BMJ Quality & Safety最新文献

{"title":"Psycholinguistic tests predict real-world drug name confusion error rates: a cross-sectional experimental study.","authors":"Bruce L Lambert, Scott Ryan Schroeder, William L Galanter, Gordon D Schiff, Allen J Vaida, Michael J Gaunt, Michelle Bryson Opfermann, Christine Rash Foanio, Suzanne Falck, Nicole Mirea","doi":"10.1136/bmjqs-2024-017688","DOIUrl":"https://doi.org/10.1136/bmjqs-2024-017688","url":null,"abstract":"<p><strong>Background: </strong>Wrong-drug medication errors are common. Regulators screen drug names for confusability, but screening methods lack empirical validation. Previous work showed that psycholinguistic tests on <i>pairs</i> of drug names are associated with real-world error rates in chain pharmacies. However, regulators evaluate <i>individual</i> names not <i>pairs</i>, and individual names can be confused with multiple drugs (eg, hydroxyzine with hydralazine but also hydrocet, thorazine, hydrochlorothiazide). This study examines whether an individual drug name's performance on psycholinguistic tests correlates with that name's sum total error rate in the real world.</p><p><strong>Methods: </strong>Nineteen pharmacists and 18 pharmacy technicians completed memory and perception tests assessing confusability of 77 drug names. Tests involved presenting a drug name to participants in conditions that hindered their ability to see, hear or remember the name. Participants typed the name they perceived and selected that name from a menu of alternatives. Error rates on the tests were assessed in relation to real-world rates, as reported by the patient safety organisation associated with a national pharmacy chain in the USA.</p><p><strong>Results: </strong>Mean error rate on the psycholinguistic tests was positively correlated with the log-adjusted real-world error rate (r=0.50, p<0.0001). Linear and mixed effects logistic regression analyses indicated that the lab-measured error rates significantly predicted the real-world error rates and vice versa.</p><p><strong>Conclusions: </strong>Lab-based psycholinguistic tests are associated with real-world drug name confusion error rates. Previous work showed that such tests were associated with error rates of specific look-alike sound-alike <i>pairs</i>, and the current work showed that lab-based error rates are also associated with an <i>individual</i> drug's <i>overall error rate</i>. Taken together, these studies validate the use of psycholinguistic tests in assessing the confusability of proposed drug names.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555746","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":"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":"https://doi.org/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":""},"PeriodicalIF":5.6,"publicationDate":"2025-03-03","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":"Implementation strategies of financial navigation and its effects on alleviating financial toxicity among cancer survivors: a systematic review.","authors":"Yujia Feng, Mingzhu Su, Xiaojie Sun, Jinxin Zhang, Nengliang Aaron Yao","doi":"10.1136/bmjqs-2024-017557","DOIUrl":"https://doi.org/10.1136/bmjqs-2024-017557","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review aims to identify the implementation strategies of financial navigation and systematically synthesise its effects on mitigating financial toxicity among cancer survivors, based on the theoretical framework of implementation science.</p><p><strong>Methods: </strong>Medline, Web of Science Core Collection, ScienceDirect and ProQuest Health & Medical Collection databases were searched for studies published before 22 August 2023. We sought original research on financial navigation interventions among adult cancer survivors with financial toxicity in healthcare settings. The Revised Cochrane risk-of-bias tool for randomised trials, 2.0 and the Risk Of Bias In Non-randomised Studies of Interventions-I were used to assess the risk of bias in included studies. In addition, the implementation strategies of the included studies were categorised and collated based on Expert Recommendations for Implementing Change, and the Consolidated Framework for Implementation Research was adopted to explain barriers and facilities for implementation.</p><p><strong>Results: </strong>In total, 6855 records were screened, yielding 14 full-text articles, which were included (3 randomised clinical trials and 11 non-randomised studies). 'Train and educate stakeholders' (n=13 (92.9%)) and 'use evaluative and iterative strategies' (n=12 (85.7%)) were the most common implementation strategies in financial navigation. The feasibility of financial navigation is relatively high, but generally hindered by the health condition of cancer survivors, low willingness to participate and insufficient number of navigators to cover all participants. After the intervention, three of seven studies reported statistically significant mitigations in patient-reported financial toxicity. In studies reporting statistically significant outcomes, 'adapt and tailor to the context' and 'change infrastructure' were proposed as key corresponding recommendations.</p><p><strong>Conclusions: </strong>Financial navigation is a potentially beneficial intervention for lessening the financial toxicity of cancer survivors, but more high-level evidence is needed for further validation. Financial navigation combined with the theoretical framework of implementation science provides a foundation for the future realisation of the leap from knowledge to practice.</p><p><strong>Prospero registration number: </strong>CRD42023469114.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522708","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":"Scoping review identifying interventions that have been tested to optimise the experience of people from ethnic minority groups receiving systemic anticancer therapy (SACT).","authors":"Jurga McLean, Pinkie Chambers, Luke Steventon, Susanne Cruickshank, Shereen Nabhani-Gebara","doi":"10.1136/bmjqs-2024-017560","DOIUrl":"https://doi.org/10.1136/bmjqs-2024-017560","url":null,"abstract":"<p><strong>Background: </strong>Disparities have been identified in many aspects of the cancer care pathway for people from minority ethnic groups (MEGs). Adherence to systemic anticancer therapies (SACTs) has been shown to impact morbidity and mortality, and therefore, inequitable experiences can have a detrimental effect on outcomes.</p><p><strong>Objectives: </strong>To identify interventions that focused on improving the experiences and clinical outcomes in people from MEG receiving SACT treatments.</p><p><strong>Methods: </strong>A scoping review was conducted according to Arksey and O'Malley's methodological framework to map the available literature. A comprehensive search was performed using three electronic databases (Medline, Embase and CINAHL). Standard scoping review methodology following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was used. Studies were included that assessed interventions to improve MEG patients' experience with SACT. Study types included in the review were evaluation studies, randomised/non-randomised controlled trials and all observational studies. Exclusion criteria were applied to studies including opinion pieces, literature and systematic reviews, non-English studies, conference abstracts and studies that were not describing an intervention. Independent duplicate screening, study selection, data extraction and quality assessment were undertaken. Results of the studies were synthesised using a published equity framework.</p><p><strong>Results: </strong>Searches yielded 1356 articles. Nine studies were included after exclusion criteria were applied. Studies described six digital, two in-person and one hybrid intervention employing different research methodologies, ranging from randomised controlled trials (RCTs), feasibility studies and mixed methods studies. The majority of interventions in this study were delivered remotely, using digital platforms such as websites, recorded educational training materials as well as social media. These interventions were conducted in the USA and primarily targeted patients with early breast cancer from African American backgrounds.</p><p><strong>Conclusions: </strong>This scoping review showed that there has been a very small number of studies investigating interventions to optimise SACT treatment experiences in people from MEG. We found evidence of interventions incorporating the equity domains that reported improved patient engagement and experience. This new knowledge will help to implement future SACT interventions, addressing health inequities across the cancer continuum.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143498929","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":"Systems analysis of clinical incidents: development of a new edition of the London Protocol.","authors":"Charles Vincent, Dulcie Irving, Tommaso Bellandi, Helen Higham, Philippe Michel, Anthony Staines, Sally Adams, Jeff Brown, Peter Damian Hibbert, Carole Hemmelgarn, Lallu Joseph, Karina Pires, Susan Sheridan, Rosa Sunol, Shin Ushiro, Albert W Wu, Lucas Zambon","doi":"10.1136/bmjqs-2024-017987","DOIUrl":"https://doi.org/10.1136/bmjqs-2024-017987","url":null,"abstract":"<p><p>The investigation of incidents and accidents, together with subsequent reflection and action, is an essential component of safety management in every safety-critical industry, including healthcare. A number of formal methods of incident analysis were developed in the early days of risk management and patient safety, including the London Protocol which was published in 2004. In this paper, we describe the development of a new edition of the London Protocol. We explain the need for a revised and expanded version of the London Protocol, addressing both the changes in healthcare in the last two decades and what has been learnt from the experience of incident analysis across the world. We describe a systematic process of development of the new edition drawing on the findings of a narrative review of incident analysis methods. The principal changes in the new edition are as follows: increased emphasis and guidance on the engagement of patients and families as partners in the investigation; giving more attention to the support of patients, families and staff in the aftermath of an incident; emphasising the value of a small number of in-depth analyses combined with thematic reviews of wider problems; including proposals and guidance for the examination of much longer time periods; emphasising the need to highlight good care as well as problems; adding guidance on direct observation of the work environment; providing a more structured and wide-ranging approach to recommendations and including more guidance on how to write safety incident reports. Finally, we offer some proposals to place research on incident analysis on a firmer foundation and make suggestions for the practice and implementation of incident investigation within safety management systems.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":""},"PeriodicalIF":5.6,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143475957","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":"Global perspectives on opioid use: shifting the conversation from deprescribing to quality use of medicines.","authors":"Aili Veronica Langford, Chung-Wei Christine Lin, Suzanne Nielsen","doi":"10.1136/bmjqs-2024-017657","DOIUrl":"10.1136/bmjqs-2024-017657","url":null,"abstract":"","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"143-145"},"PeriodicalIF":5.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142614512","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":"Reducing administrative burden by implementing a core set of quality indicators in the ICU: a multicentre longitudinal intervention study.","authors":"Gijs Hesselink, Rutger Verhage, Brigitte Westerhof, Eva Verweij, Malaika Fuchs, Inge Janssen, Catrien van der Meer, Iwan C C van der Horst, Paul de Jong, Johannes G van der Hoeven, Marieke Zegers","doi":"10.1136/bmjqs-2024-017481","DOIUrl":"10.1136/bmjqs-2024-017481","url":null,"abstract":"<p><strong>Background: </strong>The number of quality indicators for which clinicians need to record data is increasing. For many indicators, there are concerns about their efficacy. This study aimed to determine whether working with only a consensus-based core set of quality indicators in the intensive care unit (ICU) reduces the time spent on documenting performance data and administrative burden of ICU professionals, and if this is associated with more joy in work without impacting the quality of ICU care.</p><p><strong>Methods: </strong>Between May 2021 and June 2023, ICU clinicians of seven hospitals in the Netherlands were instructed to only document data for a core set of quality indicators. Time spent on documentation, administrative burden and joy in work were collected at three time points with validated questionnaires. Longitudinal data on standardised mortality rates (SMR) and ICU readmission rates were gathered from the Dutch National Intensive Care registry. Longitudinal effects and differences in outcomes between ICUs and between nurses and physicians were statistically tested.</p><p><strong>Results: </strong>A total of 390 (60%), 291 (47%) and 236 (40%) questionnaires returned at T0, T1 and T2. At T2, the overall median time spent on documentation per day was halved by 30 min (p<0.01) and respondents reported fewer unnecessary and unreasonable administrative tasks (p<0.01). Almost one-third still experienced unnecessary administrative tasks. No significant changes over time were found in joy in work, SMR and ICU readmission.</p><p><strong>Conclusions: </strong>Implementing a core set of quality indicators reduces the time ICU clinicians spend on documentation and administrative burden without negatively affecting SMR or ICU readmission rates. Time savings can be invested in patient care and improving joy in work in the ICU.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"157-165"},"PeriodicalIF":5.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104181","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":"Experiences with diagnostic delay among underserved racial and ethnic patients: a systematic review of the qualitative literature.","authors":"Elena Faugno, Alison A Galbraith, Kathleen Walsh, Paul J Maglione, Jocelyn R Farmer, Mei-Sing Ong","doi":"10.1136/bmjqs-2024-017506","DOIUrl":"10.1136/bmjqs-2024-017506","url":null,"abstract":"<p><strong>Objective: </strong>Diagnostic delay is a pervasive patient safety problem that disproportionately affects historically underserved populations. We aim to systematically examine and synthesise published qualitative studies on patient experiences with diagnostic delay among historically underserved racial and ethnic populations.</p><p><strong>Data sources: </strong>PubMed.</p><p><strong>Eligibility criteria: </strong>Primary qualitative studies detailing patient or caregiver-reported accounts of delay in the diagnosis of a disease among underserved racial and ethnic populations; conducted in the USA; published in English in a peer-reviewed journal (years 2012-2022); study cohort composed of >50% non-white racial and ethnic populations.</p><p><strong>Data analysis: </strong>Primary outcomes were barriers to timely diagnosis of a disease. Screening and thematic abstraction were performed independently by two investigators, and data were synthesised using the 'Model of Pathways to Treatment' conceptual framework.</p><p><strong>Results: </strong>Sixteen studies from multiple clinical domains were included. Barriers to timely diagnosis emerged at the socioeconomic and sociocultural level (low health literacy, distrust in healthcare systems, healthcare avoidance, cultural and linguistic barriers), provider level (cognitive biases, breakdown in patient-provider communication, lack of disease knowledge) and health systems level (inequity in organisational health literacy, administrative barriers, fragmented care environment and a lack of organisational cultural competence). None of the existing studies explored diagnostic disparities among Asian Americans/Pacific Islanders, and few examined chronic conditions known to disproportionately affect historically underserved populations.</p><p><strong>Discussion: </strong>Historically underserved racial and ethnic patients encountered many challenges throughout their diagnostic journey. Systemic strategies are needed to address and prevent diagnostic disparities.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"190-200"},"PeriodicalIF":5.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11839380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142574980","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":"The beast and the burden: will pruning performance measurement improve quality?","authors":"Eric C Schneider","doi":"10.1136/bmjqs-2024-017976","DOIUrl":"10.1136/bmjqs-2024-017976","url":null,"abstract":"","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"140-142"},"PeriodicalIF":5.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11874367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142999939","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":"Decoding behaviour change techniques in opioid deprescribing strategies following major surgery: a systematic review of interventions to reduce postoperative opioid use.","authors":"Neetu Bansal, Christopher J Armitage, Rhiannon E Hawkes, Sarah Tinsley, Darren M Ashcroft, Li-Chia Chen","doi":"10.1136/bmjqs-2024-017265","DOIUrl":"10.1136/bmjqs-2024-017265","url":null,"abstract":"<p><strong>Background and objectives: </strong>METHODS: A structured search strategy encompassing databases including MEDLINE, Embase, CINAHL Plus, PsycINFO and Cochrane Library was implemented from inception to October 2023. Included studies focused on interventions targeting opioid reduction in adults following major surgeries. The risk of bias was evaluated using Cochrane risk-of-bias tool V.2 (RoB 2) and non-randomised studies of interventions (ROBINS-I) tools, and Cohen's <i>d</i> effect sizes were calculated. BCTs were identified using a validated taxonomy.</p><p><strong>Results: </strong>22 studies, comprising 7 clinical trials and 15 cohort studies, were included, with varying risks of bias. Educational (n=12), guideline-focused (n=3), multifaceted (n=5) and pharmacist-led (n=2) interventions demonstrated diverse effect sizes (small-medium n=10, large n=12). A total of 23 unique BCTs were identified across studies, occurring 140 times. No significant association was observed between the number of BCTs and effect size, and interventions with large effect sizes predominantly targeted healthcare professionals. Key BCTs in interventions with the largest effect sizes included behaviour instructions, behaviour substitution, goal setting (outcome), social support (practical), social support (unspecified), pharmacological support, prompts/cues, feedback on behaviour, environmental modification, graded tasks, outcome goal review, health consequences information, action planning, social comparison, credible source, outcome feedback and social reward.</p><p><strong>Conclusions: </strong>Understanding the dominant BCTs in highly effective interventions provides valuable insights for future opioid tapering strategy implementations. Further research and validation are necessary to establish associations between BCTs and effectiveness, considering additional influencing factors.</p><p><strong>Prospero registration number: </strong>CRD42022290060.</p>","PeriodicalId":9077,"journal":{"name":"BMJ Quality & Safety","volume":" ","pages":"166-177"},"PeriodicalIF":5.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791789","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}