{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T20:02:31Z","timestamp":1783454551036,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003769","name":"Eisai","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003769","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:label\/>\n                    <jats:p>Onychomycosis is a common fungal infection, yet the impact of gain\u2010 versus loss\u2010framed messages on treatment intention has not been examined. This within\u2010subject study evaluated whether age and sex modified sensitivity to message framing in onychomycosis. Among 300 treatment\u2010experienced patients, we compared gain\u2010 and loss\u2010framed messages under mild\u2010 and severe\u2010risk scenarios and measured changes in treatment intention. Participants were classified into gain\u2010dominant, loss\u2010dominant, and neutral clusters based on response differences, and associations with age and sex were examined using multinomial logistic regression analysis. The neutral cluster accounted for the majority of patients, suggesting that the risk information itself may have been persuasive regardless of framing. However, effect modification was observed in the severe\u2010risk scenario: women were more likely to be classified into the loss\u2010dominant cluster, whereas older age was associated with the gain\u2010dominant cluster. These findings highlight the importance of communicating the risks of untreated onychomycosis and suggest that patient characteristics may be associated with directional framing preferences, particularly under severe\u2010risk messages. Given the hypothetical intention outcome and limited robustness in sensitivity analyses, clinical implications should therefore be interpreted cautiously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>UMIN Clinical Trials Registry registration number: UMIN000050195<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1346-8138.70304","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T07:07:52Z","timestamp":1778483272000},"page":"1067-1071","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient Characteristics Associated With Sensitivity to Message Framing: A Within\u2010Subject Comparison Study Using Data From the Illuminating Dialogues and Insights in Onychomycosis Management (\n                    <scp>IDIOM<\/scp>\n                    ) Survey"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7365-947X","authenticated-orcid":false,"given":"Atsushi","family":"Otsuka","sequence":"first","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine Kindai University  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3590-6489","authenticated-orcid":false,"given":"Yuichiro","family":"Tsunemi","sequence":"additional","affiliation":[{"name":"Department of Dermatology Saitama Medical University  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5224-721X","authenticated-orcid":false,"given":"Yusuke","family":"Nonaka","sequence":"additional","affiliation":[{"name":"Sato Pharmaceutical co., Ltd  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.2174\/1872213X13666191026090713"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.18646.1"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/10410236.2020.1723048"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102021\u2010055329"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0890117117729584"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2016.5245"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.19746"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346\u20108138.17716"},{"key":"e_1_2_11_10_1","unstructured":"Ministry of Health Labour and Welfare \u201cEthical Guidelines for Medical and Biological Research Involving Human Subjects \u201daccessed December 17 2025 https:\/\/www.mext.go.jp\/content\/20250325\u2010mxt_life\u2010000035486\u201001.pdf. (Partially revised; 2023)."},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0167\u20104870(87)90005\u20105"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1006\/obhd.2001.2983"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1037\/xap0000285"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.689467"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1257\/000282803322655392"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2023.1086699"}],"container-title":["The Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1346-8138.70304","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/1346-8138.70304","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1346-8138.70304","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T18:45:56Z","timestamp":1783449956000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1346-8138.70304"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,11]]},"references-count":15,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1111\/1346-8138.70304"],"URL":"https:\/\/doi.org\/10.1111\/1346-8138.70304","archive":["Portico"],"relation":{},"ISSN":["0385-2407","1346-8138"],"issn-type":[{"value":"0385-2407","type":"print"},{"value":"1346-8138","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,11]]},"assertion":[{"value":"2026-02-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}