{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:48:45Z","timestamp":1792586925122,"version":"4.5.0"},"reference-count":49,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi251508-4\">\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Respiratory syncytial virus (RSV) may trigger cardiorespiratory events in adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251508-5\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the risk of cardiorespiratory events in the 180 days following RSV-related hospitalization compared with a control period in adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251508-6\">\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This self-controlled case series study had an observation period from January 1, 2017, through March 31, 2024. Data were obtained from the deidentified Optum Market Clarity Dataset, including RSV-related hospitalization and associated outcomes, which were identified based on diagnosis codes. Adults with 1 or more RSV-related hospitalizations and 1 or more cardiorespiratory events (myocardial infarction [MI], stroke, chronic obstructive pulmonary disease [COPD] exacerbation, congestive heart failure [CHF] exacerbation, and arrhythmia) were included.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251508-7\">\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>RSV-related hospitalization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251508-8\">\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>A conditional Poisson regression model was fitted to compare the incidence of cardiorespiratory events during the risk period (ie, \u2264180 days after RSV-related hospital index date) and control periods (ie, &amp;amp;gt;21 days before or &amp;amp;gt;180 days after the index date). Incidence rate ratios (IRRs) and 95% CIs were estimated and adjusted for time-varying covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251508-9\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 11\u202f887 patients (mean [SD] age, 69.4 [15.5] years; 7303 females [61.4%]) with RSV-related hospitalization were included. An increased risk was associated with each cardiorespiratory event during the first 14 days following RSV-related hospitalization, with the highest IRR estimates observed in the initial 7 days. For MI, the IRRs were 8.7 (95% CI, 6.7-11.2) during days 1 to 7, decreasing to 5.2 (95% CI, 3.7-7.2) during days 8 to 14 and 2.6 (95% CI, 1.6-4.3) during days 15 to 21. For stroke, the IRRs were 7.4 (95% CI, 5.5-10.1), 5.9 (95% CI, 4.2-8.3), and 3.7 (95% CI, 2.3-5.9) during the first 3 weeks with a similar pattern for CHF exacerbation (12.5 [95% CI, 10.5-14.8], 4.1 [95% CI, 3.1-5.5], and 2.4 [95% CI, 1.6-3.6], respectively). For COPD exacerbation and arrhythmia, the IRRs decreased during the first 3 weeks from 23.1 (95% CI, 20.2-26.5) through day 7 to 1.3 (95% CI, 0.8-2.4) during days 15 to 21 and from 16.5 (95% CI, 14.5-18.7) to 1.6 (95% CI, 1.1-2.5), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"ab-zoi251508-10\">\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>This study demonstrated that RSV, similar to influenza and SARS-CoV-2, was associated with an increased risk of cardiorespiratory events 2 weeks following RSV-related hospitalization, and some conditions had significant risk elevations up to 180 days after admission. The findings reinforce the need to increase RSV immunization in adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.56767","type":"journal-article","created":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T16:00:30Z","timestamp":1770134430000},"page":"e2556767","source":"Crossref","is-referenced-by-count":13,"title":["Risk of Cardiorespiratory Events Following Respiratory Syncytial Virus\u2013Related Hospitalization"],"prefix":"10.1001","volume":"9","author":[{"given":"Caihua","family":"Liang","sequence":"first","affiliation":[{"name":"Vaccines Real-World Evidence (RWE) Epidemiology, Pfizer Inc, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Judy","sequence":"additional","affiliation":[{"name":"Vaccines Real-World Evidence (RWE) Epidemiology, Pfizer Inc, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Negar","family":"Aliabadi","sequence":"additional","affiliation":[{"name":"US Medical Affairs, Vaccines, Pfizer Inc, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reiko","family":"Sato","sequence":"additional","affiliation":[{"name":"Health Technology Assessment (HTA) Value and Evidence, Pfizer Inc, Collegeville, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Chilson","sequence":"additional","affiliation":[{"name":"US Medical Affairs, Vaccines, Pfizer Inc, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Zhou","sequence":"additional","affiliation":[{"name":"RWE Health Economics and Outcomes Research (HEOR) Scientific Solutions Division, Genesis Research Group, Hoboken, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zhao","sequence":"additional","affiliation":[{"name":"RWE Health Economics and Outcomes Research (HEOR) Scientific Solutions Division, Genesis Research Group, Hoboken, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradford D.","family":"Gessner","sequence":"additional","affiliation":[{"name":"US Medical Affairs, Vaccines, Pfizer Inc, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Begier","sequence":"additional","affiliation":[{"name":"Global Medical Strategy, Pfizer Inc, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,2,3]]},"reference":[{"issue":"3","key":"zoi251508r1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.36342","article-title":"Respiratory syncytial virus: a comprehensive review of transmission, pathophysiology, and manifestation.","volume":"15","author":"Kaler","year":"2023","journal-title":"Cureus"},{"issue":"7","key":"zoi251508r2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofac300","article-title":"Rates of medically attended RSV among US adults: a systematic review and meta-analysis.","volume":"9","author":"McLaughlin","year":"2022","journal-title":"Open Forum Infect Dis"},{"issue":"4","key":"zoi251508r3","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1007\/s40266-015-0258-9","article-title":"Respiratory syncytial virus infection in older adults: an under-recognized problem.","volume":"32","author":"Branche","year":"2015","journal-title":"Drugs Aging"},{"issue":"11","key":"zoi251508r4","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofad513","article-title":"Systematic literature review of risk factors for poor outcomes among adults with respiratory syncytial virus infection in high-income countries.","volume":"10","author":"Njue","year":"2023","journal-title":"Open Forum Infect Dis"},{"key":"zoi251508r5","doi-asserted-by":"publisher","first-page":"S71","DOI":"10.1093\/infdis\/jiab452","article-title":"World Health Organization influenza-like illness underestimates the burden of respiratory syncytial virus infection in community-dwelling older adults.","volume":"226","author":"Korsten","year":"2022","journal-title":"J Infect Dis"},{"issue":"6","key":"zoi251508r6","doi-asserted-by":"publisher","first-page":"1487","DOI":"10.1007\/s40121-023-00802-4","article-title":"Incidence of respiratory syncytial virus infection in older adults: limitations of current data.","volume":"12","author":"Rozenbaum","year":"2023","journal-title":"Infect Dis Ther"},{"issue":"2","key":"zoi251508r7","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1007\/s40121-023-00758-5","article-title":"Low levels of RSV testing among adults hospitalized for lower respiratory tract infection in the United States.","volume":"12","author":"Rozenbaum","year":"2023","journal-title":"Infect Dis Ther"},{"issue":"6","key":"zoi251508r8","doi-asserted-by":"publisher","first-page":"1593","DOI":"10.1007\/s40121-023-00805-1","article-title":"Diagnosis of respiratory syncytial virus in adults substantially increases when adding sputum, saliva, and serology testing to nasopharyngeal swab RT-PCR.","volume":"12","author":"Ramirez","year":"2023","journal-title":"Infect Dis Ther"},{"key":"zoi251508r9","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiaf204","article-title":"Detection by nasopharyngeal swabs alone underestimates respiratory syncytial virus\u2013related hospitalization incidence in adults: the Multispecimen Study\u2019s final analysis.","author":"Begier","year":"2025","journal-title":"J Infect Dis"},{"issue":"4","key":"zoi251508r10","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1007\/s40121-023-00792-3","article-title":"Adjusting for case under-ascertainment in estimating RSV hospitalisation burden of older adults in high-income countries: a systematic review and modelling study.","volume":"12","author":"Li","year":"2023","journal-title":"Infect Dis Ther"},{"issue":"8","key":"zoi251508r12","doi-asserted-by":"publisher","first-page":"2134","DOI":"10.3390\/cells10082134","article-title":"Implications of innate immunity in post-acute sequelae of non-persistent viral infections.","volume":"10","author":"Hirschenberger","year":"2021","journal-title":"Cells"},{"key":"zoi251508r13","doi-asserted-by":"publisher","first-page":"n1098","DOI":"10.1136\/bmj.n1098","article-title":"Risk of clinical sequelae after the acute phase of SARS-CoV-2 infection: retrospective cohort study.","volume":"373","author":"Daugherty","year":"2021","journal-title":"BMJ"},{"issue":"3","key":"zoi251508r14","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1016\/S1473-3099(23)00762-4","article-title":"Post-viral sequelae of COVID-19 and influenza.","volume":"24","author":"Gandhi","year":"2024","journal-title":"Lancet Infect Dis"},{"issue":"14","key":"zoi251508r15","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1016\/j.jacc.2018.02.013","article-title":"Respiratory syncytial virus and associations with cardiovascular disease in adults.","volume":"71","author":"Ivey","year":"2018","journal-title":"J Am Coll Cardiol"},{"issue":"4","key":"zoi251508r16","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1007\/s40121-024-00951-0","article-title":"Estimated incidence of hospitalizations and deaths attributable to respiratory syncytial virus infections among adults in Germany between 2015 and 2019.","volume":"13","author":"Polkowska-Kramek","year":"2024","journal-title":"Infect Dis Ther"},{"issue":"7","key":"zoi251508r17","doi-asserted-by":"publisher","first-page":"1399","DOI":"10.1007\/s40121-024-00974-7","article-title":"Respiratory syncytial virus sequelae among adults in high-income countries: a systematic literature review and meta-analysis.","volume":"13","author":"Ubamadu","year":"2024","journal-title":"Infect Dis Ther"},{"issue":"40","key":"zoi251508r18","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.15585\/mmwr.mm7240a2","article-title":"Disease severity of respiratory syncytial virus compared with COVID-19 and influenza among hospitalized adults aged =60 years\u2014IVY Network, 20 U.S. states, February 2022-May 2023.","volume":"72","author":"Surie","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"2","key":"zoi251508r19","doi-asserted-by":"publisher","first-page":"197","DOI":"10.1093\/cid\/ciy991","article-title":"Severe morbidity and mortality associated with respiratory syncytial virus versus influenza infection in hospitalized older adults.","volume":"69","author":"Ackerson","year":"2019","journal-title":"Clin Infect Dis"},{"issue":"6","key":"zoi251508r20","doi-asserted-by":"publisher","DOI":"10.1093\/ehjopen\/oead120","article-title":"Risk of arrhythmias following COVID-19: nationwide self-controlled case series and matched cohort study.","volume":"3","author":"Katsoularis","year":"2023","journal-title":"Eur Heart J Open"},{"issue":"12","key":"zoi251508r21","doi-asserted-by":"publisher","first-page":"1805","DOI":"10.1017\/S0950268811001531","article-title":"Use of the self-controlled case-series method in vaccine safety studies: review and recommendations for best practice.","volume":"139","author":"Weldeselassie","year":"2011","journal-title":"Epidemiol Infect"},{"issue":"10300","key":"zoi251508r22","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1016\/S0140-6736(21)00896-5","article-title":"Risk of acute myocardial infarction and ischaemic stroke following COVID-19 in Sweden: a self-controlled case series and matched cohort study.","volume":"398","author":"Katsoularis","year":"2021","journal-title":"Lancet"},{"issue":"4","key":"zoi251508r23","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1056\/NEJMoa1702090","article-title":"Acute myocardial infarction after laboratory-confirmed influenza infection.","volume":"378","author":"Kwong","year":"2018","journal-title":"N Engl J Med"},{"issue":"3","key":"zoi251508r24","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01794-2017","article-title":"Laboratory-confirmed respiratory infections as triggers for acute myocardial infarction and stroke: a self-controlled case series analysis of national linked datasets from Scotland.","volume":"51","author":"Warren-Gash","year":"2018","journal-title":"Eur Respir J"},{"issue":"1","key":"zoi251508r25","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1093\/biostatistics\/kxn013","article-title":"Case series analysis for censored, perturbed, or curtailed post-event exposures.","volume":"10","author":"Farrington","year":"2009","journal-title":"Biostatistics"},{"issue":"3","key":"zoi251508r26","doi-asserted-by":"publisher","first-page":"274","DOI":"10.1001\/jamacardio.2016.0433","article-title":"Seasonal influenza infections and cardiovascular disease mortality.","volume":"1","author":"Nguyen","year":"2016","journal-title":"JAMA Cardiol"},{"issue":"6","key":"zoi251508r27","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.11806","article-title":"Estimated cardiorespiratory hospitalizations attributable to influenza and respiratory syncytial virus among long-term care facility residents.","volume":"4","author":"Bosco","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"1","key":"zoi251508r28","doi-asserted-by":"publisher","first-page":"71","DOI":"10.3390\/biomedicines11010071","article-title":"Cardiovascular complications of viral respiratory infections and COVID-19.","volume":"11","author":"Franczuk","year":"2022","journal-title":"Biomedicines"},{"issue":"10","key":"zoi251508r29","doi-asserted-by":"publisher","first-page":"1348","DOI":"10.1161\/01.CIR.99.10.1348","article-title":"Detection of adenoviral genome in the myocardium of adult patients with idiopathic left ventricular dysfunction.","volume":"99","author":"Pauschinger","year":"1999","journal-title":"Circulation"},{"issue":"9","key":"zoi251508r30","doi-asserted-by":"publisher","first-page":"2753","DOI":"10.4103\/jfmpc.jfmpc_86_19","article-title":"Asthma exacerbation related to viral infections: an up to date summary.","volume":"8","author":"Adeli","year":"2019","journal-title":"J Family Med Prim Care"},{"issue":"151","key":"zoi251508r31","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0063-2018","article-title":"Respiratory viral infection: a potential \u201cmissing link\u201d in the pathogenesis of COPD.","volume":"28","author":"Linden","year":"2019","journal-title":"Eur Respir Rev"},{"issue":"1","key":"zoi251508r32","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1136\/thorax.58.1.37","article-title":"Respiratory viruses in exacerbations of chronic obstructive pulmonary disease requiring hospitalisation: a case-control study.","volume":"58","author":"Rohde","year":"2003","journal-title":"Thorax"},{"issue":"175","key":"zoi251508r33","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0197-2024","article-title":"The risk of cardiovascular, cerebrovascular and thromboembolic events after community-acquired pneumonia among adults: a systematic literature review.","volume":"34","author":"Theilacker","year":"2025","journal-title":"Eur Respir Rev"},{"issue":"14","key":"zoi251508r34","doi-asserted-by":"publisher","first-page":"1504","DOI":"10.1016\/j.jacc.2025.02.031","article-title":"Respiratory syncytial virus and incidence of cardiovascular events: a nationwide self-controlled case series analysis.","volume":"85","author":"Lassen","year":"2025","journal-title":"J Am Coll Cardiol"},{"issue":"6","key":"zoi251508r35","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1001\/jamainternmed.2024.0212","article-title":"Acute cardiac events in hospitalized older adults with respiratory syncytial virus infection.","volume":"184","author":"Woodruff","year":"2024","journal-title":"JAMA Intern Med"},{"issue":"10","key":"zoi251508r36","doi-asserted-by":"publisher","first-page":"2587","DOI":"10.1016\/j.mayocp.2021.07.002","article-title":"Thromboembolic risk in hospitalized and nonhospitalized COVID-19 patients: a self-controlled case series analysis of a nationwide cohort.","volume":"96","author":"Ho","year":"2021","journal-title":"Mayo Clin Proc"},{"issue":"5","key":"zoi251508r37","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.11764","article-title":"Cardiac events in adults hospitalized for respiratory syncytial virus vs COVID-19 or influenza.","volume":"8","author":"Wee","year":"2025","journal-title":"JAMA Netw Open"},{"issue":"3","key":"zoi251508r38","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1016\/S0735-1097(03)00648-X","article-title":"Detection of viruses in myocardial tissues by polymerase chain reaction. Evidence of adenovirus as a common cause of myocarditis in children and adults.","volume":"42","author":"Bowles","year":"2003","journal-title":"J Am Coll Cardiol"},{"issue":"4","key":"zoi251508r39","doi-asserted-by":"publisher","first-page":"523","DOI":"10.1016\/j.iac.2010.08.006","article-title":"Respiratory syncytial virus infections in the adult asthmatic\u2013mechanisms of host susceptibility and viral subversion.","volume":"30","author":"Westerly","year":"2010","journal-title":"Immunol Allergy Clin North Am"},{"issue":"1","key":"zoi251508r40","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1080\/15412550902724024","article-title":"Recognizing the importance of respiratory syncytial virus in chronic obstructive pulmonary disease.","volume":"6","author":"Ramaswamy","year":"2009","journal-title":"COPD"},{"issue":"8","key":"zoi251508r41","doi-asserted-by":"publisher","first-page":"994","DOI":"10.1164\/rccm.202308-1320OC","article-title":"Respiratory syncytial virus-related community chronic obstructive pulmonary disease exacerbations and novel diagnostics: a binational prospective cohort study.","volume":"210","author":"Wiseman","year":"2024","journal-title":"Am J Respir Crit Care Med"},{"issue":"4","key":"zoi251508r42","doi-asserted-by":"publisher","first-page":"R107","DOI":"10.1186\/cc4984","article-title":"Extrapulmonary manifestations of severe respiratory syncytial virus infection\u2013a systematic review.","volume":"10","author":"Eisenhut","year":"2006","journal-title":"Crit Care"},{"key":"zoi251508r43","doi-asserted-by":"publisher","DOI":"10.1177\/2333794X211044114","article-title":"Cardiac complications caused by respiratory syncytial virus infection: questionnaire survey and a literature review.","volume":"8","author":"Kawashima","year":"2021","journal-title":"Glob Pediatr Health"},{"issue":"16","key":"zoi251508r44","doi-asserted-by":"publisher","first-page":"1431","DOI":"10.1001\/jama.2025.15405","article-title":"Bivalent RSV prefusion F protein-based vaccine for preventing cardiovascular hospitalizations in older adults: a prespecified analysis of the DAN-RSV trial.","volume":"334","author":"Lassen","year":"2025","journal-title":"JAMA"},{"key":"zoi251508r45","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2509810","article-title":"RSV prefusion F vaccine for prevention of hospitalization in older adults.","author":"Lassen","year":"2025","journal-title":"N Engl J Med"},{"key":"zoi251508r46","doi-asserted-by":"publisher","DOI":"10.1161\/circ.152.suppl_3.4366407","article-title":"Abstract 4366407: real-world cardiorespiratory impact of respiratory syncytial virus (RSV) vaccination in the USA: a retrospective propensity-matched analysis.","volume":"152","author":"Arunachalam","year":"2025","journal-title":"Circulation"},{"key":"zoi251508r47","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(25)00546-8","article-title":"Vaccine effectiveness of a bivalent respiratory syncytial virus (RSV) pre-F vaccine against RSV-associated hospital admission among adults aged 75-79 years in England: a multicentre, test-negative, case-control study.","author":"Symes","year":"2025","journal-title":"Lancet Infect Dis"},{"issue":"3","key":"zoi251508r48","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0319436","article-title":"Evaluating the accuracy of ICD-10 codes for syncytial respiratory virus diagnosis in hospitalized patients: a record-linkage study (2022-2023).","volume":"20","author":"Bierrenbach","year":"2025","journal-title":"PLoS One"},{"issue":"6","key":"zoi251508r49","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1111\/irv.12665","article-title":"Evaluation of using ICD-10 code data for respiratory syncytial virus surveillance.","volume":"14","author":"Cai","year":"2020","journal-title":"Influenza Other Respir Viruses"},{"key":"zoi251508r11","unstructured":"Centers for Disease Control and Prevention. RSV vaccine guidance for older adults. Updated August 30, 2024. Accessed December 11, 2024. https:\/\/www.cdc.gov\/rsv\/hcp\/vaccine-clinical-guidance\/older-adults.html"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2844616\/liang_2026_oi_251508_1769460404.99424.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T16:00:33Z","timestamp":1770134433000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2844616"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,3]]},"references-count":49,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2,2]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.56767","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,3]]}}}