{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T21:14:19Z","timestamp":1790457259444,"version":"4.1.0"},"reference-count":69,"publisher":"BMJ","issue":"2","funder":[{"DOI":"10.13039\/501100011000","name":"MILDECA","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100011000","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,1,4]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The high prevalence of hepatitis C and the persistence of HIV and hepatitis C virus (HCV) risk practices in people who inject drugs (PWID) in France underlines the need for innovative prevention interventions. The main objective of this article is to describe the design of the COSINUS cohort study and outline the issues it will explore to evaluate the impact of drug consumption rooms (DCR) on PWID outcomes. Secondary objectives are to assess how DCR (a) influence other drug-related practices, such as the transition from intravenous to less risky modes of use, (b) reduce drug use frequency\/quantity, (c) increase access to treatment for addiction and comorbidities (infectious, psychiatric and other), (d) improve social conditions and (e) reduce levels of violence experienced and drug-related offences. COSINUS will also give us the opportunity to investigate the impact of other harm reduction tools in France and their combined effect with DCR on reducing HIV-HCV risk practices. Furthermore, we will be better able to identify PWID needs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>Enrollment in this prospective multi-site cohort study started in June 2016. Overall, 680 PWID in four different cities (Bordeaux, Marseilles, Paris and Strasbourg) will be enrolled and followed up for 12 months through face-to-face structured interviews administered by trained staff to all eligible participants at baseline (M0), 3\u2009month (M3), 6\u2009month (M6) and 12\u2009month (M12) follow-up visits. These interviews gather data on socio-demographic characteristics, past and current drug and alcohol consumption, drug-use related practices, access to care and social services, experience of violence (as victims), offences, other psychosocial issues and perception and needs about harm reduction interventions and services. Longitudinal data analysis will use a mixed logistic model to assess the impact of individual and structural factors, including DCR attendance and exposure to other harm reduction services, on the main outcome (HIV-HCV risk practices).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>This study was reviewed and approved by the institutional review board of the French Institute of Medical Research and Health (opinion number: 14\u2013166). The findings of this cohort study will help to assess the impact of DCR on HIV-HCV risk practices and other psycho-social outcomes and trajectories. Moreover, they will enable health authorities to shape health and harm reduction policies according to PWID needs. Finally, they will also help to improve current harm reduction and therapeutic interventions and to create novel ones.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-023683","type":"journal-article","created":{"date-parts":[[2019,2,22]],"date-time":"2019-02-22T06:16:09Z","timestamp":1550816169000},"page":"e023683","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Impact of drug consumption rooms on risk practices and access to care in people who inject drugs in France: the COSINUS prospective cohort study protocol"],"prefix":"10.1136","volume":"9","author":[{"given":"Marc","family":"Auriacombe","sequence":"first","affiliation":[{"name":"University of Bordeaux, Bordeaux, Aquitaine, France"},{"name":"Addiction Team, SANPSY, CNRS USR 3413, Bordeaux, France"},{"name":"Department of Psychiatry, University of Pennsylvania Center for Studies of Addiction, Philadelphia, Pennsylvania, USA"},{"name":"P\u00f4le Addictologie, CH Charles Perrens and CHU de Bordeaux, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Perrine","family":"Roux","sequence":"additional","affiliation":[{"name":"Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Sant\u00e9 & Traitement de l\u2019Information M\u00e9dicale, Marseille, France"},{"name":"ORS PACA, Observatoire R\u00e9gional de la Sant\u00e9 Provence-Alpes-C\u00f4te d\u2019Azur, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"La\u00e9lia","family":"Briand Madrid","sequence":"additional","affiliation":[{"name":"Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Sant\u00e9 & Traitement de l\u2019Information M\u00e9dicale, Marseille, France"},{"name":"ORS PACA, Observatoire R\u00e9gional de la Sant\u00e9 Provence-Alpes-C\u00f4te d\u2019Azur, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Kirchherr","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Addictology, INSERM 1114, University Hospital of Strasbourg, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Kervran","sequence":"additional","affiliation":[{"name":"University of Bordeaux, Bordeaux, Aquitaine, France"},{"name":"Addiction Team, SANPSY, CNRS USR 3413, Bordeaux, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Chauvin","sequence":"additional","affiliation":[{"name":"CERMES3 (INSERM U988\/UMR CNRS 8211\/EHESS\/Paris Descartes University), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Gutowski","sequence":"additional","affiliation":[{"name":"Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Sant\u00e9 & Traitement de l\u2019Information M\u00e9dicale, Marseille, France"},{"name":"ORS PACA, Observatoire R\u00e9gional de la Sant\u00e9 Provence-Alpes-C\u00f4te d\u2019Azur, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9cile","family":"Denis","sequence":"additional","affiliation":[{"name":"Addiction Team, SANPSY, CNRS USR 3413, Bordeaux, France"},{"name":"Department of Psychiatry, University of Pennsylvania Center for Studies of Addiction, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Patrizia","family":"Carrieri","sequence":"additional","affiliation":[{"name":"Aix Marseille Univ, INSERM, IRD, SESSTIM, Sciences Economiques & Sociales de la Sant\u00e9 & Traitement de l\u2019Information M\u00e9dicale, Marseille, France"},{"name":"ORS PACA, Observatoire R\u00e9gional de la Sant\u00e9 Provence-Alpes-C\u00f4te d\u2019Azur, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurence","family":"Lalanne","sequence":"additional","affiliation":[{"name":"INSERM U1114, Strasbourg, Alsace, France"},{"name":"Department of Psychiatry and Addictology, Hopitaux universitaires de Strasbourg, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Jauffret-Roustide","sequence":"additional","affiliation":[{"name":"CERMES3 (INSERM U988\/UMR CNRS 8211\/EHESS\/Paris Descartes University), Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,2,21]]},"reference":[{"key":"2025121401444652000_9.2.e023683.1","doi-asserted-by":"publisher","DOI":"10.1159\/000050713"},{"key":"2025121401444652000_9.2.e023683.2","doi-asserted-by":"crossref","first-page":"2082","DOI":"10.1007\/s10461-011-0054-4","article-title":"Change in HIV-HCV risk-taking behavior and seroprevalence among opiate users seeking treatment over an 11-year period and harm reduction policy","volume":"16","author":"Fatseas","year":"2012","journal-title":"AIDS Behav"},{"key":"2025121401444652000_9.2.e023683.3","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1007\/s11920-007-0046-2","article-title":"Why buprenorphine is so successful in treating opiate addiction in France","volume":"9","author":"Fatseas","year":"2007","journal-title":"Curr Psychiatry Rep"},{"key":"2025121401444652000_9.2.e023683.4","doi-asserted-by":"publisher","DOI":"10.1080\/10550490490440780"},{"key":"2025121401444652000_9.2.e023683.5","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1086\/630209","article-title":"Retention in opioid substitution treatment: a major predictor of long-term virological success for HIV-infected injection drug users receiving antiretroviral treatment","volume":"49","author":"Roux","year":"2009","journal-title":"Clin Infect Dis"},{"key":"2025121401444652000_9.2.e023683.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2005.01271.x"},{"key":"2025121401444652000_9.2.e023683.7","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/j.respe.2015.10.003","article-title":"Hepatitis\u00a0C virus and HIV seroprevalences, sociodemographic characteristics, behaviors and access to syringes among drug users, a comparison of geographical areas in France, ANRS-Coquelicot 2011 survey","volume":"64","author":"Weill-Barillet","year":"2016","journal-title":"Rev Epidemiol Sante Publique"},{"key":"2025121401444652000_9.2.e023683.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)61097-0"},{"key":"2025121401444652000_9.2.e023683.9","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyg102"},{"key":"2025121401444652000_9.2.e023683.10","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0b013e3282ef7701"},{"key":"2025121401444652000_9.2.e023683.11","doi-asserted-by":"crossref","DOI":"10.1016\/j.drugalcdep.2014.09.177","article-title":"Impact of 20 years harm reduction policy on HIV and HCV among opioid users not in treatment","volume":"146","author":"Denis","year":"2015","journal-title":"Drug Alcohol Depend"},{"key":"2025121401444652000_9.2.e023683.12","doi-asserted-by":"publisher","DOI":"10.1080\/10826080600847951"},{"key":"2025121401444652000_9.2.e023683.13","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1017\/S0950268816002934","article-title":"Age- and time-dependent prevalence and incidence of hepatitis C virus infection in drug users in France, 2004-2011: model-based estimation from two national cross-sectional serosurveys","volume":"145","author":"Leon","year":"2017","journal-title":"Epidemiol Infect"},{"key":"2025121401444652000_9.2.e023683.14","doi-asserted-by":"publisher","DOI":"10.1111\/add.12125"},{"key":"2025121401444652000_9.2.e023683.15","doi-asserted-by":"crossref","first-page":"1857","DOI":"10.1097\/QAD.0000000000001115","article-title":"HIV infection among persons who inject drugs: ending old epidemics and addressing new outbreaks","volume":"30","author":"Cazein","year":"2016","journal-title":"AIDS"},{"key":"2025121401444652000_9.2.e023683.16","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdh189"},{"key":"2025121401444652000_9.2.e023683.17","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1016\/j.drugalcdep.2008.12.002","article-title":"Injecting-related injury and disease among clients of a supervised injecting facility","volume":"101","author":"Salmon","year":"2009","journal-title":"Drug Alcohol Depend"},{"key":"2025121401444652000_9.2.e023683.18","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.drugalcdep.2008.08.016","article-title":"Prevalences and correlates of non-viral injecting-related injuries and diseases in a convenience sample of Australian injecting drug users","volume":"100","author":"Dwyer","year":"2009","journal-title":"Drug Alcohol Depend"},{"key":"2025121401444652000_9.2.e023683.19","doi-asserted-by":"publisher","DOI":"10.3201\/eid1901.120044"},{"key":"2025121401444652000_9.2.e023683.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2014.10.012"},{"key":"2025121401444652000_9.2.e023683.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2005.04.011"},{"key":"2025121401444652000_9.2.e023683.22","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.1040774"},{"key":"2025121401444652000_9.2.e023683.23","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62353-7"},{"key":"2025121401444652000_9.2.e023683.24","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1016\/j.drugpo.2013.05.008","article-title":"Supervised consumption rooms: the French Paradox","volume":"24","author":"Jauffret-Roustide","year":"2013","journal-title":"Int J Drug Policy"},{"key":"2025121401444652000_9.2.e023683.25","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1111\/add.13089","article-title":"Innovative community-based educational face-to-face intervention to reduce HIV, hepatitis C virus and other blood-borne infectious risks in difficult-to-reach people who inject drugs: results from the ANRS-AERLI intervention study","volume":"111","author":"Roux","year":"2016","journal-title":"Addiction"},{"key":"2025121401444652000_9.2.e023683.26","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.332.7535.220"},{"key":"2025121401444652000_9.2.e023683.27","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199708000-00001"},{"key":"2025121401444652000_9.2.e023683.28","doi-asserted-by":"publisher","DOI":"10.1046\/j.1360-0443.2003.00207.x"},{"key":"2025121401444652000_9.2.e023683.29","doi-asserted-by":"publisher","DOI":"10.1016\/0740-5472(92)90062-S"},{"key":"2025121401444652000_9.2.e023683.30","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1080\/08897077.2015.1036334","article-title":"Usefulness and validity of the modified addiction severity index: a focus on alcohol, drugs, tobacco, and gambling","volume":"37","author":"Denis","year":"2016","journal-title":"Subst Abus"},{"key":"2025121401444652000_9.2.e023683.31","doi-asserted-by":"publisher","DOI":"10.1111\/acer.12092"},{"key":"2025121401444652000_9.2.e023683.32","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1186\/s12954-016-0114-1","article-title":"A socio-structural approach to preventing injection drug use initiation: rationale for the PRIMER study","volume":"13","author":"Werb","year":"2016","journal-title":"Harm Reduct J"},{"key":"2025121401444652000_9.2.e023683.33","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.150.6.885"},{"key":"2025121401444652000_9.2.e023683.34","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.56.6.893"},{"key":"2025121401444652000_9.2.e023683.35","doi-asserted-by":"publisher","DOI":"10.1177\/070674370304800111"},{"key":"2025121401444652000_9.2.e023683.36","doi-asserted-by":"publisher","DOI":"10.1097\/00006842-197905000-00004"},{"key":"2025121401444652000_9.2.e023683.37","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.11.1621"},{"key":"2025121401444652000_9.2.e023683.38","first-page":"1696","article-title":"[\"The 5 words\": a simple and sensitive test for the diagnosis of Alzheimer\u2019s disease]","volume":"31","author":"Dubois","year":"2002","journal-title":"Presse Med"},{"key":"2025121401444652000_9.2.e023683.39","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2010.07.023"},{"key":"2025121401444652000_9.2.e023683.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2009.04.014"},{"key":"2025121401444652000_9.2.e023683.41","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.2008.02474.x"},{"key":"2025121401444652000_9.2.e023683.42","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1111\/dar.12564","article-title":"Theory versus practice, bacteriological efficiency versus personal habits: A bacteriological and user acceptability evaluation of filtering tools for people who inject drugs","volume":"37","author":"Jauffret-Roustide","year":"2018","journal-title":"Drug Alcohol Rev"},{"key":"2025121401444652000_9.2.e023683.43","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1016\/j.drugalcdep.2008.12.018","article-title":"Utilization patterns and correlates of retention among clients of the needle exchange program in Baltimore, Maryland","volume":"103","author":"Gindi","year":"2009","journal-title":"Drug Alcohol Depend"},{"key":"2025121401444652000_9.2.e023683.44","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1080\/09540120500431584","article-title":"Oral contraception and unprotected sex with occasional partners of women HIV-infected through injection drug use","volume":"18","author":"Carrieri","year":"2006","journal-title":"AIDS Care"},{"key":"2025121401444652000_9.2.e023683.45","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7517-1-9"},{"key":"2025121401444652000_9.2.e023683.46","unstructured":"Brisacier AC . Tableau de bord \u00ab Traitements de substitution aux opiac\u00e9s \u00bb Saint-Denis. OFDT, 2015."},{"key":"2025121401444652000_9.2.e023683.47","doi-asserted-by":"publisher","DOI":"10.1086\/508184"},{"key":"2025121401444652000_9.2.e023683.48","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-006-9089-7"},{"key":"2025121401444652000_9.2.e023683.49","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.e5945","article-title":"Opiate substitution treatment and HIV transmission in people who inject drugs: systematic review and meta-analysis","volume":"345","author":"MacArthur","year":"2012","journal-title":"BMJ"},{"key":"2025121401444652000_9.2.e023683.50","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-9-113"},{"key":"2025121401444652000_9.2.e023683.51","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1111\/add.12506","article-title":"Increasing public support for supervised injection facilities in Ontario, Canada","volume":"109","author":"Strike","year":"2014","journal-title":"Addiction"},{"key":"2025121401444652000_9.2.e023683.52","doi-asserted-by":"publisher","DOI":"10.1016\/S0955-3959(98)00072-3"},{"key":"2025121401444652000_9.2.e023683.53","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1186\/s12954-015-0060-3","article-title":"Ambivalence about supervised injection facilities among community stakeholders","volume":"12","author":"Strike","year":"2015","journal-title":"Harm Reduct J"},{"key":"2025121401444652000_9.2.e023683.54","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2006.11.010"},{"key":"2025121401444652000_9.2.e023683.55","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.drugalcdep.2010.02.009","article-title":"Acceptability of a safer injection facility among injection drug users in San Francisco","volume":"110","author":"Kral","year":"2010","journal-title":"Drug Alcohol Depend"},{"key":"2025121401444652000_9.2.e023683.56","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1016\/j.drugpo.2018.04.014","article-title":"Drug consumption rooms: Comparing times, spaces and actors in issues of social acceptability in French public debate","volume":"56","author":"Jauffret-Roustide","year":"2018","journal-title":"Int J Drug Policy"},{"key":"2025121401444652000_9.2.e023683.57","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2006.086256"},{"key":"2025121401444652000_9.2.e023683.58","doi-asserted-by":"publisher","DOI":"10.1521\/aeap.2011.23.5.412"},{"key":"2025121401444652000_9.2.e023683.59","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.080808"},{"key":"2025121401444652000_9.2.e023683.60","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc052939"},{"key":"2025121401444652000_9.2.e023683.61","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.drugalcdep.2008.05.014","article-title":"Accessing care for injection-related infections through a medically supervised injecting facility: a qualitative study","volume":"98","author":"Small","year":"2008","journal-title":"Drug Alcohol Depend"},{"key":"2025121401444652000_9.2.e023683.62","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdl090"},{"key":"2025121401444652000_9.2.e023683.63","doi-asserted-by":"crossref","first-page":"1351","DOI":"10.3109\/10826081003767643","article-title":"Harmful microinjecting practices among a cohort of injection drug users in vancouver Canada","volume":"45","author":"Rachlis","year":"2010","journal-title":"Subst Use Misuse"},{"key":"2025121401444652000_9.2.e023683.64","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.drugpo.2008.01.003","article-title":"Nurse-delivered safer injection education among a cohort of injection drug users: evidence from the evaluation of vancouver\u2019s supervised injection facility","volume":"19","author":"Wood","year":"2008","journal-title":"Int J Drug Policy"},{"key":"2025121401444652000_9.2.e023683.65","doi-asserted-by":"publisher","DOI":"10.1111\/add.12064"},{"key":"2025121401444652000_9.2.e023683.66","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/1477-7517-9-34","article-title":"Canada\u2019s highest court unchains injection drug users; implications for harm reduction as standard of healthcare","volume":"9","author":"Small","year":"2012","journal-title":"Harm Reduct J"},{"key":"2025121401444652000_9.2.e023683.67","doi-asserted-by":"publisher","DOI":"10.1016\/S0376-8716(98)00028-3"},{"key":"2025121401444652000_9.2.e023683.68","doi-asserted-by":"crossref","first-page":"356","DOI":"10.3109\/10826084.2011.640732","article-title":"Validity of the self-reported drug use section of the addiction severity index and associated factors used under naturalistic conditions","volume":"47","author":"Denis","year":"2012","journal-title":"Subst Use Misuse"},{"key":"2025121401444652000_9.2.e023683.69","unstructured":"Jauffret-Roustide M , Serebroskhaya D , Chollet A , et al . Comparison of social profiles\u00a0practices and situation toward Hepatitis C among Russian-speaking drug users in Paris, France. ANRS-Coquelicot Study 2017:285\u201390."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-023683","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T09:44:55Z","timestamp":1765705495000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-023683"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2]]},"references-count":69,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,2,21]]},"published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1136\/bmjopen-2018-023683"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-023683","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2]]}}}