Scandinavian Journal of Primary Health Care最新文献

{"title":"Quality of the digital gp visits and characteristics of the users: retrospective observational study.","authors":"Sanna Lakoma, Henna Pasanen, Kaisla Lahdensuo, Jaakko Pehkonen, Jutta Viinikainen, Paulus Torkki","doi":"10.1080/02813432.2024.2380921","DOIUrl":"10.1080/02813432.2024.2380921","url":null,"abstract":"<p><strong>Objectives: </strong>This study compares the demographics, diagnoses, re-admission rates, sick leaves, and prescribed medications of patients accessing digital general practitioner (GP) visits with those of patients opting for traditional face-to-face appointments in a primary health care setting.</p><p><strong>Design: </strong>The study adopted a retrospective analysis of patient record data collected in 2019, comparing visits to a digital primary health center with traditional health center visits.</p><p><strong>Setting: </strong>Primary health care.</p><p><strong>Participants: </strong>The data encompassed patients who utilized the digital clinic and those who visited public health centers for primary health care services.</p><p><strong>Main outcome measures: </strong>The study assessed demographics, health diagnoses, prescribed medications, sick leave recommendations, re-admission rates, and differences in costs between digital clinic and face-to-face visits. Secondary outcomes included a comparative analysis of medication categories, resolution rates for health problems, and potential impacts on health care utilization.</p><p><strong>Results: </strong>Digital clinic users were typically younger, more educated, and predominantly female compared with health centre users. Digital visits were well-suited for uncomplicated infections, while health centre appointments were associated with a higher prevalence of chronic conditions. Medication patterns differed between the two modalities, with digital clinic users receiving generic over-the-counter drugs and antibiotics, whereas health centre visits commonly involved cardiac and antihypertensive medications. Sick leave recommendations were slightly higher in the digital clinic, but the difference was not significant. Approximately 70% of health problems addressed in the digital clinic were successfully resolved, and the cost of digital visits was about 50,3% of face-to-face appointments.</p><p><strong>Conclusion: </strong>Digital health care services offer a cost-efficient alternative for specific health problems, appealing to younger, educated individuals, when compared to the users of public health center, and may enable improvement of cost-effectiveness combined with acceptable demand management and patient segmentation practices. The results highlight the potential benefits of digital clinics, particularly for uncomplicated cases, while also emphasizing the importance of suitable referral mechanisms for in-person consultations.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"686-694"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To neutrally offer or strongly recommend? General practitioners' perspectives on screening for gestational diabetes according to the national guideline in Norway.","authors":"Ingeborg Forthun, Kathy Ainul Møen, Stefán Hjörleifsson","doi":"10.1080/02813432.2024.2378204","DOIUrl":"10.1080/02813432.2024.2378204","url":null,"abstract":"<p><strong>Objective: </strong>To explore general practitioners' experiences and reflections on how the current Norwegian guideline for screening for gestational diabetes affects their clinical practice.</p><p><strong>Design: </strong>A qualitive study in which data were collected through semi-structured focus group interviews and analyzed thematically.</p><p><strong>Setting and subjects: </strong>Five focus groups conducted in 2020 among GPs in Norway; three interviews took place face-to-face and two were held digitally. The total number of participants was 31.</p><p><strong>Results: </strong>GPs acknowledged the potential benefits of more extensive screening, but had concerns about the medicalization of pregnancy, stating that some women experienced considerable anxiety. The GPs expressed doubts about the guideline's evidence base but differed in how they interpreted what the guideline was asking them to do. Some offered eligible women the opportunity to be screened, while other set up a screening appointment without consulting the women first. For some, fear of incrimination made them recommend screening without being convinced that it was the right thing for the patient.</p><p><strong>Conclusions: </strong>It is unclear whether the guideline for gestational diabetes requires GPs to recommend screening to pregnant women or if they should provide neutral information about the availability of screening. This ambiguity should be addressed, and the guideline evaluated against the core principles of general practice.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"668-676"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141617005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in analgesic prescriptions in Dutch general practice.","authors":"D Veldkamp, N Pooters, H J Schers, R Akkermans, T C Olde Hartman, A A Uijen","doi":"10.1080/02813432.2024.2387423","DOIUrl":"10.1080/02813432.2024.2387423","url":null,"abstract":"<p><strong>Background: </strong>Increases in opioid prescriptions have been described; however, recent trends and prescribing patterns of analgesics in Dutch general practice are largely unknown.</p><p><strong>Objective: </strong>To investigate recent changes in the number of analgesic prescriptions, and the indications for prescribing strong opioids. Furthermore, we aim to identify risk factors for chronic opioid use in Dutch general practice.</p><p><strong>Design and setting: </strong>A retrospective cohort study from 1 July 2013 to 31 June 2022, using a primary care practice based research network.</p><p><strong>Subjects: </strong>Patients with ≥1 prescription for analgesics during the study period were included.</p><p><strong>Main outcome measure: </strong>Changes in the number of prescriptions for paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs) and opioids in Dutch general practice during the 9-year study period. Moreover, we analyzed indications for prescribing strong opioids by the general practitioner (GP).</p><p><strong>Results: </strong>A total of 18,433 analgesic users were identified. Over time, prescriptions for paracetamol, NSAIDs and weak opioids decreased, while the number of strong opioid prescriptions increased. General practitioners prescribed more strong opioids for non-malignant pain, whereas prescriptions for malignant pain remained stable over time. Risk factors for chronic opioid use (≥90 days) included older age, lower educational level, smoking status and having a history of a musculoskeletal or psychological disorder, a malignancy or sexual, physical or psychological abuse.</p><p><strong>Conclusions: </strong>Considering the increase in strong opioid prescriptions for benign conditions, GPs need to be vigilant for patients who are at risk for chronic use. Regular monitoring and awareness for psychosocial factors in treatment of chronic pain may be key in preventing harms associated with persistent opioid use.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"714-722"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal disorders in Norway: trends in health care utilization and patient pathways: a nationwide register study.","authors":"Mari Kristine Tyrdal, Flavie Perrier, Cecilie Røe, Bård Natvig, Astrid Klopstad Wahl, Marit B Veierød, Hilde Stendal Robinson","doi":"10.1080/02813432.2024.2368848","DOIUrl":"10.1080/02813432.2024.2368848","url":null,"abstract":"<p><strong>Objective: </strong>Describe trends in health care utilization, demographic characteristics and patient pathways among patients with musculoskeletal disorders (MSD) in Norway.</p><p><strong>Design: </strong>Register-based cohort study.</p><p><strong>Settings: </strong>Data were obtained from two Norwegian National registries; the Norwegian Control and Payment of Health Reimbursements Database (KUHR) and the Norwegian Patient Registry (NPR).</p><p><strong>Subjects: </strong>Patients with MSD according to ICPC-2 and ICD-10 during 2014-2017.</p><p><strong>Main outcome measures: </strong>Patient pathways from the first contact and the following two years, described in a Sankey Diagram for all MSD patients and three common diagnoses: spine pain, osteoarthritis (OA) and fibromyalgia (FM).</p><p><strong>Result: </strong>About 26% of the Norwegian population consulted PHC annually while 7% were treated in SHC. Mean age was 47 and 53 years in PHC and SHC, respectively. The proportion of women increased by age. Spine pain was the most common diagnosis; 33% and 22% in PHC and SHC, respectively. Over 90% visited a GP first, 50% of them were treated by PT and/or in SHC during follow-up. Patients visiting the PT first were less likely to be treated in SHC. OA patients were most likely to be treated by more than one health care professional (>70%).</p><p><strong>Conclusion: </strong>One third of the Norwegian population consulted health care services due to MSD annually between 2014-2017. GP was the most consulted health care professional. Among MSD patients with long-term use of health care services, 50% were treated by a PT and/or in SHC in addition to a GP.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"582-592"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality improvement work in general practice; a Norwegian focus group study.","authors":"Torunn Bjerve Eide, Holgeir Skjeie, Sigurd Høye","doi":"10.1080/02813432.2024.2380920","DOIUrl":"10.1080/02813432.2024.2380920","url":null,"abstract":"<p><strong>Background: </strong>Quality improvement work is an essential feature of healthcare services, including general practice. In this study, we aimed to gain more knowledge regarding general practitioners' (GPs) motivation for such work in their practices, as well as what kind of measures were considered motivating and feasible.</p><p><strong>Materials and methods: </strong>We conducted five focus group interviews among Norwegian GPs between November 2021 and November 2022. We included 21 GPs of varying age, gender, experience, and geographic situation. The data were transcribed verbatim and analysed by Systematic Text Condensation, a thematic cross-case analysis.</p><p><strong>Results: </strong>Many GPs had a diverse and imprecise understanding of the term quality improvement, and sound routines in everyday practice were often given as examples of quality improvement measures. There was a universal attitude that quality improvement initiatives should be close to practice, professionally relevant, and sufficiently small to be manageable. The availability of professional communities, either in the GP practices or in continuous medical education groups, was important for motivation. The role of nurses and health secretaries was highlighted as essential to achieve change. Participants commonly described negative reactions to programs that were imposed by external actors without regard for the GPs' perceived needs.</p><p><strong>Conclusion: </strong>GPs were motivated for quality improvement measures provided feasibility within the framework of general practice. Well-functioning professional communities, including involvement of nurses and health-secretaries, were emphasised as requisite for quality improvement. Small scale quality improvement programs suited for the needs of general practice were well received and should be further developed.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"677-685"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitoring handgrip strength to motivate lifestyle choices for patients with diabetes type 2 - a pragmatic randomised controlled trial.","authors":"Lena Bornhöft, Susanne Bernhardsson, Lena Nordeman, Anna Grimby-Ekman, Maria Dottori, Maria E H Larsson","doi":"10.1080/02813432.2024.2373298","DOIUrl":"10.1080/02813432.2024.2373298","url":null,"abstract":"<p><strong>Methods: </strong>Measurement of HGS with Jamar dynamometers was added to annual check-ups for patients with T2DM by diabetes nurses in primary care with feedback about normal values for age and sex in the intervention group. The control group had standard check-ups. Change in self-reported PA level was measured with questionnaires.</p><p><strong>Results: </strong>Seven clinics and 334 patients participated. The intervention led to similar effects on PA in both groups. Patients with T2DM had comparable HGS to the general public. Regression analyses showed statistically significantly higher HGS in the intervention group than in the control group at follow-up and no improvement in PA, HbA1c, or waist circumference. Increased HGS was found for older people, men, and people with normal-to-high inclusion HGS, while patients with low inclusion HGS reduced their strength levels.</p><p><strong>Conclusions: </strong>Measuring HGS and giving feedback to patients with T2DM can lead to increased HGS but does not seem to affect general PA level, HbA1c, or waist circumference. People over 65 years, men, and people with normal-to-high HGS were influenced positively by the intervention. Patients with low HGS may need personalised support to increase physical activity and improve function.<b>ClinicalTrials registration:</b> NCT03693521.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"617-632"},"PeriodicalIF":16.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring colorectal cancer patients' diagnostic pathways and general practitioners' assessment of the diagnostic processes: a Danish survey study.","authors":"Dorte E Jarbøl, Sanne Rasmussen, Kirubakaran Balasubramaniam, Jesper Lykkegaard, Linda Juel Ahrenfeldt, Gitte B Lauridsen, Peter Haastrup","doi":"10.1080/02813432.2024.2432376","DOIUrl":"https://doi.org/10.1080/02813432.2024.2432376","url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal cancer (CRC) is among the most common cancers and the prognosis of CRC is highly dependent on stage at diagnosis. Although many cases are diagnosed swiftly, there is still room for improvement.</p><p><strong>Aim: </strong>We aimed to explore CRC diagnostic pathways, encompassing (1) place of initial contact; (2) associations with symptom presentations, sex, and age with events in the diagnostic process and initial referrals and (3) the general practitioner's (GP's) evaluation of the diagnostic processes.</p><p><strong>Methods: </strong>All GPs in North-, Central-, and Southern Denmark were invited to fill in questionnaires for their listed patients diagnosed with cancer during the past two years.</p><p><strong>Results: </strong>Among 1,032 recorded CRC patients, 65% had their initial contact in general practice, 5% within the out-of hours service, 10% in the hospital, and 20% were diagnosed based on screening. A total of 27% of CRC patients over 40 who initially presented in general practice were treated or referred on suspicion of another disease first, and 9% were reported to have had hesitated in seeking medical attention. Some 37% presented solely non-specific symptoms, increasing the odds of the GP advising watchful waiting (OR 2.48; 95% CI 1.06-5.81), treating or referring on the suspicion of another illness first (OR 2.57; 95% CI 1.76-3.75), wait due to normal findings (OR 2.11; 95% CI 1.16-3.85), or referring to diagnostic imaging (OR 3.07; 95% CI 1.63-5.79). The GPs assessed nearly one fifth of the diagnostic processes as poor.</p><p><strong>Conclusion: </strong>Most CRC patients are diagnosed with initial presentation in general practice. Having non-specific symptoms is common and challenges timely diagnosis.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-10"},"PeriodicalIF":1.9,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142716623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical encounters with young unaccompanied refugees: a qualitative study among general practitioners and physicians in migrant health clinics in Norway and Denmark.","authors":"Gjertrud Moe, Bente Prytz Mjølstad, Linn Okkenhaug Getz, Morten Sodemann, Borgunn Ytterhus","doi":"10.1080/02813432.2024.2428364","DOIUrl":"https://doi.org/10.1080/02813432.2024.2428364","url":null,"abstract":"<p><strong>Objective: </strong>This study examines the experiences of clinical encounters with young unaccompanied refugees in Norway and Denmark among both general practitioners (GPs) and physicians in migrant health clinics (MHC physicians), and it identifies important aspects that should be taken into consideration for improving the quality of healthcare for these patients.</p><p><strong>Methodology: </strong>Ten individual in-depth interviews with physicians in Norway and Denmark were conducted and analysed using interpretative phenomenology. Axel Honneth's theory of recognition was our theoretical lens.</p><p><strong>Results: </strong>The physicians described these patients as vulnerable individuals. They adopted a variety of approaches in their encounters with young unaccompanied refugees spanning from a 'holistic' to an 'instrumental' approach. Those who described an instrumental approach focused on understanding and categorising symptoms from a biomedical perspective, while those describing a holistic approach considered 'the whole person' within their everyday context. Those with a more holistic approach also expressed the importance of interdisciplinary collaboration and defined work-divide. Relationships of trust between physicians and the young unaccompanied refugees were shown to be an important facilitator for adequate healthcare, but this required availability, continuity, and dialogue.</p><p><strong>Conclusion: </strong>Our results highlight how physicians' encounters with vulnerable young refugees actualize previously documented contrasts between holistic and instrumental approaches in clinical work. We argue that recognition in healthcare is conditional on physicians taking a holistic approach. This approach can help build relationships of trust and can support interdisciplinary collaboration. Moreover, such an approach can facilitate the essential components of Honneth's theory of recognition, namely social esteem and emotional support. Barriers to greater interdisciplinary collaboration in healthcare services need to be addressed at the system level.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How to support researchers in the primary care setting?","authors":"Frida Gyllenberg, Niko Wasenius, Merja K Laine","doi":"10.1080/02813432.2024.2429688","DOIUrl":"10.1080/02813432.2024.2429688","url":null,"abstract":"","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-2"},"PeriodicalIF":1.9,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142668978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring participants' characteristics and self-assessed readiness to conduct clinical trials in general practice - baseline analysis of the RaPHaeL practice-based research network.","authors":"Alexander Bauer, Larissa Virnau, Eric Sven Kroeber, Heidrun Lingner, Markus Bleckwenn, Thomas Frese, Kathleen Denny, Annett Braesigk, Tobias Deutsch","doi":"10.1080/02813432.2024.2427272","DOIUrl":"https://doi.org/10.1080/02813432.2024.2427272","url":null,"abstract":"<p><strong>Background: </strong>Primary care is integral to healthcare systems extending beyond traditional illness management to include preventive care, chronic disease management, and health promotion. Practice-based research networks (PBRNs) have emerged as essential infrastructures for conducting clinical research in primary care. This study explores the establishment of the 'Research-Practices Halle-Leipzig' (RaPHaeL) PBRN in Germany, evaluating the characteristics and research readiness of participating practices.</p><p><strong>Methods: </strong>A cross-sectional survey (MORNING II) was conducted among all general practitioners (GPs) joining the RaPHaeL PBRN, assessing socio-demographic characteristics, practice infrastructure, and research readiness. After a descriptive analysis, we compared data with a previous study (MORNING) to examine potential differences between PBRN participants and non-participants. We developed a research readiness score (RRS) to quantify practices' ability to perform clinical research subtasks.</p><p><strong>Results: </strong>The response rate was 97.1% and our participants were often male, involved in undergraduate education, generally interested in research or had previous research experiences. However, they differed widely in age and size, staff structure, and patient demographics of their practices. Initially, around two-thirds of the practices were not sufficiently prepared to conduct clinical trials (self-assessed feasibility of relevant subtasks). If further research and documentation tasks are required, patient recruitment estimations are lower than for patient identification and information.</p><p><strong>Conclusion: </strong>This study highlights the variability in research readiness among GP practices and shows the need for targeted training. By systematically assessing and enhancing research capabilities of participating GPs, PBRNs can facilitate high-quality clinical research in primary care to improve patient outcomes and healthcare delivery.</p>","PeriodicalId":21521,"journal":{"name":"Scandinavian Journal of Primary Health Care","volume":" ","pages":"1-11"},"PeriodicalIF":1.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142626334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}