Telemedicine and e-Health最新文献

{"title":"Post-Telemedicine Acute Care for Undifferentiated High-Acuity Conditions: Is a Picture Worth a Thousand Words?","authors":"Mamata V Kene, Dana R Sax, Reena Bhargava, Madeline J Somers, E Margaret Warton, Jennifer Y Zhang, Adina S Rauchwerger, Mary E Reed","doi":"10.1089/tmj.2024.0425","DOIUrl":"https://doi.org/10.1089/tmj.2024.0425","url":null,"abstract":"<p><p><b>Objectives:</b> Telemedicine use increased substantially with the COVID-19 pandemic. Understanding of the impact of telemedicine modality (video vs. phone) on post-telemedicine acute care for higher risk conditions is limited. <b>Methods:</b> We conducted a retrospective study of telemedicine visits, comparing video with telephone, for selected diagnoses with potentially higher illness acuity, evaluating post-telemedicine emergency department (ED) and hospitalization rates. In a large, multicenter cohort of adult patient-initiated primary care telemedicine visits from March 1, 2020, to July 31, 2021, we evaluated 7-day ED and hospitalization rates for higher acuity diagnostic categories (cardiac, gastrointestinal, and respiratory) by telemedicine modality, provider familiarity, and patient sociodemographic and clinical characteristics. <b>Results:</b> Among 431,705 telemedicine encounters, 128,129 (29.7%) were video visits and 303,576 (70.3%) were telephone visits. Adjusting for patient and appointment factors, telephone encounters for cardiac conditions were associated with significantly higher 7-day ED visit rates than video encounters (5.5% vs. 4.9%, respectively) but similar hospitalization rates (0.7% vs. 0.8%, respectively); for gastrointestinal conditions, post-telemedicine adjusted ED and hospitalization rates were comparable between telemedicine modalities (4.0% for ED and 1.2% vs. 1.3% for hospitalization, respectively); among respiratory conditions, video encounters were associated with higher ED and hospitalization rates than telephone encounters (ED: 5.9% after video vs. 5.2% after phone; hospitalization: 1.9% after video vs. 1.5% after phone). Telemedicine encounters with patients' own primary care provider (PCP) were associated with lower adjusted rates of ED use across all conditions and modalities. <b>Conclusions:</b> Short-term ED and hospitalization rates following primary care video or telephone visits for selected acute, high-risk conditions varied by condition and PCP familiarity. Nuanced use of video visits may confer benefits triaging to downstream acute care.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Care Utilization Patterns Associated with eConsults for Headache: Insights from an Urban Academic Medical Center.","authors":"Soonmyung Hwang, Parul Agarwal, Mark Dakov, Margaret H Downes, Benjamin R Kummer","doi":"10.1089/tmj.2024.0483","DOIUrl":"https://doi.org/10.1089/tmj.2024.0483","url":null,"abstract":"<p><p><b>Introduction</b>: Interprofessional electronic consultations (eConsults) can reduce health care utilization and improve access to specialty care. However, health care utilization and access impacts of eConsults for headache disorders remain incompletely characterized. <b>Methods</b>: We conducted a retrospective, 1:3-matched cohort study comparing patients referred for in-person headache evaluations to patients who had a headache-related eConsult. The cohorts were propensity score-matched by age, sex, race, preferred language, provider specialty, insurance status, and medical comorbidities. Our primary outcome was the presence of one or more headache-related ambulatory encounters in the 12 months following the index referral date. We used univariable and conditional logistic regression models to ascertain the associations between referral type and outcome. <b>Results</b>: We identified 74 and 222 patients with eConsult and in-person referrals, respectively. Over the follow-up period, the proportion of patients with the primary outcome was significantly greater in the eConsult cohort than the in-person cohort (46.0% vs. 43.2%, <i>p</i> < 0.0001). A greater proportion of the in-person cohort had one or more ambulatory headache encounters in the 12 months preceding their referral than the eConsult cohort (10.8% vs. 5.4%, <i>p</i> < 0.0001). In the adjusted analysis, eConsult usage was not associated with significantly increased odds of the primary outcome (adjusted odds ratio [aOR] 1.1, 95% confidence interval [CI] 0.6-2.0, <i>p</i> = 0.71), although patients with one or more ambulatory neurology encounters in the preceding 12 months had significantly increased odds of the primary outcome (aOR 3.1, 95% CI 1.2-7.9, <i>p</i> = 0.015). <b>Conclusion</b>: Compared to in-person referrals, eConsult use for headache was not associated with significantly increased odds of having subsequent ambulatory headache-related encounters.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958932","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients' Acceptability and Perspective on Utilizing Telemedicine in Breast Cancer Care and Management.","authors":"Jing-Hui Ng, Mee-Hoong See, Alias Haridah, Lee-Lee Lai, Li Ping Wong","doi":"10.1089/tmj.2024.0466","DOIUrl":"https://doi.org/10.1089/tmj.2024.0466","url":null,"abstract":"<p><p><b>Background:</b> Telemedicine has emerged as a promising solution to address the challenges of providing continuous care to breast cancer patients, particularly in remote areas. This study aims to assess the acceptability of using telemedicine for breast cancer follow-up. <b>Methods:</b> A cross-sectional study utilizing a self-administered survey was conducted from January to March 2024 among 450 breast cancer patients at the Universiti Malaya Medical Center, Malaysia. Partial least-squares structural equation modeling was used to identify factors such as demographics, patients' characteristics, experience with telemedicine, attitudes, and concern of telemedicine use influencing willingness to use telemedicine for breast cancer follow-up. <b>Results:</b> Of the total 450 complete responses received, nearly half (49.3%) reported being somewhat likely to seek telemedicine for breast cancer follow-up, while only 11.1% reported being very likely. Comfort with telemedicine emerged as the strongest predictor of willingness to use it (β = 0.757, <i>p</i> < 0.001). A higher level of concern significantly negatively impacted willingness (β = -0.138, <i>p</i> < 0.001). However, attitudes toward telemedicine (β = 0.059, <i>p</i> = 0.144) were not significantly associated with its use. Among demographic factors, only age (β = 0.074, <i>p</i> = 0.018) was significantly positively associated with the willingness to use telemedicine, while education levels were found to have a significant inverse association (β = -0.076, <i>p</i> = 0.034). <b>Conclusions:</b> Improving comfort with telemedicine and addressing various concerns about its use for breast cancer follow-up through educational programs and support services are essential. Tailoring communication and support for different age groups and education levels can also enhance acceptance and utilization.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142958933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"e-Health Interventions for Promoting Physical Activity in Aging Adults: A Scoping Review.","authors":"Roua Walha, Nesrine Koubaa, Mathilde Chagnon, Eric Lortie-Milner, Mylène Aubertin-Leheudre, Mélanie Levasseur, Patrick Boissy","doi":"10.1089/tmj.2024.0414","DOIUrl":"https://doi.org/10.1089/tmj.2024.0414","url":null,"abstract":"<p><p><b>Background:</b> The use of e-health interventions to promote physical activity (PA) among older adults has significantly increased in recent years. This review aims to comprehensively summarize the various e-health modalities and strategies used to encourage PA in aging adults. <b>Methods:</b> A systematic search of Medline, Embase, CINAHL, AMED, and PubMed databases was conducted to identify studies on e-health interventions targeting PA promotion in individuals aged 50 and older, published between 2012 and 2023. Information pertaining to study characteristics and e-health intervention specificities was extracted using a standardized data collection form. A narrative synthesis approach was employed to synthesize the data collected from the included studies. <b>Results:</b> Of 4,915 studies initially retrieved, 81 met the eligibility criteria. The findings reveal a diverse array of methods and interaction modes utilized to stimulate PA in aging adults, regardless of their medical conditions. Asynchronous methods such as web-based programs, mobile apps, and activity monitors were used in 71.6% of the studies and were most frequently employed for initiating behavior change components. Synchronous interaction modes mainly included videoconferencing and were predominantly featured in studies where real-time supervision and demonstration of exercises were integral to PA programs. There was a lack of information to guide the selection of the most effective e-health intervention format for motivating older adults to engage in regular exercise. <b>Conclusion:</b> This review underscores the versatility of e-health interventions, showcasing a wide spectrum of methods and interaction modalities. Future studies should compare these different modalities and methods while also identifying their barriers and facilitators. This will help in selecting the most suitable interventions for older adults.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth Assessment of Diagnostic and Therapeutic Efficacy in Peripheral Vestibular Symptoms: A Systematic Review and Meta-Analysis.","authors":"Maria Jesus Vinolo-Gil, Ismael García-Campanario, María-José Estebanez-Pérez, Jorge Góngora-Rodríguez, Manuel Rodríguez-Huguet, Rocío Martín-Valero","doi":"10.1089/tmj.2024.0301","DOIUrl":"https://doi.org/10.1089/tmj.2024.0301","url":null,"abstract":"<p><p><b>Background:</b> Despite positive perceptions of telemedicine, there's a recognized need for stronger evidence on its safety and effectiveness. This study aims to evaluate telemedicine's current status in diagnosing and treating peripheral vestibular symptoms. <b>Methods:</b> Systematic searches across multiple databases assessed methodological quality using Physiotherapy Evidence Database scale and Revised Cochrane Risk of Bias tool for randomized trials 2.0. <b>Results:</b> Findings reveal significant improvements in vertigo-related disability with virtual vestibular rehabilitation (mean difference [MD] = -12.6; 95% confidence interval [CI] = -23.61, -1.59; <i>p</i> < 0.01; <i>I</i>² = 76%) albeit with high heterogeneity. However, pooled analysis on vertigo severity across three studies did not show a significant effect (MD = -0.41; 95% CI = -0.64, -0.17; <i>p</i> < 0.78; <i>I</i>² = 0%). <b>Conclusions:</b> Evidence suggests telemedicine holds promise in diagnosing and managing peripheral vestibular disorders, potentially alleviating symptoms and improving disability. Nonetheless, caution is warranted due to review limitations, emphasizing the need for further research to optimize telemedicine's benefits for patients experiencing vestibular symptoms.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telepractice Assessments for Individuals with Aphasia: A Systematic Review.","authors":"Selina D Teti, Laura L Murray, J B Orange, Keren S Kankam, Angela C Roberts","doi":"10.1089/tmj.2024.0268","DOIUrl":"10.1089/tmj.2024.0268","url":null,"abstract":"<p><p><b>Purpose:</b> Current literature broadly demonstrates the effectiveness and feasibility of telepractice services for people with aphasia. However, the examination of telepractice assessments for people with aphasia is limited. The purpose of this systematic review was to examine the current use of telepractice assessment protocols for people with aphasia. Specifically, the review sought to: (a) identify the assessments utilized in the aphasia telepractice literature; (b) appraise critically the quality of such investigations; and (c) evaluate critically the psychometric properties of the standardized tests used. <b>Methods:</b> A review of the literature published in English since 2000 was conducted in January 2023 by searching MEDLINE, EMBASE, PsychInfo, CINAHL, and Scopus databases. A total of 2,429 articles were screened. Two reviewers assessed records independently finding 11 articles eligible for inclusion. Data extraction was conducted once and validated by a second reviewer. Quality appraisal was carried out for the included studies as well as for the standardized testing measures used in these studies. <b>Results:</b> There was a lack of variation among the telepractice assessment protocols and aphasia tests used across all the included studies. That is, there was limited investigation of screening tests, discourse analysis, extralinguistic cognitive measures, and the use of patient-reported measures. Study characteristics lacked high-quality and free-of-bias examinations. Most standardized tests that were utilized exhibited poor validity and reliability properties. <b>Conclusions:</b> Overall, the current systematic review pointed to the need to investigate a wider range of aphasia assessment protocols that can be offered via telepractice. Moreover, more robust research designs are necessary to examine the variety of assessment tests and/or procedures that are available for in-person aphasia assessment services. Finally, given that many tests used in the included studies had psychometric property issues, the current review raised concerns regarding the use of these tests in research and clinical practices.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"37-49"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Out of the Norm-Groundbreaking and Unparalleled.","authors":"Charles R Doarn","doi":"10.1089/tmj.2024.0587","DOIUrl":"10.1089/tmj.2024.0587","url":null,"abstract":"","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"1-2"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cisgender Sexual Minority Women's Interest in Telemental Health Services: A Latent Class Analysis.","authors":"Lexie Wille, Norian Caporale-Berkowitz, Nate Woznicki, Yaritza Carmona, Mike C Parent","doi":"10.1089/tmj.2024.0230","DOIUrl":"10.1089/tmj.2024.0230","url":null,"abstract":"<p><p><b>Introduction:</b> Telemental health is increasingly recognized for its potential to overcome barriers like cost and stigma, particularly for marginalized groups. Sexual minority women in particular may benefit from increased access to telemental health services, due to the unique health disparities faced by this population. However, very little research thus far has assessed the telemental health preferences of this group. <b>Methods:</b> The present study surveyed 1,092 cisgender sexual minority women regarding their demographic information, mental health, and telemental health preferences, using the Prolific.co research platform. Latent class analysis was conducted to identify subgroups within the sample based on their responses to the survey. <b>Results:</b> Results revealed diverse attitudes toward telemental health, with some that prefer in-person sessions, whereas others show a strong interest in virtual options. Latent class analysis identified five groups, termed the Neutral, Ambivalent, Inclined, Inclined Related to Travel, and Averse groups. There were statistically significant differences between groups on measures of rurality, socioeconomic status, previous therapy experience, and symptoms of depression and anxiety. Overall, sexual minority women demonstrated interest in telemental health, especially individuals with mobility challenges and those living in rural areas. <b>Conclusion:</b> This study underscores the importance of tailoring mental health services to diverse needs and suggests that telemental health could be a valuable tool in addressing health disparities among sexual minority women. Importantly, these data were conducted prior to the COVID-19 pandemic. Further research could examine how sexual minority women's attitudes toward telemental health have shifted since the COVID-19 pandemic and how telemental health services could be tailored for marginalized subgroups.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"28-36"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142057240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Sociodemographic Factors and Interest in Remote Patient Monitoring Among Arkansas Residents.","authors":"Jennifer A Andersen, Cari A Bogulski, Surabhee Eswaran, Don E Willis, Mahip Acharya, Ji Li, Byron Marciniak, Dinesh Edem, James P Selig, Pearl A McElfish","doi":"10.1089/tmj.2023.0557","DOIUrl":"10.1089/tmj.2023.0557","url":null,"abstract":"<p><p><b>Introduction:</b> Remote patient monitoring (RPM) has the power to transform health care delivery, as it allows for the digital transmission of individual health data to health care professionals, providing the most up-to-date information to be able to make medical decisions. Although RPM use has grown exponentially during the pandemic, there is limited information on the association between sociodemographic characteristics and interest in RPM use in underserved areas of the United States after the onset of the pandemic. <b>Methods:</b> We conducted a survey via random digit dialing of 2201 adults living in Arkansas in March of 2022. Weighted estimates were generated using rank ratio estimation to approximate the 2019 American Community Survey 1-year Arkansas estimates for race/ethnicity, age, and gender. We fit a partial proportional odds model using weighted generalized ordered logistic regression to examine adjusted odds ratios (ORs) for interest in RPM. Predictors included sociodemographic characteristics, nativity, health care access, and self-rated health. <b>Results:</b> Results indicate respondents who were age 60 or older had lower odds of interest in RPM than those between the ages 18-39 (OR = 0.61). Hispanic adults had lower odds of reporting interest in RPM (OR = 0.68), and non-Hispanic adults of other races/ethnicities had lower odds of reporting any interest at all (OR = 0.67) or interest greater than a little (OR = 0.67) in RPM compared with non-Hispanic White respondents. However, respondents who had previously used telehealth had greater odds of reporting higher levels of interest in RPM than those who had not previously used it (OR = 1.93). <b>Discussion:</b> Interest in RPM use is associated with several sociodemographic factors. Future work is needed to understand and address RPM reluctance and to increase interest in RPM among marginalized and underserved populations who may need these services.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"66-74"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142044177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Satisfaction Survey of Medical Staff for Telemedicine after the COVID-19 Pandemic: A Comparison Between the COVID-Pandemic and Post-COVID Pandemic Periods.","authors":"Seung Eun Jung, Young-Mi Kwon, Soon-Yong Kwon, Young-Hoon Kim, Hyung-Youl Park","doi":"10.1089/tmj.2024.0142","DOIUrl":"10.1089/tmj.2024.0142","url":null,"abstract":"<p><p><b>Introduction</b>: The role of telemedicine should be reassessed in the post-COVID-19 pandemic era. This study aimed to evaluate the perception and satisfaction of medical staff with telemedicine after the COVID-19 pandemic and compare these findings with those during the COVID-19 pandemic. <b>Methods:</b> Between January and February 2023, a questionnaire regarding the utilization, safety, and satisfaction with telemedicine was administered to 200 medical staff members (100 doctors and 100 nurses). Additionally, open-ended questions were included to gather insights on the strengths, weaknesses, and prerequisites of telemedicine. The satisfaction levels of the medical staff were compared with those from a previous study conducted during the COVID-19 pandemic. <b>Results:</b> The response rate among medical staff was 60.0% (50 doctors and 70 nurses). Concerning patient safety, 83.3% of respondents indicated a risk of worsening symptoms in chronic patients, and 68.3% expressed concerns about emergencies related to patient safety. Eighty-two percent of doctors preferred in-person visits over telemedicine, while 48.6% of nurses reported equal or greater satisfaction with telemedicine (<i>p</i> = 0.003). The reported strengths of telemedicine included the convenience of outpatient clinics (67%), while its primary weakness was the incomplete assessment of patient conditions (73%). The likelihood of partial substitution of telemedicine for in-person visits was significantly higher in the post-COVID-19 pandemic period compared to during the pandemic (71.7% vs. 49.0%, <i>p</i> < 0.001). <b>Conclusion:</b> In the post-COVID-19 pandemic era, telemedicine continues to offer significant benefits in enhancing patient access to medical care. However, medical staff remain concerned about its safety and show lower satisfaction compared to in-person visits. In response to these concerns, an effective telemedicine platform and legal standards, including practical guidelines, should be developed.</p>","PeriodicalId":54434,"journal":{"name":"Telemedicine and e-Health","volume":" ","pages":"50-58"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}