European Journal of General Practice最新文献

{"title":"The role and utility of artificial intelligence and machine learning for diagnostic prediction in general practice.","authors":"Liesbeth Hunik, Annemarie A Uijen, Jacqueline K Kueper, Amanda L Terry, Tim C Olde Hartman, Twan van Laarhoven, Henk J Schers","doi":"10.1080/13814788.2026.2620908","DOIUrl":"10.1080/13814788.2026.2620908","url":null,"abstract":"<p><p>Diagnostic prediction models are commonly used in general practice to support clinical decision-making. Traditionally, these models have been developed using statistical methods such as logistic regression. While these approaches have proven useful, they often produce average risk estimates that may not fully account for the complexity of individual patients. In recent years, the use of machine learning (ML), a subfield of artificial intelligence (AI), has grown in healthcare. We examine the similarities and differences between traditional statistical methods and AI/ML approaches for diagnostic prediction in general practice. Using examples from daily practice, we explore how ML techniques can add value, particularly in handling large, complex datasets such as those derived from electronic health records. We also discuss key challenges that hinder the adoption of AI/ML in general practice, including interpretability, data quality, external validation, clinical relevance, implementation and legal issues, and practical usability. We provide recommendations to overcome these challenges. The potential of AI/ML can only be realised if tools are developed collaboratively with GPs, focused on real-world clinical problems, and rigorously validated in practice settings. GP associations, GPs, patients, and primary care scientists should take an active role in the development, validation, and implementation of AI/ML-based diagnostic prediction tools for general practice.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2620908"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108436","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.","authors":"","doi":"10.1080/13814788.2026.2633044","DOIUrl":"10.1080/13814788.2026.2633044","url":null,"abstract":"","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2633044"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12931342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147277668","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":"An interprofessional approach to treat bodily distress disorder in Swiss primary care - a quality improvement study.","authors":"Stefania Di Gangi, Julia Hennemann, Emanuel Brunner, Oliver Senn, Stefan Büchi","doi":"10.1080/13814788.2025.2599579","DOIUrl":"10.1080/13814788.2025.2599579","url":null,"abstract":"<p><strong>Background: </strong>Managing bodily distress disorder (BDD) requires an interprofessional, holistic therapeutic approach, which can be challenging to implement in routine care.</p><p><strong>Objectives: </strong>The aim was to evaluate a care pathway for patients with BDD involving general practitioners (GPs) and physiotherapists.</p><p><strong>Methods: </strong>Participants were patients aged 18 years or older with BDD symptoms and the PHQ-15 (Patient Health Questionnaire 15-Item) score > 9. The treatment consisted of patient education by GPs about BDD and stress, sleep interventions, physical exercises and support to develop an active lifestyle (> 150 min per week of moderate-intensity physical activity), as measured with the Physical Activity Vital Sign (PAVS). Patient outcomes (PHQ-15 and PAVS) were compared at baseline and after six months. A survey assessed the perspectives of both patients and health professionals about the treatment.</p><p><strong>Results: </strong>A total of 70 patients treated by 11 GPs and 6 physiotherapists were involved. Comparing outcomes at baseline vs. after six months (median [IQR]): PHQ-15 decreased, 14 [11, 17] vs. 8 [5, 12], <i>p</i> < 0.001; PAVS increased, 60 [30, 120] vs. 120 [60, 180], <i>p</i> < 0.001; GP confidence (scale 0-100) in treating BDD increased, 50 [38, 66] vs. 82 [66, 85], <i>p</i> = 0.005. Feedback from patients, GPs and physiotherapists about the intervention was positive.</p><p><strong>Conclusion: </strong>The interprofessional care pathway for patients with BDD had a positive impact on patient outcomes, GP treatment confidence, and was well-received by both patients and health professionals. It can be adapted across primary care systems and tailored to local contexts to improve the quality of care.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2599579"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12784638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936401","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":"Primary care providers' perspectives of experiences with transgender and gender diverse adults: A scoping review.","authors":"Kate Lauren Keaney, Marie Claire Van Hout, Geoff McCombe, Nandakumar Ravichandran, John Broughan, Walter Cullen, Des Crowley","doi":"10.1080/13814788.2026.2657083","DOIUrl":"10.1080/13814788.2026.2657083","url":null,"abstract":"<p><strong>Background: </strong>As a minority group, transgender and gender diverse (TGD) individuals may experience healthcare stressors due to stigma, transphobia and healthcare staff who lack the knowledge about their specific needs, impacting primary care entry and attendance. Extant literature is concentrated on TGD individuals' perspectives of primary care with the main message being that it is inadequate.</p><p><strong>Aim: </strong>To explore the primary care provider (PCP) perspective of experiences with adult TGD patients.</p><p><strong>Methods: </strong>A scoping review was conducted using Arksey and O'Malley's five-step framework to map and de-scribe the literature relating to PCP perspectives' of experiences with TGD adults. Four databases were searched: PubMed, Embase, PsycINFO and CINAHL Plus. The process was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). The final dataset (<i>n</i> = 22) were charted and analysed thematically.</p><p><strong>Results: </strong>Following application of exclusion criteria and removal of duplicates, twenty-two studies across five countries were included in the review. Studies include qualitative studies, surveys, mixed methods studies, a retrospective review and a pilot study with a pre- and postintervention analysis. Key themes identified related to the attitudes of PCPs towards TGD individuals, education of PCPs on TGD health issues and the barriers/facilitators to caring for TGD patients from a PCP perspective.</p><p><strong>Conclusion: </strong>The review highlights the need for improved access to TGD-specific education. Future research should explore the best way to provide this to PCPs, inform implementation into relevant policies and include a broader range of countries to strengthen global applicability.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2657083"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13097175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730707","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":"Patients' perspectives in German general practice on discussing the environmental impact of medications: A qualitative study.","authors":"Dana Neumann, Christiane Müller, Frank Müller","doi":"10.1080/13814788.2026.2675759","DOIUrl":"10.1080/13814788.2026.2675759","url":null,"abstract":"<p><strong>Background: </strong>Pharmaceuticals represent a major source of carbon emissions in primary care. General practitioners could avoid prescribing climate-harmful medications and consider eco-friendly alternatives in shared decision-making processes. However, evidence on patients' perceptions of discussing medication-specific environmental impacts in primary care consultations in Germany remains limited.</p><p><strong>Objectives: </strong>To explore patients' perceptions of discussing medications' environmental and climate impact during family medicine encounters and their willingness to switch to more eco-friendly options.</p><p><strong>Methods: </strong>This qualitative study employed semi-structured interviews with patients recruited through GP practices in Northern Germany. Inclusion criteria were long-term use of at least one medication, legal age, and informed consent. Twenty-five interviews were conducted and analysed using structured content analysis according to Kuckartz.</p><p><strong>Results: </strong>Respondents expressed surprise when environment/climate topics were to be discussed in medical encounters but demonstrated openness to these topics and desired more information about their medications' environmental impact. Many interviewees showed willingness to switch to eco-friendly medications despite potential disadvantages including more frequent intake, increased side effect risk, or co-payments. Patients exhibited high trust in provider recommendations and sought greater information and transparency.</p><p><strong>Conclusion: </strong>Results suggest opportunities to incorporate climate/environmental aspects into shared decision-making. Understanding patient perspectives enables GPs to address environmental/climate-friendly medication topics in treatment discussions. Patients are receptive to these discussions and willing to accept eco-friendly alternatives despite potential drawbacks. The high level of trust in provider recommendations positions family physicians as key actors in promoting environmental stewardship.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2675759"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215409/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148037673","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":"Reducing short-acting beta-agonist overprescribing in general practice: Evaluation of a quality improvement programme in East London.","authors":"Anna De Simoni, Hajar Hajmohammadi, Paul Pfeffer, Jim Cole, Chris J Griffiths, Sally A Hull","doi":"10.1080/13814788.2026.2619229","DOIUrl":"10.1080/13814788.2026.2619229","url":null,"abstract":"<p><strong>Background: </strong>Overprescribing of short-acting beta-agonist (SABA) inhalers is a worldwide problem.</p><p><strong>Objectives: </strong>To evaluate the impact of a system-wide quality improvement programme on SABA overprescribing, and to identify the most effective strategies.</p><p><strong>Methods: </strong>All general practices within one East London borough received the intervention between October 2020 and March 2023. Practices in two neighbouring boroughs acted as comparators. Intervention practices engaged in quality improvement activities including: electronic alerts flagging patients prescribed ≥12 SABA inhalers/year; generating lists of patients overprescribed SABA to call for review; a summary guideline for clinicians; electronic patient information leaflets. All practices were offered webinar coaching. Prescribing data were collected from electronic health records, and SABA overprescription evaluated through interrupted times series analysis. Content analysis was applied to survey data and conversations with staff.</p><p><strong>Results: </strong>During the three-year study period all localities introduced programmes to reduce SABA prescribing. We observed a significant decrease in the proportion of asthma patients prescribed more than 6 SABA/year in the study practices. The COVID pandemic triggered a temporary increase in patients on asthma registers, which persisted for 6 months. When implemented by practices the electronic prescribing alerts were effective: 50% of patients who received an active response reduced to <12 SABA in the following year.</p><p><strong>Conclusions: </strong>This quality improvement programme was associated with a reduction in SABA overuse, which could also decrease hospital admissions. Practices required individual coaching to use the electronic tools effectively. Integrated prescribing alerts reduced overprescribing, and collaborative practice cultures supported faster implementation of improvement strategies.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2619229"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108461","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":"Towards best practice recommendations: Perspectives from Australian GPs to inform the use of general practice data for research - A modified Delphi study.","authors":"Heidi Green, Justin Beilby, Chris Degeling, Carolyn Adams, Felicity Flack, Lucy Carolan, Belinda Fabrianesi, Anthony Brown, Alberto Nettel Aguirre, Allison Clarke, Christian Jung, Annette Braunack-Mayer","doi":"10.1080/13814788.2025.2601396","DOIUrl":"10.1080/13814788.2025.2601396","url":null,"abstract":"<p><strong>Background: </strong>General practice medical records offer significant potential for secondary use in research, policy and public health. In Australia, these data remain underused due to concerns around privacy, governance and ethical use. Understanding the perspectives of GPs is essential to developing best practice recommendations for responsible data use.</p><p><strong>Method: </strong>A three-round modified Delphi study was conducted with 22 Australian GPs with experience in research and/or data sharing. Participants rated and commented on 11 recommendations derived from community juries, with consensus defined as ≥75% agreement. Feedback summaries and thematic analysis informed subsequent rounds.</p><p><strong>Results: </strong>Consensus was reached on 10 of 11 recommendations. The panel supported ethical approval, transparency, protection of the doctor-patient relationship and remuneration for practices contributing data. An opt-out approach to consent was endorsed under strict conditions, with clear distinctions made between vulnerable and non-vulnerable populations. The panel also supported the establishment of a governance body and researcher cybersecurity training. However, no consensus was reached on community involvement in research design, despite its growing recognition as best practice by funding bodies.</p><p><strong>Conclusion: </strong>This study highlights the need for a nationally agreed remuneration model for general practices that contribute data, clearer ethical guidance for engaging vulnerable populations and reform of statutory frameworks to support responsible data use. The lack of consensus on community involvement is concerning, especially as initiatives such as the Australian Institute of Health and Welfare (AIHW) and Primary Health Networks (PHN) partnership advance national data standards. Bridging this gap is essential to align professional practice with public expectations and ensure inclusive, ethically robust research.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2601396"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12794724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936387","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":"Effects of a brief primary care intervention for post-traumatic stress disorder symptoms after critical illness on health-related quality of life - A secondary analysis of the PICTURE randomised controlled trial.","authors":"Robert Philipp Kosilek, Nora Schröder, Linda Sanftenberg, Caroline Jung-Sievers, Daniela Lindemann, Antina Beutel, Konrad Schmidt, Christian Brettschneider, Hans-Helmut König, Thomas Elbert, Jochen Gensichen","doi":"10.1080/13814788.2026.2702686","DOIUrl":"10.1080/13814788.2026.2702686","url":null,"abstract":"<p><strong>Background: </strong>Intensive care unit (ICU) survivors frequently experience symptoms of post-traumatic stress disorder (PTSD) and reduced health-related quality of life (HRQoL), yet evidence for effective post-ICU interventions in primary care remains limited. This secondary analysis of the PICTURE randomised controlled trial provides an in-depth evaluation of HRQoL trajectories and potential treatment mechanisms.</p><p><strong>Methods: </strong>The analysis included 319 adult ICU survivors with at least moderate PTSD symptoms, randomised to a brief general practitioner (GP)-delivered narrative exposure intervention or enhanced usual care. Longitudinal mixed-effects models estimated treatment-by-time effects on HRQoL, based on EuroQol Five-Dimension Five-Level (EQ-5D-5L) index and visual analog scale (VAS), with mediation <i>via</i> PTSD symptom change assessed using structural equation modelling.</p><p><strong>Results: </strong>The mean baseline EQ index was 0.71 ± 0.27 and EQ VAS was 60.7 ± 19.4. Mixed-effects models showed a transient improvement in EQ VAS at 6 months in the intervention group (ß = 5.85; 95% CI 0.84-10.87), followed by a delayed improvement in the EQ index at 12 months (ß = 0.075; 95% CI 0.014-0.136). About one quarter of the 12-month EQ index effect was mediated by PTSD symptom reduction at 6 months. Domain-level analyses indicated greater improvement in anxiety/depression and mobility.</p><p><strong>Conclusions: </strong>In ICU survivors with PTSD symptoms, a brief GP-delivered psychological intervention was associated with clinically meaningful improvements in health-related quality of life over 12 months, with effects emerging over time and only partly explained by PTSD symptom reduction.</p><p><strong>Trial registration: </strong>ClinTrials.gov: NCT03315390 (Registration date: 2017-10-20); German Clinical Trials Register (DRKS): DRKS00012589 (Registration date: 2017-10-17).</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2702686"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551391","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 subtle symptoms to disclosure: Communication in violence detection in primary care.","authors":"Orlane Pivert, Clémence Loubrieu, Julie Magret, Nicolas Naiditch, Stéphanie Mignot","doi":"10.1080/13814788.2026.2684128","DOIUrl":"10.1080/13814788.2026.2684128","url":null,"abstract":"<p><strong>Background: </strong>Identifying victims of interpersonal violence remains a challenge for general practitioners, who must rely on subtle clinical cues and foster an environment conducive to disclosure.</p><p><strong>Objectives: </strong>To describe the symptoms, behaviours, and communication strategies that facilitate the recognition of interpersonal violence in primary care consultations.</p><p><strong>Methods: </strong>For this qualitative study, general practice consultations by three physicians in the Poitou-Charentes department, France, were audio-recorded from June to September 2019. Adult patients (≥18 years, fluent in French) were included unless they rejected audio recording. Only the audio-recording of consultations during which interpersonal violence was disclosed were analysed following an inductive approach to identify categories and themes until saturation was reached.</p><p><strong>Results: </strong>In total 25/326 patients disclosed experiences of violence. Detection combined verbal cues (vague somatic complaints, ambiguous trauma references) by the patient and open-ended or direct questions by the general practitioners. Techniques included linking symptoms to violence, broad funnel questions, and most effectively, direct queries, such as 'Did someone hurt you?. The three physicians adapted their approach, balancing respect for the patient readiness and clinical conviction, often revisiting the topic from different perspectives. Empathy and a trusted doctor-patient relationship proved crucial for violence disclosure.</p><p><strong>Conclusion: </strong>Our findings highlight the value of the physicians' tenacity and empathic attitude for identifying hidden situations of violence, and suggest that integrating these strategies in routine general practice can enhance detection. The findings underscore the need of training physicians in patient-centred communication and suggest future research avenues for refining detection protocols in primary care.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2684128"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13307383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320612","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":"Population health management within the primary care context - scoping review.","authors":"Emmily Schaubroeck, Giorgio Sessa, Jan De Maeseneer, Sara Willems, Peter Decat","doi":"10.1080/13814788.2026.2633852","DOIUrl":"10.1080/13814788.2026.2633852","url":null,"abstract":"<p><strong>Background and objectives: </strong>Population health management (PHM) is increasingly promoted as a strategy to improve health outcomes, enhance healthcare quality, reduce costs, and, more recently, support clinician well-being and advance health equity - the Quintuple Aim. However, how PHM is conceptualised within the primary care context remains unclear. This scoping review explores how PHM is conceptualised within this context.</p><p><strong>Method: </strong>Five databases (PubMed, Embase, CINAHL, Web of Science and Scopus) were searched to find publications that conceptually addressed PHM and its interaction with the primary care context. Data extraction focused on definitions and related terms, the bidirectional influence between PHM and general practice, and interpretations of the components 'population' and 'management'.</p><p><strong>Results: </strong>27 publications were included. Definitions of PHM varied, with few explicitly addressing the primary care practice level. They highlighted the need to proactively address social determinants of health beyond clinical outcomes. Both top-down and bottom-up dynamics make general practices accountable for and increasingly involved in the identification of populations, risk stratification and impact assessment, with both clinical judgement and real-world primary care data. Management involves team-based and technology-supported care.</p><p><strong>Conclusion: </strong>Considering PHM within primary care highlighted the importance of general practice's accountability, its consideration of social determinants of health beyond clinical outcomes and its community alignment to enhance equity. What the potential added value of general practitioner's clinical intuition and real-world primary care data in assessing impact warrants additional exploration.</p>","PeriodicalId":54380,"journal":{"name":"European Journal of General Practice","volume":"32 1","pages":"2633852"},"PeriodicalIF":2.7,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12973839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147391287","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}