{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T14:55:08Z","timestamp":1774623308214,"version":"3.50.1"},"reference-count":47,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":35,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["General Practice 2023 ZDFC0401"],"award-info":[{"award-number":["General Practice 2023 ZDFC0401"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010108","name":"Zhongshan Hospital","doi-asserted-by":"publisher","award":["2023ZSFZ03"],"award-info":[{"award-number":["2023ZSFZ03"]}],"id":[{"id":"10.13039\/501100010108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Prim. Care"],"DOI":"10.1186\/s12875-026-03205-9","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T17:17:18Z","timestamp":1771607838000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Influence of a clinical decision support system on the anticoagulation treatment knowledge, attitude and practice of general practitioners and their using experience: a mixed method study"],"prefix":"10.1186","volume":"27","author":[{"given":"Xueying","family":"Ru","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tianhao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hua","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junling","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Kong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ge","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiyan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunhui","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhigang","family":"Pan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"3205_CR1","unstructured":"Department of Medical Administration and Hospital Administration. Notice on Printing and Distributing the Technical Plan for Hierarchical Diagnosis and Treatment of Atrial Fibrillation. http:\/\/www.nhc.gov.cn\/yzygj\/s3594q\/201909\/592e8b8ac8044617bc9ed9186c2ee19f.s.html. Accessed 10 Sept 2019."},{"issue":"11","key":"3205_CR2","first-page":"895","volume":"17","author":"L Ni","year":"2018","unstructured":"Ni L, Xue J, Xue F. Survey on knowledge level of atrial fibrillation among general practitioners in Shanghai Pudong new area. Chin J Gen Pract. 2018;17(11):895\u2013900.","journal-title":"Chin J Gen Pract"},{"issue":"7","key":"3205_CR3","first-page":"603","volume":"32","author":"J Zhang","year":"2018","unstructured":"Zhang J, Lin C, Liu H. Problems and countermeasures in community management of elderly people with atrial fibrillation. Practical Geriatr. 2018;32(7):603\u20136.","journal-title":"Practical Geriatr"},{"key":"3205_CR4","doi-asserted-by":"publisher","first-page":"2136922","DOI":"10.1155\/2023\/2136922","volume":"2023","author":"X Ru","year":"2023","unstructured":"Ru X, Wang T, Zhu L, Ma Y, Qian L, Sun H, et al. Using a clinical decision support system to improve anticoagulation in patients with nonvalve atrial fibrillation in china\u2019s primary care settings: A feasibility study. Int J Clin Pract. 2023;2023:2136922.","journal-title":"Int J Clin Pract"},{"issue":"10","key":"3205_CR5","first-page":"929","volume":"19","author":"X Wu","year":"2021","unstructured":"Wu X, Li J, Wu H, Ni G. Influence of medical community management mode on the effect of warfarin anticoagulation in patients with atrial fibrillation. Clin Educ Gen Pract. 2021;19(10):929\u201331.","journal-title":"Clin Educ Gen Pract"},{"issue":"1","key":"3205_CR6","first-page":"36","volume":"24","author":"R Yang","year":"2021","unstructured":"Yang R, Liu CM,Lian XY, Wang L. Refection on the collaborative and integrated management pathway for atrial fibrillation by a large tertiary general hospital and a community hospital. Chin Gen Pract. 2021;24(1):36\u20139.","journal-title":"Chin Gen Pract"},{"key":"3205_CR7","volume-title":"Analysis on the standardized training of anti\u2013coagulation of atrial fibrillation in the suburbs of Changsha and its influencing factors","author":"S Shan","year":"2019","unstructured":"Shan S. Analysis on the standardized training of anti\u2013coagulation of atrial fibrillation in the suburbs of Changsha and its influencing factors. Changsha: Hunan Normal University; 2019."},{"issue":"1","key":"3205_CR8","first-page":"37","volume":"31","author":"J Xu","year":"2022","unstructured":"Xu J, Lu Z, Ni H, Fan Y, Qian X, Zhang J. Investigation on diagnostic and therapeutic ability of community general practitioners for atrial fibrillation and improvement effect of continuing education. Chin J Cardiovasc Rehabilitation Med. 2022;31(1):37\u201342.","journal-title":"Chin J Cardiovasc Rehabilitation Med"},{"issue":"11","key":"3205_CR9","first-page":"1095","volume":"21","author":"X Ru","year":"2022","unstructured":"Ru X, Zhu L, Pan Z, Wang T. Primary care for atrial fibrillation patients with anticoagulation therapy in china: status quo and future perspective. Chin J Gen Pract. 2022;21(11):1095\u2013100.","journal-title":"Chin J Gen Pract"},{"issue":"1","key":"3205_CR10","doi-asserted-by":"publisher","first-page":"29","DOI":"10.7326\/0003-4819-157-1-201207030-00450","volume":"157","author":"TJ Bright","year":"2012","unstructured":"Bright TJ, Wong A, Dhurjati R, Bristow E, Bastian L, Coeytaux RR, et al. Effect of clinical decision-support systems: a systematic review. Ann Intern Med. 2012;157(1):29\u201343.","journal-title":"Ann Intern Med"},{"issue":"12","key":"3205_CR11","doi-asserted-by":"publisher","first-page":"e019087","DOI":"10.1136\/bmjopen-2017-019087","volume":"7","author":"ME Kessler","year":"2017","unstructured":"Kessler ME, Carter RE, Cook DA, Kor DJ, McKie PM, Pencille LJ, et al. Impact of electronic clinical decision support on adherence to guideline-recommended treatment for hyperlipidaemia, atrial fibrillation and heart failure: protocol for a cluster randomised trial. BMJ Open. 2017;7(12):e019087.","journal-title":"BMJ Open"},{"key":"3205_CR12","doi-asserted-by":"crossref","unstructured":"Klarenbeek SE, Weekenstroo HHA, Sedelaar JPM, F\u00fctterer JJ, Prokop M, Tummers M. The effect of higher level computerized clinical decision support systems on oncology care: A systematic review. Cancers (Basel). 2020;12(4):1032.","DOI":"10.3390\/cancers12041032"},{"issue":"38","key":"3205_CR13","doi-asserted-by":"publisher","first-page":"2893","DOI":"10.1093\/eurheartj\/ehw210","volume":"37","author":"P Kirchhof","year":"2016","unstructured":"Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37(38):2893\u2013962.","journal-title":"Eur Heart J"},{"issue":"677","key":"3205_CR14","doi-asserted-by":"publisher","first-page":"e844","DOI":"10.3399\/bjgp18X699809","volume":"68","author":"TA Holt","year":"2018","unstructured":"Holt TA, Dalton AR, Kirkpatrick S, Hislop J, Marshall T, Fay M, et al. Barriers to a software reminder system for risk assessment of stroke in atrial fibrillation: a process evaluation of a cluster randomised trial in general practice. Br J Gen Pract. 2018;68(677):e844\u201351.","journal-title":"Br J Gen Pract"},{"issue":"1","key":"3205_CR15","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1186\/s12875-019-1058-9","volume":"20","author":"J Orchard","year":"2019","unstructured":"Orchard J, Li J, Gallagher R, Freedman B, Lowres N, Neubeck L. Uptake of a primary care atrial fibrillation screening program (AF-SMART): a realist evaluation of implementation in metropolitan and rural general practice. BMC Fam Pract. 2019;20(1):170.","journal-title":"BMC Fam Pract"},{"issue":"2","key":"3205_CR16","doi-asserted-by":"publisher","first-page":"e0170974","DOI":"10.1371\/journal.pone.0170974","volume":"12","author":"DL Arts","year":"2017","unstructured":"Arts DL, Abu-Hanna A, Medlock SK, van Weert HCPM. Effectiveness and usage of a decision support system to improve stroke prevention in general practice: A cluster randomized controlled trial. PLoS ONE. 2017;12(2):e0170974.","journal-title":"PLoS ONE"},{"issue":"12","key":"3205_CR17","doi-asserted-by":"publisher","first-page":"1428","DOI":"10.1016\/S0300-8932(10)70269-4","volume":"63","author":"P L\u00e1zaro","year":"2010","unstructured":"L\u00e1zaro P, Murga N, Aguilar D, Hern\u00e1ndez-Presa MA. Therapeutic inertia in the outpatient management of dyslipidemia in patients with ischemic heart disease. The inertia study. Rev Esp Cardiol. 2010;63(12):1428\u201337.","journal-title":"Rev Esp Cardiol"},{"key":"3205_CR18","first-page":"17","volume":"164","author":"K Goddard","year":"2011","unstructured":"Goddard K, Roudsari A, Wyatt JC. Automation bias - a hidden issue for clinical decision support system use. Stud Health Technol Inf. 2011;164:17\u201322.","journal-title":"Stud Health Technol Inf"},{"issue":"10239","key":"3205_CR19","doi-asserted-by":"publisher","first-page":"1802","DOI":"10.1016\/S0140-6736(20)30122-7","volume":"395","author":"X Li","year":"2020","unstructured":"Li X, Krumholz HM, Yip W, Cheng KK, De Maeseneer J, Meng Q, et al. Quality of primary health care in china: challenges and recommendations. Lancet. 2020;395(10239):1802\u201312.","journal-title":"Lancet"},{"issue":"3","key":"3205_CR20","doi-asserted-by":"publisher","first-page":"e054783","DOI":"10.1136\/bmjopen-2021-054783","volume":"12","author":"L Teng","year":"2022","unstructured":"Teng L, Li Y. Analysis on the willingness and influencing factors of choosing primary healthcare institutions among patients with chronic conditions in china: a cross-sectional study. BMJ Open. 2022;12(3):e054783.","journal-title":"BMJ Open"},{"issue":"1","key":"3205_CR21","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1186\/s13063-022-06250-8","volume":"23","author":"X Ru","year":"2022","unstructured":"Ru X, Zhu L, Ma Y, Wang T, Pan Z. Effect of an artificial intelligence-assisted tool on non-valvular atrial fibrillation anticoagulation management in primary care: protocol for a cluster randomized controlled trial. Trials. 2022;23(1):316.","journal-title":"Trials"},{"key":"3205_CR22","unstructured":"Wan X, Lu X, Liu C, et al. Diagnostic(9th Version). People\u2019s Health Publishing House; 2018."},{"key":"3205_CR23","unstructured":"Ge J, Xu Y, Wang C, et al. Internal medicine(9th Version). People\u2019s Health Publishing House; 2018."},{"key":"3205_CR24","first-page":"279","volume":"22","author":"C Huang","year":"2018","unstructured":"Huang C, Zhang S, Huang J, et al. Current knowledge and management recommendations of atrial fibrillation:2018. Chin J Cardiac Arrhythm. 2018;22:279\u2013346.","journal-title":"Chin J Cardiac Arrhythm"},{"issue":"1","key":"3205_CR25","first-page":"17","volume":"22","author":"S Zhang","year":"2018","unstructured":"Zhang S, Yang M, Huang C, et al. Guideline of stroke prevention in Chinese patients with atrial fibrillation(2017). Chin J Cardiac Arrhyth. 2018;22(1):17\u201330.","journal-title":"Chin J Cardiac Arrhyth"},{"issue":"16","key":"3205_CR26","doi-asserted-by":"publisher","first-page":"e021293","DOI":"10.1161\/JAHA.121.021293","volume":"10","author":"N Zhang","year":"2021","unstructured":"Zhang N, Patel J, Chen Z, Zhou Y, Crawford S, McManus DD, et al. Geriatric conditions are associated with decreased anticoagulation use in Long-Term care residents with atrial fibrillation. J Am Heart Assoc. 2021;10(16):e021293.","journal-title":"J Am Heart Assoc"},{"issue":"1","key":"3205_CR27","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1186\/s12875-020-01236-4","volume":"21","author":"S Ye","year":"2020","unstructured":"Ye S, Wang T, Liu A, Yu Y, Pan Z, Gu J. A study of knowledge, attitudes, and practices of primary care physicians toward anticoagulant therapy in patients with non-valvular atrial fibrillation in Shanghai, China. BMC Fam Pract. 2020;21(1):165.","journal-title":"BMC Fam Pract"},{"issue":"33","key":"3205_CR28","first-page":"4118","volume":"21","author":"S Ye","year":"2018","unstructured":"Ye S, Pan Z, Liu W, et al. General practitioners\u2019 KAP questionnaire on anticoagulation in patients with nonvalvular atrial fibrillation using Delphi method. Chin Gen Pract. 2018;21(33):4118\u201326.","journal-title":"Chin Gen Pract"},{"issue":"1","key":"3205_CR29","doi-asserted-by":"publisher","first-page":"E1","DOI":"10.4102\/phcfm.v6i1.597","volume":"6","author":"LT Bhebhe","year":"2014","unstructured":"Bhebhe LT, Van Rooyen C, Steinberg WJ. Attitudes, knowledge and practices of healthcare workers regarding occupational exposure of pulmonary tuberculosis. Afr J Prim Health Care Fam Med. 2014;6(1):E1\u20136.","journal-title":"Afr J Prim Health Care Fam Med"},{"key":"3205_CR30","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1186\/1471-2288-13-117","volume":"13","author":"NK Gale","year":"2013","unstructured":"Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13:117.","journal-title":"BMC Med Res Methodol"},{"issue":"1","key":"3205_CR31","first-page":"41","volume":"35","author":"B Li","year":"2021","unstructured":"Li B, Yin H, Yao F, et al. Investigation and analysis about atrial fibrillatiion related knowledge for grassroots medical staff. Chin J Cardiac Pacing Electrophysiol. 2021;35(1):41\u20133.","journal-title":"Chin J Cardiac Pacing Electrophysiol"},{"key":"3205_CR32","first-page":"244","volume":"192","author":"R Chen","year":"2013","unstructured":"Chen R, Valladares C, Corbal I, Anani N, Koch S. Early experiences from a guideline-based computerized clinical decision support for stroke prevention in atrial fibrillation. Stud Health Technol Inf. 2013;192:244\u20137.","journal-title":"Stud Health Technol Inf"},{"key":"3205_CR33","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1186\/1472-6963-14-55","volume":"14","author":"B Bajorek","year":"2014","unstructured":"Bajorek B, Magin P, Hilmer S, Krass I. A cluster-randomized controlled trial of a computerized antithrombotic risk assessment tool to optimize stroke prevention in general practice: a study protocol. BMC Health Serv Res. 2014;14:55.","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"3205_CR34","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1161\/STROKEAHA.107.495036","volume":"39","author":"M Gattellari","year":"2008","unstructured":"Gattellari M, Worthington J, Zwar N, Middleton S. Barriers to the use of anticoagulation for nonvalvular atrial fibrillation: a representative survey of Australian family physicians. Stroke. 2008;39(1):227\u201330.","journal-title":"Stroke"},{"key":"3205_CR35","first-page":"447","volume":"192","author":"SR Abidi","year":"2013","unstructured":"Abidi SR, Stewart S, Shepherd M, Abidi SS. Usability evaluation of family physicians\u2019 interaction with the comorbidity ontological modeling and execution system (COMET). Stud Health Technol Inf. 2013;192:447\u201351.","journal-title":"Stud Health Technol Inf"},{"issue":"2","key":"3205_CR36","first-page":"79","volume":"16","author":"C Bryan","year":"2008","unstructured":"Bryan C, Boren SA. The use and effectiveness of electronic clinical decision support tools in the ambulatory\/primary care setting: a systematic review of the literature. Inf Prim Care. 2008;16(2):79\u201391.","journal-title":"Inf Prim Care"},{"issue":"Suppl 1Suppl 1","key":"3205_CR37","first-page":"4474","volume":"41","author":"P Hoonakker","year":"2012","unstructured":"Hoonakker P, Khunlertkit A, Tattersal M, Keevil J. Computer decision support tools in primary care. Work. 2012;41(Suppl 1Suppl 1):4474\u20138.","journal-title":"Work"},{"issue":"1","key":"3205_CR38","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1186\/s43058-022-00326-x","volume":"3","author":"W Chen","year":"2022","unstructured":"Chen W, O\u2019Bryan CM, Gorham G, Howard K, Balasubramanya B, Coffey P, et al. Barriers and enablers to implementing and using clinical decision support systems for chronic diseases: a qualitative systematic review and meta-aggregation. Implement Sci Commun. 2022;3(1):81.","journal-title":"Implement Sci Commun"},{"issue":"17","key":"3205_CR39","doi-asserted-by":"publisher","first-page":"2163","DOI":"10.1093\/eurheartj\/ehs167","volume":"33","author":"SA LaHaye","year":"2012","unstructured":"LaHaye SA, Gibbens SL, Ball DG, Day AG, Olesen JB, Skanes AC. A clinical decision aid for the selection of antithrombotic therapy for the prevention of stroke due to atrial fibrillation. Eur Heart J. 2012;33(17):2163\u201371.","journal-title":"Eur Heart J"},{"issue":"1","key":"3205_CR40","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s12875-023-01973-2","volume":"24","author":"E Fletcher","year":"2023","unstructured":"Fletcher E, Burns A, Wiering B, Lavu D, Shephard E, Hamilton W, et al. Workload and workflow implications associated with the use of electronic clinical decision support tools used by health professionals in general practice: a scoping review. BMC Prim Care. 2023;24(1):23.","journal-title":"BMC Prim Care"},{"issue":"4","key":"3205_CR41","doi-asserted-by":"publisher","first-page":"e0193187","DOI":"10.1371\/journal.pone.0193187","volume":"13","author":"DL Arts","year":"2018","unstructured":"Arts DL, Medlock SK, van Weert H, Wyatt JC, Abu-Hanna A. Acceptance and barriers pertaining to a general practice decision support system for multiple clinical conditions: A mixed methods evaluation. PLoS ONE. 2018;13(4):e0193187.","journal-title":"PLoS ONE"},{"issue":"5","key":"3205_CR42","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1177\/2042533313476691","volume":"4","author":"EJ Henderson","year":"2013","unstructured":"Henderson EJ, Rubin GP. The utility of an online diagnostic decision support system (Isabel) in general practice: a process evaluation. JRSM Short Rep. 2013;4(5):31.","journal-title":"JRSM Short Rep"},{"issue":"10","key":"3205_CR43","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1016\/j.amjmed.2020.03.019","volume":"133","author":"Y Guo","year":"2020","unstructured":"Guo Y, Lane DA, Chen Y, Lip GYH. Regular bleeding risk assessment associated with reduction in bleeding outcomes: the mAFA-II randomized trial. Am J Med. 2020;133(10):1195\u2013e2022.","journal-title":"Am J Med"},{"issue":"9","key":"3205_CR44","first-page":"915","volume":"35","author":"Writing Committee for Expert Consensus on the Management of Atrial Fibrillation in Elderly Population","year":"2016","unstructured":"Writing Committee for Expert Consensus on the Management of Atrial Fibrillation in Elderly Population. Chinese geriatric Society, editorial board of Chinese journal of geriatrics. Expert consensus on the management of atrial fibrillation in elderly population(2016). Chin J Geriatr. 2016;35(9):915\u201328.","journal-title":"Chin J Geriatr"},{"key":"3205_CR45","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1186\/1472-6963-12-10","volume":"12","author":"C Sikorski","year":"2012","unstructured":"Sikorski C, Luppa M, K\u00f6nig HH, van den Bussche H, Riedel-Heller SG. Does GP training in depression care affect patient outcome? - A systematic review and meta-analysis. BMC Health Serv Res. 2012;12:10.","journal-title":"BMC Health Serv Res"},{"issue":"1","key":"3205_CR46","first-page":"53","volume":"36","author":"X Zhou","year":"2022","unstructured":"Zhou X, Yu X, Sun W, et al. A qualitative study on community elderly residens\u2032 recognition on atrial fibrillation. Chin Prim Health Care. 2022;36(1):53\u20139.","journal-title":"Chin Prim Health Care"},{"issue":"7","key":"3205_CR47","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1136\/heartjnl-2020-317915","volume":"107","author":"X Du","year":"2021","unstructured":"Du X, Guo L, Xia S, Du J, Anderson C, Arima H, et al. Atrial fibrillation prevalence, awareness and management in a nationwide survey of adults in China. Heart. 2021;107(7):535\u201341.","journal-title":"Heart"}],"container-title":["BMC Primary Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12875-026-03205-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-026-03205-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12875-026-03205-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T14:02:08Z","timestamp":1774620128000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12875-026-03205-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,20]]},"references-count":47,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["3205"],"URL":"https:\/\/doi.org\/10.1186\/s12875-026-03205-9","relation":{},"ISSN":["2731-4553"],"issn-type":[{"value":"2731-4553","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,20]]},"assertion":[{"value":"21 April 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 February 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":"All methods were performed by the relevant guidelines and regulations (Declaration of Helsinki). The confidentiality of all subjects was guaranteed, and the study protocol was approved by the Ethics Committee of Zhongshan Hospital of Fudan University (approval number: B2021-579 [2]).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics 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":"107"}}