{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:35:36Z","timestamp":1792787736928,"version":"4.5.0"},"reference-count":46,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Delirium complicates 20% to 62% of the estimated 1.5 million hip fractures annually. Meta-analyses suggest that point-of-care ultrasound-guided regional anesthesia (POCUS-GRA) may reduce delirium, but uptake by emergency department (ED) physicians is highly variable.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n To measure the impact of a knowledge-to-practice intervention on uptake of POCUS-GRA by ED physicians, incidence and number of days of delirium, analgesic effectiveness, safety, and procedure time.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This stepped-wedge cluster randomized clinical trial was conducted at 7 academic EDs from 4 provinces in Canada. The order in which ED physicians were trained at each site was randomized. ED physicians working at least 1 shift per week who did not regularly perform POCUS-GRA and patients aged 65 years and older with a hip fracture who were not delirious on arrival were included. Data were analyzed in August 2025.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n A 2-hour structured training session on fascia iliaca blocks was followed by competency assessment, with a procedure bundle and email reminders provided.<\/jats:p>\n <\/jats:sec>\n \n Main Outcome and Measures<\/jats:title>\n Incidence of delirium within 7 days of ED presentation was measured using the Confusion Assessment Method, and duration of delirium was measured in days.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 208 of 213 ED physicians (97.7%) who assessed 694 eligible patients with hip fracture (median [IQR] age, 81.0 [74.0-88.0] years; 483 female [69.6%]) were trained. Among these patients, 248 individuals were analyzed prior to training per intention-to-treat analysis, including 6 with protocol violations (control group), and 446 individuals after training (intervention group). The intervention increased blocks from 6 of 264 patients (2.2%) to 236 of 446 patients (52.9%) after training, for a change of 51.7%. After adjustment for a priori confounders, time, and clustering by site, delirium risk in the intervention group was reduced (odds ratio, 0.72; 95% CI, 0.57-0.93). Mean days of delirium was not reduced. Among 186 nerve blocks with pain effectiveness data, most nerve blocks were effective (107 nerve blocks [57.5%]with \u226550% pain reduction), quick (median [IQR] time, 15 [12-20] minutes; 113 nerve blocks [90.0%] &amp;lt;25 minutes), and safe (1 minor hematoma).<\/jats:p>\n <\/jats:sec>\n \n Conclusion and Relevance<\/jats:title>\n In this study, a knowledge-to-practice intervention improved nerve block uptake, and nerve blocks were quick, safe, and mostly effective. Despite suboptimal uptake, the study adds to the evidence that POCUS-GRA reduces delirium.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT02892968<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.49337","type":"journal-article","created":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T16:31:08Z","timestamp":1765816268000},"page":"e2549337","source":"Crossref","is-referenced-by-count":11,"title":["Ultrasound-Guided Regional Anesthesia by Emergency Physicians for Hip Fractures and Delirium"],"prefix":"10.1001","volume":"8","author":[{"given":"Jacques S.","family":"Lee","sequence":"first","affiliation":[{"name":"Schwartz\/Reisman Emergency Medicine Institute, Sinai Health, Toronto, Ontario, Canada"},{"name":"University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Emergency Service, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan","family":"Chenkin","sequence":"additional","affiliation":[{"name":"University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Simard","sequence":"additional","affiliation":[{"name":"University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Emergency Service, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tina","family":"Bhandari","sequence":"additional","affiliation":[{"name":"University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Emergency Service, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Y.","family":"Woo","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada"},{"name":"University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffery J.","family":"Perry","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada"},{"name":"University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra","family":"Eagles","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada"},{"name":"University of Ottawa, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Wong","sequence":"additional","affiliation":[{"name":"University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew D.","family":"McRae","sequence":"additional","affiliation":[{"name":"University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eddy","family":"Lang","sequence":"additional","affiliation":[{"name":"University of Calgary, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Newbigging","sequence":"additional","affiliation":[{"name":"Queen\u2019s University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco L. A.","family":"Sivilotti","sequence":"additional","affiliation":[{"name":"Queen\u2019s University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Chernoff","sequence":"additional","affiliation":[{"name":"Schwartz\/Reisman Emergency Medicine Institute, Sinai Health, Toronto, Ontario, Canada"},{"name":"University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bjug","family":"Borgundvaag","sequence":"additional","affiliation":[{"name":"Schwartz\/Reisman Emergency Medicine Institute, Sinai Health, Toronto, Ontario, Canada"},{"name":"University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley L.","family":"McLeod","sequence":"additional","affiliation":[{"name":"Schwartz\/Reisman Emergency Medicine Institute, Sinai Health, Toronto, Ontario, Canada"},{"name":"University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald","family":"Melady","sequence":"additional","affiliation":[{"name":"Schwartz\/Reisman Emergency Medicine Institute, Sinai Health, Toronto, Ontario, Canada"},{"name":"University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Kiss","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, Sunnybrook Research Institute, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel","family":"\u00c9mond","sequence":"additional","affiliation":[{"name":"Axe Sant\u00e9 des Populations et Pratiques Optimales en Sant\u00e9, Centre de Recherch\u00e9 du Centre Hospitalier Universitaire de Qu\u00e9bec-Universit\u00e9 Laval, Qu\u00e9bec, Canada"},{"name":"Depart\u00e9ment de Med\u00e9cine d\u2019Urgence, Centre Hospitalier Universitaire de Qu\u00e9bec-Universit\u00e9 Laval, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2025,12,15]]},"reference":[{"issue":"5","key":"zoi251326r1","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1159\/000017163","article-title":"Clinical profile of delirium in patients treated for femoral neck fractures.","volume":"10","author":"Edlund","year":"1999","journal-title":"Dement Geriatr Cogn Disord"},{"issue":"11","key":"zoi251326r2","doi-asserted-by":"publisher","first-page":"1157","DOI":"10.1056\/NEJMra052321","article-title":"Delirium in older persons.","volume":"354","author":"Inouye","year":"2006","journal-title":"N Engl J Med"},{"issue":"9","key":"zoi251326r3","doi-asserted-by":"publisher","first-page":"696","DOI":"10.1046\/j.1525-1497.2003.20602.x","article-title":"The course of delirium in older medical inpatients: a prospective study.","volume":"18","author":"McCusker","year":"2003","journal-title":"J Gen Intern Med"},{"issue":"4","key":"zoi251326r4","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1001\/archinte.162.4.457","article-title":"Delirium predicts 12-month mortality.","volume":"162","author":"McCusker","year":"2002","journal-title":"Arch Intern Med"},{"issue":"5","key":"zoi251326r5","doi-asserted-by":"publisher","first-page":"810","DOI":"10.1111\/j.1365-2702.2006.01806.x","article-title":"Patients\u2019 experiences of being delirious.","volume":"16","author":"Duppils","year":"2007","journal-title":"J Clin Nurs"},{"issue":"11","key":"zoi251326r6","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1007\/s00198-004-1627-0","article-title":"An estimate of the worldwide prevalence, mortality and disability associated with hip fracture.","volume":"15","author":"Johnell","year":"2004","journal-title":"Osteoporos Int"},{"issue":"10","key":"zoi251326r7","doi-asserted-by":"publisher","first-page":"2791","DOI":"10.1007\/s00198-017-4153-6","article-title":"Costs of fragility hip fractures globally: a systematic review and meta-regression analysis.","volume":"28","author":"Williamson","year":"2017","journal-title":"Osteoporos Int"},{"issue":"4","key":"zoi251326r9","doi-asserted-by":"publisher","first-page":"234","DOI":"10.7326\/0003-4819-155-4-201108160-00346","article-title":"Comparative effectiveness of pain management interventions for hip fracture: a systematic review.","volume":"155","author":"Abou-Setta","year":"2011","journal-title":"Ann Intern Med"},{"key":"zoi251326r10","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.937293","article-title":"Effect of regional anesthesia on the postoperative delirium: a systematic review and meta-analysis of randomized controlled trials.","volume":"9","author":"Li","year":"2022","journal-title":"Front Surg"},{"issue":"3","key":"zoi251326r11","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1016\/j.jemermed.2006.08.011","article-title":"Single fascia iliaca compartment block for post-hip fracture pain relief.","volume":"32","author":"Godoy Monzon","year":"2007","journal-title":"J Emerg Med"},{"issue":"3","key":"zoi251326r12","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s10195-009-0062-6","article-title":"Fascia iliaca block prophylaxis for hip fracture patients at risk for delirium: a randomized placebo-controlled study.","volume":"10","author":"Mouzopoulos","year":"2009","journal-title":"J Orthop Traumatol"},{"issue":"2","key":"zoi251326r13","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1067\/mem.2003.51","article-title":"Three-in-one femoral nerve block as analgesia for fractured neck of femur in the emergency department: a randomized, controlled trial.","volume":"41","author":"Fletcher","year":"2003","journal-title":"Ann Emerg Med"},{"issue":"5","key":"zoi251326r14","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1016\/j.jemermed.2013.04.051","article-title":"A brief educational intervention is effective in teaching the femoral nerve block procedure to first-year emergency medicine residents.","volume":"45","author":"Akhtar","year":"2013","journal-title":"J Emerg Med"},{"issue":"5","key":"zoi251326r15","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1097\/ACO.0000000000000638","article-title":"Did ultrasound fulfill the promise of safety in regional anesthesia?","volume":"31","author":"Barrington","year":"2018","journal-title":"Curr Opin Anaesthesiol"},{"issue":"4","key":"zoi251326r16","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1016\/j.jemermed.2012.01.050","article-title":"Ultrasound-guided fascia iliaca compartment block for hip fractures in the emergency department.","volume":"43","author":"Haines","year":"2012","journal-title":"J Emerg Med"},{"issue":"6","key":"zoi251326r17","doi-asserted-by":"publisher","first-page":"584","DOI":"10.1136\/rapm-00115550-199823060-00013","article-title":"Ultrasonographic guidance reduces the amount of local anesthetic for 3-in-1 blocks.","volume":"23","author":"Marhofer","year":"1998","journal-title":"Reg Anesth Pain Med"},{"issue":"1","key":"zoi251326r18","doi-asserted-by":"publisher","first-page":"16","DOI":"10.5770\/cgj.16.52","article-title":"Survey of current practices: peripheral nerve block utilization by ED physicians for treatment of pain in the hip fracture patient population.","volume":"16","author":"Haslam","year":"2013","journal-title":"Can Geriatr J"},{"issue":"1","key":"zoi251326r19","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1016\/j.bja.2021.10.011","article-title":"Hospital-, anaesthetist-, and patient-level variation in peripheral nerve block utilisation for hip fracture surgery: a population-based cross-sectional study.","volume":"128","author":"McGinn","year":"2022","journal-title":"Br J Anaesth"},{"issue":"7","key":"zoi251326r20","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-047113","article-title":"Point-of-care ultrasound-guided regional anaesthesia in older ED patients with hip fractures: a study to test the feasibility of a training programme and time needed to complete nerve blocks by ED physicians after training.","volume":"11","author":"Lee","year":"2021","journal-title":"BMJ Open"},{"issue":"3","key":"zoi251326r21","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1136\/jme.2002.000919","article-title":"Capacity, consent, and selection bias in a study of delirium.","volume":"31","author":"Adamis","year":"2005","journal-title":"J Med Ethics"},{"issue":"2","key":"zoi251326r22","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1016\/j.cct.2006.05.007","article-title":"Design and analysis of stepped wedge cluster randomized trials.","volume":"28","author":"Hussey","year":"2007","journal-title":"Contemp Clin Trials"},{"issue":"3","key":"zoi251326r23","doi-asserted-by":"publisher","first-page":"1043","DOI":"10.1093\/ije\/dyaa077","article-title":"Reflection on modern methods: when is a stepped-wedge cluster randomized trial a good study design choice?","volume":"49","author":"Hemming","year":"2020","journal-title":"Int J Epidemiol"},{"issue":"12","key":"zoi251326r24","doi-asserted-by":"publisher","first-page":"941","DOI":"10.7326\/0003-4819-113-12-941","article-title":"Clarifying confusion: the confusion assessment method: a new method for detection of delirium.","volume":"113","author":"Inouye","year":"1990","journal-title":"Ann Intern Med"},{"issue":"3","key":"zoi251326r26","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-019652","article-title":"Diagnostic accuracy of the Ottawa 3DY and Short Blessed Test to detect cognitive dysfunction in geriatric patients presenting to the emergency department.","volume":"8","author":"Barbic","year":"2018","journal-title":"BMJ Open"},{"issue":"6","key":"zoi251326r27","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1176\/ajp.140.6.734","article-title":"Validation of a short orientation-memory-concentration test of cognitive impairment.","volume":"140","author":"Katzman","year":"1983","journal-title":"Am J Psychiatry"},{"issue":"11","key":"zoi251326r28","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1002\/1099-1166(200011)15:11<1021::AID-GPS234>3.0.CO;2-6","article-title":"The Mini-Cog: a cognitive \u2018vital signs\u2019 measure for dementia screening in multi-lingual elderly.","volume":"15","author":"Borson","year":"2000","journal-title":"Int J Geriatr Psychiatry"},{"issue":"10","key":"zoi251326r29","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1164\/rccm.2107138","article-title":"The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients.","volume":"166","author":"Sessler","year":"2002","journal-title":"Am J Respir Crit Care Med"},{"issue":"10","key":"zoi251326r30","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1111\/j.1532-5415.2004.52471.x","article-title":"The delirium index, a measure of the severity of delirium: new findings on reliability, validity, and responsiveness.","volume":"52","author":"McCusker","year":"2004","journal-title":"J Am Geriatr Soc"},{"issue":"4","key":"zoi251326r31","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1111\/j.1553-2712.2011.01040.x","article-title":"Four sensitive screening tools to detect cognitive dysfunction in geriatric emergency department patients: brief Alzheimer\u2019s Screen, Short Blessed Test, Ottawa 3DY, and the caregiver-completed AD8.","volume":"18","author":"Carpenter","year":"2011","journal-title":"Acad Emerg Med"},{"issue":"12","key":"zoi251326r32","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1111\/j.1532-5415.1983.tb03391.x","article-title":"Assessing self-maintenance: activities of daily living, mobility, and instrumental activities of daily living.","volume":"31","author":"Katz","year":"1983","journal-title":"J Am Geriatr Soc"},{"issue":"2","key":"zoi251326r33","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1111\/j.1532-5415.2005.53120.x","article-title":"A chart-based method for identification of delirium: validation compared with interviewer ratings using the confusion assessment method.","volume":"53","author":"Inouye","year":"2005","journal-title":"J Am Geriatr Soc"},{"issue":"6","key":"zoi251326r34","doi-asserted-by":"crossref","first-page":"474","DOI":"10.7326\/0003-4819-119-6-199309150-00005","article-title":"A predictive model for delirium in hospitalized elderly medical patients based on admission characteristics.","volume":"119","author":"Inouye","year":"1993","journal-title":"Ann Intern Med"},{"issue":"10","key":"zoi251326r35","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1197\/S1069-6563(03)00372-5","article-title":"Clinically important change in the visual analog scale after adequate pain control.","volume":"10","author":"Lee","year":"2003","journal-title":"Acad Emerg Med"},{"issue":"1","key":"zoi251326r36","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1017\/cem.2015.75","article-title":"Regional nerve blocks for hip and femoral neck fractures in the emergency department: a systematic review.","volume":"18","author":"Ritcey","year":"2016","journal-title":"CJEM"},{"issue":"4","key":"zoi251326r37","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1007\/s12245-010-0234-4","article-title":"Pain treatment in post-traumatic hip fracture in the elderly: regional block vs. systemic non-steroidal analgesics.","volume":"3","author":"Godoy Monz\u00f3n","year":"2010","journal-title":"Int J Emerg Med"},{"issue":"6","key":"zoi251326r38","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1097\/00000542-200506000-00020","article-title":"Effect of postoperative epidural analgesia on rehabilitation and pain after hip fracture surgery: a randomized, double-blind, placebo-controlled trial.","volume":"102","author":"Foss","year":"2005","journal-title":"Anesthesiology"},{"issue":"4","key":"zoi251326r39","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1177\/102490790801500403","article-title":"A pilot randomised clinical trial of 3-in-1 femoral nerve block and intravenous morphine as primary analgesia for patients presenting to the emergency department with fractured hip.","volume":"15","author":"Graham","year":"2008","journal-title":"Hong Kong J Emerg Med"},{"issue":"1","key":"zoi251326r40","doi-asserted-by":"crossref","DOI":"10.1016\/j.otsr.2021.103151","article-title":"The effect of regional nerve block on perioperative delirium in hip fracture surgery for the elderly: a systematic review and meta-analysis of randomized controlled trials.","volume":"108","author":"Kim","year":"2022","journal-title":"Orthop Traumatol Surg Res"},{"issue":"5","key":"zoi251326r43","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1136\/rapm-2020-102315","article-title":"Pericapsular nerve group (PENG) block provides improved short-term analgesia compared with the femoral nerve block in hip fracture surgery: a single-center double-blinded randomized comparative trial.","volume":"46","author":"Lin","year":"2021","journal-title":"Reg Anesth Pain Med"},{"issue":"3","key":"zoi251326r44","first-page":"95","article-title":"Comparison of conventional infrainguinal versus modified proximal suprainguinal approach of fascia iliaca compartment block for postoperative analgesia in total hip arthroplasty. a prospective randomized study.","volume":"66","author":"Kumar","year":"2015","journal-title":"Acta Anaesthesiol Belg"},{"key":"zoi251326r45","doi-asserted-by":"crossref","DOI":"10.1016\/j.jclinepi.2025.111838","article-title":"The performance of small sample correction methods for controlling type I error when analyzing parallel cluster randomized trials: a systematic review of simulation studies.","volume":"185","author":"Hemming","year":"2025","journal-title":"J Clin Epidemiol"},{"key":"zoi251326r46","doi-asserted-by":"crossref","first-page":"k1614","DOI":"10.1136\/bmj.k1614","article-title":"Reporting of stepped wedge cluster randomised trials: extension of the CONSORT 2010 statement with explanation and elaboration.","volume":"363","author":"Hemming","year":"2018","journal-title":"BMJ"},{"key":"zoi251326r8","volume-title":"Pain Management Interventions for Hip Fracture","author":"Abou-Setta","year":"2011"},{"key":"zoi251326r25","volume-title":"The CAM-S Score for Delirium Severity: Training Manual and Coding Guide","author":"Inouye","year":"2014"},{"key":"zoi251326r41","unstructured":"Health Quality Ontario. Quality statement 3: mulitmodal analgesia. 2024. Accessed November 10, 2025. https:\/\/www.hqontario.ca\/Evidence-to-Improve-Care\/Quality-Standards\/View-all-Quality-Standards\/Hip-Fracture\/Quality-Statement-3-Multimodal-Analgesia"},{"key":"zoi251326r42","unstructured":"Australian and New Zealand Hip Fracture Registry. Annual report 2023. Accessed November 10, 2025. https:\/\/anzhfr.org\/wp-content\/uploads\/sites\/1164\/2023\/09\/ANZHFR-2023-Annual-Report-%E2%80%93-eReport-%E2%80%93-FINAL.pdf"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2842817\/lee_2025_oi_251326_1765214655.4929.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T16:31:13Z","timestamp":1765816273000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2842817"}},"subtitle":["A Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2025,12,15]]},"references-count":46,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.49337","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,15]]}}}