{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:14:56Z","timestamp":1791976496610,"version":"4.4.0"},"reference-count":69,"publisher":"American Medical Association (AMA)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Otolaryngol Head Neck Surg"],"published-print":{"date-parts":[[2022,10,1]]},"abstract":"<jats:sec id=\"ab-orv220006-1\"><jats:title>Importance<\/jats:title><jats:p>The benefits of breastfeeding are well established, with the American Academy of Pediatrics and Canadian guidelines recommending exclusive breastfeeding for the first 6 months of life. However, maternal hospitalization, illness, medication use, and poor support can result in early termination of breastfeeding. Caring for breastfeeding patients in otolaryngology is a challenge because of the lack of literature regarding otolaryngology-specific medication safety, patient concerns, and inadequate education among otolaryngologists. This review highlights recent literature regarding lactation in otolaryngology patients, including medication, radiologic imaging, perioperative considerations, and subspecialty-specific considerations for lactating patients.<\/jats:p><\/jats:sec><jats:sec id=\"ab-orv220006-2\"><jats:title>Observations<\/jats:title><jats:p>The majority of common medications used in general otolaryngology are safe for breastfeeding patients, including antihistamines, mucolytics, antitussives, antifungals, and decongestants. Certain analgesics and anti-inflammatories, such as tramadol, are not preferred in breastfeeding individuals. Some subspeciality-specific medications such as biologics (dupilumab) and methotrexate should be avoided. Lactating patients require special perioperative attention to ensure that optimal patient care is provided, such as managing supply, considering length of surgery, managing postoperative pain, and determining the safe amount of time until an infant can be fed.<\/jats:p><\/jats:sec><jats:sec id=\"ab-orv220006-3\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>Most medications can be safely used with lactating patients. If physicians are unsure about a medication\u2019s safety, they should consult appropriate resources prior to recommending breastfeeding cessation or to discard pumped milk.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamaoto.2022.2286","type":"journal-article","created":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T15:01:00Z","timestamp":1660230060000},"page":"973","source":"Crossref","is-referenced-by-count":6,"title":["Supporting Lactation in Otolaryngology Patients Through Medication Optimization, Radiology Considerations, and More"],"prefix":"10.1001","volume":"148","author":[{"given":"Emily","family":"Elder","sequence":"first","affiliation":[{"name":"Northern Ontario School of Medicine, Sudbury, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiersten","family":"Pianosi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire M.","family":"Lawlor","sequence":"additional","affiliation":[{"name":"George Washington School of Medicine and Health Science & Children\u2019s National Hospital, Washington, DC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Elise","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"4","key":"orv220006r2","first-page":"222","article-title":"The risks of not breastfeeding for mothers and infants.","volume":"2","author":"Stuebe","year":"2009","journal-title":"Rev Obstet Gynecol"},{"issue":"3","key":"orv220006r3","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1001\/archpedi.157.3.237","article-title":"Breastfeeding and the risk of hospitalization for respiratory disease in infancy: a meta-analysis.","volume":"157","author":"Bachrach","year":"2003","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"5","key":"orv220006r4","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1093\/aje\/kwi222","article-title":"Duration of breastfeeding and risk of overweight: a meta-analysis.","volume":"162","author":"Harder","year":"2005","journal-title":"Am J Epidemiol"},{"issue":"8","key":"orv220006r5","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1016\/j.amjmed.2019.02.021","article-title":"Maternal implications of breastfeeding: a review for the internist.","volume":"132","author":"Sattari","year":"2019","journal-title":"Am J Med"},{"issue":"467","key":"orv220006r6","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1111\/apa.2015.104.issue-S467","article-title":"Breastfeeding and maternal health outcomes: a systematic review and meta-analysis.","volume":"104","author":"Chowdhury","year":"2015","journal-title":"Acta Paediatr"},{"issue":"8","key":"orv220006r7","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1007\/s00103-018-2769-0","article-title":"Psychological effects of breastfeeding on children and mothers.","volume":"61","author":"Krol","year":"2018","journal-title":"Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz"},{"issue":"3","key":"orv220006r9","doi-asserted-by":"publisher","first-page":"e726","DOI":"10.1542\/peds.2012-1295","article-title":"Reasons for earlier than desired cessation of breastfeeding.","volume":"131","author":"Odom","year":"2013","journal-title":"Pediatrics"},{"issue":"3","key":"orv220006r10","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1177\/0890334414535507","article-title":"Breastfeeding knowledge, confidence, beliefs, and attitudes of Canadian physicians.","volume":"30","author":"Pound","year":"2014","journal-title":"J Hum Lact"},{"issue":"2","key":"orv220006r11","doi-asserted-by":"publisher","first-page":"126","DOI":"10.5694\/mja2.2009.191.issue-2","article-title":"Medicines for breastfeeding women: a postal survey of general practitioners in Victoria.","volume":"191","author":"Amir","year":"2009","journal-title":"Med J Aust"},{"issue":"6","key":"orv220006r12","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1001\/jama.1995.03520300046035","article-title":"National assessment of physicians\u2019 breast-feeding knowledge, attitudes, training, and experience.","volume":"273","author":"Freed","year":"1995","journal-title":"JAMA"},{"issue":"11","key":"orv220006r13","doi-asserted-by":"publisher","first-page":"1482","DOI":"10.1111\/anae.v75.11","article-title":"Guideline on anaesthesia and sedation in breastfeeding women 2020: guideline from the Association of Anaesthetists.","volume":"75","author":"Mitchell","year":"2020","journal-title":"Anaesthesia"},{"key":"orv220006r14","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1186\/s12884-016-0907-y","article-title":"Transmasculine individuals\u2019 experiences with lactation, chestfeeding, and gender identity: a qualitative study.","volume":"16","author":"MacDonald","year":"2016","journal-title":"BMC Pregnancy Childbirth"},{"issue":"1","key":"orv220006r15","first-page":"10","article-title":"Medications in pregnancy and lactation.","volume":"30","author":"McCarter-Spaulding","year":"2005","journal-title":"MCN Am J Matern Child Nurs"},{"issue":"5","key":"orv220006r16","doi-asserted-by":"publisher","first-page":"156","DOI":"10.18773\/austprescr.2015.056","article-title":"Drugs in breastfeeding.","volume":"38","author":"Hotham","year":"2015","journal-title":"Aust Prescr"},{"issue":"4","key":"orv220006r17","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1016\/j.jopan.2014.09.006","article-title":"Perianesthetic considerations for the breastfeeding mother.","volume":"31","author":"Smathers","year":"2016","journal-title":"J Perianesth Nurs"},{"issue":"3","key":"orv220006r19","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1177\/1938640014532132","article-title":"Performing elective surgery on the breastfeeding patient: a review of the literature.","volume":"7","author":"Lobkova","year":"2014","journal-title":"Foot Ankle Spec"},{"issue":"6","key":"orv220006r20","doi-asserted-by":"publisher","first-page":"581","DOI":"10.1111\/j.1447-0756.1995.tb00916.x","article-title":"Effect on neonatal thyroid function of povidone-iodine used on mothers during perinatal period.","volume":"21","author":"Koga","year":"1995","journal-title":"J Obstet Gynaecol (Tokyo 1995)"},{"issue":"4","key":"orv220006r22","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1002\/aorn.2018.107.issue-4","article-title":"Perioperative care of the breastfeeding patient.","volume":"107","author":"Simon","year":"2018","journal-title":"AORN J"},{"issue":"5","key":"orv220006r23","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1089\/bfm.2014.9984","article-title":"ABM clinical protocol #4: mastitis, revised March 2014.","volume":"9","author":"Amir","year":"2014","journal-title":"Breastfeed Med"},{"issue":"1","key":"orv220006r24","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1111\/bcp.1987.24.issue-1","article-title":"Passage of paracetamol into breast milk and its subsequent metabolism by the neonate.","volume":"24","author":"Notarianni","year":"1987","journal-title":"Br J Clin Pharmacol"},{"issue":"13","key":"orv220006r25","doi-asserted-by":"publisher","first-page":"925","DOI":"10.2165\/00002018-200326130-00002","article-title":"Use of antibiotic and analgesic drugs during lactation.","volume":"26","author":"Bar-Oz","year":"2003","journal-title":"Drug Saf"},{"issue":"2","key":"orv220006r26","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1177\/0890334417695207","article-title":"Transfer of low dose aspirin into human milk.","volume":"33","author":"Datta","year":"2017","journal-title":"J Hum Lact"},{"issue":"1","key":"orv220006r27","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1177\/000992288102000107","article-title":"A 16-day-old breast-fed infant with metabolic acidosis caused by salicylate.","volume":"20","author":"Clark","year":"1981","journal-title":"Clin Pediatr (Phila)"},{"issue":"3","key":"orv220006r28","doi-asserted-by":"publisher","first-page":"223","DOI":"10.2165\/00128072-200002030-00006","article-title":"Analgesics and breast-feeding: safety considerations.","volume":"2","author":"Spigset","year":"2000","journal-title":"Paediatr Drugs"},{"issue":"5","key":"orv220006r29","doi-asserted-by":"publisher","first-page":"964","DOI":"10.1002\/cpt.v108.5","article-title":"The implausibility of neonatal opioid toxicity from breastfeeding.","volume":"108","author":"Zipursky","year":"2020","journal-title":"Clin Pharmacol Ther"},{"issue":"1","key":"orv220006r30","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1089\/bfm.2019.0122","article-title":"Breastfeeding motivators and barriers in women receiving medications for opioid use disorder.","volume":"15","author":"Yonke","year":"2020","journal-title":"Breastfeed Med"},{"issue":"2","key":"orv220006r31","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1592\/phco.23.2.153.32081","article-title":"Hydromorphone transfer into breast milk after intranasal administration.","volume":"23","author":"Edwards","year":"2003","journal-title":"Pharmacotherapy"},{"key":"orv220006r32","doi-asserted-by":"publisher","first-page":"335","DOI":"10.4172\/2155-9554","article-title":"Tramadol intoxication in an 8-months-old infant through breastfeeding: a case report.","volume":"7","author":"Hussien","year":"2017","journal-title":"J Clin Toxicol"},{"issue":"8","key":"orv220006r33","first-page":"2919","article-title":"Safety of tramadol hydrochloride\/acetaminophen combination tablet use for postpartum pain","volume":"47","author":"Nagae Seika","year":"2021","journal-title":"J Obstet Gynaecol Res"},{"issue":"5","key":"orv220006r34","doi-asserted-by":"publisher","first-page":"661","DOI":"10.1111\/j.1365-2125.2008.03117.x","article-title":"Use of a sparse sampling study design to assess transfer of tramadol and its O-desmethyl metabolite into transitional breast milk.","volume":"65","author":"Ilett","year":"2008","journal-title":"Br J Clin Pharmacol"},{"issue":"12","key":"orv220006r35","doi-asserted-by":"publisher","first-page":"1110","DOI":"10.1136\/archdischild-2017-313786","article-title":"Tramadol, breast feeding and safety in the newborn.","volume":"103","author":"Palmer","year":"2018","journal-title":"Arch Dis Child"},{"issue":"6","key":"orv220006r36","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1111\/apa.2015.104.issue-6","article-title":"Codeine should not be prescribed for breastfeeding mothers or children under the age of 12.","volume":"104","author":"Lazaryan","year":"2015","journal-title":"Acta Paediatr"},{"issue":"3","key":"orv220006r37","doi-asserted-by":"publisher","first-page":"e796","DOI":"10.1542\/peds.2013-1985","article-title":"The transfer of drugs and therapeutics into human breast milk: an update on selected topics.","volume":"132","author":"Sachs","year":"2013","journal-title":"Pediatrics"},{"issue":"3","key":"orv220006r38","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1089\/bfm.2020.0384","article-title":"Local anesthesia and breastfeeding.","volume":"16","author":"Anderson","year":"2021","journal-title":"Breastfeed Med"},{"issue":"2","key":"orv220006r40","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1097\/00005176-200102000-00009","article-title":"Could local anesthesia while breast-feeding be harmful to infants?","volume":"32","author":"Giuliani","year":"2001","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"4","key":"orv220006r41","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1097\/01.ftd.0000168294.25356.d0","article-title":"The safety of amoxicillin\/clavulanic acid and cefuroxime during lactation.","volume":"27","author":"Benyamini","year":"2005","journal-title":"Ther Drug Monit"},{"issue":"3","key":"orv220006r42","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/0165-1110(94)90001-9","article-title":"Genotoxicity and carcinogenicity of metronidazole.","volume":"317","author":"Dobi\u00e1s","year":"1994","journal-title":"Mutat Res"},{"issue":"2","key":"orv220006r44","doi-asserted-by":"publisher","first-page":"e29","DOI":"10.1097\/INF.0b013e3181fe353d","article-title":"Ciprofloxacin use in neonates: a systematic review of the literature.","volume":"30","author":"Kaguelidou","year":"2011","journal-title":"Pediatr Infect Dis J"},{"issue":"5","key":"orv220006r46","doi-asserted-by":"publisher","first-page":"585","DOI":"10.1177\/106002809402800506","article-title":"Acyclovir excretion in human breast milk.","volume":"28","author":"Taddio","year":"1994","journal-title":"Ann Pharmacother"},{"issue":"1","key":"orv220006r47","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1067\/mob.2002.119183","article-title":"Acyclovir concentrations in human breast milk after valaciclovir administration.","volume":"186","author":"Sheffield","year":"2002","journal-title":"Am J Obstet Gynecol"},{"issue":"10","key":"orv220006r49","first-page":"875","article-title":"Fluconazole use during breastfeeding.","volume":"61","author":"Kaplan","year":"2015","journal-title":"Can Fam Physician"},{"issue":"2","key":"orv220006r50","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01208-2019","article-title":"ERS\/TSANZ Task Force Statement on the management of reproduction and pregnancy in women with airways diseases.","volume":"55","author":"Middleton","year":"2020","journal-title":"Eur Respir J"},{"issue":"6","key":"orv220006r51","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1016\/S0022-3476(85)80259-6","article-title":"Prednisolone excretion in human milk.","volume":"106","author":"Ost","year":"1985","journal-title":"J Pediatr"},{"issue":"1","key":"orv220006r53","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1046\/j.1365-2125.2003.01822.x","article-title":"Pseudoephedrine: effects on milk production in women and estimation of infant exposure via breastmilk.","volume":"56","author":"Aljazaf","year":"2003","journal-title":"Br J Clin Pharmacol"},{"issue":"5","key":"orv220006r54","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1016\/S0002-9378(11)90771-6","article-title":"Prospective follow-up of adverse reactions in breast-fed infants exposed to maternal medication.","volume":"168","author":"Ito","year":"1993","journal-title":"Am J Obstet Gynecol"},{"issue":"4","key":"orv220006r56","first-page":"294","article-title":"Decongestants and milk production.","volume":"16","author":"Anderson","year":"2000","journal-title":"J Hum Lact"},{"issue":"S4","key":"orv220006r58","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1111\/imj.2018.48.issue-S4","article-title":"A case series of patients with rheumatoid arthritis exposed to tocilizumab during pregnancy","volume":"48","author":"Salonga","year":"2018","journal-title":"Intern Med J"},{"issue":"3","key":"orv220006r59","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/j.ctrv.2012.10.002","article-title":"Chemotherapy, targeted agents, antiemetics and growth-factors in human milk: how should we counsel cancer patients about breastfeeding?","volume":"39","author":"Pistilli","year":"2013","journal-title":"Cancer Treat Rev"},{"key":"orv220006r60","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1089\/bfm.2016.0166","article-title":"After chemotherapy treatment for maternal cancer during pregnancy, is breastfeeding possible?","volume":"12","author":"Stopenski","year":"2017","journal-title":"Breastfeed Med"},{"issue":"1","key":"orv220006r62","doi-asserted-by":"publisher","first-page":"8","DOI":"10.4103\/0019-5154.60343","article-title":"Botulinum toxin.","volume":"55","author":"Nigam","year":"2010","journal-title":"Indian J Dermatol"},{"issue":"3","key":"orv220006r63","doi-asserted-by":"publisher","first-page":"417.e1","DOI":"10.1016\/j.jaad.2013.09.009","article-title":"Safety of dermatologic medications in pregnancy and lactation: part II. lactation.","volume":"70","author":"Butler","year":"2014","journal-title":"J Am Acad Dermatol"},{"issue":"6","key":"orv220006r64","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1056\/NEJM197802092980620","article-title":"Botulism and breast milk.","volume":"298","author":"Middaugh","year":"1978","journal-title":"N Engl J Med"},{"issue":"3","key":"orv220006r66","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1148\/rg.323115120","article-title":"Quality initiatives: guidelines for use of medical imaging during pregnancy and lactation.","volume":"32","author":"Tremblay","year":"2012","journal-title":"Radiographics"},{"key":"orv220006r18","volume-title":"Breastfeeding and Human Lactation","author":"Riordan","year":"2010","edition":"4th ed"},{"key":"orv220006r65","year":"2017"},{"key":"orv220006r69","volume-title":"Hale\u2019s Medications and Mothers\u2019 Milk 2021: A Manual of Lactational Pharmacology","author":"Hale","year":"2021","edition":"19th ed"},{"key":"orv220006r1","unstructured":"World Health Organization. Infant and young child feeding. June 9, 2021. Accessed January 19, 2021. https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/infant-and-young-child-feeding"},{"key":"orv220006r8","unstructured":"UNICEF. UNICEF data: breastfeeding. Accessed February 15, 2022. https:\/\/data.unicef.org\/topic\/nutrition\/breastfeeding\/#:~:text=Additionally%2C%20the%20prevalence%20of%20continued,persist%20within%20countries%20as%20well"},{"key":"orv220006r21","unstructured":"US National Library of Medicine. Povidone-iodine. [updated March 17, 2021]. Drugs and Lactation Database (LactMed). Accessed July 14, 2022. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK501354\/"},{"key":"orv220006r39","unstructured":"US National Library of Medicine. Epinephrine [updated July 20, 2020]. Drugs and Lactation Database (LactMed). Accessed July 14, 2022. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK501642\/"},{"key":"orv220006r43","unstructured":"US National Library of Medicine. Vancomycin [updated October 31, 2018]. Drugs and Lactation Database (LactMed). Accessed July 14, 2022. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK501263\/"},{"key":"orv220006r45","unstructured":"US National Library of Medicine. Tetracycline. [updated February 23, 2021]. Drugs and Lactation Database (LactMed). Accessed July 14, 2022. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK501108\/"},{"key":"orv220006r48","unstructured":"US National Library of Medicine. Nystatin [updated February 15, 2021]. Drugs and Lactation Database (LactMed). Accessed July 14, 2022. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK501241\/"},{"key":"orv220006r52","unstructured":"US National Library of Medicine. Ipratropium [updated December 3, 2018]. Drugs and Lactation Database (LactMed). Accessed July 14, 2022. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK501483\/"},{"key":"orv220006r55","unstructured":"US National Library of Medicine. Phenylephrine. [updated October 31, 2018]. Drugs and Lactation Database (LactMed). Accessed July 14, 2022. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK501438\/"},{"key":"orv220006r57","unstructured":"US National Library of Medicine. Fexofenadine. [updated September 20, 2021]. Drugs and Lactation Database (LactMed). Accessed July 14, 2022. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK500677\/"},{"key":"orv220006r61","unstructured":"US National Library of Medicine. Cetuximab [updated April 19, 2021]. Drugs and Lactation Database (LactMed). Accessed July 14, 2022. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK500578\/"},{"key":"orv220006r67","unstructured":"InfantRisk Center at Texas Tech University Health Sciences Center. Accessed June 22, 2022. https:\/\/www.infantrisk.com\/"},{"key":"orv220006r68","unstructured":"US National Library of Medicine. Drugs and Lactation Database (LactMed). Accessed July 14, 2022. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK501922\/"}],"container-title":["JAMA Otolaryngology\u2013Head &amp; Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamaotolaryngology\/articlepdf\/2795330\/jamaotolaryngology_elder_2022_rv_220006_1664995479.56946.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T15:25:28Z","timestamp":1665674728000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamaotolaryngology\/fullarticle\/2795330"}},"subtitle":["A Literature Review"],"short-title":[],"issued":{"date-parts":[[2022,10,1]]},"references-count":69,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2022,10,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamaoto.2022.2286","relation":{},"ISSN":["2168-6181"],"issn-type":[{"value":"2168-6181","type":"print"}],"subject":[],"published":{"date-parts":[[2022,10,1]]}}}