Journal of Medical Screening最新文献

{"title":"Timely adherence to follow-up after high-risk lung cancer screenings.","authors":"Dustin Kee,&nbsp;Keith M Sigel,&nbsp;Juan P Wisnivesky,&nbsp;Minal S Kale","doi":"10.1177/09691413231162507","DOIUrl":"https://doi.org/10.1177/09691413231162507","url":null,"abstract":"<p><strong>Objective: </strong>To achieve the lung cancer screening (LCS) mortality benefit in clinical trials, timely, real-world follow-up of abnormal test results is necessary. Presently, annual LCS rates are lower than in trials, and adherence to follow-up after suspicious findings has not been well studied. This study examined timely adherence to follow-up recommendations after positive low-dose computed tomography (LDCT) screenings.</p><p><strong>Methods: </strong>This retrospective study included individuals from two academic primary care practices in New York City who met United States Preventative Services Task Force LCS eligibility and had a positive LDCT scan between 2013 and 2020. They were recommended for shorter interval follow-up repeat computed tomography (CT), CT biopsy, or positron emission tomography/CT. Adherence was completion of the prescribed imaging by 15 days after the recommended 7-, 30-, and 90-day follow-up and by 30 days after the 180-day recommended follow-up.</p><p><strong>Results: </strong>Among 106 individuals with a positive LDCT scan, 64 (60%) were adherent to follow-up recommendations. Adherence was 72%, 63%, and 42% for recommended follow-ups of 30, 90, and 180 days, respectively. Being male was a predictor of a lower adherence rate. Among 23 individuals newly diagnosed with lung cancer after a positive LDCT scan, 83% were adherent to follow-up testing and 82% of cancers were Stage 1A or limited stage.</p><p><strong>Conclusions: </strong>There was variable adherence to the LCS follow-up recommendations despite positive screening CT, suggesting that even in a well-established screening program there may not be an efficient, systematic approach for follow-up. The delays in repeat testing potentially undermine the benefits of early detection.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":"30 3","pages":"150-155"},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10016280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Test accuracy of artificial intelligence-based grading of fundus images in diabetic retinopathy screening: A systematic review.","authors":"Zhivko Zhelev,&nbsp;Jaime Peters,&nbsp;Morwenna Rogers,&nbsp;Michael Allen,&nbsp;Goda Kijauskaite,&nbsp;Farah Seedat,&nbsp;Elizabeth Wilkinson,&nbsp;Christopher Hyde","doi":"10.1177/09691413221144382","DOIUrl":"https://doi.org/10.1177/09691413221144382","url":null,"abstract":"<p><strong>Objectives: </strong>To systematically review the accuracy of artificial intelligence (AI)-based systems for grading of fundus images in diabetic retinopathy (DR) screening.</p><p><strong>Methods: </strong>We searched MEDLINE, EMBASE, the Cochrane Library and the ClinicalTrials.gov from 1st January 2000 to 27th August 2021. Accuracy studies published in English were included if they met the pre-specified inclusion criteria. Selection of studies for inclusion, data extraction and quality assessment were conducted by one author with a second reviewer independently screening and checking 20% of titles. Results were analysed narratively.</p><p><strong>Results: </strong>Forty-three studies evaluating 15 deep learning (DL) and 4 machine learning (ML) systems were included. Nine systems were evaluated in a single study each. Most studies were judged to be at high or unclear risk of bias in at least one QUADAS-2 domain. Sensitivity for referable DR and higher grades was ≥85% while specificity varied and was <80% for all ML systems and in 6/31 studies evaluating DL systems. Studies reported high accuracy for detection of ungradable images, but the latter were analysed and reported inconsistently. Seven studies reported that AI was more sensitive but less specific than human graders.</p><p><strong>Conclusions: </strong>AI-based systems are more sensitive than human graders and could be safe to use in clinical practice but have variable specificity. However, for many systems evidence is limited, at high risk of bias and may not generalise across settings. Therefore, pre-implementation assessment in the target clinical pathway is essential to obtain reliable and applicable accuracy estimates.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":"30 3","pages":"97-112"},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10399100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10328122","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":"Trends in colorectal cancer screening in the United States, 2012 to 2020.","authors":"Yue He,&nbsp;Tong Xu,&nbsp;Jiaxin Fang,&nbsp;Li Tong,&nbsp;Wenhui Gao,&nbsp;Yuan Zhang,&nbsp;Yanfang Wang,&nbsp;Yan Xu,&nbsp;Shunyao Shi,&nbsp;Siyu Liu,&nbsp;Lina Jin","doi":"10.1177/09691413231174163","DOIUrl":"https://doi.org/10.1177/09691413231174163","url":null,"abstract":"<p><strong>Objectives: </strong>Despite recommendations to increase the uptake of colorectal cancer (CRC) screening, trends in CRC screening vary with sociodemographic status. We aimed to evaluate trends in CRC screening in the US population and subpopulations.</p><p><strong>Methods: </strong>A total of 1,082,924 participants aged 50 to 75 from five cycles (2012, 2014, 2016, 2018, and 2020) of the Behavioral Risk Factor Surveillance System were involved. Multivariable logistic regression models were performed to evaluate linear trends in CRC screening utilization from 2012 to 2018. Rao-Scott chi-square tests were used to assess the differences in CRC screening utilization between 2018 and 2020.</p><p><strong>Results: </strong>The estimated percentage reporting up-to-date with CRC screening increased significantly (<i>P</i> for trend <0.001), from 62.8% (95% CI, 62.4%-63.2%) in 2012 to 66.7% (95% CI, 66.3%-67.2%) in 2018 and 70.4% (95% CI, 69.8%-71.0%) in 2020, in accordance with 2008 US Preventive Services Task Force recommendations. Trends followed similar patterns in most subgroups, although with different magnitudes in several subgroups, primarily those underweight showed a stable percentage over time (<i>P</i> for trend  =  0.170). In 2020, 72.4% of participants reported they were up to date with CRC screening, including the utilization of stool DNA tests and virtual colonoscopy. Colonoscopy was the most commonly used test in 2020 (64.5%), followed by FOBT (12.6%), stool DNA test (5.8%), sigmoidoscopy (3.8%), and virtual colonoscopy (2.7%).</p><p><strong>Conclusions: </strong>In this nationally representative survey of the US population from 2012 through 2020, the percentage reporting up to date with CRC screening has increased, but not equally among all subgroups.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":"30 3","pages":"125-133"},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9962455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Overcoming barriers: Modelling the effect of potential future changes of organized breast cancer screening in Italy.","authors":"Nadine Zielonke,&nbsp;Carlo Senore,&nbsp;Antonio Ponti,&nbsp;Marcell Csanadi,&nbsp;Harry J de Koning,&nbsp;Eveline A M Heijnsdijk,&nbsp;Nicolien T van Ravesteyn","doi":"10.1177/09691413231153568","DOIUrl":"https://doi.org/10.1177/09691413231153568","url":null,"abstract":"<p><strong>Objectives: </strong>Organized breast cancer screening may not achieve its full potential due to organizational and cultural barriers. In Italy, two identified barriers were low attendance in Southern Italy and, in Italy as a whole, underscreening and overscreening in parts of the eligible population. The objective of this study was to identify potential changes to overcome these barriers and to quantify their costs and effects.</p><p><strong>Methods: </strong>To assess the impact of potential measures to improve breast cancer screening in Italy, we performed an evaluation of costs and effects for increasing adherence for Southern Italy and harmonizing screening intervals (biennial screening) for the whole of Italy, using an online tool (EU-TOPIA evaluation tool) based on the MIcrosimulation SCreening ANalysis (MISCAN) model.</p><p><strong>Results: </strong>Increasing adherence in Southern Italy through investing in mobile screening units has an acceptable cost-effectiveness ratio of €9531 per quality-adjusted life year gained. Harmonizing the screening interval by investing in measures to reduce opportunistic screening and simultaneously investing in mobile screening units to reduce underscreening is predicted to gain 1% fewer life-years, while saving 19% of total screening costs compared to the current situation.</p><p><strong>Conclusions: </strong>Increasing adherence in Southern Italy and harmonizing the screening interval could result in substantial improvements at acceptable costs, or in the same benefits at lower costs. This example illustrates a systematic approach that can be easily applied to other European countries, as the online tools can be used by stakeholders to quantify effects and costs of a broad range of specific barriers, and ways to overcome them.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":"30 3","pages":"134-141"},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10399099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10333960","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":"Validation of a monoclonal unconjugated estriol antibody for use in prenatal maternal serum screening.","authors":"Geralyn M Lambert-Messerlian,&nbsp;Jonathan P Bestwick,&nbsp;Nicholas J Wald","doi":"10.1177/09691413231160109","DOIUrl":"https://doi.org/10.1177/09691413231160109","url":null,"abstract":"<p><strong>Objectives: </strong>Unconjugated estriol (uE3) is used as a marker for fetal aneuploidy in maternal serum screening tests. The goal of this study was to examine the validity of a new immunoassay for uE3 that uses a monoclonal antibody (m-uE3) rather than the more commonly used polyclonal antibody (p-uE3).</p><p><strong>Setting: </strong>Assays were performed in the Special Chemistry laboratory at Women and Infants Hospital of Rhode Island.</p><p><strong>Methods: </strong>Residual fresh (<i>n</i> = 100) and frozen (<i>n</i> = 533) second trimester serum samples from routine clinical care were tested using p-uE3 and/or m-uE3 assays. Assay results were compared between methods using Bland-Altman plots. A median equation was developed for m-uE3 results. Down syndrome risks were compared between the two assays in a case-control sample set (21 cases each matched with five controls for the completed week of gestation, duration of freezer storage and race).</p><p><strong>Results: </strong>Log-transformed serum uE3 levels were highly correlated between the assays (<i>r</i> = 0.93, <i>p</i> < 0.001), with the m-uE3 assay levels yielding, on average, 23% higher (standard deviation of differences in log uE3 concentrations = 0.07) results. Assay and gestation-based median equations were calculated and used to convert m-uE3 concentrations to multiples of the median (MoM). The m-uE3 MoM values fit a log Gaussian distribution well with a log standard deviation of 0.11. Down syndrome risk results were not significantly different between assays.</p><p><strong>Conclusions: </strong>The m-uE3 assay, with results expressed in MoMs, is suitable for screening and as a monoclonal-based assay offers the advantage of a predictable and indefinite supply of antibody to perform the assay.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":"30 3","pages":"120-124"},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10016279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Consensus Project: Participation in cervical cancer screening by the first cohorts of girls offered HPV vaccination at age 15-16 years in Italy.","authors":"Carmen B Visioli,&nbsp;Paolo Giorgi Rossi,&nbsp;Paola Armaroli,&nbsp;Anna Iossa,&nbsp;Raffaella Rizzolo,&nbsp;Luigina A Bonelli,&nbsp;Ezio Venturino,&nbsp;Francesca M Carozzi,&nbsp;Simonetta Bisanzi,&nbsp;Laura De Marco,&nbsp;Livia Giordano,&nbsp;Elisa Camussi,&nbsp;Annarosa Del Mistro,&nbsp;Marco Zappa","doi":"10.1177/09691413231165237","DOIUrl":"https://doi.org/10.1177/09691413231165237","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between human papillomavirus vaccination status and participation in cervical cancer screening (at age 25) by the first cohorts of girls who were offered vaccination at the age of 15 to 16 years in Italy.</p><p><strong>Methods: </strong>Women born in 1993, 1994 and 1995 were invited to participate in cervical cancer screening between 2018 and 2020. We report participation in screening by vaccination status in three large areas, Florence province, Piedmont region and Savona province, where the Consensus Project was carried out. The relative risk of participation among vaccinated (≥2 doses) and unvaccinated women was estimated. Odds ratios (OR) of participation by vaccination status were estimated by logistic regression, adjusted by birthplace and birth cohort.</p><p><strong>Results: </strong>Overall, 34,993 women were invited for screening: 13,006 (37.2%) participated and 10,062 of these agreed to participate in the Consensus intervention study. Among the invited women and screening participants, vaccinated women were 51.0% and 60.6%, respectively. Comparing vaccinated and unvaccinated women, the adjusted OR of screening participation was 1.80 (95% confidence interval (CI): 1.72-1.89), 2.17 (95% CI: 1.94-2.42), 1.59 (95% CI: 1.50-1.68) and 1.15 (95% CI: 0.86-1.54) for overall, Florence, Piedmont and Savona, respectively. About 33% of the invited women were unvaccinated and did not participate in screening: 25.8%, 59.5% and 64.2% of women born in Italy, in high migration pressure countries and in advanced development countries, respectively.</p><p><strong>Conclusions: </strong>Screening participation was higher among vaccinated than unvaccinated women. Active policies are needed to reduce inequalities, targeting the unscreened and unvaccinated population, particularly non-native women, to accelerate cervical cancer elimination in Italy.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":"30 3","pages":"142-149"},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9962409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of colorectal cancer and breast cancer screening according to history of diabetes in 2010-2019.","authors":"Zechen Liu,&nbsp;Mingyang Song","doi":"10.1177/09691413231175724","DOIUrl":"https://doi.org/10.1177/09691413231175724","url":null,"abstract":"<p><p>As cancer is overtaking cardiovascular disease as the leading cause of death among diabetics, improved cancer prevention efforts are needed for individuals with diabetes. In this research letter, we used data from the US National Health Interview Survey to examine the use of screening for two major diabetes-related cancers, colorectal cancer, and breast cancer, in individuals with and without diabetes. We found that individuals with diabetes had slightly higher use of colorectal cancer screening and similar use of breast cancer screening compared to those without diabetes in the US. Besides, despite the increasing use of colorectal cancer and breast cancer screening over the past 10 years, screening uptake remains suboptimal. We believe that these findings provide important data to inform policymaking and cancer prevention efforts.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":"30 3","pages":"156-158"},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10318159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Did the use of open invitations in place of timed appointment invitations reduce the uptake of breast screening in the London region during the COVID-19 recovery?","authors":"Sue M Hudson, Kathie Binysh, Stephen W Duffy","doi":"10.1177/09691413221127583","DOIUrl":"10.1177/09691413221127583","url":null,"abstract":"<p><strong>Objective: </strong>The Covid-19 pandemic created a backlog of women awaiting an invitation for breast screening in the UK. To recover in a timely fashion, the National Health Service programme opted to issue open invitations (OI) to women rather than the standard pre-booked timed appointments (TA). Historically, OIs have been shown to result in lower uptake. The aim of this study was to make use of a natural experiment to compare uptake in groups sent an OI with those sent a TA during a period when both invitation methods were in use.</p><p><strong>Methods: </strong>Women invited for routine screening at one of the six London breast screening services from September 2020 to March 2021 were included and grouped according to the type of invitation they had received (TA or OI). The outcome was attendance within 6 months of opening the screening episode. Data were analysed by logistic regression.</p><p><strong>Results: </strong>During the period of the study, 78,192 (32.5%) women received a TA and 162,680 (67.5%) received an OI. In the TA group, 47,391 (60.6%) attended within six months of offered appointment and in the OI group 86,430 (53.1%) attended. This difference was significant (<i>p</i> < 0.001). The odds ratio (95% CI) for the attended outcome was 1.44 (1.33-1.55) adjusted for differences in deprivation and for invitation category (first invitation or subsequent invitation).</p><p><strong>Conclusions: </strong>This study supports the view that TA delivers a higher uptake than OI. It suggests that during this period over 12,000 women in London, who would have been expected to attend if given the standard TA, did not attend their appointment having received an OI.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":"30 2","pages":"87-91"},"PeriodicalIF":2.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9554567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9650176","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":"Guidance on terminology.","authors":"Nicholas J Wald","doi":"10.1177/09691413231163128","DOIUrl":"10.1177/09691413231163128","url":null,"abstract":"","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":"30 2","pages":"53-54"},"PeriodicalIF":2.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9487668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Availability of data for cost-effectiveness comparison of child vision and hearing screening programmes.","authors":"Jan Kik,&nbsp;Eveline A M Heijnsdijk,&nbsp;Allison R Mackey,&nbsp;Gwen Carr,&nbsp;Anna M Horwood,&nbsp;Maria Fronius,&nbsp;Jill Carlton,&nbsp;Helen J Griffiths,&nbsp;Inger M Uhlén,&nbsp;Huibert Jan Simonsz","doi":"10.1177/09691413221126677","DOIUrl":"https://doi.org/10.1177/09691413221126677","url":null,"abstract":"<p><strong>Objective: </strong>For cost-effectiveness comparison of child vision and hearing screening programmes, methods and data should be available. We assessed the current state of data collection and its availability in Europe.</p><p><strong>Methods: </strong>The EUSCREEN Questionnaire, conducted in 2017-2018, assessed paediatric vision and hearing screening programmes in 45 countries in Europe. For the current study, its items on data collection, monitoring and evaluation, and six of eleven items essential for cost-effectiveness analysis: prevalence, sensitivity, specificity, coverage, attendance and loss to follow-up, were reappraised with an additional questionnaire.</p><p><strong>Results: </strong>The practice of data collection in vision screening was reported in 36% (N = 42) of countries and in hearing screening in 81% (N = 43); collected data were published in 12% and 35%, respectively. Procedures for quality assurance in vision screening were reported in 19% and in hearing screening in 26%, research of screening effectiveness in 43% and 47%, whereas cost-effectiveness analysis was performed in 12% for both. Data on prevalence of amblyopia were reported in 40% and of hearing loss in 77%, on sensitivity of screening tests in 17% and 14%, on their specificity in 19% and 21%, on coverage of screening in 40% and 84%, on attendance in 21% and 37%, and on loss to follow-up in 12% and 40%, respectively.</p><p><strong>Conclusions: </strong>Data collection is insufficient in hearing screening and even more so in vision screening: data essential for cost-effectiveness comparison could not be reported from most countries. When collection takes place, this is mostly at a local level for quality assurance or accountability, and data are often not accessible. The resulting inability to compare cost-effectiveness among screening programmes perpetuates their diversity and inefficiency.</p>","PeriodicalId":51089,"journal":{"name":"Journal of Medical Screening","volume":"30 2","pages":"62-68"},"PeriodicalIF":2.9,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/20/66/10.1177_09691413221126677.PMC10149880.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9662610","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}