BMJ Quality & Safety最新文献

{"title":"Selecting and tailoring implementation strategies for deimplementing fall prevention alarms in US hospitals: a group concept mapping study.","authors":"Kea Turner, Mona Al Taweel, Carrie Petrucci, Scott Rosas, Catima Potter, Emily Cramer, Ronald I Shorr, Lorraine C Mion, Molly McNett","doi":"10.1136/bmjqs-2024-018391","DOIUrl":"10.1136/bmjqs-2024-018391","url":null,"abstract":"<p><strong>Objectives: </strong>Many hospitals use fall prevention alarms, despite the limited evidence of effectiveness. The objectives of this study were (1) to identify, conceptualise and select strategies to deimplement fall prevention alarms and (2) to obtain feedback from key stakeholders on tailoring selected deimplementation strategies for the local hospital context.</p><p><strong>Methods: </strong>Hospital staff working on fall prevention participated in group concept mapping (GCM) to brainstorm strategies that could be used for fall prevention alarm deimplementation, sort statements into conceptually similar categories and rate statements based on importance and current use. Hospital staff also participated in site-specific focus groups to discuss current fall prevention practices, strategies prioritised through GCM and theory-informed strategies recommended by the study team, and potential barriers/facilitators to deimplementing fall prevention alarms.</p><p><strong>Results: </strong>90 hospital staff across 13 hospitals brainstormed, rated and sorted strategies for alarm deimplementation. Strategies that were rated as highly important but underutilised included creating/revising staff roles to support fall prevention (eg, hiring or designating mobility technicians) and revising policies and procedures to encourage tailored rather than universal fall precautions. 192 hospital staff across 22 hospitals participated in site-specific focus groups. Participants provided feedback on each strategy's relevance for their site (eg, if site currently has a mobility technician) and local barriers or facilitators (eg, importance of having separate champions for day and night shift). Findings were used to develop a tailored implementation package for each site that included a core set of strategies (eg, external facilitation, education, audit-and-feedback, champions), a select set of site-specific strategies (eg, designating a mobility technician to support fall prevention) and guidance for how to operationalise and implement each strategy given local barriers and facilitators.</p><p><strong>Conclusion: </strong>Findings from this study can be used to inform future programmes and policies aimed at deimplementing fall prevention alarms in hospitals.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"247-256"},"PeriodicalIF":6.5,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12309417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143728438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of volume and prehospital paediatric care quality in emergency medical services: retrospective analysis of a national sample.","authors":"Sriram Ramgopal, Caleb E Ward, Rebecca E Cash, Christian Martin-Gill, Kenneth A Michelson","doi":"10.1136/bmjqs-2024-018224","DOIUrl":"10.1136/bmjqs-2024-018224","url":null,"abstract":"<p><strong>Background: </strong>Children represent fewer than 10% of emergency medical services (EMS) encounters in the USA. We evaluated whether agency-level paediatric volume is associated with the quality of prehospital care provided.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 7104 agencies that contributed data consistently to the 2022-2023 National Emergency Medical Services Information System database, including children (<18 years) from an out-of-hospital EMS encounter. We assessed outcomes based on adherence to paediatric-specific quality benchmarks using mixed-effects models.</p><p><strong>Results: </strong>We identified 3 403 925 paediatric encounters (median age 10 years; IQR 3-15). The annual paediatric volumes serviced by the study agencies per year ranged from 0.5 to 62 443. Six measures had a positive association with EMS volume, one measure had a negative association with EMS volume and four measures had no association with EMS volume. Higher volumes were associated with beta agonist administration for asthma/wheeze (adjusted OR (aOR) 1.08 per twofold increase in volume, 95% CI 1.06 to 1.11), epinephrine for anaphylaxis (aOR 1.09, 95% CI 1.05 to 1.08), vital signs assessment in trauma (aOR 1.05, 95% CI 1.04 to 1.07), benzodiazepines for status epilepticus (aOR 1.21, 95% CI 1.17 to 1.25), oxygen or positive pressure ventilation for hypoxia (aOR 1.06, 95% CI 1.04 to 1.09) and naloxone for opioid overdose (aOR 1.08, 95% CI 1.02 to 1.14). Higher paediatric volume was negatively associated with improvement of pain status in trauma (aOR 0.96, 95% CI 0.95 to 0.97). Paediatric volume was not associated with management of hypoglycaemia (aOR 1.01, 95% CI 0.97 to 1.06) or hypotension (aOR 0.98, 95% CI 0.92 to 1.04), or analgesia (0.99, 95% CI 0.97 to 1.01) and pain assessment (aOR 1.01, 95% CI 0.99 to 1.04) in trauma.</p><p><strong>Conclusion: </strong>Higher paediatric volume EMS agencies had better adherence to some paediatric care quality measures but showed no association or an inverse association with others. Efforts to improve prehospital paediatric care quality should pay special attention to low-volume agencies.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"228-236"},"PeriodicalIF":6.5,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and clinician perspectives on misgendering in healthcare.","authors":"Kyle Okamuro, Alan Card, Hanna J Barton, Falisha Kanji, Victor Trasvina, Jill Blumenthal, Tara Cohen, Jennifer T Anger","doi":"10.1136/bmjqs-2024-018364","DOIUrl":"10.1136/bmjqs-2024-018364","url":null,"abstract":"<p><strong>Purpose: </strong>Misgendering of transgender and non-binary (TGNB) individuals in healthcare settings can lead to worsened mental and physical health outcomes and decreased utilisation of care. Few studies have investigated the factors that contribute to this phenomenon. The purpose of this study was to apply qualitative methods to explore sources of misgendering, its perceived impact, prevention strategies and clinician responses to accidentally misgendering a patient, as identified by TGNB patients and gender-affirming care clinicians.</p><p><strong>Methods: </strong>Between April and June 2022, 20 semi-structured interviews were performed at an academic medical centre in Southern California. Participants were recruited via purposive sampling and included: (1) TGNB patients (n=8) recruited from an interdisciplinary gender-affirming urological practice and (2) gender-affirming care clinicians (n=12) recruited from a regional interdisciplinary Gender Health conference, three of whom identified as TGNB. Interviews were conducted in person or virtually using an open-ended topic guide, audio recorded and transcribed verbatim. Inductive thematic analysis was performed by two independent study personnel who hand-coded the transcripts.</p><p><strong>Results: </strong>Four overarching themes were identified: (1) misgendering originates from multiple sources, (2) misgendering discourages individual access to healthcare, creates community hesitation and its perceived impact is modified by setting and intentionality, (3) building a gender-affirming healthcare system requires integration of behaviour, policy and technology and (4) clinicians respond to accidental misgendering by acknowledging, apologising, advancing and acting.</p><p><strong>Conclusion: </strong>Our data suggest that misgendering arises from both interpersonal communication and structural factors within healthcare systems, leading to perceived harm and diminished TGNB access to health services. Any potential solution to reduce this phenomenon will require a multifaceted approach integrating behavioural, technological and institutional policy strategies with system-level implementation efforts.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"257-265"},"PeriodicalIF":6.8,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13165897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Near-wins in the pursuit of quality: does transparency matter if no one is looking?","authors":"Sigall K Bell, Catherine DesRoches","doi":"10.1136/bmjqs-2025-019394","DOIUrl":"10.1136/bmjqs-2025-019394","url":null,"abstract":"","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"224-227"},"PeriodicalIF":6.5,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of online patient access to clinical notes on quality of care: a systematic review.","authors":"Yoko Yoshimura, Geva Greenfield, Elena Lammila-Escalera, Brian Mcmillan, Benedict Hayhoe, Azeem Majeed, Ana Luisa Neves","doi":"10.1136/bmjqs-2024-018363","DOIUrl":"10.1136/bmjqs-2024-018363","url":null,"abstract":"<p><strong>Background: </strong>Access to electronic health records (EHRs) has the potential to improve the quality of care. Clinical notes, free-text entries documenting clinicians' observations and decisions, are central to EHRs. Sharing these notes may reduce information asymmetry, enhance transparency and empower patients. However, their impact on care quality remains unclear.</p><p><strong>Aim: </strong>To assess the impact of sharing clinical notes online with patients on the domains of quality as defined by the Institute of Medicine (ie, patient-centredness, effectiveness, efficiency, safety, timeliness and equity).</p><p><strong>Methodology: </strong>A systematic review was conducted with no time limit, using CINAHL, Cochrane, OVID Embase, HMIC, Medline/PubMed and PsycINFO. A narrative synthesis method was employed to extract the study characteristics, and reported outcomes were organised using the six IOM quality domains. The risk of bias of included studies was assessed using the Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) tool.</p><p><strong>Results: </strong>Nineteen studies involving 203 152 participants met inclusion criteria. Outcomes included patient-centredness (n=16), patient safety (n=14), equity (n=6), efficiency (n=4), timeliness (n=0) and effectiveness (n=0). Patient-centredness studies reported high satisfaction (n=6), increased engagement (n=11) and stronger patient-provider trust (n=7). Patient safety studies noted improvements in medication adherence (n=4) and note accuracy (n=5), alongside privacy concerns (n=5). Equity studies found benefits for minority (n=3) and less-educated patients (n=2), with one reporting equitable outcomes (n=1). No significant changes in efficiency were observed (n=4).</p><p><strong>Discussion: </strong>Online sharing of clinical notes with patients positively impacted self-reported patient-centredness and patient safety, particularly benefiting underserved populations. However, privacy concerns must be effectively addressed, and robust safeguarding is essential to mitigate confidentiality issues. Further research is needed to evaluate the long-term impact on timeliness, effectiveness and efficiency of care.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"266-274"},"PeriodicalIF":6.8,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13018785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How can we promote greater adoption of AI in healthcare?","authors":"Ian Scott, Kathrin Cresswell, Robin Williams, Anton van der Vegt","doi":"10.1136/bmjqs-2025-019405","DOIUrl":"10.1136/bmjqs-2025-019405","url":null,"abstract":"","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"288-292"},"PeriodicalIF":6.5,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145386843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is independent double-checking superior to single-checking in medication administration error detection? A randomised controlled simulation trial.","authors":"Johanna I Westbrook, Ryan Daniel McMullan, Erin Fitzpatrick, Alison Merchant, Mark Wiggins, Nanda Aryal, Magdalena Z Raban, Alan Gardo, Caleb Lapointe, Philip Williams, Ling Li","doi":"10.1136/bmjqs-2025-019743","DOIUrl":"https://doi.org/10.1136/bmjqs-2025-019743","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Double-checking of medication administration is a safety practice used in hospitals around the world. Independence is recommended as the key to effectiveness. Independent double-checking (IDC) requires each nurse to separately check the five rights (eg, right drug, dose). There is no empirical evidence that IDC is more effective in error detection than a single-nurse check.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To compare the effectiveness of IDC versus single-checking in detecting medication errors during administration, assess the time required and explore factors influencing performance, including nurse experience and social dynamics.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A multicentre randomised controlled simulation trial with 82 nurses from two paediatric hospitals. Forty-one 2-hour simulations each involved two nurses exposed to single-checking and IDC conditions administering medication sets containing embedded errors. Condition order and medication sets were randomised. Primary outcomes were error detection and time taken. Multivariable models compared primary outcomes by condition. Secondary analyses examined the influence of nurse experience and social loafing, defined as reduced individual performance when working in pairs. Social loafing was assessed by comparing error detection performance when nurses single-checked with error detection in the role of first checker in IDC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Across 1160 dose administrations with 640 error detection opportunities, nurses detected 72.2% (95% CI 68.6 to 75.5) of errors. Overall, IDC yielded an 11% higher error detection rate than single-checking (adjusted incident rate ratio (aIRR): 1.11, 95% CI 1.01 to 1.21; p=0.02; 77.7% (95% CI 72.9 to 81.9) for IDC vs 66.3% (95% CI 60.9 to 71.4) for single checks). However, this benefit was limited to experienced nurses. Among early career nurses (&lt;5 years clinical experience), IDC produced no significant improvement in error detection (aIRR: 0.98, 95% CI 0.86 to 1.11; p=0.7; IDC 67.0% (95% CI 57.3 to 75.4) vs single checking 73.0% (95% CI 63.6 to 80.7) error detection). In contrast, experienced nurses showed a 26% improvement in error detection with IDC (aIRR 1.26, 95% CI 1.11 to 1.44; p&lt;0.001; IDC 82.5% (95% CI 77.0 to 86.8) vs single-checking 63.2% (95% CI 56.5 to 69.4)). Evidence of social loafing was observed, particularly among early career nurses whose error detection performance was 26.0% higher when single-checking compared with their performance in the role of first checker in IDC. IDC required significantly more time per medication set (mean difference 4.96 min (95% CI 2.10 to 7.83; p&lt;0.001)).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;IDC improved error detection for experienced nurses, but not for early career nurses. Given its inconsistent benefits, resource demands and susceptibility to social loafing, IDC may be unsuitable as a universal safety strategy. Strengthening single-checking competence and suppo","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147455324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does bypassing nearby hospitals for high-quality care reduce case fatality among inpatients who had a stroke? A retrospective study of 328 206 cases.","authors":"Qingyu Wang, Lu Ao, Kun Tan, Xiang Yan, Jay Pan","doi":"10.1136/bmjqs-2025-019330","DOIUrl":"https://doi.org/10.1136/bmjqs-2025-019330","url":null,"abstract":"<p><strong>Introduction: </strong>Patients who had a stroke often confront the trade-off between timely care at nearby hospitals and potentially higher quality but more distant care. Evidence remains limited on whether bypassing the nearest hospital in favour of a high-quality facility improves health outcomes. This study examines the causal effect of bypass behaviours on case fatality among inpatients who had a stroke and the time-bound survival benefits of bypassing behaviours directed to high-quality healthcare facilities.</p><p><strong>Methods: </strong>A retrospective study of 328 206 inpatients who had a stroke admitted via emergency departments in Sichuan Province, China (2017-2019), using complete discharge records. Bypass behaviour was defined as patients bypassing the nearest hospital to attend a more distant facility. Inverse probability weighting and instrumental variable analyses were applied. The differential travel distance between the nearest secondary and tertiary hospitals served as the instrumental variable to evaluate the causal effect of tertiary hospital admission on case fatality for haemorrhagic and ischaemic stroke.</p><p><strong>Results: </strong>Among 328 206 patients, 78% engaged in bypass behaviour. Inverse probability weighting analysis showed that receiving care at tertiary hospitals was associated with significantly lower case-fatality, regardless of whether patients bypassed the nearest facility, with ORs below 0.8 for overall, 7-day and 30-day case fatality. Bypassing to a more distant secondary hospital was not associated with differences in case fatality. Instrumental variable analysis revealed a survival benefit from treatment at tertiary hospitals, with significant reductions in overall case fatality observed among patients who had an ischaemic stroke within 30 min (OR: 0.66, 95% CI 0.46 to 0.94) and patients who had a haemorrhagic stroke within 60 min (OR: 0.23, 95% CI 0.09 to 0.61).</p><p><strong>Conclusions: </strong>Bypassing a nearby hospital to seek care at a distant tertiary hospital was associated with a lower stroke case fatality rate. Favourable outcomes were observed when tertiary hospitals were reachable within 30 min for ischaemic stroke and within 60 min for haemorrhagic stroke.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":""},"PeriodicalIF":6.5,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147389324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient portal messaging to address delayed follow-up for uncontrolled diabetes: a pragmatic, randomised clinical trial.","authors":"Arielle R Nagler, Leora Idit Horwitz, Aamina Ahmed, Amrita Mukhopadhyay, Isaac Dapkins, William King, Simon A Jones, Adam Szerencsy, Claudia Pulgarin, Jennifer Gray, Tony Mei, Saul Blecker","doi":"10.1136/bmjqs-2024-018249","DOIUrl":"10.1136/bmjqs-2024-018249","url":null,"abstract":"<p><strong>Importance: </strong>Patients with poor glycaemic control have a high risk for major cardiovascular events. Improving glycaemic monitoring in patients with diabetes can improve morbidity and mortality.</p><p><strong>Objective: </strong>To assess the effectiveness of a patient portal message in prompting patients with poorly controlled diabetes without a recent glycated haemoglobin (HbA1c) result to have their HbA1c repeated.</p><p><strong>Design: </strong>A pragmatic, randomised clinical trial.</p><p><strong>Setting: </strong>A large academic health system consisting of over 350 ambulatory practices.</p><p><strong>Participants: </strong>Patients who had an HbA1c greater than 10% who had not had a repeat HbA1c in the prior 6 months.</p><p><strong>Exposures: </strong>A single electronic health record (EHR)-based patient portal message to prompt patients to have a repeat HbA1c test versus usual care.</p><p><strong>Main outcomes: </strong>The primary outcome was a follow-up HbA1c test result within 90 days of randomisation.</p><p><strong>Results: </strong>The study included 2573 patients with a mean (SD) HbA1c of 11.2%. Among 1317 patients in the intervention group, 24.2% had follow-up HbA1c tests completed within 90 days, versus 21.1% of 1256 patients in the control group (p=0.07). Patients in the intervention group were more likely to log into the patient portal within 60 days as compared with the control group (61.2% vs 52.3%, p<0.001).</p><p><strong>Conclusions: </strong>Among patients with poorly controlled diabetes and no recent HbA1c result, a brief patient portal message did not significantly increase follow-up testing but did increase patient engagement with the patient portal. Automated patient messages could be considered as a part of multipronged efforts to involve patients in their diabetes care.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"181-187"},"PeriodicalIF":6.5,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing AI in healthcare: three strategic roles for quality and safety leaders.","authors":"Jeffrey Rakover, Marina Lynne Renton, Pierre Barker, Gareth Kantor","doi":"10.1136/bmjqs-2025-019050","DOIUrl":"10.1136/bmjqs-2025-019050","url":null,"abstract":"","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"213-218"},"PeriodicalIF":6.5,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}