{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T03:16:14Z","timestamp":1790306174407,"version":"4.1.0"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2024,3,26]],"date-time":"2024-03-26T00:00:00Z","timestamp":1711411200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Measurements of aldosterone by mass spectrometry are more accurate and less prone to interferences than immunoassay measurements, and may produce a more accurate aldosterone:renin ratio (ARR) when screening for primary aldosteronism (PA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Differences in diagnostic performance of the ARR using mass spectrometry vs immunoassay measurements of aldosterone were examined in 710 patients screened for PA. PA was confirmed in 153 patients and excluded in 451 others. Disease classifications were not achieved in 106 patients. Areas under receiver-operating characteristic curves (AUROC) and other measures were used to compare diagnostic performance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Mass spectrometry-based measurements yielded lower plasma aldosterone concentrations than immunoassay measurements. For the ARR based on immunoassay measurements of aldosterone, AUROCs were slightly lower (P = 0.018) than those using mass spectrometry measurements (0.895 vs 0.906). The cutoff for the ARR to reach a sensitivity of 95% was 30 and 21.5\u2005pmol\/mU by respective immunoassay and mass spectrometry-based measurements, which corresponded to specificities of 57% for both. With data restricted to patients with unilateral PA, diagnostic sensitivities of 94% with specificities &amp;gt;81% could be achieved at cutoffs of 68 and 52\u2005pmol\/mU for respective immunoassay and mass spectrometry measurements.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Mass spectrometry-based measurements of aldosterone for the ARR provide no clear diagnostic advantage over immunoassay-based measurements. Both approaches offer limited diagnostic accuracy for the ARR as a screening test. One solution is to employ the higher cutoffs to triage patients likely to have unilateral PA for further tests and possible adrenalectomy, while using the lower cutoffs to identify others for targeted medical therapy.<\/jats:p>\n                  <jats:p>German Clinical Trials Register ID: DRKS00017084.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jalm\/jfae017","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T05:08:22Z","timestamp":1711516102000},"page":"752-766","source":"Crossref","is-referenced-by-count":19,"title":["Screening for Primary Aldosteronism by Mass Spectrometry Versus Immunoassay Measurements of Aldosterone: A Prospective Within-Patient Study"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8560-9920","authenticated-orcid":false,"given":"Sybille","family":"Fuld","sequence":"first","affiliation":[{"name":"Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden , Dresden , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7304-2557","authenticated-orcid":false,"given":"Georgiana","family":"Constantinescu","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden , Dresden , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0772-1604","authenticated-orcid":false,"given":"Christina","family":"Pamporaki","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden , Dresden , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2472-675X","authenticated-orcid":false,"given":"Mirko","family":"Peitzsch","sequence":"additional","affiliation":[{"name":"Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden , Dresden , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Schulze","sequence":"additional","affiliation":[{"name":"Center for Interdisciplinary Digital Sciences, Department Information Services and High Performance Computing, Technische Universit\u00e4t Dresden , Dresden , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4620-4976","authenticated-orcid":false,"given":"Jun","family":"Yang","sequence":"additional","affiliation":[{"name":"Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research , Clayton , Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Medicine IV, University Hospital, Ludwig Maximilian University Munich , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksander","family":"Prejbisz","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Cardiovascular Prevention and Health Promotion, National Institute of Cardiology , Warsaw , Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrzej","family":"Januszewicz","sequence":"additional","affiliation":[{"name":"Department of Hypertension, National Institute of Cardiology , Warsaw , Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3499-5910","authenticated-orcid":false,"given":"Hanna","family":"Remde","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of W\u00fcrzburg , W\u00fcrzburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"K\u00fcrzinger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of W\u00fcrzburg , W\u00fcrzburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Dischinger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital, University of W\u00fcrzburg , W\u00fcrzburg , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias","family":"Ernst","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH) , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Gruber","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH) , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9817-9875","authenticated-orcid":false,"given":"Martin","family":"Reincke","sequence":"additional","affiliation":[{"name":"Department of Medicine IV, University Hospital, Ludwig Maximilian University Munich , Munich , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7826-3984","authenticated-orcid":false,"given":"Felix","family":"Beuschlein","sequence":"additional","affiliation":[{"name":"Department of Medicine IV, University Hospital, Ludwig Maximilian University Munich , Munich , Germany"},{"name":"Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH) , Zurich , Switzerland"},{"name":"The LOOP Medical Research Center , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7658-4466","authenticated-orcid":false,"given":"Jacques W M","family":"Lenders","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden , Dresden , Germany"},{"name":"Department of Internal Medicine, Radboud University Medical Center , Nijmegen , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8601-9903","authenticated-orcid":false,"given":"Graeme","family":"Eisenhofer","sequence":"additional","affiliation":[{"name":"Department of Medicine III, University Hospital Carl Gustav Carus, Technische Universit\u00e4t Dresden , Dresden , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,3,27]]},"reference":[{"key":"2024070115221577700_jfae017-B1","doi-asserted-by":"crossref","first-page":"1889","DOI":"10.1210\/jc.2015-4061","article-title":"The management of primary aldosteronism: case detection, diagnosis, and treatment: an endocrine society clinical practice guideline","volume":"101","author":"Funder","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"2024070115221577700_jfae017-B2","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1001\/archinte.1981.00340130033011","article-title":"A screening test to identify aldosterone-producing adenoma by measuring plasma renin activity: results in hypertensive patients","volume":"141","author":"Hiramatsu","year":"1981","journal-title":"Arch Intern Med"},{"key":"2024070115221577700_jfae017-B3","doi-asserted-by":"crossref","DOI":"10.1177\/1470320316657450","article-title":"Aldosterone\/direct renin concentration ratio as a screening test for primary aldosteronism: a meta-analysis","volume":"17","author":"Li","year":"2016","journal-title":"J Renin Angiotensin Aldosterone Syst"},{"key":"2024070115221577700_jfae017-B4","doi-asserted-by":"crossref","first-page":"221","DOI":"10.3949\/ccjm.88a.20166","article-title":"Our evolving understanding of primary aldosteronism","volume":"88","author":"Mehdi","year":"2021","journal-title":"Cleve Clin J Med"},{"key":"2024070115221577700_jfae017-B5","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.jchromb.2014.08.042","article-title":"Enhancement of specificity of aldosterone measurement in human serum and plasma using 2D-LC\u2013MS\/MS and comparison with commercial immunoassays","volume":"970","author":"Ray","year":"2014","journal-title":"J Chromatogr B Analyt Technol Biomed Life Sci"},{"key":"2024070115221577700_jfae017-B6","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1373\/clinchem.2005.061184","article-title":"Plasma aldosterone assays: comparison between chemiluminescence-based and ria methods","volume":"52","author":"Pizzolo","year":"2006","journal-title":"Clin Chem"},{"key":"2024070115221577700_jfae017-B7","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3343\/alm.2022.42.1.3","article-title":"Hormone immunoassay interference: a 2021 update","volume":"42","author":"Ghazal","year":"2021","journal-title":"Ann Lab Med"},{"key":"2024070115221577700_jfae017-B8","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.jchromb.2007.11.005","article-title":"Determination of aldosterone in serum by liquid chromatography\u2013tandem mass spectrometry","volume":"862","author":"Turpeinen","year":"2008","journal-title":"J Chromatogr B Analyt Technol Biomed Life Sci"},{"key":"2024070115221577700_jfae017-B9","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.jchromb.2012.11.013","article-title":"Quantitation of aldosterone in human plasma by ultra high performance liquid chromatography tandem mass spectrometry","volume":"913\u2013914","author":"Hinchliffe","year":"2013","journal-title":"J Chromatogr B Analyt Technol Biomed Life Sci"},{"key":"2024070115221577700_jfae017-B10","doi-asserted-by":"crossref","first-page":"e2027","DOI":"10.1210\/clinem\/dgab924","article-title":"The saline infusion test for primary aldosteronism: implications of immunoassay inaccuracy","volume":"107","author":"Eisenhofer","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"key":"2024070115221577700_jfae017-B11","doi-asserted-by":"crossref","first-page":"bvac049","DOI":"10.1210\/jendso\/bvac049","article-title":"Recalibrating interpretations of aldosterone assays across the physiologic range: immunoassay and liquid chromatography-tandem mass spectrometry measurements under multiple controlled conditions","volume":"6","author":"Brown","year":"2022","journal-title":"J Endocr Soc"},{"key":"2024070115221577700_jfae017-B12","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.cca.2020.04.019","article-title":"Mass spectrometry reveals misdiagnosis of primary aldosteronism with scheduling for adrenalectomy due to immunoassay interference","volume":"507","author":"Constantinescu","year":"2020","journal-title":"Clin Chim Acta"},{"key":"2024070115221577700_jfae017-B13","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1210\/jcem-73-5-952","article-title":"Diagnosis under random conditions of all disorders of the renin-angiotensin-aldosterone axis, including primary hyperaldosteronism","volume":"73","author":"Mckenna","year":"1991","journal-title":"J Clin Endocrinol Metab"},{"key":"2024070115221577700_jfae017-B14","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/978-1-0716-2565-1_5","article-title":"Quantitation of aldosterone in serum or plasma using liquid chromatography-tandem mass spectrometry (LC-MS\/MS)","volume":"2546","author":"van der Gugten","year":"2022","journal-title":"Methods Mol Biol"},{"key":"2024070115221577700_jfae017-B15","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1097\/SLA.0000000000003200","article-title":"The primary aldosteronism surgical outcome score for the prediction of clinical outcomes after adrenalectomy for unilateral primary aldosteronism","volume":"272","author":"Burrello","year":"2020","journal-title":"Ann Surg"},{"key":"2024070115221577700_jfae017-B16","doi-asserted-by":"crossref","first-page":"4113","DOI":"10.1210\/jc.2018-01394","article-title":"Comparison of seated with recumbent saline suppression testing for the diagnosis of primary aldosteronism","volume":"103","author":"Stowasser","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"key":"2024070115221577700_jfae017-B17","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.jsbmb.2014.10.006","article-title":"An LC\u2013MS\/MS method for steroid profiling during adrenal venous sampling for investigation of primary aldosteronism","volume":"145","author":"Peitzsch","year":"2015","journal-title":"J Steroid Biochem Mol Biol"},{"key":"2024070115221577700_jfae017-B18","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1530\/EJE-20-0073","article-title":"Confirmatory testing of primary aldosteronism with saline infusion test and LC-MS\/MS","volume":"184","author":"Fuss","year":"2021","journal-title":"Eur J Endocrinol"},{"key":"2024070115221577700_jfae017-B19","doi-asserted-by":"crossref","first-page":"e477","DOI":"10.1210\/clinem\/dgz150","article-title":"Diagnosis of primary aldosteronism by seated saline suppression test -variability between immunoassay and HPLC-MS\/MS","volume":"105","author":"Thuzar","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"2024070115221577700_jfae017-B20","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1097\/HJH.0000000000001735","article-title":"Criteria for diagnosing primary aldosteronism on the basis of liquid chromatography-tandem mass spectrometry determinations of plasma aldosterone concentration","volume":"36","author":"Baron","year":"2018","journal-title":"J Hypertens"},{"key":"2024070115221577700_jfae017-B21","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1161\/HYPERTENSIONAHA.117.09078","article-title":"Rapid screening of primary aldosteronism by a novel chemiluminescent immunoassay","volume":"70","author":"Morimoto","year":"2017","journal-title":"Hypertension"},{"key":"2024070115221577700_jfae017-B22","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.plabm.2016.11.002","article-title":"Screening for primary aldosteronism using the newly developed IDS-iSYS\u00ae automated assay system","volume":"7","author":"O\u2019Shea","year":"2017","journal-title":"Pract Lab Med"},{"key":"2024070115221577700_jfae017-B23","doi-asserted-by":"crossref","first-page":"2500","DOI":"10.1097\/HJH.0000000000000727","article-title":"Clinical validation for the aldosterone-to-renin ratio and aldosterone suppression testing using simultaneous fully automated chemiluminescence immunoassays","volume":"33","author":"Manolopoulou","year":"2015","journal-title":"J Hypertens"},{"key":"2024070115221577700_jfae017-B24","first-page":"115","article-title":"Active renin mass concentration to determine aldosterone-to-renin ratio in screening for primary aldosteronism","volume":"4","author":"Corbin","year":"2011","journal-title":"Int J Nephrol Renovasc Dis"},{"key":"2024070115221577700_jfae017-B25","doi-asserted-by":"crossref","first-page":"981","DOI":"10.1097\/HJH.0b013e3282f61f8c","article-title":"Plasma and urine aldosterone to plasma renin activity ratio in the diagnosis of primary aldosteronism","volume":"26","author":"Bernini","year":"2008","journal-title":"J Hypertens"},{"key":"2024070115221577700_jfae017-B26","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1210\/jc.2004-1149","article-title":"The use of aldosterone-renin ratio as a diagnostic test for primary hyperaldosteronism and its test characteristics under different conditions of blood sampling","volume":"90","author":"Tiu","year":"2005","journal-title":"J Clin Endocrinol Metab"},{"key":"2024070115221577700_jfae017-B27","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.cca.2014.03.015","article-title":"Combination of LC-MS\/MS aldosterone and automated direct renin in screening for primary aldosteronism","volume":"433","author":"Juutilainen","year":"2014","journal-title":"Clin Chim Acta"},{"key":"2024070115221577700_jfae017-B28","doi-asserted-by":"crossref","first-page":"3965","DOI":"10.1210\/jc.2018-01041","article-title":"Aldosterone LC-MS\/MS assay-specific threshold values in screening and confirmatory testing for primary aldosteronism","volume":"103","author":"Guo","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"key":"2024070115221577700_jfae017-B29","first-page":"e13353","article-title":"The aldosterone to renin ratio in the diagnosis of primary aldosteronism: promises and challenges","volume":"73","author":"O\u2019Shea","year":"2019","journal-title":"Int J Clin Pract"},{"key":"2024070115221577700_jfae017-B30","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1097\/HJH.0000000000000880","article-title":"Diagnostic accuracy of aldosterone and renin measurement by chemiluminescent immunoassay and radioimmunoassay in primary aldosteronism","volume":"34","author":"Burrello","year":"2016","journal-title":"J Hypertens"},{"key":"2024070115221577700_jfae017-B31","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1097\/HJH.0b013e3283656b54","article-title":"Test characteristics of the aldosterone-to-renin ratio as a screening test for primary aldosteronism","volume":"32","author":"Jansen","year":"2014","journal-title":"J Hypertens"},{"key":"2024070115221577700_jfae017-B32","doi-asserted-by":"crossref","first-page":"1748","DOI":"10.1210\/js.2019-00145","article-title":"Diagnostic accuracy of the aldosterone\u2013to\u2013active renin ratio for detecting primary aldosteronism","volume":"3","author":"Pilz","year":"2019","journal-title":"J Endocr Soc"},{"key":"2024070115221577700_jfae017-B33","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1097\/HJH.0000000000001718","article-title":"Case detection in primary aldosteronism: high-diagnostic value of the aldosterone-to-renin ratio when performed under standardized conditions","volume":"36","author":"Vorselaars","year":"2018","journal-title":"J Hypertens"},{"key":"2024070115221577700_jfae017-B34","doi-asserted-by":"crossref","first-page":"e0223832","DOI":"10.1371\/journal.pone.0223832","article-title":"Diagnostic test evaluation methodology: a systematic review of methods employed to evaluate diagnostic tests in the absence of gold standard\u2014an update","volume":"14","author":"Umemneku Chikere","year":"2019","journal-title":"PLoS One"},{"key":"2024070115221577700_jfae017-B35","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1161\/HYPERTENSIONAHA.122.19377","article-title":"Performance of confirmatory tests for diagnosing primary aldosteronism: a systematic review and meta-analysis","volume":"79","author":"Leung","year":"2022","journal-title":"Hypertension"},{"key":"2024070115221577700_jfae017-B36","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1097\/EDE.0b013e318207fc5c","article-title":"Adjusting for differential-verification bias in diagnostic-accuracy studies: a Bayesian approach","volume":"22","author":"de Groot","year":"2011","journal-title":"Epidemiology"},{"key":"2024070115221577700_jfae017-B37","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1002\/sim.4232","article-title":"Bias in estimating accuracy of a binary screening test with differential disease verification","volume":"30","author":"Alonzo","year":"2011","journal-title":"Stat Med"},{"key":"2024070115221577700_jfae017-B38","doi-asserted-by":"crossref","first-page":"1708","DOI":"10.1210\/clinem\/dgaa974","article-title":"Development of a prediction score to avoid confirmatory testing in patients with suspected primary aldosteronism","volume":"106","author":"Burrello","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"key":"2024070115221577700_jfae017-B39","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1161\/HYPERTENSIONAHA.121.17444","article-title":"Clinical score and machine learning-based model to predict diagnosis of primary aldosteronism in arterial hypertension","volume":"78","author":"Buffolo","year":"2021","journal-title":"Hypertension"}],"container-title":["The Journal of Applied Laboratory Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jalm\/article-pdf\/9\/4\/752\/58379435\/jfae017.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jalm\/article-pdf\/9\/4\/752\/58379435\/jfae017.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T18:23:31Z","timestamp":1719858211000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jalm\/article\/9\/4\/752\/7635659"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,27]]},"references-count":39,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,3,27]]},"published-print":{"date-parts":[[2024,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jalm\/jfae017","relation":{},"ISSN":["2475-7241"],"issn-type":[{"value":"2475-7241","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,7]]},"published":{"date-parts":[[2024,3,27]]}}}