Value in Health最新文献

{"title":"Economic Evaluations of Treatment of Depressive Disorders in Adolescents: A Scoping Review.","authors":"Claire de Oliveira, Joyce Mason, Bahar Amani, Terri Rodak, Peter Szatmari, Jo Henderson, Darren B Courtney","doi":"10.1016/j.jval.2025.02.005","DOIUrl":"10.1016/j.jval.2025.02.005","url":null,"abstract":"<p><strong>Objectives: </strong>Depressive disorders in adolescents are common and impairing. The objective of this review was to ascertain the existing literature on economic evaluations of treatments for adolescent depression.</p><p><strong>Methods: </strong>We searched MEDLINE, Embase, PsyclNFO, EconLit, and the International Health Technology Assessment Database from inception to May 2024 and the National Health Services Economic Evaluation Database from inception to December 2014. We included publications containing economic evaluations of clinical trials or model-based studies, which tested the treatment of depression in adolescents, regardless of jurisdiction. We extracted data, assessed the quality of reporting and methodology of all studies using the Consolidated Health Economic Evaluation Reporting Standards and Quality of Health Economic Studies checklists, respectively, and used a narrative approach to synthesize findings by treatment.</p><p><strong>Results: </strong>Among 1381 records, we found 10 eligible studies. Two studies reported that cognitive behavioral therapy (CBT) was cost-effective when compared with treatment as usual. Findings were mixed when combined CBT and selective serotonin reuptake inhibitors were compared with selective serotonin reuptake inhibitors alone because results were dependent on the applied willingness-to-pay thresholds (ie, the maximum price a decision maker is willing to pay for a given treatment). Overall, the quality of reporting and methodology was fairly high, although there were areas in which the studies could be improved upon.</p><p><strong>Conclusions: </strong>Eight studies indicate that CBT, alone or in combination with other treatments, can be cost-effective for treating adolescent depression. Future economic evaluations should consider characterizing distributional effects, describing how uncertainty about analytic judgments, inputs, or projections affect study findings, undertaking equity subanalyses, and engaging with patients and others affected by the study.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573868","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":"A Comprehensive View of the Methods Used to Measure the Societal Impact of Healthcare Interventions: A Systematic Review.","authors":"Ahmed H Seddik, Jeroen Paulissen, Ramesh Marapin, Sebastiaan Fuhler, Sukhvinder Johal, Mats Rosenlund, Kyle Dunton, Maarten Postma, Roel Freriks","doi":"10.1016/j.jval.2025.02.009","DOIUrl":"10.1016/j.jval.2025.02.009","url":null,"abstract":"<p><strong>Objectives: </strong>This study summarizes the concepts that have been used to date to demonstrate societal impact of healthcare interventions and establish an analytical framework to comprehensively organize and describe the different elements of societal impact.</p><p><strong>Methods: </strong>We conducted a systematic review following Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase, gray literature from ISPOR and Value Balancing Alliance websites, and the reference lists of the identified systematic reviews. Eligible studies assessed the societal impact and described a specific approach. For each included study, we extracted relevant characteristics, such as disease area, methodology, and societal impact metrics.</p><p><strong>Results: </strong>From a pool of 12 525 studies, 159 were included. Studies broadly examined the societal impact of an intervention at the patients, caregivers, healthcare organizations, and the societal level. Within those categories, we identified a total of 42 different concepts of societal value. We presented a frequency count of those concepts in a hierarchical framework and analyzed the studies qualitatively. We also assessed the literature against the ISPOR value flower.</p><p><strong>Conclusions: </strong>Our findings reveal recurrent themes and highlight the demand for methodological harmonization. While addressing the limitations of the studied literature from a decision-making perspective, we propose a consensus-driven path forward. Through our research, we emphasize the importance of refining the existing methods, the need for developing a standardized reporting format for future studies, and the importance of developing concise definitions for subjective concepts for societal impact of healthcare interventions.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573755","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":"The Health Economics of Alzheimer’s Disease and Related Dementias","authors":"Thomas Rapp PhD ,&nbsp;Pei-Jung Lin PhD","doi":"10.1016/j.jval.2025.02.002","DOIUrl":"10.1016/j.jval.2025.02.002","url":null,"abstract":"","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":"28 4","pages":"Pages 495-496"},"PeriodicalIF":4.9,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433681","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":"Qini Curves for Potential Impact Assessment of Risk Predictive Models Informing Intervention Policies.","authors":"Pierpaolo Palumbo","doi":"10.1016/j.jval.2025.01.024","DOIUrl":"10.1016/j.jval.2025.01.024","url":null,"abstract":"<p><strong>Objectives: </strong>Predictive models in medicine help make decisions about which individual to treat with a given therapeutic or preventive intervention. Before being tested in large field studies and recommended for clinical adoption, it is important to evaluate not only their statistical accuracy but also the impact they may have when used to inform health intervention policies. We aim to provide simple methods for the potential impact assessment of health intervention policies based on predictive models.</p><p><strong>Methods: </strong>We propose an analytic framework based on Qini curves wherein prediction-based policies are analyzed on 2 impact endpoints: (1) the fraction of the population that would be selected for the intervention (coverage) and (2) the effect on the clinical outcomes of interest (disutility). The drivers of values are the disease prevalence, the predictive performance of the model, and the effectiveness of the intervention.</p><p><strong>Results: </strong>We present simple formulas for calculating coverage and disutility from either observational or randomized controlled data. We illustrate possible value measures arising from geometrical properties on the Qini plane: delta coverage and disutility, number needed to treat, and integrated difference between Qini curves. We show the applicability of the Qini analysis by providing examples about the prevention of falls in older adults and prevention of secondary cardiovascular events with pioglitazone.</p><p><strong>Conclusions: </strong>Coverage and disutility capture key value components of prediction-based policies. The method can be used for comparing models or tuning risk thresholds for managing trade-offs between conflicting objectives (eg, clinical benefits, side effects, and healthcare resources).</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426307","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":"Cost Savings and Improved Clinical Outcomes From a Mobile Health Cardiovascular Disease Self-Management Program.","authors":"Walter Roberts, Helena Lyson, Clint Speer, Elena Tovar, Edo Paz, Eyal Zimlichman","doi":"10.1016/j.jval.2025.01.025","DOIUrl":"10.1016/j.jval.2025.01.025","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated the impact of a mobile health (mHealth) cardiovascular disease (CVD) self-management program on medical spending, healthcare utilization, and clinical outcomes.</p><p><strong>Methods: </strong>We conducted a retrospective cohort, pre-post observational analysis of medical claims data from February 2018 to September 2023. Participants enrolled in the mHealth CVD self-management program were compared with matched nonparticipants to assess changes in medical spending and utilization, using a difference-in-differences (DiD) approach. Moderation analyses tested whether the effect of participation on medical costs differed according to participants' demographic and employer characteristics. Linear mixed models were also used to evaluate changes in participant blood pressure.</p><p><strong>Results: </strong>There were 7112 participants and an equal number of matched nonparticipants from 14 employers included in the cost-savings analysis. Participation in the mHealth CVD self-management program was associated with an annualized per member savings of $1709 as compared with matched nonparticipants. Although savings were consistent across participant sex and employer type, older participants experienced greater savings. Program participation was associated with fewer inpatient hospital days and increased primary care utilization after enrollment. Program participants experienced significant reductions in blood pressure, with the largest reductions seen among those with stage 2 hypertension at baseline.</p><p><strong>Conclusions: </strong>Participation in an mHealth CVD self-management program was associated with significant cost savings and clinical improvements across diverse populations, highlighting its effectiveness as a cost-efficient tool for managing CVD and improving health outcomes. Further research is needed to explore the long-term benefits and cost-effectiveness of mHealth programs to support broader adoption.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426300","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":"A Scoping Review of Interventions to Reduce the Environmental Footprint of Healthcare.","authors":"Anna-Veera Seppänen, Zeynep Or","doi":"10.1016/j.jval.2025.01.021","DOIUrl":"10.1016/j.jval.2025.01.021","url":null,"abstract":"<p><strong>Objectives: </strong>The healthcare sector contributes significantly to global warming; yet, strategies for reducing its impact are not well integrated into health policy. This scoping review aimed to identify the range of effective interventions that can reduce the environmental footprint of healthcare and to provide an overview of their impact.</p><p><strong>Methods: </strong>We searched for peer-reviewed articles published in English, French, or Swedish between 2010 and September 2024 in Medline and Web of Science, following the Joanna Briggs Institute guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Publications were selected by 2 researchers and a documentalist. Data from included studies were extracted and synthesized in tables and described in a narrative synthesis.</p><p><strong>Results: </strong>We identified 7 systematic reviews and 44 original research articles. Most of the effective interventions targeted hospitals and varied from energy saving practices and reducing potent anesthetic gases to changing care protocols and improving waste management. The measured impact of interventions was context specific and depended on national energy sources. Only a few studies reported on the impact of structural and strategic changes in healthcare provision across care settings.</p><p><strong>Conclusions: </strong>There is an urgent need for better understanding the costs and benefits of diffusing effective green interventions across care providers and developing more systemic approaches for optimizing care provision and utilisation to achieve a meaningful impact.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426207","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":"Statistical Methods for Analyzing EQ-5D in Randomized Clinical Trials: A Systematic Literature Review.","authors":"Jiajun Yan, Brittany Humphries, Ruinan Xie, Ziran Yin, Zhenyan Bo, Sha Diao, Jing Cai, Preston Tse, Meixuan Li, Eleanor Pullenayegum, Shun Fu Lee, Feng Xie","doi":"10.1016/j.jval.2025.02.001","DOIUrl":"10.1016/j.jval.2025.02.001","url":null,"abstract":"<p><strong>Objectives: </strong>We conducted a systematic literature review to summarize the application of statistical methods for analyzing treatment effect on EQ-5D in randomized clinical trials (RCTs).</p><p><strong>Method: </strong>We searched 2 electronic databases (MEDLINE and EMBASE, from inception through 2021) and www.</p><p><strong>Clinicaltrial: </strong>gov. Eligible studies were RCTs that analyzed postbaseline EQ-5D data by treatment group. Information on trial characteristics, EQ-5D data characteristics, and statistical methods were extracted. Descriptive statistics were used to summarize results by dimension response, EQ visual analog scale (EQ VAS), and EQ-5D utility.</p><p><strong>Results: </strong>A total of 2125 trials met the eligibility criteria. EQ-5D was commonly considered a secondary (n = 1219, 57.4%) or exploratory (n = 775, 36.5%) endpoint in RCTs. EQ-5D utilities were the most analyzed. Both utilities and EQ VAS were primarily analyzed in numerical format. The most common statistical models for analyzing utilities were the linear fixed-effect model for single postbaseline (192/589, 32.6%) and the linear mixed-effect model for multiple post-baselines (338/984, 34.3%). Of the 2054 studies that analyzed numerical EQ-5D, 221 (10.8%) examined model assumptions and 438 (21.3%) adjusted for the baseline score. Missing data were explicitly assessed in 661 trials, among which 347 (52.5% of 661) applied imputations, with the 2 most used imputation methods being multiple imputations (n = 200, 57.6% of 347) and last observation carried forward (n = 106, 30.5% of 347).</p><p><strong>Conclusions: </strong>This review found that health utilities are the most frequently analyzed EQ-5D data collected in clinical trials, followed by EQ VAS. Significant variation was observed in the selection of models, with most trials lacking adjustments for baseline data and appropriate methods for handling missing data.</p>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426312","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":"Role of Health Equity in Health Technology Assessment Processes: A Landscape Analysis of 13 Health Systems in Asia","authors":"Chanthawat Patikorn PharmD, PhD ,&nbsp;Chia Jie Tan PhD ,&nbsp;Jeong-Yeon Cho PharmD, PhD ,&nbsp;Sarayuth Khuntha BSc ,&nbsp;Nguyen Thi Ha PhD ,&nbsp;Rini Noviyani PhD ,&nbsp;Mac Ardy J. Gloria PhD ,&nbsp;Anton L.V. Avanceña PhD ,&nbsp;Sitaporn Youngkong PhD ,&nbsp;Kyoko Shimamoto PhD ,&nbsp;Nathorn Chaiyakunapruk PharmD, PhD","doi":"10.1016/j.jval.2025.01.012","DOIUrl":"10.1016/j.jval.2025.01.012","url":null,"abstract":"<div><h3>Objectives</h3><div>This landscape analysis aimed to summarize the role of health equity in the health technology assessment (HTA) process (topic nomination, topic prioritization, assessment, appraisal, and decision making) in Asia.</div></div><div><h3>Methods</h3><div>A comprehensive literature review was conducted, followed by in-depth interviews with key informants. Content analysis was performed to summarize the role of health equity in HTA in 13 health systems in Asia, including Brunei Darussalam, Cambodia, China, Indonesia, Japan, Malaysia, Myanmar, Philippines, Singapore, South Korea, Taiwan, Thailand, and Vietnam.</div></div><div><h3>Results</h3><div>Health equity was reported to be considered in most health systems’ HTA processes, except for Cambodia and Myanmar, which do not have an established HTA process. Interviews revealed that health equity has been more frequently considered to address the unmet medical needs of specific diseases (eg, high disease burden or severity, rare diseases, cancer, and diseases affecting children and the elderly) in Brunei Darussalam, China, Japan, Malaysia, Singapore, South Korea, Taiwan, Thailand, and Vietnam or inequities in socially disadvantaged groups (eg, socioeconomic status and geographical location) in Indonesia and the Philippines. Equity-informative economic evaluation was still in the early stages, with only 3 health systems reporting their use.</div></div><div><h3>Conclusions</h3><div>Health equity is considered in the HTA process in most Asian health systems. However, quantitative evaluation of health equity impact is still in its infancy because few health systems have just begun to perform equity-informative economic evaluations.</div></div>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":"28 4","pages":"Pages 582-590"},"PeriodicalIF":4.9,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373993","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":"Exploring a Patient-Centered Methodology to Identify Suitable Proxy Conditions as a Source for Utility Data, Using Alopecia Areata as a Case Example","authors":"Alice M. Biggane PhD ,&nbsp;Sofia Schiavo MSc ,&nbsp;Rowena Randall PhD ,&nbsp;Masara Elgares MSc ,&nbsp;Patrice Carter PhD","doi":"10.1016/j.jval.2025.01.017","DOIUrl":"10.1016/j.jval.2025.01.017","url":null,"abstract":"<div><h3>Objectives</h3><div>In the absence of EQ-5D utility data, the National Institute for Health and Care Excellence recommends sourcing utility values from a proxy health condition, provided that data indicate that the health-related quality of life (HRQoL) impact of the conditions is similar. Given that there is no standard practice for identifying proxy conditions, this study presents a patient-centered approach for selecting a proxy condition, using alopecia areata (AA) as an example.</div></div><div><h3>Methods</h3><div>A structured electronic search was conducted to identify conceptual models for conditions similar to AA with overlapping HRQoL domains. Conceptual models were compared to determine the most suitable proxy condition, defined as the condition with the most overlapping domains and reported similarities between patient HRQoL. A search and comparison of utility data between AA and the selected proxy condition was conducted to validate their comparability in HRQoL impact.</div></div><div><h3>Results</h3><div>Seven conditions with overlapping HRQoL domains with AA were identified using conceptual models. Atopic dermatitis (AD) had the most overlapping domains (n = 6) and the greatest evidence of similarities between patient HRQoL; thus, it was selected as the proxy condition. Conceptual models indicated that both conditions affected patients’ physical, emotional, and functional well-being. Furthermore, AD and AA utilities were comparable, supporting the choice of AD as the proxy condition.</div></div><div><h3>Conclusions</h3><div>Given the correlation observed between AA and the selected proxy condition using this methodology, this study presents a potential approach to identify proxy conditions for diseases that may be underrepresented in terms of HRQoL data.</div></div>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":"28 4","pages":"Pages 599-610"},"PeriodicalIF":4.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-Effectiveness of a Digitally Supported Care Management Program for Caregivers of People With Dementia","authors":"Michelle Pfaff MSc ,&nbsp;Wolfgang Hoffmann MD, MPH ,&nbsp;Melanie Boekholt MA ,&nbsp;Olga Biernetzky PhD ,&nbsp;Iris Blotenberg PhD ,&nbsp;Dilshad Afrin MSc ,&nbsp;Moritz Platen PhD ,&nbsp;Stefan Teipel MD ,&nbsp;Jochen René Thyrian PhD ,&nbsp;Ingo Kilimann MD ,&nbsp;Bernhard Michalowsky PhD","doi":"10.1016/j.jval.2025.01.011","DOIUrl":"10.1016/j.jval.2025.01.011","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine the cost-effectiveness of a digitally supported care management system (CMS) for caregivers of people with dementia (PwD) compared with usual care.</div></div><div><h3>Methods</h3><div>The analysis was based on 192 caregivers (<em>n</em> = 96 CMS, <em>n</em> = 96 usual care) of PwD in a cluster-randomized controlled trial testing a digitally supported CMS, aiming to identify and address caregivers’ unmet needs and develop and implement an individualized support and care plan over 6 months. Incremental costs from the public-payer and societal perspectives, quality-adjusted life years (QALY), and the incremental cost-effectiveness ratio 6 months after baseline were calculated using multivariate regression models. We assessed the probability of cost-effectiveness using a range of willingness-to-pay thresholds.</div></div><div><h3>Results</h3><div>Caregivers in the intervention group gained QALYs (+0.004 [95% CI −0.003 to 0.012], <em>P</em> value = .225) and had lower costs from the public payer (−378€ [1926-1168], <em>P</em> value = .630), but higher costs from the societal perspective (+1324 [−3634 to 6284], <em>P</em> value = .599). The intervention dominated usual care from the payer perspective, whereas the incremental cost-effectiveness ratio was €331 000/QALY from a societal perspective. The probability of cost-effectiveness was 72% and 79% from the public payer and 33% and 35% from a societal perspective at the willingness-to-pay thresholds threshold of €40 000 and €80 000/QALY gained.</div></div><div><h3>Conclusions</h3><div>CMS was likely cost-effective from the payer but not from a societal perspective, underlining the importance of informal care. The gain in QALY was marginal and could be due to the short observation period. Focusing on both the caregiver and the PwD, rather than assessing the PwD needs through the caregiver, could improve the cost-effectiveness results.</div></div>","PeriodicalId":23508,"journal":{"name":"Value in Health","volume":"28 4","pages":"Pages 527-535"},"PeriodicalIF":4.9,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}