Journal of pain and symptom management最新文献

{"title":"Understanding Transition From Home to Inpatient Setting in Palliative Care: A Qualitative Synthesis.","authors":"Yijing Li, Shanshan Liu, Ting Yu, Yan Jiang","doi":"10.1016/j.jpainsymman.2026.08.004","DOIUrl":"10.1016/j.jpainsymman.2026.08.004","url":null,"abstract":"<p><strong>Context: </strong>Patients receiving palliative care often experience multiple transitions among care settings at the end of life, with transitions from home to inpatient settings being the most common. However, how these transitions occur and how care needs and preferences change over time have not been systematically synthesized.</p><p><strong>Objective: </strong>To synthesize the experiences of patients receiving palliative care and their caregivers regarding transitions from home to inpatient settings.</p><p><strong>Methods: </strong>A qualitative evidence synthesis was conducted following JBI guidance and reported in accordance with ENTREQ. The PubMed, Web of Science, Cochrane Library, Embase, CINAHL, CNKI, WanFang, and VIP databases were searched from inception to January 2024 and updated in March 2026. The eligible studies were assessed using the Joanna Briggs Institute critical appraisal instrument for qualitative research. Thematic synthesis was conducted by using Thomas and Harden's approach.</p><p><strong>Findings: </strong>A total of nine studies were included. Three themes emerged: 1) triggers for making decisions, including symptom crises, caregiving burden, treatment preferences, and reluctance to die at home; 2) concerns about inpatient care, involving continuity of care, communication, and comfort; 3) reflections on the care transfer, with caregivers viewing the transition as the right decision and describing a calmer period with their loved ones.</p><p><strong>Conclusions: </strong>Preferences regarding the place of care at the end of life are not a clear and stable choice but are shaped by uncertainty relating to the illness, the caregiver and the services needed.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CMS Hospice Care Index Live Discharge Quality Measurement: Insights From Nonprofit Hospice Leaders.","authors":"Kira G Sheldon, Elizabeth A Luth, Caitlin Brennan, Morgan Murphy, Yongkang Zhang","doi":"10.1016/j.jpainsymman.2026.08.007","DOIUrl":"10.1016/j.jpainsymman.2026.08.007","url":null,"abstract":"<p><strong>Background: </strong>Hospice live discharge affects approximately 20% of enrollees and often disrupts supportive care, increasing patient and family burden. The CMS Hospice Care Index (HCI) assesses hospice quality, including four live discharge-focused measures: early (<7 days), late (>180 days), Type 1 burdensome transition (discharge-hospital-readmission) and Type 2 (discharge-hospital-death). Little is known about the utility and implications of the HCI live discharge measures on clinical care and policy since their implementation.</p><p><strong>Methods: </strong>This study analyzed responses from semi-structured interviews of hospice leaders (N = 20) from seven nonprofit hospices, collected November 2024-July 2025. Analysis was conducted using a four-step rapid approach, suitable for exploratory interviews.</p><p><strong>Results: </strong>Participants viewed the HCI live discharge measures as important quality indicators for promoting accountability and improving staff training and communication to prevent inappropriate discharges. However, they expressed concerns surrounding: 1) accurate indication of care quality, 2) implications for hospice admissions and discharge practices to avoid enrolling high-risk patients, and 3) financial impacts of nonreimbursed discharge-focused care.</p><p><strong>Conclusion: </strong>The HCI live discharge measures are important for monitoring care quality but may have unintended clinical and operational consequences. Future research should refine quality measurement and consider the role of reimbursement incentives to promote care continuity and support comprehensive discharge planning to mitigate adverse outcomes.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frequency, Rationale, and Doses for Opioid Switching in Advanced Cancer: A Longitudinal Cohort Study.","authors":"Aaron K Wong, Adarsh Das, Dorothy Wang, Brian Le, Jennifer Philip","doi":"10.1016/j.jpainsymman.2026.08.006","DOIUrl":"10.1016/j.jpainsymman.2026.08.006","url":null,"abstract":"<p><strong>Background: </strong>Pain is common in advanced cancer, and many people require opioid switching to achieve adequate analgesia. However, longitudinal patterns of switching across the complete illness trajectory remain poorly characterized. This study describes the incidence, indications, dose thresholds, and prescribing patterns of opioid switching from advanced cancer diagnosis to death.</p><p><strong>Measures: </strong>This retrospective cohort study analyzed opioid prescribing data for 200 adults with advanced cancer from diagnosis to death. Prescribing data were converted to standardized oral morphine equivalent daily dose (oMEDD). Switching frequency, dose thresholds, duration of opioid use, documented indications, and prescriber patterns were analyzed using descriptive statistics.</p><p><strong>Outcomes: </strong>Opioid switching occurred in 58% of patients (n = 116), with some requiring up to four switches. Each successive switch occurred after substantial dose escalation during treatment on a given opioid, where starting doses of each successive switch approximately doubled: 20 mg oMEDD for the first opioid, 30 mg at first switch, 60 mg at second, and 180 mg at third switch. Median duration on each opioid progressively shortened with each switch: 39 days interquartile range (IQR 9-98), 25 days (IQR 6-103), and 18 days (IQR 5-53) for the first, second, and third switches, respectively. Inadequate analgesia was the predominant indication (58% of switches). Palliative care clinicians initiated an increasing proportion of switches (31% of first opioids; 89% of third).</p><p><strong>Conclusion/lessions learned: </strong>Opioid switching is common across the advanced cancer trajectory, characterized by progressive dose escalation and shortening duration of use with each successive switch. These findings highlight the importance of access to multiple opioid options and timely specialist palliative care involvement.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validating the Minimal Clinically Important Difference for the Edmonton Symptom Assessment Scale (ESAS) Total Symptom Distress Score (TSDS).","authors":"Taylan Gurgenci, Seunghun Lee, Lachlan Webb, Anita Pelecanos, Dominic Eu, Claire Stokes, Phillip Good","doi":"10.1016/j.jpainsymman.2026.08.009","DOIUrl":"10.1016/j.jpainsymman.2026.08.009","url":null,"abstract":"<p><strong>Background: </strong>The Edmonton Symptom Assessment Scale (ESAS) Total Symptom Distress Score (TSDS) is widely used in palliative care to assess symptom burden. While minimal clinically important difference (MCID) values have been established by Hui and colleagues' validation across different patient populations is essential.</p><p><strong>Objective: </strong>To validate the MCID values for the ESAS TSDS using data from two randomized controlled trials of medicinal cannabis in advanced cancer.</p><p><strong>Methods: </strong>We analyzed data from 186 patients with incurable cancer. The Patient Global Impression (PGI) scale served as the anchor, with \"minimally improved\" defining improvement and \"minimally worse\" defining deterioration. We employed anchor-based methods (sensitivity-specificity approach and within-patient change approach) and distribution-based methods (0.3 and 0.5 standard deviations) to validate MCID values.</p><p><strong>Results: </strong>For improvement, the within-patient change method yielded an MCID of -6.6 points (SD 11.5) for the TSDS, consistent with prior research. The sensitivity-specificity approach identified an optimal cutoff of a decrease of at least four points, and distribution-based estimates were 4.25 and 7.08 points. The sample size for deterioration was too small to draw meaningful conclusions. Individual symptom domains showed varying patterns of change.</p><p><strong>Conclusion: </strong>Our findings for improvement are consistent with previously established MCID values for the ESAS TSDS, providing supportive evidence for its use as an outcome measure in palliative care research.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Frailty on Palliative Care Setting in Patients With Advanced Cancer in a Safety-net System.","authors":"Lisa DiMartino, Vincent Merrill, Celette Sugg Skinner, Ramona Rhodes, Timothy P Hogan, Winnie S Wang, Navid Sadeghi, Arthur S Hong","doi":"10.1016/j.jpainsymman.2026.08.008","DOIUrl":"10.1016/j.jpainsymman.2026.08.008","url":null,"abstract":"<p><strong>Context: </strong>Frailty is common among patients with advanced cancer and increases risk for poorer outcomes. Frail patients may benefit from palliative care (PC) services. Limited data examine how frailty relates to PC delivery within safety-net systems.</p><p><strong>Objectives: </strong>To examine association between frailty and setting of PC initiation (inpatient consultation vs. outpatient clinic referral) among patients with advanced cancer. Secondarily, we examined whether frailty was associated with PC exposure exclusively in the inpatient setting vs. only outpatient referral.</p><p><strong>Methods: </strong>Patients with advanced-stage solid tumor exposed to PC from January 2018 to July 2023 at Parkland Health were identified via electronic health record. Multivariate logistic regression examined associations between frailty level, using a modified electronic frailty index, and 1) initial PC exposure as inpatient consultation (vs. outpatient referral) and 2) inpatient consultation-only (vs. outpatient referral-only). Models adjusted for key covariates.</p><p><strong>Results: </strong>Among 1053 patients (44.3% female, 75% non-White, mean age: 57.7), 46.2% were mildly frail and 23.6% were moderately/severely frail. In multivariate regression, frailty was associated with greater odds of initiating PC as an inpatient consultation (v fit; moderate/severe frailty: adjusted Odds Ratio (aOR), 3.50 [95% Confidence Interval [CI] 1.71-7.18]; mild frailty: aOR, 2.37 [95% CI 1.34-4.19]) and inpatient consultation-only (v fit; moderate/severe frailty: aOR 4.48, [95% CI 2.67-7.53]; mild frailty: (aOR 2.72, [95% CI 1.74-4.24]).</p><p><strong>Conclusion: </strong>Higher frailty was associated with inpatient PC initiation among patients with advanced cancer exposed to PC. These findings reflect the complex interplay of increased disease burden and access challenges faced by vulnerable cancer patients.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794497","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Conditions to People: Multimorbidity in SeriousHealth-Related Suffering Estimates.","authors":"Fei Yang, Haoyang Hu","doi":"10.1016/j.jpainsymman.2026.07.021","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2026.07.021","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149069769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in Goals of Care Documentation by Patient Language Preference.","authors":"Astha Ray, Enya Zhu, Hannah Levine, Zhimeng Jia, Deepshikha Ashana, Cara McDermott, Kathryn I Pollak, Hayden B Bosworth, Karen Steinhauser, David Casarett, Jessica E Ma","doi":"10.1016/j.jpainsymman.2026.08.001","DOIUrl":"10.1016/j.jpainsymman.2026.08.001","url":null,"abstract":"<p><strong>Context: </strong>Patients who use a language other than English (LOE) face barriers to communication and goal-concordant care, which can be improved through the conduct and comprehensive documentation of goals of care (GOC) conversations.</p><p><strong>Objective: </strong>To compare GOC documentation between LOE-preferring and English-preferring patients.</p><p><strong>Methods: </strong>We evaluated GOC documentation written in the last 6 months of life for adults who died between January 10, 2021 and January 10, 2024 at a tertiary health system. To control for factors which may impact communication, patients with a non-English language preference were matched by race and ethnicity to English-preferring patients using propensity matching. Content analysis was used to compare key components of GOC documentation in the notes. Statistical comparisons involved chi-square tests.</p><p><strong>Results: </strong>Among 244 patients (122 LOE, 122 English), we reviewed 687 notes. Patients were on average 65.8 years old, 49.2% female, 24.6% Caucasian, and 50.8% Hispanic. GOC component frequency was similar between patient groups. Although cultural/spiritual needs and clinician view of prognosis were more frequently documented for LOE-preferring patients (P = 0.006, 0.009, respectively), overall documentation of cultural, spiritual, and psychosocial needs was less than 50%. While both groups had a median of five out of 10 components documented across notes, LOE-preferring patients often had their first note written over a month closer to death than English-preferring patients.</p><p><strong>Conclusion: </strong>LOE-preferring patients were more likely to have their GOC notes written closer to death and while hospitalized compared to English-preferring patients. Additional interventions are needed to support earlier GOC conversations and improve comprehensive documentation.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized Sedation Goals for Agitated End-of-Life Delirium: Secondary Analysis of RECORD Trial.","authors":"Hsien Liang Huang, Shao-Yi Cheng, Jaw-Shiun Tsai, Allison de la Rosa, Jen-Kuei Peng, Chien-An Yao, David Hui","doi":"10.1016/j.jpainsymman.2026.08.003","DOIUrl":"10.1016/j.jpainsymman.2026.08.003","url":null,"abstract":"<p><strong>Context: </strong>End-of-life delirium causes substantial distress for patients and families. Personalized sedation goals (PSGs) offer a patient-centered approach to delirium management by defining treatment targets based on caregiver preferences.</p><p><strong>Objectives: </strong>We compared haloperidol, lorazepam, haloperidol plus lorazepam, and placebo in achieving caregiver-defined PSGs for agitated end-of-life delirium.</p><p><strong>Methods: </strong>This preplanned secondary analysis used data from a multicenter, double-blind, double-dummy, parallel-group randomized clinical trial conducted from July 16, 2019, to June 8, 2023, with 30-day follow-up. Patients with advanced cancer and persistent agitation despite nonpharmacologic measures and standard-dose haloperidol were enrolled from three acute palliative care units in the United States and Taiwan. Participants received haloperidol dose escalation, lorazepam rotation, combination therapy, or placebo. Caregivers defined PSGs at enrollment. A personalized response was defined as a Richmond Agitation-Sedation Scale score within ±1 category of the PSG.</p><p><strong>Results: </strong>Of 245 eligible patients, 111 were enrolled and 72 included in the primary analysis. Caregiver-defined PSGs were available for 67 patients included in this secondary analysis. At 24 hours, PSG achievement differed significantly across groups (P = 0.02): lorazepam 10/13 (76.9%), combination therapy 8/13 (61.5%), placebo 7/13 (53.8%), and haloperidol 3/14 (21.4%). Compared with haloperidol, lorazepam (odds ratio = 12.2; 95% CI = 2.0-75.1; P = 0.01) and combination therapy (odds ratio = 5.9; 95% CI = 1.1-32.0; P = 0.04) were more likely to achieve caregiver-defined PSGs.</p><p><strong>Conclusions: </strong>Lorazepam-based regimens were more likely than haloperidol alone to achieve caregiver-defined sedation goals, supporting their role in goal-concordant care for agitated end-of-life delirium.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advance Care Planning in Amyotrophic Lateral Sclerosis: A Retrospective Population-based Study.","authors":"Francesca Palumbo, Barbara Iazzolino, Antonio Canosa, Umberto Manera, Rosario Vasta, Maurizio Grassano, Antonio Ilardi, Sara Cabras, Enrico Matteoni, Alessandra Maccabeo, Francesca Di Pede, Filippo De Mattei, Giorgio Pellegrino, Emilio Minerva, Federica Riva-Rovedda, Marco Clari, Grazia Zocco, Daniela Pascariu, Marcella Testa, Martina Arcari, Simone Veronese, Adriano Chiò, Cristina Moglia, Andrea Calvo","doi":"10.1016/j.jpainsymman.2026.08.002","DOIUrl":"10.1016/j.jpainsymman.2026.08.002","url":null,"abstract":"<p><strong>Context: </strong>In recent decades, autonomy and self-determination in Amyotrophic Lateral Sclerosis (ALS), have gained increasing attention, and Advance Care Planning (ACP) has been incorporated into ALS guidelines. In Italy, Law 219 emphasizes the role of ACP in respecting patients' healthcare preferences. However, longitudinal data on ACP prevalence and impact remain limited.</p><p><strong>Objectives: </strong>To assess the prevalence of ACP discussions in a population of ALS patients, their effectiveness in end-of-life management, and the impact of Law 219/2017.</p><p><strong>Methods: </strong>Demographic and clinical data from the PARALS Register (2008-2020) were retrospectively examined, with particular focus on ACP discussions, tracheostomy preferences, and end-of-life outcomes.</p><p><strong>Results: </strong>Of 1219 ALS patients, 655 (53.7%) had ACP discussions, with 90.8% concordance between expressed choices and outcomes. The ACP prevalence increased over time from 51.6% to 61.94% (P = 0.025). Cognitive impairment, including fronto-temporal dementia and intermediate cognitive-behavioral impairment, and absence of NIMV use were negatively associated with ACP (P = 0.029 and P < 0.001). Older age was associated with tracheostomy placement (P < 0.001). ACP discussion was positively associated with gastrostomy placement, Palliative Care activation, and home death.</p><p><strong>Conclusion: </strong>ACP plays a crucial role in ALS care, with high alignment between expressed choices and outcomes. Cognitive impairment reduced ACP participation, highlighting the need for earlier, tailored interventions. The ACP increase over the last decade reflects a growing emphasis on patient autonomy in Italy. Further efforts are needed to expand ACP adoption in ALS care, to support self-determination despite cognitive decline and disease progression.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148727737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Decision Support for Service Coverage of AYA Palliative Care: An Interrupted Time Series.","authors":"Drew Walker, Kelsea LeBeau, Emily Marchi, Anna Swygert, Erin E Hahn, Michael K Gould, Melvin Livingston","doi":"10.1016/j.jpainsymman.2026.07.033","DOIUrl":"10.1016/j.jpainsymman.2026.07.033","url":null,"abstract":"<p><strong>Context: </strong>Volunteer-based palliative care programs often lack the tools to ensure consistent service delivery across their full patient census.</p><p><strong>Objectives: </strong>This study assessed the impact of a clinical decision support system (CDSS) on the daily percentage of eligible patients visited in a hospital-based adolescent and young adult (AYA) palliative care peer support program.</p><p><strong>Methods: </strong>We analyzed data from Streetlight at University of Florida (UF) Health from November 14, 2021 to November 14, 2025. On November 14, 2022, a CDSS feature was introduced to display each patient's cumulative percentage of days visited on the program census. Segmented generalized linear regression was used to estimate changes in the level and slope of daily visit coverage before and after implementation. Estimates were adjusted for census size, volunteer staffing, and temporal patterns.</p><p><strong>Results: </strong>CDSS implementation was associated with an immediate 7.6 percentage-point increase in visit coverage (95% CI: 2.5 to 12.6), equivalent to approximately 1.7 additional patients visited per day at a median census of 22 patients. This corresponds to roughly 440 additional patient visits per year assuming weekday-only operation. The intervention also significantly improved the postimplementation trend, reversing a pre-existing decline in visit coverage.</p><p><strong>Conclusion: </strong>CDSSs can leverage real time program data to improve service delivery in palliative care support programs by increasing coverage and complementing human decision-making.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148679038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}