{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:09:35Z","timestamp":1786975775231,"version":"build-2736575974"},"reference-count":45,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Generic pediatric patient-reported outcome measures (P-PROMs) have the potential to enhance care and patient-clinician interactions in specialty hospital settings. However, evidence about their feasibility and acceptability is lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify the feasibility and acceptability of a P-PROM at the point of care among children receiving outpatient care from selected specialty clinics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, Setting, and Participants<\/jats:title>\n                    <jats:p>This nonblinded, pilot feasibility and acceptability randomized clinical trial was conducted from February to June 2024 across 4 pediatric specialty clinics (asthma, sleep, encopresis, and chronic constipation) at The Royal Children\u2019s Hospital in Melbourne, Victoria, Australia. Children aged 4 to 17 years (and their caregivers) were eligible for inclusion if they had an appointment at one of the participating clinics during the trial period. Patients and their caregivers were randomly assigned to the intervention or control group. Clinicians (physicians, nurses, and allied health staff) providing specialty care services to eligible patients were also invited to participate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Children and\/or their caregivers assigned to the intervention arm were asked to complete a generic P-PROM\u2014the EuroQoL 5-Dimensional Questionnaire for Youth, 5 Levels (EQ-5D-Y-5L)\u20147 days before their appointment and to indicate which EQ-5D-Y-5L items they would like to discuss with their clinician during their appointment. Responses to the completed P-PROM were displayed to clinicians in the electronic medical record, and children and their caregivers received information to act on the P-PROM items. Clinicians received training, clinical decision support, and resources to support patient actions. Patients assigned to the control arm received standard outpatient care, which excluded completing a P-PROM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcomes and Measures<\/jats:title>\n                    <jats:p>Primary outcomes were feasibility and acceptability of the P-PROM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 170 eligible patients, 87 children (51.2%) and their caregivers were randomly assigned to the intervention arm (n\u2009=\u200943) or control arm (n\u2009=\u200944). Patients included 44 females (50.6%) with a mean (SD) age of 8.8 (3.2) years, and caregivers included 82 females (94.3%) with a mean (SD) age of 41.8 (6.9) years. Of the 17 eligible clinicians, 14 were included in the study; they reported working in a specialty clinic for a mean (SD) of 9.7 (8.4) years. Thirty-three of 37 caregivers (89.2%) in the intervention arm and 9 of 14 clinicians (64.3%) reported that the P-PROM was acceptable. A P-PROM completion rate of 93.0% (40 of 43 patients) was achieved, indicating feasibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>In this pilot randomized clinical trial, the collection and use of the EQ-5D-Y-5L was feasible and acceptable in routine outpatient specialty pediatric care. Further study should examine the quantitative impacts of the intervention on quality of care and outcomes as well as the impacts over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      ISRCTN Identifier:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.isrctn.com\/ISRCTN16030620\">ISRCTN16030620<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.58973","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T16:30:28Z","timestamp":1770913828000},"page":"e2558973","source":"Crossref","is-referenced-by-count":1,"title":["Use of Parent- and Patient-Reported Outcome Measures in Pediatric Specialty Clinics"],"prefix":"10.1001","volume":"9","author":[{"given":"Renee","family":"Jones","sequence":"first","affiliation":[{"name":"Melbourne Health Economics, University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Health Services and Economics, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Devlin","sequence":"additional","affiliation":[{"name":"Melbourne Health Economics, University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"McLean","sequence":"additional","affiliation":[{"name":"Centre for Community Child Health, The Royal Children\u2019s Hospital, Parkville, Victoria, Australia"},{"name":"Policy and Equity, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia"},{"name":"Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gehan","family":"Roberts","sequence":"additional","affiliation":[{"name":"Centre for Community Child Health, The Royal Children\u2019s Hospital, Parkville, Victoria, Australia"},{"name":"Policy and Equity, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia"},{"name":"Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adele","family":"Berry","sequence":"additional","affiliation":[{"name":"Complex Care Hub, The Royal Children\u2019s Hospital, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivanthan","family":"Shanthikumar","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Respiratory and Sleep Medicine, The Royal Children\u2019s Hospital, Parkville, Victoria, Australia"},{"name":"Respiratory, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misel","family":"Trajanovska","sequence":"additional","affiliation":[{"name":"Surgical Research, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia"},{"name":"Department of Paediatric Surgery, The Royal Children\u2019s Hospital, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"King","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Surgical Research, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia"},{"name":"Department of Paediatric Surgery, The Royal Children\u2019s Hospital, Parkville, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harriet","family":"Hiscock","sequence":"additional","affiliation":[{"name":"Health Services and Economics, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia"},{"name":"Centre for Community Child Health, The Royal Children\u2019s Hospital, Parkville, Victoria, Australia"},{"name":"Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim M.","family":"Dalziel","sequence":"additional","affiliation":[{"name":"Melbourne Health Economics, University of Melbourne, Melbourne, Victoria, Australia"},{"name":"Health Services and Economics, Murdoch Children\u2019s Research Institute, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"zoi251566r1","first-page":"61","article-title":"Patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs).","volume":"6","author":"Weldring","year":"2013","journal-title":"Health Serv Insights"},{"issue":"3","key":"zoi251566r2","doi-asserted-by":"publisher","first-page":"747","DOI":"10.1007\/s11136-013-0607-2","article-title":"Measuring pediatric patient-reported outcomes: good progress but a long way to go.","volume":"23","author":"Huang","year":"2014","journal-title":"Qual Life Res"},{"issue":"10","key":"zoi251566r4","doi-asserted-by":"publisher","first-page":"1791","DOI":"10.1016\/j.jval.2022.04.1723","article-title":"A systematic review of international guidance for self-report and proxy completion of child-specific utility instruments.","volume":"25","author":"Mpundu-Kaambwa","year":"2022","journal-title":"Value Health"},{"issue":"4","key":"zoi251566r5","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1111\/hex.13254","article-title":"Patient-reported outcome measures (PROMs): a review of generic and condition-specific measures and a discussion of trends and issues.","volume":"24","author":"Churruca","year":"2021","journal-title":"Health Expect"},{"key":"zoi251566r6","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/s41687-021-00375-1","article-title":"A multi-level approach for the use of routinely collected patient-reported outcome measures (PROMs) data in healthcare systems.","volume":"5","author":"Al Sayah","year":"2021","journal-title":"J Patient Rep Outcomes"},{"issue":"1","key":"zoi251566r7","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1186\/s12913-023-09050-1","article-title":"A landscape assessment of the use of patient reported outcome measures in research, quality improvement and clinical care across a healthcare organisation.","volume":"23","author":"Snowdon","year":"2023","journal-title":"BMC Health Serv Res"},{"key":"zoi251566r8","doi-asserted-by":"publisher","first-page":"f167","DOI":"10.1136\/bmj.f167","article-title":"Patient reported outcome measures could help transform healthcare.","volume":"346","author":"Black","year":"2013","journal-title":"BMJ"},{"key":"zoi251566r9","doi-asserted-by":"publisher","first-page":"d8191","DOI":"10.1136\/bmj.d8191","article-title":"Patient reported outcome measures: how are we feeling today?","volume":"344","author":"Appleby","year":"2011","journal-title":"BMJ"},{"issue":"8","key":"zoi251566r10","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1007\/s11136-011-0049-7","article-title":"Characteristics and quality of pediatric cost-utility analyses.","volume":"21","author":"Kromm","year":"2012","journal-title":"Qual Life Res"},{"issue":"7297","key":"zoi251566r11","doi-asserted-by":"publisher","first-page":"1297","DOI":"10.1136\/bmj.322.7297.1297","article-title":"Measuring quality of life: using quality of life measures in the clinical setting.","volume":"322","author":"Higginson","year":"2001","journal-title":"BMJ"},{"issue":"5","key":"zoi251566r12","doi-asserted-by":"publisher","first-page":"507","DOI":"10.2217\/cer-2015-0014","article-title":"Framework and guidance for implementing patient-reported outcomes in clinical practice: evidence, challenges and opportunities.","volume":"5","author":"Porter","year":"2016","journal-title":"J Comp Eff Res"},{"issue":"5","key":"zoi251566r13","doi-asserted-by":"publisher","first-page":"1505","DOI":"10.1007\/s11136-013-0596-1","article-title":"Framework to assess the effects of using patient-reported outcome measures in chronic care management.","volume":"23","author":"Santana","year":"2014","journal-title":"Qual Life Res"},{"issue":"1","key":"zoi251566r14","doi-asserted-by":"publisher","first-page":"101","DOI":"10.1186\/s12955-024-02312-4","article-title":"The use of patient-reported outcome measures to improve patient-related outcomes: a systematic review.","volume":"22","author":"Bonsel","year":"2024","journal-title":"Health Qual Life Outcomes"},{"issue":"1","key":"zoi251566r15","doi-asserted-by":"publisher","DOI":"10.1136\/bmjquality.u204088.w3767","article-title":"Improving patient reported outcome measures (PROMs) in total knee replacement by changing implant and preserving the infrapatella fatpad: a quality improvement project.","volume":"5","author":"Partridge","year":"2016","journal-title":"BMJ Qual Improv Rep"},{"issue":"1","key":"zoi251566r16","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1111\/j.1526-4637.2010.01020.x","article-title":"Collaborative quality improvement to manage pain in acute care hospitals.","volume":"12","author":"Haller","year":"2011","journal-title":"Pain Med"},{"issue":"7","key":"zoi251566r17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-008325","article-title":"The effectiveness of providing peer benchmarked feedback to hip replacement surgeons based on patient-reported outcome measures\u2013results from the PROFILE (Patient-Reported Outcomes: Feedback Interpretation and Learning Experiment) trial: a cluster randomised controlled study.","volume":"5","author":"Boyce","year":"2015","journal-title":"BMJ Open"},{"issue":"2","key":"zoi251566r18","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1177\/1355819613506187","article-title":"Impact on hospital performance of introducing routine patient reported outcome measures in surgery.","volume":"19","author":"Varagunam","year":"2014","journal-title":"J Health Serv Res Policy"},{"issue":"3","key":"zoi251566r19","doi-asserted-by":"publisher","first-page":"567","DOI":"10.1007\/s11136-018-2016-z","article-title":"A systematic review of randomised controlled trials evaluating the use of patient-reported outcome measures (PROMs).","volume":"28","author":"Ishaque","year":"2019","journal-title":"Qual Life Res"},{"issue":"10","key":"zoi251566r20","doi-asserted-by":"publisher","first-page":"1436","DOI":"10.1016\/j.jval.2024.05.013","article-title":"Patient-reported outcome measures as an intervention: a comprehensive overview of systematic reviews on the effects of feedback.","volume":"27","author":"Wittich","year":"2024","journal-title":"Value Health"},{"key":"zoi251566r21","doi-asserted-by":"publisher","first-page":"364","DOI":"10.3389\/fped.2020.00364","article-title":"Patient-reported outcome measures in routine pediatric clinical care: a systematic review.","volume":"8","author":"Bele","year":"2020","journal-title":"Front Pediatr"},{"issue":"11","key":"zoi251566r22","doi-asserted-by":"publisher","first-page":"1119","DOI":"10.1200\/JCO.2013.51.5981","article-title":"Improving the care of children with advanced cancer by using an electronic patient-reported feedback intervention: results from the PediQUEST randomized controlled trial.","volume":"32","author":"Wolfe","year":"2014","journal-title":"J Clin Oncol"},{"issue":"8","key":"zoi251566r23","doi-asserted-by":"publisher","first-page":"1521","DOI":"10.2337\/dc08-0394","article-title":"Monitoring and discussing health-related quality of life in adolescents with type 1 diabetes improve psychosocial well-being: a randomized controlled trial.","volume":"31","author":"de Wit","year":"2008","journal-title":"Diabetes Care"},{"issue":"12","key":"zoi251566r24","doi-asserted-by":"publisher","first-page":"3267","DOI":"10.1007\/s11136-017-1682-6","article-title":"Impact of monitoring health-related quality of life in clinical practice in children with type 1 diabetes mellitus.","volume":"26","author":"Murillo","year":"2017","journal-title":"Qual Life Res"},{"issue":"7347","key":"zoi251566r25","doi-asserted-by":"publisher","first-page":"1183","DOI":"10.1136\/bmj.324.7347.1183","article-title":"Increasing response rates to postal questionnaires: systematic review.","volume":"324","author":"Edwards","year":"2002","journal-title":"BMJ"},{"issue":"10","key":"zoi251566r26","doi-asserted-by":"publisher","first-page":"1604","DOI":"10.3390\/children10101604","article-title":"Collecting paediatric health-related quality of life data: assessing the feasibility and acceptability of the Australian Paediatric Multi-Instrument Comparison (P-MIC) Study.","volume":"10","author":"Jones","year":"2023","journal-title":"Children (Basel)"},{"key":"zoi251566r27","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1007\/s40273-023-01330-2","article-title":"Comparative psychometric performance of common generic paediatric health-related quality of life instrument descriptive systems: results from the Australian Paediatric Multi-Instrument Comparison Study.","volume":"42","author":"Jones","year":"2024","journal-title":"Pharmacoeconomics"},{"issue":"1","key":"zoi251566r28","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1002\/pbc.24089","article-title":"The influence of patient reported outcomes on the discussion of psychosocial issues in children with cancer.","volume":"59","author":"Engelen","year":"2012","journal-title":"Pediatr Blood Cancer"},{"issue":"2","key":"zoi251566r29","doi-asserted-by":"publisher","first-page":"e533","DOI":"10.1542\/peds.2012-0958","article-title":"Effectiveness of a web-based application to monitor health-related quality of life.","volume":"131","author":"Haverman","year":"2013","journal-title":"Pediatrics"},{"issue":"3","key":"zoi251566r30","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1007\/s11136-015-1219-9","article-title":"Implementation of the Kids-CAT in clinical settings: a newly developed computer-adaptive test to facilitate the assessment of patient-reported outcomes of children and adolescents in clinical practice in Germany.","volume":"25","author":"Barthel","year":"2016","journal-title":"Qual Life Res"},{"issue":"3","key":"zoi251566r31","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1007\/s11136-018-2048-4","article-title":"Implementing patient-reported outcome measures in clinical practice: a companion guide to the ISOQOL user\u2019s guide.","volume":"28","author":"Chan","year":"2019","journal-title":"Qual Life Res"},{"issue":"9913","key":"zoi251566r32","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1016\/S0140-6736(13)62228-X","article-title":"Reducing waste from incomplete or unusable reports of biomedical research.","volume":"383","author":"Glasziou","year":"2014","journal-title":"Lancet"},{"issue":"1","key":"zoi251566r33","doi-asserted-by":"publisher","first-page":"143","DOI":"10.2307\/3791443","article-title":"The two cultures of academia and policy-making: bridging the gap.","volume":"15","author":"George","year":"1994","journal-title":"Polit Psychol"},{"issue":"2","key":"zoi251566r34","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1111\/1468-0009.12197","article-title":"Achieving research impact through co-creation in community-based health services: literature review and case study.","volume":"94","author":"Greenhalgh","year":"2016","journal-title":"Milbank Q"},{"issue":"8","key":"zoi251566r35","doi-asserted-by":"publisher","first-page":"2189","DOI":"10.1007\/s11136-025-03990-3","article-title":"Use of a generic Paediatric Patient Reported Outcome Measure (P-PROM) in Routine Hospital Outpatient Care for Kids (ROCK): a qualitative exploration of adolescent, caregiver and service provider perspectives (P-PROM ROCK phase 1).","volume":"34","author":"Jones","year":"2025","journal-title":"Qual Life Res"},{"issue":"8","key":"zoi251566r36","doi-asserted-by":"publisher","first-page":"2205","DOI":"10.1007\/s11136-025-03996-x","article-title":"\u201cIf we ask, we must act\u201d: co-designing the implementation of the EQ-5D-Y-5L as a Paediatric Patient Reported Outcome Measure in Routine Hospital Outpatient Care for Kids to meaningfully impact clinical visits (P-PROM ROCK phase 2).","volume":"34","author":"Jones","year":"2025","journal-title":"Qual Life Res"},{"issue":"22","key":"zoi251566r37","doi-asserted-by":"publisher","first-page":"1998","DOI":"10.1001\/jama.2025.4347","article-title":"CONSORT 2025 Statement: Updated Guideline for Reporting Randomized Trials.","volume":"333","author":"Hopewell","year":"2025","journal-title":"JAMA"},{"issue":"7","key":"zoi251566r38","doi-asserted-by":"publisher","first-page":"1951","DOI":"10.1007\/s11136-019-02115-x","article-title":"EQ-5D-Y-5L: developing a revised EQ-5D-Y with increased response categories.","volume":"28","author":"Kreimeier","year":"2019","journal-title":"Qual Life Res"},{"issue":"1","key":"zoi251566r39","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1186\/s12913-022-07577-3","article-title":"Development of a theory-informed questionnaire to assess the acceptability of healthcare interventions.","volume":"22","author":"Sekhon","year":"2022","journal-title":"BMC Health Serv Res"},{"issue":"3","key":"zoi251566r40","doi-asserted-by":"publisher","first-page":"1057","DOI":"10.1177\/0962280215588241","article-title":"Estimating the sample size for a pilot randomised trial to minimise the overall trial sample size for the external pilot and main trial for a continuous outcome variable.","volume":"25","author":"Whitehead","year":"2016","journal-title":"Stat Methods Med Res"},{"issue":"1","key":"zoi251566r41","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1097\/MLR.0000000000001664","article-title":"Guidelines for designing and evaluating feasibility pilot studies.","volume":"60","author":"Teresi","year":"2022","journal-title":"Med Care"},{"issue":"1","key":"zoi251566r42","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/s13012-017-0555-2","article-title":"The physician\u2019s experience of changing clinical practice: a struggle to unlearn.","volume":"12","author":"Gupta","year":"2017","journal-title":"Implement Sci"},{"issue":"1","key":"zoi251566r44","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/s41687-023-00554-2","article-title":"Facilitators and barriers to implementing electronic patient-reported outcome and experience measures in a health care setting: a systematic review.","volume":"7","author":"Glenwright","year":"2023","journal-title":"J Patient Rep Outcomes"},{"issue":"3","key":"zoi251566r45","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1093\/ije\/dyi060","article-title":"Proper interpretation of non-differential misclassification effects: expectations vs observations.","volume":"34","author":"Jurek","year":"2005","journal-title":"Int J Epidemiol"},{"key":"zoi251566r3","doi-asserted-by":"crossref","DOI":"10.1093\/acprof:oso\/9780199547494.001.0001","volume-title":"Economic Evaluation in Child Health","author":"Ungar","year":"2009"},{"key":"zoi251566r43","unstructured":"Aaronson N, Elliott T, Greenhalgh J, et al; the International Society for Quality of Life Research. User\u2019s guide to implementing patient-reported outcomes assessment in clinical practice. 2015. Accessed July 28, 2025. https:\/\/www.isoqol.org\/wp-content\/uploads\/2019\/09\/2015UsersGuide-Version2.pdf?"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2844974\/jones_2026_oi_251566_1770311112.49319.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T16:30:34Z","timestamp":1770913834000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2844974"}},"subtitle":["A Pilot Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2026,2,12]]},"references-count":45,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2,2]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2025.58973","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,12]]}}}