{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T09:00:31Z","timestamp":1791536431548,"version":"4.3.4"},"reference-count":81,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2015,11,23]],"date-time":"2015-11-23T00:00:00Z","timestamp":1448236800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"},{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Clin Microbiol Rev"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n          <jats:sec>\n            <jats:title>Background.<\/jats:title>\n            <jats:p>Bloodstream infection (BSI) is a major cause of morbidity and mortality throughout the world. Rapid identification of bloodstream pathogens is a laboratory practice that supports strategies for rapid transition to direct targeted therapy by providing for timely and effective patient care. In fact, the more rapidly that appropriate antimicrobials are prescribed, the lower the mortality for patients with sepsis. Rapid identification methods may have multiple positive impacts on patient outcomes, including reductions in mortality, morbidity, hospital lengths of stay, and antibiotic use. In addition, the strategy can reduce the cost of care for patients with BSIs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objectives.<\/jats:title>\n            <jats:p>\n              The purpose of this review is to evaluate the evidence for the effectiveness of three rapid diagnostic practices in decreasing the time to targeted therapy for hospitalized patients with BSIs. The review was performed by applying the Centers for Disease Control and Prevention's (CDC's) Laboratory Medicine Best Practices Initiative (LMBP) systematic review methods for quality improvement (QI) practices and translating the results into evidence-based guidance (R. H. Christenson et al., Clin Chem\n              <jats:bold>57<\/jats:bold>\n              :816\u2013825, 2011,\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/dx.doi.org\/10.1373\/clinchem.2010.157131\">http:\/\/dx.doi.org\/10.1373\/clinchem.2010.157131<\/jats:ext-link>\n              ).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Search strategy.<\/jats:title>\n            <jats:p>A comprehensive literature search was conducted to identify studies with measurable outcomes. A search of three electronic bibliographic databases (PubMed, Embase, and CINAHL), databases containing \u201cgray\u201d literature (unpublished academic, government, or industry evidence not governed by commercial publishing) (CIHI, NIHR, SIGN, and other databases), and the Cochrane database for English-language articles published between 1990 and 2011 was conducted in July 2011.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Dates of search.<\/jats:title>\n            <jats:p>The dates of our search were from 1990 to July 2011.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Selection criteria.<\/jats:title>\n            <jats:p>\n              Animal studies and non-English publications were excluded. The search contained the following medical subject headings: bacteremia; bloodstream infection; time factors; health care costs; length of stay; morbidity; mortality; antimicrobial therapy; rapid molecular techniques, polymerase chain reaction (PCR);\n              <jats:italic>in situ<\/jats:italic>\n              hybridization, fluorescence; treatment outcome; drug therapy; patient care team; pharmacy service, hospital; hospital information systems; Gram stain; pharmacy service; and spectrometry, mass, matrix-assisted laser desorption-ionization. Phenotypic as well as the following key words were searched: targeted therapy; rapid identification; rapid; Gram positive; Gram negative; reduce(ed); cost(s); pneumoslide; PBP2; tube coagulase; matrix-assisted laser desorption\/ionization time of flight; MALDI TOF; blood culture; EMR; electronic reporting; call to provider; collaboration; pharmacy; laboratory; bacteria; yeast; ICU; and others. In addition to the electronic search being performed, a request for unpublished quality improvement data was made to the clinical laboratory community.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main results.<\/jats:title>\n            <jats:p>Rapid molecular testing with direct communication significantly improves timeliness compared to standard testing. Rapid phenotypic techniques with direct communication likely improve the timeliness of targeted therapy. Studies show a significant and homogeneous reduction in mortality associated with rapid molecular testing combined with direct communication.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Author's conclusions.<\/jats:title>\n            <jats:p>\n              No recommendation is made for or against the use of the three assessed practices of this review due to insufficient evidence. The overall strength of evidence is suggestive; the data suggest that each of these three practices has the potential to improve the time required to initiate targeted therapy and possibly improve other patient outcomes, such as mortality. The meta-analysis results suggest that the implementation of any of the three practices may be more effective at increasing timeliness to targeted therapy than routine microbiology techniques for identification of the microorganisms causing BSIs. Based on the included studies, results for all three practices appear applicable across multiple microorganisms, including methicillin-resistant\n              <jats:named-content content-type=\"genus-species\">\n                <jats:italic>Staphylococcus aureus<\/jats:italic>\n              <\/jats:named-content>\n              (MRSA), methicillin-sensitive\n              <jats:named-content content-type=\"genus-species\">\n                <jats:italic>S. aureus<\/jats:italic>\n              <\/jats:named-content>\n              (MSSA),\n              <jats:named-content content-type=\"genus-species\">\n                <jats:italic>Candida<\/jats:italic>\n              <\/jats:named-content>\n              species, and\n              <jats:named-content content-type=\"genus-species\">\n                <jats:italic>Enterococcus<\/jats:italic>\n              <\/jats:named-content>\n              species.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/cmr.00053-14","type":"journal-article","created":{"date-parts":[[2015,11,24]],"date-time":"2015-11-24T03:19:05Z","timestamp":1448335145000},"page":"59-103","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":274,"title":["Effectiveness of Practices To Increase Timeliness of Providing Targeted Therapy for Inpatients with Bloodstream Infections: a Laboratory Medicine Best Practices Systematic Review and Meta-analysis"],"prefix":"10.1128","volume":"29","author":[{"given":"Stephanie S.","family":"Buehler","sequence":"first","affiliation":[{"name":"Battelle Center for Analytics and Public Health, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bereneice","family":"Madison","sequence":"additional","affiliation":[{"name":"Battelle Center for Analytics and Public Health, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan R.","family":"Snyder","sequence":"additional","affiliation":[{"name":"Battelle Center for Analytics and Public Health, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James H.","family":"Derzon","sequence":"additional","affiliation":[{"name":"Battelle Center for Analytics and Public Health, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy E.","family":"Cornish","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Center for Surveillance, Epidemiology and Laboratory Services (CSELS), Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Saubolle","sequence":"additional","affiliation":[{"name":"Banner Good Samaritan Medical Center, Banner Health, Phoenix, Arizona, USA, and University of Arizona College of Medicine, Phoenix, and University of Arizona College of Medicine, Tucson, Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice S.","family":"Weissfeld","sequence":"additional","affiliation":[{"name":"Microbiology Specialists Incorporated, Houston, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melvin P.","family":"Weinstein","sequence":"additional","affiliation":[{"name":"Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward B.","family":"Liebow","sequence":"additional","affiliation":[{"name":"Battelle Center for Analytics and Public Health, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna M.","family":"Wolk","sequence":"additional","affiliation":[{"name":"Geisinger Health System, Danville, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2010.157131"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcmed.2005.02.005"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.7.3119-3125.2003"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)07900-X"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1994.03510440058033"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1086\/591698"},{"key":"e_1_3_2_8_2","volume-title":"NCHS Data Brief 118","author":"Hall M","year":"2013","unstructured":"Hall M , Levant S , DeFrances C . 2013. Trends in inpatient hospital deaths: National Hospital Discharge Survey, 2000\u20132010. NCHS Data Brief 118. National Center for Health Statistics, Centers for Disease Control and Prevention, Atlanta, GA."},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.5804"},{"key":"e_1_3_2_10_2","volume-title":"hospitals, 2009: HCUP Statistical Brief 122","author":"Elixhauser A","year":"2006","unstructured":"Elixhauser A , Friedman B , Stranges E . 2006. Septicemia in U.S. hospitals, 2009: HCUP Statistical Brief 122. Agency for Healthcare Research and Quality, Rockville, MD."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1086\/502584"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12634"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e3181cc4824"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000620"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000217961.75225.E9"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.2165\/11533020-000000000-00000"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jp.7211597"},{"key":"e_1_3_2_18_2","first-page":"126","article-title":"Rapid identification of methicillin-resistant staphylococci bacteremia among intensive care unit patients","volume":"10","author":"Diab M","year":"2008","unstructured":"Diab M , El-Damarawy M , Shemis M . 2008. Rapid identification of methicillin-resistant staphylococci bacteremia among intensive care unit patients. Medscape J Med 10:126.","journal-title":"Medscape J Med"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2003.10.001"},{"key":"e_1_3_2_20_2","volume-title":"Coordinating ed, Baron EJ","author":"Baron EJ","year":"2005","unstructured":"Baron EJ , Weinstein MP , Dunne WM, Jr , Yagupsky P , Welch DF , Wilson DM . 2005. Cumitech 1C, Blood cultures IV. Coordinating ed, Baron EJ. ASM Press, Washington, DC."},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01085-06"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1994.00420230024004"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1086\/424520"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1699-0463.1995.tb01077.x"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/5.1.54"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00567-09"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.50.12.1010"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(89)80146-9"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00751-06"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1086\/514752"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1086\/502213"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.14.1868"},{"key":"e_1_3_2_33_2","volume-title":"Approved guidelines","author":"CLSI","year":"2007","unstructured":"CLSI. 2007. Principles and procedures for blood cultures. Approved guidelines. CLSI, Wayne, PA."},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.1.495-497.2003"},{"key":"e_1_3_2_35_2","unstructured":"Centers for Disease Control and Prevention. 2014. Rapid diagnostic tests: how they work. Centers for Disease Control and Prevention Atlanta GA. \nhttp:\/\/www.cdc.gov\/malaria\/malaria_worldwide\/reduction\/dx_rdt.html\n."},{"key":"e_1_3_2_36_2","unstructured":"World Health Organization. 2014. Simple\/rapid tests. World Health Organization Geneva Switzerland. \nhttp:\/\/www.who.int\/diagnostics_laboratory\/faq\/simple_rapid_tests\/en\/\n."},{"key":"e_1_3_2_37_2","doi-asserted-by":"crossref","unstructured":"Garcia LS\n (ed). 2010. Clinical microbiology procedures handbook 3rd ed. ASM Press Washington DC.","DOI":"10.1128\/9781555817435"},{"key":"e_1_3_2_38_2","doi-asserted-by":"crossref","unstructured":"Versalovic J Carroll KC Funke G Jorgensen JH Landry ML Warnock DW\n (ed). 2011. Manual of clinical microbiology 10th ed. ASM Press Washington DC.","DOI":"10.1128\/9781555816728"},{"key":"e_1_3_2_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-2712(18)30403-7"},{"key":"e_1_3_2_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2013.04.018"},{"key":"e_1_3_2_41_2","doi-asserted-by":"crossref","unstructured":"Marlowe EM Wolk DM\n. 2006. Pathogen detection in the genomic era p 505\u2013525. In Tang Y (ed) Advanced techniques in diagnostic microbiology\n. Springer Verlag New York NY.","DOI":"10.1007\/0-387-32892-0_28"},{"key":"e_1_3_2_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cll.2013.03.010"},{"key":"e_1_3_2_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cll.2013.03.006"},{"key":"e_1_3_2_44_2","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPVMDQU2ZJDPBL"},{"key":"e_1_3_2_45_2","unstructured":"Institute of Medicine. 2011. Finding what works in healthcare: standards for systematic reviews. National Academies Press Washington DC."},{"key":"e_1_3_2_46_2","first-page":"221","volume-title":"The handbook of research synthesis","author":"Borenstein M","year":"2009","unstructured":"Borenstein M . 2009. Effect sizes for continuous data, p 221\u2013235. In Cooper H , Hedges L , Valentine J (ed), The handbook of research synthesis, 2nd ed. Russell Sage, New York, NY.","edition":"2"},{"key":"e_1_3_2_47_2","doi-asserted-by":"crossref","unstructured":"Borenstein M Hedges L Higgins J Rothsteins H\n. 2009. Introduction to meta-analysis. Chichester West Sussex United Kingdom.","DOI":"10.1002\/9780470743386"},{"key":"e_1_3_2_48_2","first-page":"237","volume-title":"The handbook of research synthesis","author":"Fleiss J","year":"2009","unstructured":"Fleiss J , Berlin J . 2009. Effect size for dichotomous data, p 237\u2013256. In Cooper H , Hedges L , Valentine J (ed), The handbook of research synthesis, 2nd ed. Russell Sage, New York, NY.","edition":"2"},{"key":"e_1_3_2_49_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.8.3942-3944.2003"},{"key":"e_1_3_2_50_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02150-09"},{"key":"e_1_3_2_51_2","doi-asserted-by":"publisher","DOI":"10.1086\/656248"},{"key":"e_1_3_2_52_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.06169-11"},{"key":"e_1_3_2_53_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0163-4453(99)90049-X"},{"key":"e_1_3_2_54_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02461-10"},{"key":"e_1_3_2_55_2","doi-asserted-by":"publisher","DOI":"10.1586\/14737159.7.3.231"},{"key":"e_1_3_2_56_2","doi-asserted-by":"publisher","DOI":"10.1086\/656623"},{"key":"e_1_3_2_57_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00283-08"},{"key":"e_1_3_2_58_2","doi-asserted-by":"publisher","DOI":"10.2147\/TCRM.S2838"},{"key":"e_1_3_2_59_2","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp110604"},{"key":"e_1_3_2_60_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkl146"},{"key":"e_1_3_2_61_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.27.6.1342-1345.1989"},{"key":"e_1_3_2_62_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkm497"},{"key":"e_1_3_2_63_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-005-1309-7"},{"key":"e_1_3_2_64_2","doi-asserted-by":"publisher","DOI":"10.1128\/jcm.32.7.1757-1762.1994"},{"key":"e_1_3_2_65_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.313.7052.275"},{"key":"e_1_3_2_66_2","unstructured":"Drummond MF O'Brien B Stoddart G\n. 1997. Methods for the economic evaluation of health care programmes. Oxford Medical Publications Oxford United Kingdom."},{"key":"e_1_3_2_67_2","first-page":"886","article-title":"OMERACT 6 Economics Working Group report: a proposal for a reference case for economic evaluation in rheumatoid arthritis","volume":"30","author":"Gabriel S","year":"2003","unstructured":"Gabriel S , Drummond M , Maetzel A , Boers M , Coyle D , Welch V , Tugwell P . 2003. OMERACT 6 Economics Working Group report: a proposal for a reference case for economic evaluation in rheumatoid arthritis. J Rheumatol 30:886\u2013890.","journal-title":"J Rheumatol"},{"key":"e_1_3_2_68_2","unstructured":"World Health Organization. 2011. The burden of health care-associated infection worldwide. World Health Organization Geneva Switzerland."},{"key":"e_1_3_2_69_2","doi-asserted-by":"publisher","DOI":"10.1093\/clinchem\/43.9.1771"},{"key":"e_1_3_2_70_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.40.6.2182-2186.2002"},{"key":"e_1_3_2_71_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1525-1578(10)60590-9"},{"key":"e_1_3_2_72_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0031126"},{"key":"e_1_3_2_73_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.7.3293-3298.2003"},{"key":"e_1_3_2_74_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.13444"},{"key":"e_1_3_2_75_2","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12329"},{"key":"e_1_3_2_76_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis1204"},{"key":"e_1_3_2_77_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit498"},{"key":"e_1_3_2_78_2","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12282"},{"key":"e_1_3_2_79_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0032589"},{"key":"e_1_3_2_80_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.2.218"},{"key":"e_1_3_2_81_2","doi-asserted-by":"publisher","DOI":"10.1373\/49.1.1"},{"key":"e_1_3_2_82_2","doi-asserted-by":"crossref","unstructured":"Whitley E Ball J\n. 2002. Statistics review 4: sample size calculations. Crit Care 6:335\u2013341. \nhttp:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC137461\/pdf\/cc1521.pdf\n. (Accessed 18 April 2014.)","DOI":"10.1186\/cc1521"}],"container-title":["Clinical Microbiology Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/CMR.00053-14","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/CMR.00053-14","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T12:55:22Z","timestamp":1645620922000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/CMR.00053-14"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,1]]},"references-count":81,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2016,1]]}},"alternative-id":["10.1128\/CMR.00053-14"],"URL":"https:\/\/doi.org\/10.1128\/cmr.00053-14","relation":{},"ISSN":["0893-8512","1098-6618"],"issn-type":[{"value":"0893-8512","type":"print"},{"value":"1098-6618","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,1]]},"assertion":[{"value":"2015-11-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}