Journal of evaluation in clinical practice最新文献

{"title":"Duagnosis: Locating Clinical Uncertainty in the Diagnostic Framework.","authors":"Kosei Hanaoka, Daisuke Miyamori, Keiko Ogawa-Ochiai","doi":"10.1111/jep.70621","DOIUrl":"10.1111/jep.70621","url":null,"abstract":"<p><strong>Rationale, aims and objectives: </strong>Clinical reasoning research has predominantly operated within a single epistemological system. The prevailing response to clinical uncertainty in primary care has been to cultivate tolerance, embrace ambiguity, or learn to navigate it: each treats uncertainty as inherent to the encounter. We propose a complementary move. Much of what is called clinical uncertainty may be attributed less to the patient's condition than to the reach of the diagnostic framework through which the clinician reasons. We introduce the concept of duagnosis (dual + gnosis, 'knowing'): the clinical cognition in which two independent diagnostic systems are simultaneously activated within a single clinician's reasoning.</p><p><strong>Methods: </strong>Conceptual analysis proceeding through concept definition, differentiation from neighbouring frameworks, development of the epistemological argument, and institutional comparison across East Asia. The analysis draws on clinical reasoning research, the philosophy of medicine, evidence on the care of persistent physical symptoms, and comparative scholarship on traditional medicine.</p><p><strong>Results: </strong>The core contribution is epistemological: what one framework cannot formulate may resolve into a recognisable, actionable pattern in another, so that uncertainty is partly a property of the framework and not only of the patient. Duagnosis can be stated in two versions: a broad sense continuous with family medicine's plural readings of the patient, and a strict sense in which the criteria of evidence themselves change. An East Asian institutional comparison shows that Japan's unified medical licence locates diagnostic duality within individual clinician cognition for every physician, a capacity medical education has not cultivated.</p><p><strong>Conclusion: </strong>Expanding the diagnostic repertoire, not merely tolerating uncertainty, can reduce the proportion of presentations for which no clinical formulation exists. Locating uncertainty partly in the reach of the framework, rather than in the patient, is a reframing that applies beyond any one health system, with implications for communication and referral.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":"e70621"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039050","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":"Bioethics and Medical Litigation in France: An Exploratory Study.","authors":"Rania Nader, Henri-Corto Stoeklé, Louisa Smail Shehba, Pascal Jazat, Christian Hervé","doi":"10.1111/jep.70618","DOIUrl":"10.1111/jep.70618","url":null,"abstract":"<p><strong>Aims and objectives: </strong>Medical litigation is a matter of particular concern for hospitals. We decided to examine whether bioethics might offer additional insights into these disputes.</p><p><strong>Method: </strong>We conducted a highly exploratory and descriptive study in empirical bioethics, relying exclusively on a sample of scientific articles addressing medical litigation in France and primarily derived from real-world healthcare settings. Analysis proceeded manually in three stages: (i) a content analysis of the sample; (ii) a thematic analysis of the collected information; and (iii) a bio-ethical analysis of the identified themes and codes, and collected information.</p><p><strong>Results: </strong>We ultimately derived three broader themes, presented in descending order of importance: \"Legal Claims\", \"Poor Practices\", and \"Specific Laws\". Informed by these themes, but also associated codes and collected information, we may already infer several ethical tensions between responsibility-but understood here as a fundamental moral value rather than a simple legal obligation to account for one's professional actions-and a wide range of health and life science practices, most of which relate to surgical interventions to dis day. However, it remains difficult to determine whether these tensions reflect a single macro-bio-ethical issue-that is, an ethical tension or dilemma between health and/or life science practices and moral values and/or standards at a societal or country level-or rather a set of distinct micro-bio-ethical issues-arising at the level of given individuals or institutions.</p><p><strong>Conclusion: </strong>Bioethics warrants closer engagement with such disputes, insofar as they might embody bio-ethical issues of sufficient significance.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":"e70618"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039103","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":"Exploring Operational Efficiency and Environmental Sustainability in Critical Care: A Qualitative Study of Healthcare Professional Perspectives.","authors":"Mohamed Achref Boubaker","doi":"10.1111/jep.70627","DOIUrl":"10.1111/jep.70627","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale: &lt;/strong&gt;Intensive care units (ICUs) represent among the most resource-intensive environments in modern healthcare, generating significant operational, financial, and environmental pressures. Despite growing policy interest - including guidance from the European Society of Intensive Care Medicine (ESICM) and the Société Française d'Anesthésie et de Réanimation (SFAR) - the integration of operational efficiency and environmental sustainability within ICU practice remains poorly understood at the level of frontline professionals. Qualitative evidence exploring how ICU staff and managers perceive and navigate these dual pressures is particularly limited in the German healthcare context.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;A qualitative-dominant mixed-methods study was conducted in a 520-bed acute care hospital in North Rhine-Westphalia, Germany. Seventeen semi-structured interviews were conducted with purposively sampled ICU professionals, including physicians, nursing leadership, respiratory therapists, administrative staff, bed management specialists, and IT managers. Interviews lasted 35-50 min (mean 41 min) and were audio-recorded and transcribed verbatim. Data were analysed using the six-phase thematic analysis framework of Braun and Clarke. Secondary operational data - including 2025 ICU bed occupancy reports from the hospital's Medical Controlling department, staffing documentation, and hospital sustainability reports - were used for contextual triangulation. No patient-level clinical data were accessed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Six major themes influencing ICU operational efficiency and sustainability were identified: (1) workforce shortages and staffing pressures; (2) patient flow and bed management constraints; (3) administrative workload and bureaucratic complexity; (4) technological infrastructure and resource management; (5) economic pressures and financial governance; and (6) sustainability awareness and environmental challenges. ICU bed occupancy, as reported in the hospital's 2025 Medical Controlling data, consistently exceeded 85%, confirming capacity pressures described by participants. Sustainability was broadly acknowledged as a relevant concern but perceived as secondary to immediate clinical priorities. Two preliminary conceptual frameworks (Figures S1 and S2) - an ICU Operational Efficiency Model and a Sustainability Integration Model - were developed from the findings and require further external validation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study provides qualitative evidence that operational efficiency and environmental sustainability are perceived as interconnected but competing priorities by ICU professionals in a German communal hospital. Key barriers include staffing constraints, administrative burden, and limited institutional sustainability infrastructure. The two conceptual models should be regarded as preliminary frameworks derived from a single-site study rather than validated practica","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":"e70627"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039187","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":"Generalizing the Prevalence Threshold Under Prevalence-Dependent Diagnostic Accuracy.","authors":"Jacques Balayla","doi":"10.1111/jep.70622","DOIUrl":"10.1111/jep.70622","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Rationale, aims and objectives: &lt;/strong&gt;When a diagnostic test returns a positive result, the probability that the patient truly has the condition depends on how common the condition is in the population being tested. The prevalence threshold marks the point on that relationship below which a positive result stops being trustworthy. Its familiar closed form assumes that sensitivity and specificity stay fixed as the population changes, yet large empirical surveys of the diagnostic literature show that measured accuracy shifts systematically with prevalence, because prevalence acts as a marker for differences in disease spectrum, case mix, referral and verification. This study asked how the prevalence-threshold framework should be generalised when accuracy varies in this way, which of its classical properties survive, and whether the difference matters in practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;Sensitivity and specificity were allowed to vary smoothly across populations indexed by prevalence, producing a prevalence-indexed positive likelihood ratio and a corresponding adaptive Bayesian screening curve. We derived the resulting threshold, introduced a dimensionless evidence-drift function that measures how quickly the strength of diagnostic evidence changes as the population changes, and established conditions for the threshold to exist, to be unique, and to be computable by simple iteration. Full derivations and proofs are provided in the Supplementary Appendix. We then applied the framework to two sources of published data: summary accuracy estimates for SARS-CoV-2 rapid antigen tests from a Cochrane review, and pooled prevalence-accuracy regression coefficients from a meta-epidemiological analysis of 6909 diagnostic accuracy studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The generalised threshold is defined implicitly rather than by a closed formula, because the likelihood ratio must be evaluated at the threshold itself. Three properties that identify the same point under fixed accuracy-balance on the anti-diagonal of the probability square, unit slope, and maximal curvature-separate once accuracy varies with prevalence, and the size of that separation is itself informative. Evidence drift governs the slope at the threshold and supplies a sufficient condition for uniqueness. In the rapid antigen application, sensitivity fell and specificity rose between the higher-prevalence symptomatic setting and the lower-prevalence asymptomatic setting, so the positive likelihood ratio more than doubled as prevalence fell; carrying the symptomatic likelihood ratio into the asymptomatic setting understated post-test probability by roughly 19 percentage points. In the meta-epidemiological calibration, drift was negative across every clinical subgroup examined and large enough in several to abolish the classical unit-slope property.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The classical prevalence threshold is the constant-accuracy, zero-drift case of a broader","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":"e70622"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039209","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":"Pre-Procedural Safety Screening in Diagnostic Imaging Across England: A Freedom of Information Study.","authors":"Martine Ann Mallinson, Bryony Brown, Beverly Snaith","doi":"10.1111/jep.70616","DOIUrl":"10.1111/jep.70616","url":null,"abstract":"<p><strong>Rationale: </strong>Patient safety screening forms are a way of identifying medical history and contraindications prior to diagnostic imaging examinations. Current utilisation of patient safety forms and variation in their design is unclear.</p><p><strong>Aims and objectives: </strong>Adopting a pragmatic research approach, we aimed to explore pre-procedural patient-completed safety screening forms from imaging providers across England to identify similarities and variation in documents currently used in clinical practice.</p><p><strong>Method: </strong>A freedom of information (FOI) request was sent to all acute National Health Service (NHS) Trusts in England and Independent Service Providers (IS) between 6th July 2025 and 22nd July 2025. Organisations were asked whether screening forms used across the diagnostic imaging were completed on paper or through digital methods. Paper versions requested for analysis. Documents have been assessed with regards to procedure or purpose and design.</p><p><strong>Results: </strong>FOI responses were received from 126 NHS organisations and three IS providers, an overall response rate of 83.2%, with 91.3% of the NHS organisations responding. The average response time was 21.7 working days (range 2-106), with 72 organisations (55.8%) responding within the anticipated 20 working days. Organisations most commonly use paper forms, with only one organisation confirming that all pre-procedural checks were completed using digital forms.</p><p><strong>Conclusion: </strong>This study has drawn on data obtained through the FOI Act. Current patient safety screening forms are largely paper-based and demonstrate inconsistencies which may influence their interpretation and lead to errors. Future studies should evaluate their use in practice to inform evidence-based developments in this area.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":"e70616"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039165","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":"Strategic Alignment: Driving Patient Satisfaction and Performance in Public Hospitals.","authors":"Neda Abdolvand, Mohammad Mehdi Sepehri, Rohail Hassan","doi":"10.1111/jep.70632","DOIUrl":"10.1111/jep.70632","url":null,"abstract":"<p><strong>Rationale: </strong>Healthcare IT investments in Iranian public hospitals often fail to translate into better perioperative experiences when IT initiatives are not strategically aligned, leading to delays in diagnostics, scheduling, and discharge and, consequently, lower patient satisfaction.</p><p><strong>Aims and objectives: </strong>Drawing on Dynamic Capabilities Theory, this study examines whether strategic alignment improves perceived organisational performance and patient satisfaction in perioperative care settings, assesses whether IT strategic orientation strengthens the alignment-satisfaction relationship, and tests whether patient satisfaction contributes to organisational performance.</p><p><strong>Method: </strong>A mixed-methods design was employed. Quantitative data from 91 public hospitals were analysed using PLS-SEM. Qualitative insights were obtained through semi-structured interviews with 374 patients, over 80% of whom had recently undergone surgery or other operating room procedures, to identify key sources of dissatisfaction.</p><p><strong>Results: </strong>Strategic alignment positively influenced perceived organisational performance and patient satisfaction. IT strategic orientation moderated the alignment-satisfaction relationship, with stronger effects in hospitals with a disciplined, risk-aware, innovative IT orientation. Patient satisfaction did not significantly predict perceived organisational performance, suggesting that patient-facing improvements may not immediately translate into managerial resource/financial performance in public hospitals. Qualitative findings highlighted prolonged waiting times and the unavailability of preoperative laboratory tests as major drivers of dissatisfaction.</p><p><strong>Conclusion: </strong>Strategic alignment, particularly when supported by a disciplined, risk-aware, innovative IT orientation, improves non-financial outcomes in perioperative pathways. Hospitals should prioritise interoperable systems and perioperative workflow integration, while policymakers should support targeted digital transformation in public hospitals.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":"e70632"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039201","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":"Risk Attribution for Clinical Prioritization in Multimorbidity.","authors":"Eytan Ellenberg","doi":"10.1111/jep.70636","DOIUrl":"https://doi.org/10.1111/jep.70636","url":null,"abstract":"","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":"e70636"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061757","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 Comprehensive Scientometric Analysis of Placebo and Nocebo Effects in Pain Research: From Placebo Mechanisms to Clinical Trials.","authors":"Francesca Borghesi, Valeria Volpino, Elisa Rho, Giorgia Cecconato, Francesco Campaci, Pietro Cipresso, Alessandro Piedimonte, Elisa Carlino","doi":"10.1111/jep.70570","DOIUrl":"10.1111/jep.70570","url":null,"abstract":"<p><p>Placebo and nocebo phenomena are central in neuroscience, psychology, and clinical research, yet comprehensive bibliometric analyses remain limited. This study mapped placebo and nocebo research in pain, distinguishing mechanistic studies from randomised controlled trials (RCTs), using data from the Web of Science Core Collection up to March 2025, which yielded 1246 mechanistic studies and 35,134 RCTs. Analyses performed with the Bibliometrix R package included descriptive statistics, co-citation and keyword co-occurrence networks, and local citations to assess internal impact. Mechanistic studies grew 3.97% annually, focusing on expectation, conditioning, and pain modulation, with key contributions from Benedetti, Colloca, and Wager, concentrated in the USA, Germany, Italy, and the UK. RCTs grew 3.52% per year, emphasising systematic reviews and methodological standards (Jadad scale, PRISMA), led by Moore and Manchikanti, with the USA, China, and the UK dominating output. Co-citation analyses identified mechanistic clusters around opioidergic and dopaminergic pathways and prefrontal-cingulate circuits, and RCT clusters emphasising methodological rigour and pain outcomes. Keyword analyses highlighted pain, analgesia, and expectation as central themes, with emerging trends reflecting evolving clinical applications and innovative trial designs. This scientometric mapping underscores the dual role of placebo as a neurobiological phenomenon and methodological cornerstone, offering a comprehensive overview of the evolution, structure, and thematic organisation of placebo and nocebo research in pain.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":"e70570"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13571793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148963397","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":"When Shared Decision-Making Is Vulnerable: Patient Advocacy at the Limits of Deliberation in Surgical Practice.","authors":"Francesco Di Maggio","doi":"10.1111/jep.70625","DOIUrl":"https://doi.org/10.1111/jep.70625","url":null,"abstract":"","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":"e70625"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039185","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":"Facts Do Not Organise Themselves: Whewell and the Conceptual Crisis in Medicine.","authors":"Robin J Evans","doi":"10.1111/jep.70617","DOIUrl":"10.1111/jep.70617","url":null,"abstract":"<p><strong>Rationale, aims and objectives: </strong>Medicine has never possessed more data, yet the conviction that understanding has deepened with it is difficult to sustain. This paper argues that the shortfall is conceptual rather than empirical and turns to the philosophy of science of William Whewell to name it. Evidence-based medicine tells clinicians how to weigh evidence once it is in hand. The paper aims to show that Whewell describes the earlier and harder task, the forming of the conceptions that make observations count as evidence in the first place.</p><p><strong>Method: </strong>The analysis is conceptual and historical. Whewell held that facts do not organise themselves but require colligation, the superinduction of a clarifying conception upon observations, and that discovery is most strongly warranted by consilience, the convergence of independent classes of fact upon a single cause. His account is read alongside Peirce on abduction and Fleck on how a scientific fact is held in place, illustrated through a case history of craniosynostosis from Virchow's law to the FGFR discoveries of the 1990s and applied to precision medicine, subspecialisation and artificial intelligence.</p><p><strong>Results: </strong>In craniosynostosis, children moved between diagnostic categories and a new syndrome came into being without a single new observation, because a conception arrived that reorganised what existing observations were observations of. The contemporary difficulties are versions of the same problem. Precision medicine has delivered where a true cause was secured and stalled where it offered only correlation. Subspecialisation fragments enquiry so that consiliences crossing organ systems go unrecognised. Artificial intelligence extends the power of observation without extending the power of conception.</p><p><strong>Conclusion: </strong>Medicine has perfected the appraisal of evidence while leaving the formation of concepts largely to chance. The crisis is not one of insufficient data but of insufficient ideas. New conceptions come from prepared minds, and history and philosophy are part of that preparation.</p>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"32 6","pages":"e70617"},"PeriodicalIF":1.5,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039155","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}