Cost Effectiveness and Resource Allocation最新文献

{"title":"Coverage and distributional benefit-cost of rotavirus vaccine in Uganda: an analysis of routine health facility aggregated data.","authors":"Rornald Muhumuza Kananura, Gatien de Broucker, Anthony Ssebagereka, Aloysius Mutebi, Elizabeth Ekirapa Kiracho, Bryan Patenaude","doi":"10.1186/s12962-024-00586-5","DOIUrl":"10.1186/s12962-024-00586-5","url":null,"abstract":"<p><strong>Introduction: </strong>Owing to the lack of local cost and clinical effectiveness data in sub-Saharan Africa, economic evaluations of the rotavirus vaccine are still limited in the region. In this study, we utilize different data sources, including aggregated routine health information system data to examine the net benefits of the rotavirus vaccine in Uganda. We also present ways in which health facility data can be used to assess subnational vaccination coverage as well as the effect of the vaccine on diarrhoea hospitalization.</p><p><strong>Methods: </strong>We used monthly health facility data collected between 2015 and 2021 to study the relationship between rollout of rotavirus vaccine and diarrhoea hospitalization. We gathered information from empirical studies on the cost of diarrhoea (household and health facility) and vaccine administration to estimate the costs averted due to the rotavirus vaccine. As household costs, we considered out-of-pocket payments associated with the episodes of diarrhoea and the productivity loss associated with time spent on treatment and with mortality using a human capital approach. Finally, we employed an interrupted time series analysis to examine the effect of rotavirus vaccine on diarrhoea hospitalization. Costs are presented in 2018 US dollars.</p><p><strong>Results: </strong>As of 2021, nationwide coverage of the first and second doses of the rotavirus vaccine (RV) in Uganda was estimated at 89% and 65% respectively, with variations observed across the regions. The study revealed a decrease in diarrhoea hospitalization by 1% for each 1% increase in RV coverage. Moreover, the study showed that diarrhoea hospitalization reduced by 2% for each additional month post- vaccine rollout. Excluding productivity losses due to mortality, the analyses of costs averted due to the RV reveal that between 2018 and 2021, Uganda saved approximately $57 million ($7 per capita) in expenses associated with diarrhoea. The return on investment (ROI) due to RV was calculated to be $1.48 per dollar invested. When including mortality costs, the net benefit reached up to $3 billion in economic cost ($385 per capita), and an ROI of $78 overall. Furthermore, the study demonstrated that RV provided substantial health benefits, particularly for socially disadvantaged groups. Excluding mortality costs, the ROI for the two most disadvantaged groups ranged from $1.71 to $2.03 per dollar spent, while for the remaining groups, it ranged from $1.10 to $1.14.</p><p><strong>Conclusion: </strong>This manuscript stresses the importance of RV in alleviating the burden of diarrhoeal diseases and associated costs in Uganda. The study not only emphasizes the tangible benefits derived from the vaccine but also highlights the role of routine aggregated healthcare information systems in systematically monitoring the effectiveness and coverage of interventions.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"85"},"PeriodicalIF":1.7,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692762","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":"Cost-effectiveness of fenofibrate for preventing diabetic complications in Australia.","authors":"Hansoo Kim, Juntao Lyu, Vikrama Raja, Kyoo Kim","doi":"10.1186/s12962-024-00591-8","DOIUrl":"10.1186/s12962-024-00591-8","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the cost-effectiveness of using fenofibrate to treat type 2 diabetes in Australia. The financial burden of type 2 diabetes mellitus is estimated to surpass AUD10 billion, mainly due to the cost of diabetic complications from diabetic neuropathy. Clinical evidence from the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study demonstrated that fenofibrate can reduce the risk of amputation and other diabetes-related complications.</p><p><strong>Methods: </strong>This study used a calibrated UKPDS model with an Australian diabetes cohort to simulate complications and deaths over a 20-year time horizon. The effectiveness of fenofibrate was assessed using the FIELD study. Total cost was calculated over the 20-year time horizon. Input data was obtained from the Australian Refined-Disease Related Groups and the Australian Pharmaceutical Benefits Scheme.</p><p><strong>Results: </strong>The model estimated that fenofibrate is associated with lower complication costs, which save over AUD 4.6 million per 1,000 patients. The most significant savings were observed in amputations. The incremental cost-effectiveness ratio for fenofibrate treatment was estimated to be AUD 739/LY gained and AUD 1189/QALY gained.</p><p><strong>Conclusion: </strong>The use of fenofibrate in Type 2 diabetes patients is estimated to result in cost savings in an Australian setting due to fewer diabetes complications.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"84"},"PeriodicalIF":1.7,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11575035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669303","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":"Cost-effectiveness of high-dose vitamin D supplementation to reduce the occurrence of repeat episodes of pneumonia in children.","authors":"Jefferson Antonio Buendía, Diana Guerrero Patiño","doi":"10.1186/s12962-024-00589-2","DOIUrl":"10.1186/s12962-024-00589-2","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the growing evidence on efficacy, little is known regarding the efficiency of Vitamin D supplementation (VDS) to reduce the incidence of repeat episodes of pneumonia in children. This study aimed to determine the cost-utility of VDS to reduce the incidence rate of repeat episodes of pneumonia in children.</p><p><strong>Methods: </strong>A decision tree model was used to estimate the cost and quality-adjusted life-years (QALYs) of VDS in a patient aged 2 to 60 months with a clinical diagnosis of community-acquired pneumonia requiring in-hospital management. Multiple sensitivity analyses were conducted to evaluate the robustness of the model. Cost-effectiveness was evaluated at a willingness-to-pay (WTP) value of US$5180.</p><p><strong>Results: </strong>The QALYs per person were 0,93 with VDS and 0,92 without VDS. The total costs per person were US$ 1148 for VDS and US$ 1284 without VDS. This position of absolute dominance of VDS makes it unnecessary to estimate the incremental cost-effectiveness ratio. The ICER was sensitive to changes in the relative risk of Vitamin D supplementation.</p><p><strong>Conclusion: </strong>In conclusion, our study shows that VDS is a cost-effective to reduce the incidence rate of repeat episodes of pneumonia in children, from a societal perspective. However, the sensitivity of ICER to relative risk makes it necessary to take the results of this economic evaluation with caution.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"83"},"PeriodicalIF":1.7,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629604","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":"Cost-effectiveness analysis of Tocilizumab compared to Adalimumab in the treatment of severe active rheumatoid arthritis in Iran.","authors":"Yalda Metghalchi, Neda Yaghoubi, Nazila Yousefi, Razieh Ahmadi, Alireza Kargar, Marzieh Zargaran, Soheila Rezaei","doi":"10.1186/s12962-024-00592-7","DOIUrl":"10.1186/s12962-024-00592-7","url":null,"abstract":"<p><strong>Background and objective: </strong>This study aimed to determine the cost-effectiveness of Tocilizumab (TCZ) compared with Adalimumab (ADA) in patients with Rheumatoid Arthritis (RA), who had not responded to methotrexate (MTX), from a societal perspective in Iran.</p><p><strong>Method: </strong>To conduct the cost-utility analysis, using an individual microsimulation Markov model, a hypothetical cohort of 1,000 patients was evaluated over a lifetime horizon. The efficacy and safety of each treatment were estimated using the American College of Rheumatology (ACR) criteria to determine the continuation or switching of treatment every six months. Treatment responses were captured based on Health Assessment Questionnaire (HAQ) scores and mapped into utility values to determine QALY gained for each treatment. All direct and indirect costs associated with the disease and perspective were included according to societal perspective. Deterministic and Probabilistic sensitivity analyses were performed to assess the robustness of the model.</p><p><strong>Results: </strong>The result of the study estimated that TCZ is a more cost-effective treatment option, with a probability of 76%. TCZ was associated with a higher cost ($6,990 versus $6,608) and higher QALYs gained (4.24 versus 3.95) compared to ADA with an incremental cost-effectiveness ratio (ICER) of USD 1,301, which is below the willingness-to-pay threshold of 1,448 USD in Iran.</p><p><strong>Conclusion: </strong>This study provides convincing evidence of the cost-effectiveness of TCZ compared to ADA in the treatment of active severe RA in Iran.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"82"},"PeriodicalIF":1.7,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11562510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629223","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":"From pilot to national roll-out of the improved Community Health Fund (iCHF) in Tanzania: lessons learnt and way forward.","authors":"Ntuli A Kapologwe, Boniphace Marwa, Heri Marwa, Ally Kebby, James Tumaini Kengia, George Ruhago, Stephen M Kibusi, Innocent B Mboya, Gemini Mtei, Albino Kalolo","doi":"10.1186/s12962-024-00571-y","DOIUrl":"10.1186/s12962-024-00571-y","url":null,"abstract":"<p><strong>Introduction: </strong>Scaling up public health interventions in the health systems of resource poor settings come with technical and operational challenges. Little is documented on scaling up complex health financing interventions and their related outcomes, especially the voluntary health insurance schemes. This study aimed to analyse the scale-up steps, successes and challenges of the improved community health fund (iCHF), a voluntary health insurance scheme in Tanzania, METHODS: In this paper, guided by the Expand Net framework (a scale-up framework for health system interventions), we present a systematic analysis of countrywide scale-up of the iCHF that started in 2019 and implemented in partnership between the government and development partners. We systematically collected information on the scale-up steps and the success and challenges. The collected data was analysed using descriptive statistics.</p><p><strong>Results: </strong>The scale-up involved multiple steps and actions at different levels of the health system. The initial step involved gathering stakeholders' views on scale-up options and strategies. The subsequent steps focused on mobilizing resources for scale-up, advocacy and promotion of the scheme through media, community leaders and role models, capacity building to implementing organs, institutionalizing the scale-up processes, intensifying the scale-upscale-up activities for expansion and spontaneous scale-up and technical backstopping to lower levels of the health system on the scale-up process. We found success and challenges as the scale-upscale-up progressed to mature stages. The success included acceptability and institutionalization of the scale-up activities and growing enrolments and funds in the scheme. The challenges included: the costs to sustaining advocacy and enrolments, equity in scale-upscale-up activities across regions, relying on top-down scale-upscale-up approaches, influence of contextual factors and lack of implementation research alongside the scale-upscale-up process.</p><p><strong>Conclusion: </strong>This paper underscores the scale up steps and success and challenges of scaling-up a voluntary health insurance scheme in a resource-constrained health system. Sustaining the scale-upscale-up gains will require utilizing program data and experiences to sustainably improve the scheme performance while also harnessing support from stakeholders. Further research is needed to assess equity and quality of outcomes of the scale up.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"80"},"PeriodicalIF":1.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629723","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":"Identifying and prioritizing inefficiency causes in Iran's health system.","authors":"Alireza Olyaeemanesh, Farhad Habibi, Mohammadreza Mobinizadeh, Amirhossein Takian, Bahman Khosravi, Jawad Jafarzadeh, Ahad Bakhtiari, Efat Mohamadi","doi":"10.1186/s12962-024-00593-6","DOIUrl":"10.1186/s12962-024-00593-6","url":null,"abstract":"<p><strong>Background: </strong>Enhancing efficiency is crucial in addressing the escalating scarcity of healthcare resources. It plays a pivotal role in achieving Universal Health Coverage (UHC), with the ultimate goal of ensuring health equity for all. A fundamental strategy to bolster efficiency involves pinpointing the underlying causes of inefficiency within the healthcare system through empirical research. This study aimed to determine and prioritize the causes of inefficiency in Iran's health system.</p><p><strong>Methods: </strong>This mixed-method study comprised three phases. The initial phase involved identifying the causes of inefficiency through a comprehensive literature review of relevant studies published between January 1, 2010, to January 1, 2021. The causes were then aligned and prioritized using criteria derived from the literature and expert opinion. Finally, the identified causes were ranked based on their significance using Multiple-Criteria Decision Analysis (MCDA).</p><p><strong>Results: </strong>From an initial pool of 307 causes of inefficiency, they were reduced to 121 causes in the first round of screening which were categorized into 13 thematic topics. The second screening process further narrowed the list to 48 causes. Among these, the leading causes of inefficiency included the inadequate supply and unequal distribution of hospital beds, the overuse of health services, and the mismanagement of the health workforce. In contrast, the use of traditional treatment methods was determined to be the least significant factor contributing to inefficiency.</p><p><strong>Conclusion: </strong>This study identified key inefficiencies in Iran's health system, such as resource misallocation, overuse of services, and workforce mismanagement. Addressing these issues is essential for optimizing resource utilization, enhancing service delivery, and achieving UHC. The findings suggest that policymakers should prioritize reforms in hospital bed distribution, implement strategies to reduce unnecessary health service use, and strengthen human resource management. Additionally, targeted policies that focus on decentralizing healthcare decision-making and enhancing primary care could significantly improve system-wide efficiency. Future research should evaluate the effectiveness of these interventions and explore the role of digital health solutions in mitigating identified inefficiencies.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"81"},"PeriodicalIF":1.7,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629733","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":"Correction: The costs of implementing anaemia reduction interventions among women fish processors in Ghana.","authors":"Francis Adane, Richmond Aryeetey, Genevieve Aryeetey, Justice Nonvignon","doi":"10.1186/s12962-024-00590-9","DOIUrl":"10.1186/s12962-024-00590-9","url":null,"abstract":"","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"79"},"PeriodicalIF":1.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583533","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":"Correction: Global bibliometric analysis of cost effectiveness analysis in healthcare research from 2013 to 2023.","authors":"Kemdi Lugard Okoroiwu, Henshaw Uchechi Okoroiwu, Love Ogochukwu Ude, Chidimma Odilia Ezuma, Emmanuel Ikechukwu Omeje","doi":"10.1186/s12962-024-00587-4","DOIUrl":"10.1186/s12962-024-00587-4","url":null,"abstract":"","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"78"},"PeriodicalIF":1.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142583467","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":"The role of economic evaluation in modelling public health and social measures for pandemic policy: a systematic review.","authors":"Shania Rossiter, Samantha Howe, Joshua Szanyi, James M Trauer, Tim Wilson, Tony Blakely","doi":"10.1186/s12962-024-00585-6","DOIUrl":"10.1186/s12962-024-00585-6","url":null,"abstract":"<p><strong>Background: </strong>Dynamic transmission models are often used to provide epidemiological guidance for pandemic policy decisions. However, how economic evaluation is typically incorporated into this technique to generate cost-effectiveness estimates of pandemic policy responses has not previously been reviewed.</p><p><strong>Methods: </strong>We systematically searched the Embase, PubMed and Scopus databases for dynamic epidemiological modelling studies that incorporated economic evaluation of public health and social measures (PHSMs), with no date restrictions, on 7 July 2024.</p><p><strong>Results: </strong>Of the 2,719 screened studies, 51 met the inclusion criteria. Most studies (n = 42, 82%) modelled SARS-CoV-2. A range of PHSMs were examined, including school closures, testing/screening, social distancing and mask use. Half of the studies utilised an extension of a Susceptible-Exposed-Infectious-Recovered (SEIR) compartmental model. The most common type of economic evaluation was cost-effectiveness analysis (n = 24, 47%), followed by cost-utility analysis (n = 17, 33%) and cost-benefit analysis (n = 17, 33%).</p><p><strong>Conclusions: </strong>Economic evaluation is infrequently incorporated into dynamic epidemiological modelling studies of PHSMs. The scope of this research should be expanded, given the substantial cost implications of pandemic PHSM policy responses.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"77"},"PeriodicalIF":1.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565286","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":"Financing immunisation in Kenya: examining bottlenecks in health sector planning and budgeting at the decentralised level.","authors":"Alex Olateju Adjagba, James Odhiambo Oguta, Catherine Akoth, Elvis Omondi Achach Wambiya, Justice Nonvignon, Debra Jackson","doi":"10.1186/s12962-024-00581-w","DOIUrl":"10.1186/s12962-024-00581-w","url":null,"abstract":"<p><strong>Background: </strong>Decentralisation has increasingly been adopted by countries as an important health sector reform aimed at increasing community participation in decision making while enhancing swift response at decentralised levels, to accelerate the attainment of health system goals. Kenya adopted a devolved system of government where health services delivery became a function of the 47 semi-autonomous county governments with planning and budgeting functions practised at both levels of government. This study sought to explore challenges facing health sector planning and budgeting and how they affect immunisation service delivery at the county level.</p><p><strong>Methods: </strong>Data were collected through 77 in-depth interviews of senior county department of health officials across 15 counties in Kenya. We applied an inductive thematic approach in analysing the qualitative data using NVIVO software.</p><p><strong>Findings: </strong>The study found a lack of alignment between planning and budgeting processes, with planning being more inclusive compared to budgeting. Inadequate capacity in conducting planning and budgeting and political interference were reported to hinder the processes. Limited budget allocations and delayed and untimely disbursement of funds were reported to affect execution of health and immunisation budgets. Low prioritisation of preventive health interventions like immunisation due to their perceived intangibility influenced resource allocation to the programs.</p><p><strong>Conclusion: </strong>The findings highlight the need for effective strategies to align planning and budgeting processes, increased technical support to counties to enhance the requisite capacity, and efforts to improve budget execution to improve budget credibility. Counties should plan to increase their funding commitment toward immunisation to ensure sustainability of the program as Kenya transitions from GAVI support.</p>","PeriodicalId":47054,"journal":{"name":"Cost Effectiveness and Resource Allocation","volume":"22 1","pages":"76"},"PeriodicalIF":1.7,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548269","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}