{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T02:31:49Z","timestamp":1793673109251,"version":"4.5.1"},"reference-count":41,"publisher":"American Medical Association (AMA)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Pediatr"],"published-print":{"date-parts":[[2023,11,1]]},"abstract":"Importance<\/jats:title>Peripheral intravenous catheters (PIVCs) frequently fail during treatment causing therapy interruption, pain, recatheterization, and additional health care costs. Midline catheters (MCs) may improve functional dwell time and reduce failure compared with traditional PIVCs.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare device failure of MCs with PIVCs<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This was a pragmatic, randomized clinical superiority trial with an embedded internal pilot study conducted from July 2020 to May 2022. The study took place in a quaternary pediatric hospital in Brisbane, Queensland, Australia. Inclusion criteria were patients aged 1 to 18 years requiring peripherally compatible intravenous therapy for 4 days or longer.<\/jats:p><\/jats:sec>Interventions<\/jats:title>Patients were randomly assigned 1:1 to receive a PIVC or MC, stratified by age (\u22645 years, &amp;gt;5 years). One catheter was studied per patient.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was all-cause device failure, defined as premature cessation of device function. Secondary outcomes included number of insertion attempts, insertion failure, pain (on insertion), procedural time, patient\/parent satisfaction (with insertion), device dwell time, device complications during dwell time, additional vascular access devices required to complete treatment, clinician satisfaction (at removal), and health care costs.<\/jats:p><\/jats:sec>Results<\/jats:title>Of the 128 patients randomly assigned to study groups, 127 patients (median [IQR] age, 7 [2-13] years; 71 male [56%]) had a device inserted, with 65 (51.2%) in the PIVC group and 62 (48.8%) in the MC group. All patients were included in the intention-to-treat analysis. Device failure was lower in patients in the MC group (10 [16.1%]) compared with those in the PIVC group (30 [46.2%]; odds ratio [OR], 0.22; 95% CI, 0.10-0.52; P<\/jats:italic>\u2009&amp;lt;.001). MCs were associated with fewer insertion attempts (mean difference [MD], \u22120.3; 95% CI, \u22120.5 to 0; P<\/jats:italic>\u2009=\u2009.04), increased dwell time (MD, 66.9 hours; 95% CI, 36.2-97.5 hours; P<\/jats:italic>\u2009&amp;lt;.001), and fewer patients required additional vascular access devices to complete treatment in the MC group (4 [6.5%]) and PIVC group (19 [29.2%]; OR, 0.17; 95% CI, 0.05-0.52; P<\/jats:italic>\u2009=\u2009.002). Compared with PIVCs, use of MCs was associated with greater patient (9.0 vs 7.1 of 10; P<\/jats:italic>\u2009=\u2009.002) and parent (9.1 vs 8.2 of 10; P<\/jats:italic>\u2009=\u2009.02) satisfaction and lower health care costs (AUS \u2212$151.67 [US \u2212$101.13] per person; 95% credible interval, AUS \u2212$171.45 to \u2212$131.90 [US \u2212$114.20 to \u2212$87.95]).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>Findings suggest that MC insertion for patients requiring peripherally compatible intravenous therapy for 4 days or longer should be prioritized to reduce the resource intensive, expensive, and burdensome sequelae of device failure.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>Australia New Zealand Clinical Trials Registry, ACTRN12620000724976<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapediatrics.2023.3526","type":"journal-article","created":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T15:01:33Z","timestamp":1694444493000},"page":"1132","source":"Crossref","is-referenced-by-count":17,"title":["Midline Compared With Peripheral Intravenous Catheters for Therapy of 4 Days or Longer in Pediatric Patients"],"prefix":"10.1001","volume":"177","author":[{"given":"Tricia M.","family":"Kleidon","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Pain, Children\u2019s Health Queensland Hospital and Health Service, Queensland Children\u2019s Hospital, Brisbane, Queensland, Australia"},{"name":"School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia"},{"name":"Alliance for Vascular Access Teaching and Research, Griffith University, Brisbane, Queensland, Australia"},{"name":"Nursing and Midwifery Research Centre, Royal Brisbane and Women\u2019s Hospital, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Gibson","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain, Children\u2019s Health Queensland Hospital and Health Service, Queensland Children\u2019s Hospital, Brisbane, Queensland, Australia"},{"name":"School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia"},{"name":"Alliance for Vascular Access Teaching and Research, Griffith University, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Cattanach","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain, Children\u2019s Health Queensland Hospital and Health Service, Queensland Children\u2019s Hospital, Brisbane, Queensland, Australia"},{"name":"Alliance for Vascular Access Teaching and Research, Griffith University, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Schults","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain, Children\u2019s Health Queensland Hospital and Health Service, Queensland Children\u2019s Hospital, Brisbane, Queensland, Australia"},{"name":"School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia"},{"name":"Alliance for Vascular Access Teaching and Research, Griffith University, Brisbane, Queensland, Australia"},{"name":"Nursing and Midwifery Research Centre, Royal Brisbane and Women\u2019s Hospital, Brisbane, Queensland, Australia"},{"name":"Herston Infectious Diseases Institute, Metro North Hospital and Health Service, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth H.","family":"Royle","sequence":"additional","affiliation":[{"name":"Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia"},{"name":"Centre for Applied Health Economics, School of Medicine and Dentistry, Griffith University, Nathan, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Ware","sequence":"additional","affiliation":[{"name":"Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Marsh","sequence":"additional","affiliation":[{"name":"School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia"},{"name":"Alliance for Vascular Access Teaching and Research, Griffith University, Brisbane, Queensland, Australia"},{"name":"Nursing and Midwifery Research Centre, Royal Brisbane and Women\u2019s Hospital, Brisbane, Queensland, Australia"},{"name":"Herston Infectious Diseases Institute, Metro North Hospital and Health Service, Brisbane, Queensland, Australia"},{"name":"Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"Pitt","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain, Children\u2019s Health Queensland Hospital and Health Service, Queensland Children\u2019s Hospital, Brisbane, Queensland, Australia"},{"name":"Alliance for Vascular Access Teaching and Research, Griffith University, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Dean","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain, Children\u2019s Health Queensland Hospital and Health Service, Queensland Children\u2019s Hospital, Brisbane, Queensland, Australia"},{"name":"Alliance for Vascular Access Teaching and Research, Griffith University, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Byrnes","sequence":"additional","affiliation":[{"name":"Menzies Health Institute Queensland, Griffith University, Nathan, Queensland, Australia"},{"name":"Centre for Applied Health Economics, School of Medicine and Dentistry, Griffith University, Nathan, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire M.","family":"Rickard","sequence":"additional","affiliation":[{"name":"School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia"},{"name":"Alliance for Vascular Access Teaching and Research, Griffith University, Brisbane, Queensland, Australia"},{"name":"Nursing and Midwifery Research Centre, Royal Brisbane and Women\u2019s Hospital, Brisbane, Queensland, Australia"},{"name":"Herston Infectious Diseases Institute, Metro North Hospital and Health Service, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda J.","family":"Ullman","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Pain, Children\u2019s Health Queensland Hospital and Health Service, Queensland Children\u2019s Hospital, Brisbane, Queensland, Australia"},{"name":"School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Queensland, Australia"},{"name":"Alliance for Vascular Access Teaching and Research, Griffith University, Brisbane, Queensland, Australia"},{"name":"Nursing and Midwifery Research Centre, Royal Brisbane and Women\u2019s Hospital, Brisbane, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"key":"poi230053r1","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1097\/NAN.0000000000000396","article-title":"Infusion therapy standards of practice, 8th edition.","volume":"44","author":"Gorski","year":"2021","journal-title":"J Infus Nurs"},{"key":"poi230053r2","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.1016\/j.pedn.2019.09.023","article-title":"Global pediatric peripheral intravenous catheter practice and performance: a secondary analysis of 4206 catheters.","volume":"50","author":"Ullman","year":"2020","journal-title":"J Pediatr Nurs"},{"key":"poi230053r3","doi-asserted-by":"crossref","first-page":"S269","DOI":"10.1542\/peds.2019-3474I","article-title":"The Michigan appropriateness guide for intravenous catheters in pediatrics: miniMAGIC.","volume":"145","author":"Ullman","year":"2020","journal-title":"Pediatrics"},{"issue":"5","key":"poi230053r4","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1177\/0009922811435164","article-title":"Peripheral intravenous access in pediatric inpatients.","volume":"51","author":"Reigart","year":"2012","journal-title":"Clin Pediatr (Phila)"},{"issue":"6","key":"poi230053r5","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1037\/a0024817","article-title":"Children\u2019s fear during procedural pain: preliminary investigation of the Children\u2019s Fear Scale.","volume":"30","author":"McMurtry","year":"2011","journal-title":"Health Psychol"},{"issue":"10","key":"poi230053r6","doi-asserted-by":"publisher","first-page":"1214","DOI":"10.1111\/jpc.v55.10","article-title":"Implementation of a paediatric peripheral intravenous catheter care bundle: a quality improvement initiative.","volume":"55","author":"Kleidon","year":"2019","journal-title":"J Paediatr Child Health"},{"issue":"9847","key":"poi230053r7","doi-asserted-by":"publisher","first-page":"1066","DOI":"10.1016\/S0140-6736(12)61082-4","article-title":"Routine vs clinically indicated replacement of peripheral intravenous catheters: a randomised controlled equivalence trial.","volume":"380","author":"Rickard","year":"2012","journal-title":"Lancet"},{"issue":"1","key":"poi230053r8","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1086\/674398","article-title":"Risk factors for peripheral intravenous catheter failure: a multivariate analysis of data from a randomized controlled trial.","volume":"35","author":"Wallis","year":"2014","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"9","key":"poi230053r9","doi-asserted-by":"publisher","first-page":"e402","DOI":"10.1016\/S2352-3026(17)30145-X","article-title":"Peripheral intravenous catheter assessment: beyond phlebitis.","volume":"4","author":"Rickard","year":"2017","journal-title":"Lancet Haematol"},{"issue":"9","key":"poi230053r10","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1093\/qjmed\/hcn078","article-title":"Factors that affect longevity of intravenous cannulas: a prospective study.","volume":"101","author":"Dillon","year":"2008","journal-title":"QJM"},{"issue":"4","key":"poi230053r11","doi-asserted-by":"publisher","first-page":"45","DOI":"10.2309\/1552-8855-8.4.45","article-title":"Improving short peripheral IV outcomes: a clinical trial of 2 securement methods.","volume":"8","author":"Royer","year":"2003","journal-title":"J Assoc Vasc Access"},{"issue":"5","key":"poi230053r12","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1071\/AH18102","article-title":"Cost of vascular access devices in public hospitals in Queensland.","volume":"43","author":"Tuffaha","year":"2019","journal-title":"Aust Health Rev"},{"issue":"8","key":"poi230053r13","doi-asserted-by":"publisher","first-page":"S10","DOI":"10.12968\/bjon.2021.30.8.S10","article-title":"Midline venous catheters as an alternative to central line catheter placement: a product evaluation.","volume":"30","author":"Carr","year":"2021","journal-title":"Br J Nurs"},{"issue":"9","key":"poi230053r14","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1111\/pan.v31.9","article-title":"Comparison of midline catheters and peripherally inserted central catheters to reduce the need for general anesthesia in children with respiratory disease: a feasibility randomized controlled trial.","volume":"31","author":"Kleidon","year":"2021","journal-title":"Paediatr Anaesth"},{"key":"poi230053r15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2019.103488","article-title":"Incidence of peripheral intravenous catheter failure and complications in paediatric patients: Systematic review and meta-analysis.","volume":"102","author":"Indarwati","year":"2020","journal-title":"Int J Nurs Stud"},{"issue":"1","key":"poi230053r16","doi-asserted-by":"publisher","first-page":"208","DOI":"10.1186\/s12887-017-0965-y","article-title":"Peripheral venous catheter complications in children: predisposing factors in a multicenter prospective cohort study.","volume":"17","author":"Ben Abdelaziz","year":"2017","journal-title":"BMC Pediatr"},{"issue":"2","key":"poi230053r17","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-000877","article-title":"Standard vs long peripheral catheters for multiday IV therapy: a randomized controlled trial.","volume":"147","author":"Qin","year":"2021","journal-title":"Pediatrics"},{"issue":"5","key":"poi230053r18","doi-asserted-by":"publisher","first-page":"313","DOI":"10.1097\/00129804-200409000-00005","article-title":"Midline catheters: the middle ground of intravenous therapy administration.","volume":"27","author":"Anderson","year":"2004","journal-title":"J Infus Nurs"},{"issue":"9","key":"poi230053r19","doi-asserted-by":"publisher","first-page":"1118","DOI":"10.1016\/j.ajic.2019.03.001","article-title":"Infection-free midline catheter implementation at a community hospital (2 years).","volume":"47","author":"DeVries","year":"2019","journal-title":"Am J Infect Control"},{"key":"poi230053r20","doi-asserted-by":"publisher","first-page":"427","DOI":"10.2147\/MDER","article-title":"Inhibition of bacterial attachment and biofilm formation by a novel intravenous catheter material using an in vitro percutaneous catheter insertion model.","volume":"11","author":"Pathak","year":"2018","journal-title":"Med Devices (Auckl)"},{"issue":"2","key":"poi230053r21","doi-asserted-by":"publisher","first-page":"e140","DOI":"10.1097\/CCM.0000000000004764","article-title":"The practice and complications of midline catheters: a systematic review.","volume":"49","author":"Tripathi","year":"2021","journal-title":"Crit Care Med"},{"issue":"6","key":"poi230053r22","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.7326\/M15-0744","article-title":"The Michigan Appropriateness Guide for Intravenous Catheters (MAGIC): results from a multispecialty panel using the RAND\/UCLA appropriateness method.","volume":"163","author":"Chopra","year":"2015","journal-title":"Ann Intern Med"},{"issue":"3","key":"poi230053r23","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.java.2016.03.007","article-title":"Comparison of outcomes of extended dwell\/midline peripheral intravenous catheters and peripherally inserted central catheters in children.","volume":"21","author":"Anderson","year":"2016","journal-title":"J Assoc Vasc Access"},{"issue":"4","key":"poi230053r24","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1016\/j.java.2015.10.050","article-title":"Complications associated with midline catheters.","volume":"20","author":"Beard","year":"2015","journal-title":"J Assoc Vasc Access"},{"issue":"1","key":"poi230053r25","first-page":"1","article-title":"Extended dwell peripheral catheters in patients with difficult venous access: comparison of a peripheral intravenous catheter and midline catheter.","volume":"4","author":"Alexandrou","year":"2018","journal-title":"J Vasc Access"},{"issue":"1","key":"poi230053r26","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1186\/s13063-019-3578-y","article-title":"Progression criteria in trials with an internal pilot: an audit of publicly funded randomised controlled trials.","volume":"20","author":"Herbert","year":"2019","journal-title":"Trials"},{"issue":"1","key":"poi230053r27","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1186\/s13063-020-04241-1","article-title":"Early switch from intravenous to oral antibiotic therapy in patients with cancer who have low-risk neutropenic sepsis (the EASI-SWITCH trial): study protocol for a randomised controlled trial.","volume":"21","author":"Forde","year":"2020","journal-title":"Trials"},{"issue":"1","key":"poi230053r28","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1097\/NAN.0000000000000202","article-title":"Development of an evidence-based list of noncytotoxic vesicant medications and solutions.","volume":"40","author":"Gorski","year":"2017","journal-title":"J Infus Nurs"},{"issue":"1","key":"poi230053r29","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1097\/NAN.0b013e3182798844","article-title":"Reducing risk of harm from extravasation: a 3-tiered evidence-based list of pediatric peripheral intravenous infusates.","volume":"36","author":"Clark","year":"2013","journal-title":"J Infus Nurs"},{"issue":"2","key":"poi230053r31","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/j.jtv.2020.03.006","article-title":"Smile\u2014secure my intravenous line effectively: a pilot randomised controlled trial of peripheral intravenous catheter securement in paediatrics.","volume":"29","author":"Kleidon","year":"2020","journal-title":"J Tissue Viability"},{"issue":"1","key":"poi230053r32","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1111\/jpc.v56.1","article-title":"Flushing of peripheral intravenous catheters: a pilot, factorial, randomised controlled trial of high vs low frequency and volume in paediatrics.","volume":"56","author":"Kleidon","year":"2020","journal-title":"J Paediatr Child Health"},{"issue":"9","key":"poi230053r33","doi-asserted-by":"publisher","first-page":"714","DOI":"10.1136\/bmjqs-2018-008554","article-title":"Variation in use and outcomes related to midline catheters: results from a multicentre pilot study.","volume":"28","author":"Chopra","year":"2019","journal-title":"BMJ Qual Saf"},{"issue":"5","key":"poi230053r34","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1016\/j.ijnurstu.2013.09.002","article-title":"The safety and efficacy of midlines compared to peripherally inserted central catheters for adult cystic fibrosis patients: a retrospective, observational study.","volume":"51","author":"Sharp","year":"2014","journal-title":"Int J Nurs Stud"},{"issue":"9","key":"poi230053r35","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1136\/bmjqs-2020-011274","article-title":"International recommendations for a vascular access minimum data set: a Delphi consensus-building study.","volume":"30","author":"Schults","year":"2021","journal-title":"BMJ Qual Saf"},{"issue":"1","key":"poi230053r36","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1071\/AH21053","article-title":"Understanding consumer preference for vascular access safety and quality measurement: an international survey.","volume":"46","author":"Schults","year":"2022","journal-title":"Aust Health Rev"},{"issue":"2","key":"poi230053r37","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2013a metadata-driven methodology and workflow process for providing translational research informatics support.","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"issue":"2","key":"poi230053r39","doi-asserted-by":"publisher","DOI":"10.1111\/ijn.v29.2","article-title":"Safety and efficacy of midline catheters vs peripheral intravenous catheters: a pilot randomized controlled trial.","volume":"29","author":"Marsh","year":"2023","journal-title":"Int J Nurs Pract"},{"issue":"2","key":"poi230053r40","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-047765","article-title":"Comparing ivWatch biosensor to standard care to identify extravasation injuries in the paediatric intensive care: a protocol for a randomised controlled trial.","volume":"12","author":"McBride","year":"2022","journal-title":"BMJ Open"},{"issue":"12","key":"poi230053r41","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1002\/jhm.v17.12","article-title":"Long peripheral catheters in children: a scoping review.","volume":"17","author":"Burek","year":"2022","journal-title":"J Hosp Med"},{"key":"poi230053r30","unstructured":"National Healthcare Safety Network. CDC\/NHSN surveillance definitions for specific types of infections. Accessed November 20, 2022. https:\/\/www.cdc.gov\/nhsn\/pdfs\/pscmanual\/17pscnosinfdef_current.pdf"},{"key":"poi230053r38","unstructured":"Queensland Health. Intravascular device management. Accessed November 1, 2022. https:\/\/www.health.qld.gov.au\/clinical-practice\/guidelines-procedures\/diseases-infection\/infection-prevention\/intravascular-device-management"}],"container-title":["JAMA Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamapediatrics\/articlepdf\/2808914\/jamapediatrics_kleidon_2023_oi_230053_1698695780.2284.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,6]],"date-time":"2023-11-06T16:03:34Z","timestamp":1699286614000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamapediatrics\/fullarticle\/2808914"}},"subtitle":["A Randomized Clinical Trial"],"short-title":[],"issued":{"date-parts":[[2023,11,1]]},"references-count":41,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamapediatrics.2023.3526","relation":{},"ISSN":["2168-6203"],"issn-type":[{"value":"2168-6203","type":"print"}],"subject":[],"published":{"date-parts":[[2023,11,1]]}}}