{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T19:53:44Z","timestamp":1781639624245,"version":"3.54.5"},"reference-count":51,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T00:00:00Z","timestamp":1772409600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Herzzentrum G\u00f6ttingen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Inform Decis Mak"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>To obtain sufficient data for clinical research on Rare Diseases (RDs), the project \u201cCollaboration on Rare Diseases\u201d (CORD-MI) has connected 24 University Medical Centers (UMCs) in Germany. As part of the national Medical Informatics Initiative (MII), which aims at making the EHR data of all German UMCs FAIR and jointly usable for research, CORD-MI extends the methods and tools along the special requirements of RD data. Major challenges are insufficient coding of RDs and the high influence of individual data records on the results due to low cohort sizes. Hence, high data quality (DQ) of each data record is vital and exclusion due to quality issues may lead to insufficient sample sizes. DQ deficiencies induced by a FAIRification process may be corrected retrospectively; therefore their identification is of high relevance for RD research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used a self-developed DQ assessment tool to investigate the impact of the implemented FAIRification processes. Seven normalized DQ indicators \u2013 encompassing completeness, uniqueness, and plausibility \u2013 were assessed automatically across two datasets created from the same patient information system (PAS) but processed differently: claims data available in a FAIR format by MII standards (FHIR-DS), and a direct export (EXP-DS). The results were independently validated by domain experts, and measures to resolve the DQ issues were investigated. Furthermore, the tool\u2019s FAIRness and computational performance were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We found a higher number of DQ issues in FHIR-DS than in EXP-DS. Specifically, FHIR-DS contained 1988 distinct DQ issues: nine ambiguous RD cases, two missing data items, and 1977 completeness issues induced by the FAIRification processes. We could successfully resolve the majority (68%) of all identified DQ issues in FHIR-DS. The runtime performance could be reduced from 12.52\u00a0min to 0.12\u00a0min for FHIR-DS by multi-core parallelization. A comparison with current FAIR guidelines of the software showed compliance with 16 of 17 principles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Completeness indicators are crucial for evaluating the quality of RD data, as most identified issues are related to the completeness dimension and largely stem from FAIRification processes. Our findings have shown the efficiency and effectiveness of our methodology in improving the quality and usefulness of FAIR data both retrospectively and prospectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial number<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12911-025-03153-x","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T12:39:20Z","timestamp":1772455160000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sharing EHR data of patients with rare diseases for research - The role of quality assessments in a national federated research data infrastructure"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9683-0575","authenticated-orcid":false,"given":"Kais","family":"Tahar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Verbuecheln","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"Martin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holm","family":"Graessner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Biergans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dagmar","family":"Krefting","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,2]]},"reference":[{"issue":"6","key":"3153_CR1","doi-asserted-by":"publisher","first-page":"607","DOI":"10.1007\/s12265-014-9579-z","volume":"7","author":"LV Rasmussen","year":"2014","unstructured":"Rasmussen LV. The electronic health record for translational research. J Cardiovasc Transl Res. 2014;7(6):607\u201314.","journal-title":"J Cardiovasc Transl Res"},{"issue":"Suppl 1","key":"3153_CR2","first-page":"e50","volume":"57","author":"SC Semler","year":"2018","unstructured":"Semler SC, Wissing F, Heyder R. German medical informatics initiative. Methods Inf Med. 2018;57(Suppl 1):e50\u20136.","journal-title":"Methods Inf Med"},{"issue":"2","key":"3153_CR3","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1097\/MOL.0000000000000662","volume":"31","author":"MS Safarova","year":"2020","unstructured":"Safarova MS, Kullo IJ. Using the electronic health record for genomics research. Curr Opin Lipidol. 2020;31(2):85\u201393.","journal-title":"Curr Opin Lipidol"},{"issue":"1","key":"3153_CR4","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1037\/pag0000653","volume":"37","author":"BP Taylor","year":"2022","unstructured":"Taylor BP, Rebok GW, Marsiske M. Good clinical practice improves rigor and transparency: lessons from the ACTIVE trial. Psychol Aging. 2022;37(1):43\u201350.","journal-title":"Psychol Aging"},{"issue":"4","key":"3153_CR5","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.4338\/ACI-2017-03-RA-0042","volume":"08","author":"SG Johnson","year":"2017","unstructured":"Johnson SG, Speedie S, Simon G, Kumar V, Westra BL. Quantifying the effect of data quality on the validity of an eMeasure. Appl Clin Inf. 2017;08(4):1012\u201321.","journal-title":"Appl Clin Inf"},{"key":"3153_CR6","doi-asserted-by":"crossref","unstructured":"Wang RY, Strong DM. J Manag Inf Syst. 1996;12(4):5\u201333. Beyond accuracy: what data quality means to data consumers.","DOI":"10.1080\/07421222.1996.11518099"},{"key":"3153_CR7","unstructured":"Martin T, Tahar K, Lehne M, Hebestreit H, Schepers J, Krefting D, et al. Problems of finding rare diseases in the documentation of German hospitals. In German Medical Science GMS Publishing House; 2021. p. DocAbstr."},{"key":"3153_CR8","unstructured":"Use Case CORD-MI. | Medical Informatics Initiative [Internet]. [cited 2024 Oct 08]. Available from: https:\/\/www.medizininformatik-initiative.de\/en\/CORD"},{"issue":"1","key":"3153_CR9","doi-asserted-by":"publisher","first-page":"160018","DOI":"10.1038\/sdata.2016.18","volume":"3","author":"MD Wilkinson","year":"2016","unstructured":"Wilkinson MD, Dumontier M, Aalbersberg IJ, Appleton G, Axton M, Baak A, et al. The FAIR guiding principles for scientific data management and stewardship. Sci Data. 2016;3(1):160018.","journal-title":"Sci Data"},{"key":"3153_CR10","doi-asserted-by":"crossref","unstructured":"Bender D, Sartipi K. HL7 FHIR: An Agile and RESTful approach to healthcare information exchange. In: Proceedings of the 26th IEEE International Symposium on Computer-based Medical Systems. 2013. p. 326\u201331.","DOI":"10.1109\/CBMS.2013.6627810"},{"issue":"6","key":"3153_CR11","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1007\/s00103-024-03884-8","volume":"67","author":"D Waltemath","year":"2024","unstructured":"Waltemath D, Beyan O, Crameri K, Dedi\u00e9 A, Gierend K, Gr\u00f6ber P, Inau ET, Michaelis L, Reinecke I, Sedlmayr M, Thun S, Krefting D. FAIRe Gesundheitsdaten im nationalen und internationalen Datenraum. Bundesgesundheitsbl. 2024;67(6):710\u201320.","journal-title":"Bundesgesundheitsbl"},{"key":"3153_CR12","unstructured":"FDPG - Forschungsdatenportal f\u00fcr Gesundheit [Internet]. [cited 2025 May 24]. Available from: https:\/\/forschen-fuer-gesundheit.de\/en\/"},{"key":"3153_CR13","doi-asserted-by":"publisher","first-page":"594117","DOI":"10.3389\/fpubh.2020.594117","volume":"8","author":"LA Kapsner","year":"2021","unstructured":"Kapsner LA, Kampf MO, Seuchter SA, Gruendner J, Gulden C, Mate S, et al. Reduced rate of inpatient hospital admissions in 18 German university hospitals during the COVID\u201319 lockdown. Front Public Health. 2021;8:594117.","journal-title":"Front Public Health"},{"key":"3153_CR14","doi-asserted-by":"crossref","unstructured":"Spengler H, Gatz I, Kohlmayer F, Kuhn KA, Prasser F. Improving data quality in medical research: a monitoring architecture for clinical and translational data warehouses. In: 2020 IEEE 33rd international symposium on computer-based medical systems (CBMS). Rochester, MN, USA: IEEE; 2020. pp. 415\u201320.","DOI":"10.1109\/CBMS49503.2020.00085"},{"issue":"1","key":"3153_CR15","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1136\/amiajnl-2012-001145","volume":"20","author":"G Hripcsak","year":"2013","unstructured":"Hripcsak G, Albers DJ. Next-generation phenotyping of electronic health records. J Am Med Inf Assoc JAMIA. 2013;20(1):117\u201321.","journal-title":"J Am Med Inf Assoc JAMIA"},{"key":"3153_CR16","unstructured":"BfArM -. ICD-10-GM [Internet]. [cited 2024 Oct 08]. Available from: https:\/\/www.bfarm.de\/EN\/Code-systems\/Classifications\/ICD\/ICD-10-GM\/_node.html"},{"issue":"1","key":"3153_CR17","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1186\/s13023-015-0251-8","volume":"10","author":"S Aym\u00e9","year":"2015","unstructured":"Aym\u00e9 S, Bellet B, Rath A. Rare diseases in ICD11: making rare diseases visible in health information systems through appropriate coding. Orphanet J Rare Dis. 2015;10(1):35.","journal-title":"Orphanet J Rare Dis"},{"key":"3153_CR18","unstructured":"Orphanet [Internet]. [cited 2024 Oct 08]. Available from: https:\/\/www.orpha.net\/"},{"key":"3153_CR19","doi-asserted-by":"crossref","unstructured":"Ramasamy A, Chowdhury S. Big data quality dimensions: a systematic literature review. J Inf Technol Manag. 2020;17(0).","DOI":"10.4301\/S1807-1775202017003"},{"key":"3153_CR20","doi-asserted-by":"crossref","unstructured":"Kahn MG, Callahan TJ, Barnard J, Bauck AE, Brown J, Davidson BN, et al. EGEMs gener evid methods improve patient outcomes. A harmonized data quality assessment terminology and framework for the secondary use of electronic health record data. 2016;4(1):18.","DOI":"10.13063\/2327-9214.1244"},{"issue":"1","key":"3153_CR21","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1186\/s12874-021-01252-7","volume":"21","author":"CO Schmidt","year":"2021","unstructured":"Schmidt CO, Struckmann S, Enzenbach C, Reineke A, Stausberg J, Damerow S, et al. Facilitating harmonized data quality assessments. A data quality framework for observational health research data collections with software implementations in R. BMC Med Res Methodol. 2021;21(1):63.","journal-title":"BMC Med Res Methodol"},{"key":"3153_CR22","doi-asserted-by":"crossref","unstructured":"Tahar K, Verbuecheln R, Martin T, Graessner H, Krefting D. Local data quality assessments on EHR-based real-world data for rare diseases. Stud Health Technol Inform. 2023 May 18;302:292\u20136.","DOI":"10.3233\/SHTI230121"},{"issue":"3\/4","key":"3153_CR23","first-page":"71","volume":"62","author":"K Tahar","year":"2023","unstructured":"Tahar K, Martin T, Mou Y, Verbuecheln R, Graessner H, Krefting D. Rare diseases in hospital information systems \u2014 An interoperable methodology for distributed data quality assessments. Methods Inf Med. 2023;62(3\/4):71\u201389.","journal-title":"Methods Inf Med"},{"key":"3153_CR24","first-page":"307","volume":"302","author":"HU Prokosch","year":"2023","unstructured":"Prokosch HU, Gebhardt M, Gruendner J, Kleinert P, Buckow K, Rosenau L, et al. Towards a national portal for medical research data (FDPG): vision, status, and lessons learned. Stud Health Technol Inf. 2023;302:307\u201311.","journal-title":"Stud Health Technol Inf"},{"key":"3153_CR25","unstructured":"The Medical Informatics. Initiative\u2019s core data set | Medical Informatics Initiative [Internet]. [cited 2024 Oct 08]. Available from: https:\/\/www.medizininformatik-initiative.de\/en\/medical-informatics-initiatives-core-data-set"},{"key":"3153_CR26","unstructured":"Maike S. Pr\u00e4valenz seltener Erkrankungen in der ambulanten Versorgung in Deutschland im Zeitraum 2008 bis 201. 2008;24."},{"key":"3153_CR27","unstructured":"Tahar K. Data quality assessment on rare diseases data \u2013 A set of metrics and tools for BMC Journal of Medical Informatics and Decision Making [Internet]. [cited 2025 Jun 20]. Available from: https:\/\/github.com\/KaisTahar\/cordDqChecker\/tree\/bmc_dqTools"},{"key":"3153_CR28","unstructured":"BfArM -, Alpha. -ID-SE [Internet]. [cited 2024 sep. 22]. Available from: https:\/\/www.bfarm.de\/EN\/Code-systems\/Terminologies\/Alpha-ID-SE\/_node.html"},{"key":"3153_CR29","unstructured":"SAP [Internet]. [cited 2024 Oct 08]. SAP Software Solutions | Business Applications and Technology. Available from: https:\/\/www.sap.com\/index.html"},{"key":"3153_CR30","unstructured":"Daten\u00fcbermittlung an das InEK. | Deutsche Krankenhausgesellschaft e. V. [Internet]. [cited 2024 Oct 30]. Available from: https:\/\/www.dkgev.de\/themen\/digitalisierung-daten\/elektronische-datenuebermittlung\/datenuebermittlung-an-das-inek\/"},{"key":"3153_CR31","unstructured":"ISO 8000\u20132. 2022(en), Data quality \u2014 Part 2: Vocabulary [Internet]. [cited 2024 Oct 08]. Available from: https:\/\/www.iso.org\/obp\/ui\/#iso:std:iso:8000:\u20132:ed\u20135:v1:en"},{"key":"3153_CR32","doi-asserted-by":"publisher","unstructured":"Tahar K. (2025). Data quality library (dqLib): an R package for explainable and traceable assessments of clinical data quality (v1.32.1). Zenodo https:\/\/doi.org\/10.5281\/zenodo.15124127","DOI":"10.5281\/zenodo.15124127"},{"issue":"1","key":"3153_CR33","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1038\/s41597-022-01710-x","volume":"9","author":"M Barker","year":"2022","unstructured":"Barker M, Chue Hong NP, Katz DS, Lamprecht AL, Martinez-Ortiz C, Psomopoulos F, et al. Introducing the FAIR principles for research software. Sci Data. 2022;9(1):622.","journal-title":"Sci Data"},{"issue":"1","key":"3153_CR34","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1186\/s13023-022-02529-w","volume":"17","author":"N Denton","year":"2022","unstructured":"Denton N, Mulberg AE, Molloy M, Charleston S, Fajgenbaum DC, Marsh ED, et al. Sharing is caring: a call for a new era of rare disease research and development. Orphanet J Rare Dis. 2022;17(1):389.","journal-title":"Orphanet J Rare Dis"},{"key":"3153_CR35","first-page":"167","volume":"302","author":"J Stausberg","year":"2023","unstructured":"Stausberg J, Harkener S, Engel C, Finger R, Heinz C, Jenetzky E, et al. Cross-registry benchmarking of data quality: lessons learned. Stud Health Technol Inf. 2023;302:167\u201371.","journal-title":"Stud Health Technol Inf"},{"issue":"5","key":"3153_CR36","doi-asserted-by":"publisher","first-page":"803","DOI":"10.1002\/humu.22078","volume":"33","author":"A Rath","year":"2012","unstructured":"Rath A, Olry A, Dhombres F, Brandt MM, Urbero B, Ayme S. Representation of rare diseases in health information systems: the Orphanet approach to serve a wide range of end users. Hum Mutat. 2012;33(5):803\u20138.","journal-title":"Hum Mutat"},{"key":"3153_CR37","first-page":"98","volume":"296","author":"K Yusuf","year":"2022","unstructured":"Yusuf K, Tahar K, Sax U, Hoffmann W, Krefting D. Assessment of the consistency of categorical features within the DZHK biobanking basic set. Stud Health Technol Inf. 2022;296:98\u2013106.","journal-title":"Stud Health Technol Inf"},{"key":"3153_CR38","first-page":"93","volume":"302","author":"D Krefting","year":"2023","unstructured":"Krefting D, Anton G, Chaplinskaya-Sobol I, Hanss S, Hoffmann W, Hopff SM, et al. The importance of being FAIR and FAST - The clinical epidemiology and study platform of the German network university medicine (NUKLEUS). Stud Health Technol Inf. 2023;302:93\u20137.","journal-title":"Stud Health Technol Inf"},{"issue":"06","key":"3153_CR39","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1055\/s-0040-1709158","volume":"58","author":"M Parciak","year":"2019","unstructured":"Parciak M, Bender T, Sax U, Bauer CR. Applying FAIRness: redesigning a biomedical informatics research data management pipeline. Methods Inf Med. 2019;58(06):229\u201334.","journal-title":"Methods Inf Med"},{"key":"3153_CR40","doi-asserted-by":"publisher","first-page":"1276407","DOI":"10.3389\/fninf.2023.1276407","volume":"17","author":"ME Martone","year":"2023","unstructured":"Martone ME. The past, present and future of neuroscience data sharing: a perspective on the state of practices and infrastructure for FAIR. Front Neuroinformatics. 2023;17:1276407.","journal-title":"Front Neuroinformatics"},{"issue":"1","key":"3153_CR41","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1186\/s12911-022-01961-z","volume":"22","author":"JM Mang","year":"2022","unstructured":"Mang JM, Seuchter SA, Gulden C, Schild S, Kraska D, Prokosch HU, et al. DQAgui: a graphical user interface for the MIRACUM data quality assessment tool. BMC Med Inf Decis Mak. 2022;22(1):213.","journal-title":"BMC Med Inf Decis Mak"},{"issue":"1","key":"3153_CR42","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1186\/s12911-021-01458-1","volume":"21","author":"E Tute","year":"2021","unstructured":"Tute E, Scheffner I, Marschollek M. A method for interoperable knowledge-based data quality assessment. BMC Med Inf Decis Mak. 2021;21(1):93.","journal-title":"BMC Med Inf Decis Mak"},{"issue":"1","key":"3153_CR43","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1186\/s13023-020-01358-z","volume":"15","author":"K Tingley","year":"2020","unstructured":"Tingley K, Lamoureux M, Pugliese M, Geraghty MT, Kronick JB, Potter BK, et al. Evaluation of the quality of clinical data collection for a pan-Canadian cohort of children affected by inherited metabolic diseases: lessons learned from the Canadian inherited metabolic diseases research network. Orphanet J Rare Dis. 2020;15(1):89.","journal-title":"Orphanet J Rare Dis"},{"key":"3153_CR44","doi-asserted-by":"publisher","unstructured":"Krefting D, Tahar K, Keszty\u00fcs T, Rosewich H, H\u00fcgel J, G\u00f6ttingen GAU. CORD-MI - Konsortien \u00fcbergreifender Use Case Collaboration on Rare Diseases - Teilprojekt Uni G\u00f6ttingen: Arbeitspapier zu besonderen Aspekten des Kerndatensatzes der Medizininformatik-Initiative bei seltenen Erkrankungen: Schlussbericht: Laufzeit: 01.07.2020\u201330.06.2023 [Internet]. G\u00f6ttingen; 2023. Available from: https:\/\/doi.org\/10.2314\/KXP:1891347608","DOI":"10.2314\/KXP:1891347608"},{"key":"3153_CR45","unstructured":"Tahar K, CvdDqChecker:. A Software Solution for Explainable and Traceable Assessments of Cardiovascular Disease Data Quality. [Internet]. [cited 2025 Jun 20]. Available from: https:\/\/github.com\/KaisTahar\/cvdDqChecker"},{"issue":"8","key":"3153_CR46","doi-asserted-by":"publisher","first-page":"e27842","DOI":"10.2196\/27842","volume":"9","author":"H Aerts","year":"2021","unstructured":"Aerts H, Kalra D, S\u00e1ez C, Ram\u00edrez-Anguita JM, Mayer MA, Garcia-Gomez JM, et al. Quality of hospital electronic health record (EHR) data based on the international consortium for health outcomes measurement (ICHOM) in heart failure: pilot data quality assessment study. JMIR Med Inf. 2021;9(8):e27842.","journal-title":"JMIR Med Inf"},{"issue":"1","key":"3153_CR47","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1136\/amiajnl-2011-000681","volume":"20","author":"NG Weiskopf","year":"2013","unstructured":"Weiskopf NG, Weng C. Methods and dimensions of electronic health record data quality assessment: enabling reuse for clinical research. J Am Med Inf Assoc. 2013;20(1):144\u201351.","journal-title":"J Am Med Inf Assoc"},{"key":"3153_CR48","first-page":"1","volume":"2010","author":"T Botsis","year":"2010","unstructured":"Botsis T, Hartvigsen G, Chen F, Weng C. Secondary use of EHR: data quality issues and informatics opportunities. Summit Transl Bioinform. 2010;2010:1\u20135.","journal-title":"Summit Transl Bioinform"},{"key":"3153_CR49","unstructured":"European Reference Networks - European Commission [Internet]. 2025 [cited 2025 May 13]. Available from: https:\/\/health.ec.europa.eu\/rare-diseases-and-european-reference-networks\/european-reference-networks_en"},{"key":"3153_CR50","unstructured":"ERDERA - European Rare. Diseases Research Alliance [Internet]. [cited 2025 May 20]. Available from: https:\/\/erdera.org\/"},{"issue":"1","key":"3153_CR51","doi-asserted-by":"publisher","first-page":"188573","DOI":"10.1016\/j.bbcan.2021.188573","volume":"1876","author":"NE Sharpless","year":"2021","unstructured":"Sharpless NE, Kerlavage AR. The potential of AI in cancer care and research. Biochim Biophys Acta BBA - Rev Cancer. 2021;1876(1):188573.","journal-title":"Biochim Biophys Acta BBA - Rev Cancer"}],"container-title":["BMC Medical Informatics and Decision Making"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12911-025-03153-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12911-025-03153-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12911-025-03153-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T19:10:31Z","timestamp":1781637031000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12911-025-03153-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,2]]},"references-count":51,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3153"],"URL":"https:\/\/doi.org\/10.1186\/s12911-025-03153-x","relation":{},"ISSN":["1472-6947"],"issn-type":[{"value":"1472-6947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,2]]},"assertion":[{"value":"9 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the principles outlined in the Declaration of Helsinki. The requirement for informed consent was waived by the Institutional Review Board (IRB) of University Hospital T\u00fcbingen, known as \u201cEthik-Kommission an der Medizinischen Fakult\u00e4t der Eberhard-Karls-Universit\u00e4t und am Universit\u00e4tsklinikum T\u00fcbingen\u201d. All analyses conducted in this study received ethical approval from the Institutional Review Board of the University Hospital T\u00fcbingen under reference number 514\/2020BO2 due to the application of the k-anonymity principle and the implementation of the national infrastructure of the MII for decentralized privacy-preserving data storage.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"60"}}