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Development of a refined harmonization approach for longitudinal cognitive data in people with HIV 为艾滋病毒感染者的纵向认知数据开发一种精细的协调方法。
IF 7.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-02-01 DOI: 10.1016/j.jclinepi.2024.111620
Lang Lang , Leah H. Rubin , Raha M. Dastgheyb , David E. Vance , Scott L. Letendre , Donald R. Franklin Jr. , Yanxun Xu

Objectives

The aim of this study was to develop a refined method for harmonizing longitudinal cognitive data across several large-scale studies in people with HIV (PWH), in whom cognitive complications are common and heterogeneous in presentation.

Study Design and Setting

We developed a refined method for harmonizing longitudinal cognitive data across five large-scale studies in PWH that used different cognitive batteries with only some overlapping tests—Women's Interagency HIV Study (WIHS), Multicenter AIDS Cohort Study, CNS HIV Antiretroviral Therapy Effects Research (CHARTER), National NeuroAIDS Tissue Consortium, and the HIV Neurobehavioral Research Program. Traditional data harmonization methods using latent variable models focus on cross-sectional data and require the presence of common cognitive tests to serve as “linking” assessments. However, the absence of such common tests for certain cognitive domains can preclude the direct application of these traditional techniques. To address these challenges, we developed a harmonization method that leveraged a second-order factor model, which capitalized on the structural relationships among cognitive domains.

Results

Our approach yielded harmonized cognitive domain scores that are demographically consistent across different cohorts and exhibit strong correlations with the raw or log transformed (eg, timed outcomes) cognitive test scores. These harmonized scores accurately reflected variations according to age, educational status, and other demographic factors, while preserving participants’ longitudinal cognitive trajectories.

Conclusion

Our harmonization methods are essential for future analyses of large-scale, retrospective data to understand the heterogeneity in cognitive complications in PWH. These methods can be applied to harmonize new datasets with similar measures.
目的:本研究的目的是开发一种改进的方法来协调几项大规模研究中HIV感染者(PWH)的纵向认知数据,在这些研究中,认知并发症是常见的,并且在表现上是不同的。研究设计和设置:我们开发了一种改进的方法来协调五项大规模PWH研究的纵向认知数据,这些研究使用不同的认知电池,只有一些重叠的测试-妇女跨机构艾滋病毒研究(WIHS),多中心艾滋病队列研究(MACS), CNS艾滋病毒抗逆转录病毒治疗效果研究(CHARTER),国家神经艾滋病组织联盟(NNTC)和艾滋病毒神经行为研究计划(HNRP)。使用潜在变量模型的传统数据协调方法侧重于横截面数据,并要求存在共同的认知测试作为“链接”评估。然而,缺乏对某些认知领域的通用测试可能会妨碍这些传统技术的直接应用。为了应对这些挑战,我们开发了一种利用二阶因子模型的协调方法,该模型利用了认知领域之间的结构关系。结果:我们的方法产生了统一的认知领域分数,这些分数在不同的队列中在人口统计学上是一致的,并且与原始或对数转换(例如,时间结果)的认知测试分数表现出很强的相关性。这些统一的分数准确地反映了年龄、教育状况和其他人口统计因素的变化,同时保留了参与者的纵向认知轨迹。结论:我们的协调方法对于未来分析大规模回顾性数据以了解PWH患者认知并发症的异质性至关重要。这些方法可用于协调具有相似度量的新数据集。
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引用次数: 0
Guideline developers in low- and middle-income countries want to develop and use living guidelines, but are currently limited by important barriers: findings from a qualitative study
IF 7.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-30 DOI: 10.1016/j.jclinepi.2025.111707
Bekele Tesfaye Meteku , Kevindu De Silva , Sally E. Green , Tari Turner

Objectives

Evidence-based clinical guidelines have the potential to improve health care and health outcomes. Living guidelines methods provide an approach to ensuring guidelines are always up-to-date, maximizing this potential. However, to date, most work on living guidelines has been conducted in high income countries. The objective of this study is to explore the barriers and facilitators to the development, adaptation, and use of living guidelines among evidence-based guideline developers in low- and middle-income countries (LMICs).

Study Design and Setting

We used a descriptive qualitative study design. We employed purposive and snowball sampling techniques to recruit guideline developers from LMICs and World Health Organization offices to participate in online, semistructured interviews. Data were analysed using a thematic approach with NVivo 20 software. Ethics approval was granted by Monash University.

Results

We interviewed 18 participants from LMICs (Colombia, India, Iran, Indonesia, Argentina, and Malaysia) and WHO offices (including headquarters, regional offices, and country offices). Two main themes emerged, along with six associated subthemes. The main themes were as follows: (1) People in LMICs want living guidelines and (2) Resource limitations and their implications for living guidelines in LMICs.

Conclusion

Our research identified that guideline developers in LMICs have a strong desire to both develop and use living guidelines, but are currently limited by important barriers. Initiatives to support development, adaptation, and use of living guidelines in LMICs may help overcome barriers and meet the need for living guidelines in LMICs. It is also essential to design strategies that overcome identified barriers to developing, adapting, and implementing living guidelines, such as a lack of resources, delays in updates, and limited accessibility.

Plain Language Summary

This study looked at how living (continuously updated) approaches can be used to develop, adapt, and use clinical guidelines in settings with limited resources, and explored the pros and cons of each. The findings revealed a strong need to develop and use living guidelines in low-resource settings despite challenges, such as resource scarcity, delays in updating, and limited access to these guidelines. Overall, the findings revealed that living guidelines were worthwhile in LMICs despite all of the related challenges.
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引用次数: 0
Massive covidization and subsequent decovidization of the scientific literature involved 2 million authors
IF 7.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-30 DOI: 10.1016/j.jclinepi.2025.111705
John P.A. Ioannidis , Thomas A. Collins , Eran Bendavid , Jeroen Baas

Objectives

We aimed to examine the growth trajectory and impact of COVID-19-related papers in the scientific literature and how the scientific workforce engaged in this work.

Study Design and Setting

We used Scopus data to August 1, 2024, and a search string for COVID-19-related publications. Authors of COVID-19 work were mapped against databases of top-cited authors.

Results

Scopus indexed 718,660 COVID-19-related publications. As the proportion of all indexed scientific publications, COVID-19-related publications peaked in September 2021 (4.7%) remained at 4.3%–4.6% for another year and then gradually declined but was still 1.9% in July 2024. COVID-19-related publications included 1,978,612 unique authors: 1,127,215 authors had ≥5 full papers in their career and 53,418 authors were in the top 2% of their scientific subfield. Authors with >10%, >30%, and >50% of their total career citations attributed to COVID-19-related publications were 376,942, 201,702, and 125,523, respectively. As of August 1, 2024, 65 of the top 100 most cited papers published in 2020 were COVID-19-related, declining to 24/100, 19/100, 7/100, and 5/100 for the most cited papers published in 2021, 2022, 2023, and 2024, respectively. Across 174 scientific subfields, 132 had ≥10% of their active influential (top 2% by composite citation indicator) authors publish something on COVID-19 during 2020–2024. Among the 300 authors with highest composite citation indicator specifically for their COVID-19-related publications, 41 were editors or journalists or columnists.

Conclusion

COVID-19 massively engaged the scientific workforce in unprecedented ways. As the pandemic ended, there has been a sharp decline in the overall volume and high impact of newly published COVID-19-related publications.

Plain Language Summary

We evaluated Scopus, a bibliometric database, for the increase and waning of the COVID-19 scientific literature. Until August 1, 2024, we identified 718,660 COVID-19-related publications indexed in Scopus that had involved 1,978,612 unique authors. The rise and subsequent decline pattern of COVID-19 publications was similar to other previous epidemics like Zika, Ebola, and H1N1, but at a far larger, unprecedented scale. 125,523 authors had >50% of their total career citations attributed to COVID-19 papers. 132/174 scientific subfields had at least one of every 10 of their top-cited authors publish something on COVID-19 during 2020–2024. Many influential authors were editors or journalists or columnists. Overall, COVID-19 massively engaged a huge number of authors and created a vast literature. As the interest has now sharply declined, one needs to examine what this immense COVID-19 scientific workforce will do in the future.
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引用次数: 0
Characteristics of search methods in dental meta-research studies: a methodological study.
IF 7.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-30 DOI: 10.1016/j.jclinepi.2025.111693
Leonie Weeber, Naichuan Su, Clovis Mariano Faggion

Background: Meta-research studies, defined as. "research on research", should transparently report search methods used to identify the assessed research. Currently, there is no published evaluation of search methods reporting in meta-research studies. The aim of this study was to assess the characteristics of search methods in dental meta-research studies and to identify factors associated with the completeness of the reported search strategies.

Methods: With a focus on the assessment of reporting quality and methodological quality, we searched in the Web of Science Core Collection database for dental meta-research studies published from the database's inception to February 13, 2024. The extracted data included the examined meta-research studies, characteristics of their authors and journals and search methods reporting of the examined studies. Logistic regression models were applied to examine the associations between relevant variables and search strategy reporting completeness.

Results: The search generated 3,774 documents, and 224 meta-research studies were included in the final analysis. Nearly all studies (99.6%) disclosed their general search methods, but only 130 studies (58%) provided both keywords and Boolean operators. Regression analyses indicated that meta-research studies published more recently, with prospective registration, with a shorter time between the searches and publication, a lack of language restrictions and librarian involvement were more likely to report a more complete search strategy.

Conclusion: The results highlight the importance of unrestricted language searches, structured methodologies and librarian support in improving the quality and transparency of reporting search strategies in dental meta-research.

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引用次数: 0
Supplementary databases increased literature search coverage beyond PubMed and Embase
IF 7.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-29 DOI: 10.1016/j.jclinepi.2025.111704
Tove Faber Frandsen , Caroline Moos , Cecilia Isabella Linnemann Herrera Marino , Mette Brandt Eriksen

Objectives

In health sciences, comprehensive literature searches are crucial for ensuring the accuracy and completeness of systematic reviews. Relying on only a few databases can lead to the omission of relevant studies. The variability in database coverage for different specialties means that important literature might be missed if searches are not broadened. Supplementary databases can enhance the thoroughness of literature reviews, but the efficiency and necessity of these additional searches remain subject to debate. This study aims to explore methods for retrieving publications not indexed in PubMed and Embase, examining coverage of various specialties to determine the most effective search strategies for systematic reviews.

Methods

We selected reviews from the following Cochrane review groups: public health, incontinence, hepato-biliary, and stroke groups. All reviews published in these groups between 2017 and 2022 were analyzed. Publications included in these reviews were manually searched for in PubMed and Embase. If the publication was not found, additional databases such as Cochrane Library, PsycInfo, CINAHL, and ClinicalTrials.gov were searched. Descriptive statistics were used to analyze the data.

Results

The mean coverage of publications in PubMed and Embase across all four speciality groups was 71.5%, with individual group coverage ranging from 64.5% to 75.9%. An average of 5.8% of publications could not be retrieved in any of the databases studied. Additional databases varied in their coverage.

Conclusion

While PubMed and Embase provide substantial coverage, supplementary databases can increase retrieval of more relevant studies and are essential for a comprehensive literature search.
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引用次数: 0
Meta-analysis of individual participant data and informed consent: a small step, but important and neglected 对个体参与者数据和知情同意进行元分析:一小步,但很重要,却被忽视了。
IF 7.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-27 DOI: 10.1016/j.jclinepi.2025.111692
Rafael Dal-Ré , Lars G. Hemkens
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引用次数: 0
Visualizing the value of diagnostic tests and prediction models, part III. Numerical example with discrete risk groups and miscalibration.
IF 7.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-27 DOI: 10.1016/j.jclinepi.2025.111691
Michael A Kohn, Thomas B Newman

Background and objectives: In this third of a 3-part series, we use net benefit (NB) graphs to evaluate a risk model that divides D-dimer results into 8 intervals to estimate the probability of pulmonary embolism (PE). This demonstrates the effect of miscalibration on NB graphs.

Method: We evaluate the risk model's performance using pooled data on 6013 participants from 5 PE diagnostic management studies. For a range of values of the "exchange rate" (w, the treatment threshold odds), we obtained NB of applying the risk model by subtracting the number of unnecessary treatments weighted by the exchange rate from the number of appropriate treatments and then dividing by the population size.

Results: In NB graphs, in which the x-axis is scaled linearly with the exchange rate w, miscalibration causes vertical changes in NB. If the risk model overestimates risk, as in this example, the NB graph for the risk model has vertical jumps up. These are due to the sudden gain in NB resulting from less overtreatment when the treatment threshold first exceeds the overestimated predicted risks.

Conclusion: Calculating NB is a logical approach to quantifying the value of a diagnostic test or risk prediction model. In the same dataset at the same treatment threshold probability, the risk model with the higher net benefit is the better model in that dataset. Most net benefit calculations omit the harm of doing the test or applying the risk model, but if it is nontrivial, this harm can be subtracted from the net benefit.

{"title":"Visualizing the value of diagnostic tests and prediction models, part III. Numerical example with discrete risk groups and miscalibration.","authors":"Michael A Kohn, Thomas B Newman","doi":"10.1016/j.jclinepi.2025.111691","DOIUrl":"10.1016/j.jclinepi.2025.111691","url":null,"abstract":"<p><strong>Background and objectives: </strong>In this third of a 3-part series, we use net benefit (NB) graphs to evaluate a risk model that divides D-dimer results into 8 intervals to estimate the probability of pulmonary embolism (PE). This demonstrates the effect of miscalibration on NB graphs.</p><p><strong>Method: </strong>We evaluate the risk model's performance using pooled data on 6013 participants from 5 PE diagnostic management studies. For a range of values of the \"exchange rate\" (w, the treatment threshold odds), we obtained NB of applying the risk model by subtracting the number of unnecessary treatments weighted by the exchange rate from the number of appropriate treatments and then dividing by the population size.</p><p><strong>Results: </strong>In NB graphs, in which the x-axis is scaled linearly with the exchange rate w, miscalibration causes vertical changes in NB. If the risk model overestimates risk, as in this example, the NB graph for the risk model has vertical jumps up. These are due to the sudden gain in NB resulting from less overtreatment when the treatment threshold first exceeds the overestimated predicted risks.</p><p><strong>Conclusion: </strong>Calculating NB is a logical approach to quantifying the value of a diagnostic test or risk prediction model. In the same dataset at the same treatment threshold probability, the risk model with the higher net benefit is the better model in that dataset. Most net benefit calculations omit the harm of doing the test or applying the risk model, but if it is nontrivial, this harm can be subtracted from the net benefit.</p>","PeriodicalId":51079,"journal":{"name":"Journal of Clinical Epidemiology","volume":" ","pages":"111691"},"PeriodicalIF":7.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
To adjust, or not to adjust, for multiple comparisons
IF 7.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-24 DOI: 10.1016/j.jclinepi.2025.111688
Richard Hooper
Questions often arise concerning when, whether, and how we should adjust our interpretation of the results from multiple hypothesis tests. Strong arguments have been put forward in the epidemiological literature against any correction or adjustment for multiplicity, but regulatory requirements (particularly for pharmaceutical trials) can sometimes trump other concerns. The formal basis for adjustment is often the control of error rates, and hence the problems of multiplicity may seem rooted in a purely frequentist paradigm, though this can be a restrictive viewpoint. Commentators may never wholly agree on any of these things. This article draws some of the key threads from the discussion and suggests further reading.
{"title":"To adjust, or not to adjust, for multiple comparisons","authors":"Richard Hooper","doi":"10.1016/j.jclinepi.2025.111688","DOIUrl":"10.1016/j.jclinepi.2025.111688","url":null,"abstract":"<div><div>Questions often arise concerning when, whether, and how we should adjust our interpretation of the results from multiple hypothesis tests. Strong arguments have been put forward in the epidemiological literature against any correction or adjustment for multiplicity, but regulatory requirements (particularly for pharmaceutical trials) can sometimes trump other concerns. The formal basis for adjustment is often the control of error rates, and hence the problems of multiplicity may seem rooted in a purely frequentist paradigm, though this can be a restrictive viewpoint. Commentators may never wholly agree on any of these things. This article draws some of the key threads from the discussion and suggests further reading.</div></div>","PeriodicalId":51079,"journal":{"name":"Journal of Clinical Epidemiology","volume":"180 ","pages":"Article 111688"},"PeriodicalIF":7.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pain and physical function are common core domains across 40 core outcome sets of musculoskeletal conditions: a systematic review 疼痛和身体功能是 40 个肌肉骨骼疾病核心结果组的共同核心领域:系统综述。
IF 7.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-24 DOI: 10.1016/j.jclinepi.2025.111687
Tamer S. Sabet , David B. Anderson , Peter W. Stubbs , Rachelle Buchbinder , Caroline B. Terwee , Alessandro Chiarotto , Joel Gagnier , Arianne P. Verhagen

Objectives

To determine common domains across existing musculoskeletal core outcome sets (COSs). Secondary aims were to assess the development quality of existing musculoskeletal COSs and whether development quality and patient participation was associated with domain selection.

Study Design and Setting

A systematic review of musculoskeletal COSs. We searched six databases from inception until December 2023. Studies were included if they reported on the development of a COS in adults with musculoskeletal conditions for any type of intervention. Quality was assessed using the Core Outcome Set-Standards for Development recommendations (COS-STAD). Data extracted included scope of the COS, health condition, interventions, and outcome domains. We defined a common core domain when present in >66% of all COSs. Analyses were performed using descriptive statistics.

Results

We included 51 studies reporting on 40 COSs, 25 were developed for research settings only, five for clinical settings only, and 10 for both. We identified 310 domains consisting of 255 mandatory or compulsory or not specified, 45 important, and 10 for further research. Pain (90%) and physical function (88%) were common core domains. COS development quality varied (range: 4–11 recommendations met); six COS met all standards. Domain definitions were provided in 13 COSs, 27 included patients or representatives in their development process, while nine met all recommendations for the consensus process. COSs involving patients were of higher quality (median: nine vs five for those not involving patients).

Conclusion

Pain and physical function core domains should be considered for inclusion in all new musculoskeletal COSs. Developers should follow COS development recommendations and include patients or their representatives.
{"title":"Pain and physical function are common core domains across 40 core outcome sets of musculoskeletal conditions: a systematic review","authors":"Tamer S. Sabet ,&nbsp;David B. Anderson ,&nbsp;Peter W. Stubbs ,&nbsp;Rachelle Buchbinder ,&nbsp;Caroline B. Terwee ,&nbsp;Alessandro Chiarotto ,&nbsp;Joel Gagnier ,&nbsp;Arianne P. Verhagen","doi":"10.1016/j.jclinepi.2025.111687","DOIUrl":"10.1016/j.jclinepi.2025.111687","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine common domains across existing musculoskeletal core outcome sets (COSs). Secondary aims were to assess the development quality of existing musculoskeletal COSs and whether development quality and patient participation was associated with domain selection.</div></div><div><h3>Study Design and Setting</h3><div>A systematic review of musculoskeletal COSs. We searched six databases from inception until December 2023. Studies were included if they reported on the development of a COS in adults with musculoskeletal conditions for any type of intervention. Quality was assessed using the Core Outcome Set-Standards for Development recommendations (COS-STAD). Data extracted included scope of the COS, health condition, interventions, and outcome domains. We defined a common core domain when present in &gt;66% of all COSs. Analyses were performed using descriptive statistics.</div></div><div><h3>Results</h3><div>We included 51 studies reporting on 40 COSs, 25 were developed for research settings only, five for clinical settings only, and 10 for both. We identified 310 domains consisting of 255 mandatory or compulsory or not specified, 45 important, and 10 for further research. Pain (90%) and physical function (88%) were common core domains. COS development quality varied (range: 4–11 recommendations met); six COS met all standards. Domain definitions were provided in 13 COSs, 27 included patients or representatives in their development process, while nine met all recommendations for the consensus process. COSs involving patients were of higher quality (median: nine vs five for those not involving patients).</div></div><div><h3>Conclusion</h3><div>Pain and physical function core domains should be considered for inclusion in all new musculoskeletal COSs. Developers should follow COS development recommendations and include patients or their representatives.</div></div>","PeriodicalId":51079,"journal":{"name":"Journal of Clinical Epidemiology","volume":"180 ","pages":"Article 111687"},"PeriodicalIF":7.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Visualizing the Value of Diagnostic Tests and Prediction Models, Part II. Net Benefit Graphs: Net Benefit as a Function of the Exchange Rate.
IF 7.3 2区 医学 Q1 HEALTH CARE SCIENCES & SERVICES Pub Date : 2025-01-24 DOI: 10.1016/j.jclinepi.2025.111690
Michael A Kohn, Thomas B Newman
{"title":"Visualizing the Value of Diagnostic Tests and Prediction Models, Part II. Net Benefit Graphs: Net Benefit as a Function of the Exchange Rate.","authors":"Michael A Kohn, Thomas B Newman","doi":"10.1016/j.jclinepi.2025.111690","DOIUrl":"https://doi.org/10.1016/j.jclinepi.2025.111690","url":null,"abstract":"","PeriodicalId":51079,"journal":{"name":"Journal of Clinical Epidemiology","volume":" ","pages":"111690"},"PeriodicalIF":7.3,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Journal of Clinical Epidemiology
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