{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T13:32:06Z","timestamp":1770730326708,"version":"3.49.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T00:00:00Z","timestamp":1745884800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Federal Joint Committee (Gemeinsamer Bundesausschuss","award":["01VSF19028"],"award-info":[{"award-number":["01VSF19028"]}]},{"name":"Federal Joint Committee (Gemeinsamer Bundesausschuss","award":["01VSF19028"],"award-info":[{"award-number":["01VSF19028"]}]},{"name":"Federal Joint Committee (Gemeinsamer Bundesausschuss","award":["01VSF19028"],"award-info":[{"award-number":["01VSF19028"]}]},{"name":"Federal Joint Committee (Gemeinsamer Bundesausschuss","award":["01VSF19028"],"award-info":[{"award-number":["01VSF19028"]}]},{"name":"Federal Joint Committee (Gemeinsamer Bundesausschuss","award":["01VSF19028"],"award-info":[{"award-number":["01VSF19028"]}]},{"name":"Federal Joint Committee (Gemeinsamer Bundesausschuss","award":["01VSF19028"],"award-info":[{"award-number":["01VSF19028"]}]},{"name":"Federal Joint Committee (Gemeinsamer Bundesausschuss","award":["01VSF19028"],"award-info":[{"award-number":["01VSF19028"]}]},{"name":"Federal Joint Committee (Gemeinsamer Bundesausschuss","award":["01VSF19028"],"award-info":[{"award-number":["01VSF19028"]}]},{"DOI":"10.13039\/501100008977","name":"Universit\u00e4t Ulm","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100008977","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med"],"abstract":"<jats:title>Abstract\n<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Orthogeriatric co-management (OGCM) has been proposed as care model for geriatric patients with fragility fractures. However, its impact on nursing home (NH) admissions following non-hip fractures is unclear. This study aims to assess the association between OGCM and the probability of NH admissions within 6 months in older patients with fragility fractures other than the hip.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This retrospective cohort study utilized nationwide insurance claims data from Germany (from years 2014\u20132018), covering individuals aged 80 years or older with fractures of the humerus, forearm, pelvis, or vertebrae. Based on the number of\u00a0OGCM claims per year, hospitals were categorized as either OGCM or no OGCM. The primary outcome was the incidence of NH admissions within 6 months of the index fracture. Quasi-Poisson regression models were used to calculate incidence rate ratios (IRRs) with 95% confidence intervals (CI), adjusted for age, sex, prior care needs, comorbidity score, and rehabilitation transfer rates.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 106,217 patients were included in the analysis. The incidence of NH admissions varied by fracture site, ranging from 11.1% for pelvic to 24.7% for vertebrae fractures, respectively. OGCM was associated with a reduced probability of NH admissions for humerus fractures (IRR 0.94, 95% CI 0.88\u20131.00) and vertebral fractures (IRR 0.92, 95% CI 0.87\u20130.97). No statistically significant associations were found for forearm (IRR 1.06, 95% CI 0.97\u20131.15) or pelvic fractures (IRR 1.02, 95% CI 0.96\u20131.09).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>OGCM went along with a reduced probability of NH admissions in geriatric patients with humerus and vertebral fractures but showed no statistically significant benefit for forearm or pelvic fractures. The results highlight the need for targeted OGCM strategies based on fracture type and patient demographics to optimize outcomes in this vulnerable population.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1186\/s12916-025-04073-3","type":"journal-article","created":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T20:01:27Z","timestamp":1745956887000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Orthogeriatric co-management and incident nursing home admissions in older patients with fragility fractures other than the hip\u2014a retrospective cohort study using insurance claims data from Germany"],"prefix":"10.1186","volume":"23","author":[{"given":"Daniel","family":"Schoene","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kilian","family":"Rapp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Roigk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clemens","family":"Becker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Jaensch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Konnopka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans-Helmut","family":"K\u00f6nig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Friess","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gisela","family":"B\u00fcchele","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dietrich","family":"Rothenbacher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,29]]},"reference":[{"issue":"7","key":"4073_CR1","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1007\/s00198-019-04922-x","volume":"30","author":"P Benzinger","year":"2019","unstructured":"Benzinger P, Riem S, Bauer J, Jaensch A, Becker C, B\u00fcchele G, et al. Risk of institutionalization following fragility fractures in older people. Osteoporos Int. 2019;30(7):1363\u201370.","journal-title":"Osteoporos Int"},{"issue":"1","key":"4073_CR2","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1007\/s11657-020-0706-y","volume":"15","author":"F Borgstr\u00f6m","year":"2020","unstructured":"Borgstr\u00f6m F, Karlsson L, Orts\u00e4ter G, Norton N, Halbout P, Cooper C, et al. Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos. 2020;15(1):59.","journal-title":"Arch Osteoporos"},{"issue":"2","key":"4073_CR3","first-page":"169","volume":"31","author":"L S\u00e0nchez-Riera","year":"2017","unstructured":"S\u00e0nchez-Riera L, Wilson N. Fragility fractures & their impact on older people. Ageing Musculoskelet Health. 2017;31(2):169\u201391.","journal-title":"Ageing Musculoskelet Health"},{"issue":"1","key":"4073_CR4","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1186\/s12877-016-0332-0","volume":"16","author":"SM Dyer","year":"2016","unstructured":"Dyer SM, Crotty M, Fairhall N, Magaziner J, Beaupre LA, Cameron ID, et al. A critical review of the long-term disability outcomes following hip fracture. BMC Geriatr. 2016;16(1):158.","journal-title":"BMC Geriatr"},{"issue":"9319","key":"4073_CR5","doi-asserted-by":"publisher","first-page":"1761","DOI":"10.1016\/S0140-6736(02)08657-9","volume":"359","author":"SR Cummings","year":"2002","unstructured":"Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. The Lancet. 2002;359(9319):1761\u20137.","journal-title":"The Lancet"},{"issue":"6","key":"4073_CR6","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1007\/s11914-020-00623-1","volume":"18","author":"P Szulc","year":"2020","unstructured":"Szulc P. Impact of bone fracture on muscle strength and physical performance\u2014narrative review. Curr Osteoporos Rep. 2020;18(6):633\u201345.","journal-title":"Curr Osteoporos Rep"},{"key":"4073_CR7","doi-asserted-by":"publisher","first-page":"215145932110589","DOI":"10.1177\/21514593211058969","volume":"12","author":"A Wiedl","year":"2021","unstructured":"Wiedl A, F\u00f6rch S, Otto A, Lisitano L, Rau K, Nachbaur T, et al. Beyond hip fractures: other fragility fractures\u2019 associated mortality, functional and economic importance: a 2-year-follow-up. Geriatr Orthop Surg Rehabil. 2021;12:21514593211058969.","journal-title":"Geriatr Orthop Surg Rehabil"},{"key":"4073_CR8","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1017\/9781108594455.002","volume-title":"Falls in older people: risk factors, strategies for prevention and implications for practice","author":"SR Lord","year":"2021","unstructured":"Lord SR, Sherrington C, Hicks C. Epidemiology of falls and fall-related injuries. In: Lord SR, Sherrington C, Naganathan V, editors. Falls in older people: risk factors, strategies for prevention and implications for practice. 3rd ed. Cambridge: Cambridge University Press; 2021. pp. 3\u201322.","edition":"3"},{"issue":"suppl_4","key":"4073_CR9","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1093\/ageing\/30.suppl_4.3","volume":"30","author":"T Masud","year":"2001","unstructured":"Masud T, Morris RO. Epidemiology of falls. Age Ageing. 2001;30(suppl_4):3\u20137.","journal-title":"Age Ageing"},{"key":"4073_CR10","unstructured":"Evans W. After a fall: consequences and implications of falls by old people. In: Falls, balance, and gait disorders in the elderly: proceedings of the International Symposium \u2018Falls in the Elderly\u2019. Paris: Elsevier Academic Press; 1992."},{"issue":"4","key":"4073_CR11","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1007\/s11914-021-00685-9","volume":"19","author":"V Komisar","year":"2021","unstructured":"Komisar V, Robinovitch SN. The role of fall biomechanics in the cause and prevention of bone fractures in older adults. Curr Osteoporos Rep. 2021;19(4):381\u201390.","journal-title":"Curr Osteoporos Rep"},{"key":"4073_CR12","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/978-3-030-48126-1_5","volume-title":"Orthogeriatrics: the management of older patients with fragility fractures","author":"T Ong","year":"2021","unstructured":"Ong T, Sahota O. Establishing an orthogeriatric service. In: Falaschi P, Marsh D, editors. Orthogeriatrics: the management of older patients with fragility fractures. Cham: Springer International Publishing; 2021. pp. 69\u201382. https:\/\/doi.org\/10.1007\/978-3-030-48126-1_5."},{"issue":"2","key":"4073_CR13","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1007\/s00223-021-00913-5","volume":"110","author":"A Van Heghe","year":"2022","unstructured":"Van Heghe A, Mordant G, Dupont J, Dejaeger M, Laurent MR, Gielen E. Effects of orthogeriatric care models on outcomes of hip fracture patients: a systematic review and meta-analysis. Calcif Tissue Int. 2022;110(2):162\u201384.","journal-title":"Calcif Tissue Int"},{"issue":"2","key":"4073_CR14","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1097\/TA.0000000000002482","volume":"88","author":"K Mukherjee","year":"2020","unstructured":"Mukherjee K, Brooks SE, Barraco RD, Como JJ, Hwang F, Robinson BRH, et al. Elderly adults with isolated hip fractures- orthogeriatric care versus standard care: a practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2020;88(2):266\u201378.","journal-title":"J Trauma Acute Care Surg."},{"issue":"1","key":"4073_CR15","first-page":"672702","volume":"2013","author":"AL Holm","year":"2013","unstructured":"Holm AL, Severinsson E. A qualitative systematic review of older persons\u2019 perceptions of health, ill health, and their community health care needs. Nurs Res Pract. 2013;2013(1):672702.","journal-title":"Nurs Res Pract"},{"issue":"4","key":"4073_CR16","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1111\/opn.12116","volume":"11","author":"S Fjordside","year":"2016","unstructured":"Fjordside S, Morville A. Factors influencing older people\u2019s experiences of participation in autonomous decisions concerning their daily care in their own homes: a review of the literature. Int J Older People Nurs. 2016;11(4):284\u201397.","journal-title":"Int J Older People Nurs"},{"issue":"1","key":"4073_CR17","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1007\/s12062-020-09315-1","volume":"16","author":"EALM Molenaar","year":"2023","unstructured":"Molenaar EALM, Barten JA, te Velde S, van der Schoot L, Bleijenberg N, de Wit NJ, et al. Functional independence in the community dwelling older people: a scoping review. J Popul Ageing. 2023;16(1):243\u201362.","journal-title":"J Popul Ageing"},{"issue":"3","key":"4073_CR18","doi-asserted-by":"publisher","first-page":"419","DOI":"10.1093\/geronb\/gbu008","volume":"69","author":"S Hillcoat-Nall\u00e9tamby","year":"2014","unstructured":"Hillcoat-Nall\u00e9tamby S. The meaning of \u201cindependence\u201d for older people in different residential settings. J Gerontol Ser B. 2014;69(3):419\u201330.","journal-title":"J Gerontol Ser B"},{"key":"4073_CR19","doi-asserted-by":"crossref","unstructured":"Handoll H, Cameron I, Mak J, Panagoda C, Finnegan T. Multidisciplinary rehabilitation for older people with hip fractures. Cochrane Database Syst Rev. 2021;11(11):CD007125.","DOI":"10.1002\/14651858.CD007125.pub3"},{"key":"4073_CR20","doi-asserted-by":"publisher","DOI":"10.1055\/a-2134-5803","author":"EAK Jan","year":"2023","unstructured":"Jan EAK, Daniel. Langzeitergebnisse des orthogeriatrischen Co-Managements: eine Literatur\u00fcbersicht. Z F\u00fcr Orthop Unfallchirurgie. 2023. https:\/\/doi.org\/10.1055\/a-2134-5803.","journal-title":"Z F\u00fcr Orthop Unfallchirurgie"},{"issue":"1","key":"4073_CR21","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1093\/gerona\/63.1.92","volume":"63","author":"YIL Shyu","year":"2008","unstructured":"Shyu YIL, Liang J, Wu CC, Su JY, Cheng HS, Chou SW, et al. Interdisciplinary intervention for hip fracture in older Taiwanese: benefits last for 1 year. J Gerontol Ser A. 2008;63(1):92\u20137.","journal-title":"J Gerontol Ser A"},{"issue":"9","key":"4073_CR22","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1007\/s00402-014-2057-x","volume":"134","author":"N Suhm","year":"2014","unstructured":"Suhm N, Kaelin R, Studer P, Wang Q, Kressig RW, Rikli D, et al. Orthogeriatric care pathway: a prospective survey of impact on length of stay, mortality and institutionalisation. Arch Orthop Trauma Surg. 2014;134(9):1261\u20139.","journal-title":"Arch Orthop Trauma Surg"},{"issue":"1","key":"4073_CR23","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1186\/s12877-022-03037-z","volume":"22","author":"K Rapp","year":"2022","unstructured":"Rapp K, Becker C, Todd C, Rehm M, Rothenbacher D, Konnopka C, et al. Association of two geriatric treatment systems on care home admission and mortality in patients with hip fracture. BMC Geriatr. 2022;22(1):459.","journal-title":"BMC Geriatr"},{"issue":"4","key":"4073_CR24","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s11914-009-0022-3","volume":"7","author":"JL Kelsey","year":"2009","unstructured":"Kelsey JL, Samelson EJ. Variation in risk factors for fractures at different sites. Curr Osteoporos Rep. 2009;7(4):127\u201333.","journal-title":"Curr Osteoporos Rep"},{"issue":"3","key":"4073_CR25","first-page":"101777","volume":"36","author":"PJ Mitchell","year":"2022","unstructured":"Mitchell PJ, Chan DC, Lee JK, Tabu I, Alpuerto BB. The global burden of fragility fractures \u2013 what are the differences, and where are the gaps. Osteoporosis. 2022;36(3):101777.","journal-title":"Osteoporosis"},{"issue":"1","key":"4073_CR26","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.mayocp.2014.09.011","volume":"90","author":"A Singer","year":"2015","unstructured":"Singer A, Exuzides A, Spangler L, O\u2019Malley C, Colby C, Johnston K, et al. Burden of illness for osteoporotic fractures compared with other serious diseases among postmenopausal women in the United States. Mayo Clin Proc. 2015;90(1):53\u201362.","journal-title":"Mayo Clin Proc"},{"issue":"9","key":"4073_CR27","doi-asserted-by":"publisher","first-page":"e580","DOI":"10.1016\/S2666-7568(21)00172-0","volume":"2","author":"AM Wu","year":"2021","unstructured":"Wu AM, Bisignano C, James SL, Abady GG, Abedi A, Abu-Gharbieh E, et al. Global, regional, and national burden of bone fractures in 204 countries and territories, 1990\u20132019: a systematic analysis from the Global Burden of Disease Study 2019. Lancet Healthy Longev. 2021;2(9):e580\u201392.","journal-title":"Lancet Healthy Longev"},{"key":"4073_CR28","doi-asserted-by":"publisher","first-page":"1030","DOI":"10.1186\/1471-2458-13-1030","volume":"13","author":"CA Huber","year":"2013","unstructured":"Huber CA, Szucs TD, Rapold R, Reich O. Identifying patients with chronic conditions using pharmacy data in Switzerland: an updated mapping approach to the classification of medications. BMC Public Health. 2013;13:1030.","journal-title":"BMC Public Health"},{"issue":"8","key":"4073_CR29","doi-asserted-by":"publisher","first-page":"715.e7","DOI":"10.1016\/j.jamda.2015.05.013","volume":"16","author":"K Rapp","year":"2015","unstructured":"Rapp K, Rothenbacher D, Magaziner J, Becker C, Benzinger P, K\u00f6nig HH, et al. Risk of nursing home admission after femoral fracture compared with stroke, myocardial infarction, and pneumonia. J Am Med Dir Assoc. 2015;16(8):715.e7-715.e12.","journal-title":"J Am Med Dir Assoc"},{"issue":"11","key":"4073_CR30","doi-asserted-by":"publisher","first-page":"3609","DOI":"10.1111\/jgs.18522","volume":"71","author":"JE Gaugler","year":"2023","unstructured":"Gaugler JE, Zmora R, Peterson CM, Mitchell LL, Jutkowitz E, Duval S. What interventions keep older people out of nursing homes? A systematic review and meta-analysis. J Am Geriatr Soc. 2023;71(11):3609\u201321.","journal-title":"J Am Geriatr Soc"},{"issue":"2","key":"4073_CR31","doi-asserted-by":"publisher","first-page":"afac007","DOI":"10.1093\/ageing\/afac007","volume":"51","author":"L Geyskens","year":"2022","unstructured":"Geyskens L, Jeuris A, Deschodt M, Van Grootven B, Gielen E, Flamaing J. Patient-related risk factors for in-hospital functional decline in older adults: a systematic review and meta-analysis. Age Ageing. 2022;51(2):afac007.","journal-title":"Age Ageing"},{"issue":"1","key":"4073_CR32","doi-asserted-by":"publisher","first-page":"268","DOI":"10.1186\/s12877-019-1299-4","volume":"19","author":"C Abrahamsen","year":"2019","unstructured":"Abrahamsen C, N\u00f8rgaard B, Draborg E, Nielsen MF. The impact of an orthogeriatric intervention in patients with fragility fractures: a cohort study. BMC Geriatr. 2019;19(1):268.","journal-title":"BMC Geriatr"},{"issue":"1","key":"4073_CR33","doi-asserted-by":"publisher","first-page":"e0279312","DOI":"10.1371\/journal.pone.0279312","volume":"18","author":"A Sagari","year":"2023","unstructured":"Sagari A, Tabira T, Maruta M, Tanaka K, Iso N, Okabe T, et al. Risk factors for nursing home admission among older adults: analysis of basic movements and activities of daily living. PLoS ONE. 2023;18(1):e0279312.","journal-title":"PLoS ONE"},{"issue":"10","key":"4073_CR34","doi-asserted-by":"publisher","first-page":"1866","DOI":"10.1111\/jgs.15546","volume":"66","author":"V Mor","year":"2018","unstructured":"Mor V, Thomas KS, Rahman M. Defining and measuring nursing home placement. J Am Geriatr Soc. 2018;66(10):1866\u20138.","journal-title":"J Am Geriatr Soc"},{"issue":"13","key":"4073_CR35","first-page":"438","volume":"121","author":"K Rapp","year":"2024","unstructured":"Rapp K, Becker C, Roigk P, Konnopka C, K\u00f6nig HH, Friess T, et al. Orthogeriatric co-management of spine, arm, forearm, and pelvis fractures. Dtsch Arzteblatt Int. 2024;121(13):438\u20139.","journal-title":"Dtsch Arzteblatt Int"},{"key":"4073_CR36","doi-asserted-by":"publisher","first-page":"215145932098629","DOI":"10.1177\/2151459320986299","volume":"12","author":"Y Bugaevsky","year":"2021","unstructured":"Bugaevsky Y, Levy Y, Hershkovitz A, Ocheretny I, Nissenholtz A, Cooper L, et al. Characteristics and outcomes of hip fracture patients hospitalized in an orthogeriatric unit versus an orthopedic department: a retrospective cohort study. Geriatr Orthop Surg Rehabil. 2021;12:2151459320986299.","journal-title":"Geriatr Orthop Surg Rehabil"}],"container-title":["BMC Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12916-025-04073-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12916-025-04073-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12916-025-04073-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,29]],"date-time":"2025-04-29T20:01:31Z","timestamp":1745956891000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcmedicine.biomedcentral.com\/articles\/10.1186\/s12916-025-04073-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,29]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["4073"],"URL":"https:\/\/doi.org\/10.1186\/s12916-025-04073-3","relation":{},"ISSN":["1741-7015"],"issn-type":[{"value":"1741-7015","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,29]]},"assertion":[{"value":"22 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 April 2025","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 approved by the ethics committee of the University of Ulm (177\/20). For this type of study with anonymized data, formal consent is not required.","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":"248"}}