This paper presents the findings of the first England-wide national peer-to-peer based diffusion model to disseminate information about PrEP. Ask Me About PrEP (AMAP) was a 5-month pilot programme which commenced in November 2021. Volunteer mobilisers were encouraged to use their existing knowledge of their communities and geographical areas to assist them in discussing PrEP with their peers.</p><p><strong>Method: </strong>12 enrolled mobilisers took part in three project evaluation focus groups between November 2021 and March 2022, and five AMAP project staff took part in one focus group in March 2022. Additionally, descriptive statistical analysis explored volunteer mobiliser recruitment to the AMAP project, demographical data of project staff and volunteer mobilisers, volunteer mobiliser attrition rates, and the project's impact.</p><p><strong>Results: </strong>96 volunteers enrolled, completed training and volunteered as mobilisers. Thoroughout the project, mobilisers engaged their peers in 11,889 conversations about PrEP through individual conversations, online group conversations, online workplace educational events, and social media. The focus groups enabled key stakeholders to reflect on their experiences of the pilot programme. Four key themes were identified during the focus groups: motivations to mobilise and recruitment experiences; training, learning, and materials; mobilisation activity; and support and social networking.</p><p><strong>Conclusion: </strong>Our evaluation demonstrates that peer-to-peer diffusion models used to increase awareness of HIV PrEP in key unreached groups, offer an acceptable public health intervention model for volunteers and project staff.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of knowledge, attitude, and practice scale regarding antibiotic use for Chinese medical students.","authors":"Hui Sun, Linghui Xiang, Jiajia Zhang, Xin Xiong, Xuemei Sun, Yinyan Gao, Jinlu Song, Han Luo, Dingkui Sun, Xiangfeng Lin, Boya Xu, Irene X Y Wu, Wenjie Dai","doi":"10.1111/jep.14209","DOIUrl":"https://doi.org/10.1111/jep.14209","url":null,"abstract":"<p><strong>Aims and objectives: </strong>This study aimed to develop and validate a knowledge, attitude, and practice scale of antibiotic use for Chinese medical students.</p><p><strong>Method: </strong>A five-phased procedure was adopted: (a) A item pool was constructed after literature review; (b) Delphi method was used to refine the items; (c) A pilot study was conducted to clarify the item; (d) Item analysis and exploratory factor analysis were used to finalize the scale; (e) Content validity, construct validity and reliability of the scale were analysed.</p><p><strong>Results: </strong>The scale of 32 items, respectively 15, 9, and 8 for knowledge, attitude, and practice, was finalized. The item-level content validity ranged from 0.80 to 1.00. The scale-level content validity of the scale was 0.90. Model fit indices of total scale and the three dimensions met the criteria. Cronbach's α and the split-half coefficient were respectively 0.81 and 0.65 for the total scale. For each dimension, Cronbach's α varied from 0.68 to 0.89 and the split-half coefficient varied from 0.64 to 0.83.</p><p><strong>Conclusion: </strong>The scale can be used as a whole or separately, serving as an effective tool to measure medical students' knowledge, attitude, or practice regarding antibiotic use.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review and meta-analysis of frailty in patients with heart failure.","authors":"Xia Chen, Xiangying Meng","doi":"10.1111/jep.14192","DOIUrl":"https://doi.org/10.1111/jep.14192","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the effect of frailty on the prognosis of patients with heart failure.</p><p><strong>Methods: </strong>Computer searches were conducted on PubMed, Embase, The Cochrane Library, Web of Science, CNKI, Wanfang Data Knowledge Service platform, Weipu full-text database of Chinese scientific and technological journals, and Chinese biomedical literature database from August 12, 2022. After literature screening was completed by two researchers, the data extraction (such as study type, sample size, age of included patients, New York Heart Association (NYHA) Functional Classification, frailty assessment tool, frailty positive rate, outcome indicators, etc.) was performed and the risk of bias in the included studies was assessed. Meta-analysis was performed using Revman 5.4 and Stata 14.0 software.</p><p><strong>Results: </strong>A total of 32 studies were included, including 406,269 patients with heart failure. All included studies were rated high overall quality. The results of meta-analysis showed: Frailty increases the risk of all-cause death in patients with heart failure (hazard ratio [HR] = 1.73, 95% confidence interval [CI]: 1.50 - 2.00, p < 0.001), unplanned readmission (HR = 1.96, 95% CI: 1.21 - 3.17, p = 0.006), and joint endpoint risk (HR = 1.66, 95% CI: 1.48 - 1.86, p < 0.001).</p><p><strong>Conclusion: </strong>Current evidence suggests that frailty increases the risk of all-cause death, unplanned readmission, and joint endpoints in patients with heart failure.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of Mobile-Assisted training and counseling on nurses' ventrogluteal injections application of nursing: A mixed method study.","authors":"Emel Gülnar, Gamze Özener, Aslı Yilmaz, Sinan Aydogan, Özge Gencer, Şule Bıyık Bayram, Deniz Öztürk, Nurcan Çalişkan","doi":"10.1111/jep.14214","DOIUrl":"https://doi.org/10.1111/jep.14214","url":null,"abstract":"<p><strong>Background: </strong>Nurses often administer intramuscular (IM) injections. However, they do not use the ventrogluteal (VG) site, although it is highly recommended.</p><p><strong>Aim: </strong>This study investigated whether a mobile-assisted training and counseling program (intervention) encouraged nurses to use the VG site to administer IM injections.</p><p><strong>Methods: </strong>This study adopted a pretest-posttest interventional design with no control group and employed a mixed research design. The sample consisted of 105 nurses from a public hospital in a metropolitan city in Turkey. Quantitative data were collected using a descriptive characteristics form and a Ventrogluteal Site Information Form (VSIF). Qualitative data were collected using a semi-structured interview form. First, participants took a pretest and then watched an animation about VG injections on their mobile devices. Afterward, they were provided with counseling and then administered a posttest. Sixteen participants were interviewed after the posttest.</p><p><strong>Results: </strong>Participants had a significantly higher mean posttest VSIF score (17.50 + 3.23) than the pretest score (12.73 + 5.40) (p < 0.05). They stated that the intervention helped them reinforce what they already knew and encouraged them to use the VG site to administer IM injections. They also noted that it boosted their confidence and helped them experience less anxiety.</p><p><strong>Conclusion: </strong>The results showed that the intervention helped participants learn more about IM injections into the VG site. Therefore, hospitals should provide nurses with mobile-assisted training and counseling programs to encourage them to use the VG site to administer IM injections.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142502030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}