{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T02:38:39Z","timestamp":1790044719519,"version":"4.0.1"},"reference-count":55,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CJASN"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Patient centeredness is widely advocated as a cornerstone of health care, but it is yet to be fully realized, including in nephrology. Our study aims to describe nephrologists\u2019 perspectives on defining and implementing patient-centered outcomes in hemodialysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design, setting, participants, &amp; measurements<\/jats:title>\n                    <jats:p>Face-to-face, semistructured interviews were conducted with 58 nephrologists from 27 dialysis units across nine countries, including the United States, the United Kingdom, Australia, Austria, Belgium, Canada, Germany, Singapore, and New Zealand. Transcripts were thematically analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified five themes on defining and implementing patient-centered outcomes in hemodialysis: explicitly prioritized by patients (articulated preferences and goals, ascertaining treatment burden, defining hemodialysis success, distinguishing a physician-patient dichotomy, and supporting shared decision making), optimizing wellbeing (respecting patient choice, focusing on symptomology, perceptible and tangible, and judging relevance and consequence), comprehending extensive heterogeneity of clinical and quality of life outcomes (distilling diverse priorities, highly individualized, attempting to specify outcomes, and broadening context), clinically hamstrung (professional deficiency, uncertainty and complexity in measurement, beyond medical purview, specificity of care, mechanistic mindset [focused on biochemical targets and comorbidities], avoiding alarm, and paradoxical dilemma), and undermined by system pressures (adhering to overarching policies, misalignment with mandates, and resource constraints).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Improving patient-centered outcomes is regarded by nephrologists to encompass strategies that address patient goals and improve wellbeing and treatment burden in patients on hemodialysis. However, efforts are hampered by ambiguities about how to prioritize, measure, and manage the plethora of critical comorbidities and broader quality of life outcomes in a care setting that is technically demanding and driven by biochemical targets. Identifying critical patient\u2013important outcomes and mechanisms for integrating them into practice may help to deliver patient-centered care in hemodialysis and other chronic disease settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Podcast<\/jats:title>\n                    <jats:p>This article contains a podcast at https:\/\/www.asn-online.org\/media\/podcast\/CJASN\/2017_02_28_Tong.mp3<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2215\/cjn.08370816","type":"journal-article","created":{"date-parts":[[2017,2,21]],"date-time":"2017-02-21T20:20:14Z","timestamp":1487708414000},"page":"454-466","source":"Crossref","is-referenced-by-count":46,"title":["Nephrologists\u2019 Perspectives on Defining and Applying Patient-Centered Outcomes in Hemodialysis"],"prefix":"10.2215","volume":"12","author":[{"given":"Allison","family":"Tong","sequence":"first","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia;"},{"name":"Centre for Kidney Research, The Children\u2019s Hospital at Westmead, Sydney, New South Wales, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolfgang C.","family":"Winkelmayer","sequence":"additional","affiliation":[{"name":"Selzman Institute for Kidney Health, Section of Nephrology, Baylor College of Medicine, Houston, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David C.","family":"Wheeler","sequence":"additional","affiliation":[{"name":"Centre for Nephrology, University College London, London, United Kingdom;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim","family":"van Biesen","sequence":"additional","affiliation":[{"name":"Renal Division, Ghent University Hospital, Ghent, Belgium;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Tugwell","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Braden","family":"Manns","sequence":"additional","affiliation":[{"name":"Medicine and"},{"name":"Community Health Sciences, Libin Cardiovascular Institute and O\u2019Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Hemmelgarn","sequence":"additional","affiliation":[{"name":"Medicine and"},{"name":"Community Health Sciences, Libin Cardiovascular Institute and O\u2019Brien Institute of Public Health, University of Calgary, Calgary, Alberta, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tess","family":"Harris","sequence":"additional","affiliation":[{"name":"Polycystic Kidney Disease International, London, United Kingdom; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Crowe","sequence":"additional","affiliation":[{"name":"Crowe Associates Ltd, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Ju","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia;"},{"name":"Centre for Kidney Research, The Children\u2019s Hospital at Westmead, Sydney, New South Wales, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"O\u2019Lone","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia;"},{"name":"Centre for Kidney Research, The Children\u2019s Hospital at Westmead, Sydney, New South Wales, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Evangelidis","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia;"},{"name":"Centre for Kidney Research, The Children\u2019s Hospital at Westmead, Sydney, New South Wales, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan C.","family":"Craig","sequence":"additional","affiliation":[{"name":"Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia;"},{"name":"Centre for Kidney Research, The Children\u2019s Hospital at Westmead, Sydney, New South Wales, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the SONG-HD Initiative","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,2,21]]},"reference":[{"key":"B2-20230813","doi-asserted-by":"crossref","first-page":"2543","DOI":"10.1001\/jama.299.21.2543","article-title":"Patient-important outcomes in registered diabetes trials.","volume":"299","author":"Gandhi","year":"2008","journal-title":"JAMA"},{"key":"B3-20230813","doi-asserted-by":"crossref","first-page":"d7995","DOI":"10.1136\/bmj.d7995","article-title":"The idolatry of the surrogate.","volume":"343","author":"Yudkin","year":"2011","journal-title":"BMJ"},{"key":"B4-20230813","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1056\/NEJMp1109283","article-title":"Shared decision making--pinnacle of patient-centered care.","volume":"366","author":"Barry","year":"2012","journal-title":"N Engl J Med"},{"key":"B5-20230813","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1056\/NEJMp1200070","article-title":"Defining \u201cpatient-centered medicine.\u201d","volume":"366","author":"Bardes","year":"2012","journal-title":"N Engl J Med"},{"key":"B6-20230813","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1001\/jama.1996.03530260066035","article-title":"Patient-centered medicine. A professional evolution.","volume":"275","author":"Laine","year":"1996","journal-title":"JAMA"},{"key":"B7-20230813","doi-asserted-by":"crossref","first-page":"1870","DOI":"10.1001\/jamainternmed.2014.4782","article-title":"Readmissions in the era of patient engagement.","volume":"174","author":"Howard-Anderson","year":"2014","journal-title":"JAMA Intern Med"},{"key":"B8-20230813","doi-asserted-by":"crossref","first-page":"i3319","DOI":"10.1136\/bmj.i3319","article-title":"Patient focused registries can improve health, care, and science.","volume":"354","author":"Nelson","year":"2016","journal-title":"BMJ"},{"key":"B9-20230813","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1056\/NEJMp1209500","article-title":"Shared decision making to improve care and reduce costs.","volume":"368","author":"Oshima Lee","year":"2013","journal-title":"N Engl J Med"},{"key":"B10-20230813","doi-asserted-by":"crossref","first-page":"2189","DOI":"10.2215\/CJN.01930214","article-title":"Patient-centered care: An opportunity to accomplish the \u201cThree Aims\u201d of the National Quality Strategy in the Medicare ESRD program.","volume":"9","author":"O\u2019Hare","year":"2014","journal-title":"Clin J Am Soc Nephrol"},{"key":"B11-20230813","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1016\/j.amjmed.2003.09.031","article-title":"The end of the disease era.","volume":"116","author":"Tinetti","year":"2004","journal-title":"Am J Med"},{"key":"B12-20230813","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1001\/jama.2014.11100","article-title":"The PCORI perspective on patient-centered outcomes research.","volume":"312","author":"Frank","year":"2014","journal-title":"JAMA"},{"key":"B13-20230813","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1370\/afm.1239","article-title":"The values and value of patient-centered care.","volume":"9","author":"Epstein","year":"2011","journal-title":"Ann Fam Med"},{"key":"B14-20230813","doi-asserted-by":"crossref","first-page":"1109","DOI":"10.1001\/jama.2016.0505","article-title":"Health care delivery innovations that integrate care? Yes! But integrating what?","volume":"315","author":"Herzlinger","year":"2016","journal-title":"JAMA"},{"key":"B15-20230813","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.1001\/jama.2012.500","article-title":"The Patient-Centered Outcomes Research Institute (PCORI) national priorities for research and initial research agenda.","volume":"307","author":"Selby","year":"2012","journal-title":"JAMA"},{"key":"B17-20230813","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1001\/archinte.166.7.754","article-title":"Adoption of patient-centered care practices by physicians: Results from a national survey.","volume":"166","author":"Audet","year":"2006","journal-title":"Arch Intern Med"},{"key":"B18-20230813","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1111\/j.1525-1497.2005.0178.x","article-title":"A 2020 vision of patient-centered primary care.","volume":"20","author":"Davis","year":"2005","journal-title":"J Gen Intern Med"},{"key":"B19-20230813","doi-asserted-by":"crossref","first-page":"2848","DOI":"10.1001\/jama.296.23.2848","article-title":"A systems approach to patient-centered care.","volume":"296","author":"Bergeson","year":"2006","journal-title":"JAMA"},{"key":"B20-20230813","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.ijcard.2016.04.170","article-title":"Sudden cardiac death and chronic kidney disease: From pathophysiology to treatment strategies.","volume":"217","author":"Di Lullo","year":"2016","journal-title":"Int J Cardiol"},{"key":"B21-20230813","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1161\/CIRCOUTCOMES.112.970194","article-title":"Time for a thorough evaluation of patient-centered care.","volume":"6","author":"Heidenreich","year":"2013","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"B23-20230813","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1001\/jama.2012.211273","article-title":"Realigning reimbursement policy and financial incentives to support patient-centered out-of-hospital care.","volume":"309","author":"Munjal","year":"2013","journal-title":"JAMA"},{"key":"B24-20230813","doi-asserted-by":"crossref","first-page":"448","DOI":"10.7326\/0003-4819-157-6-201209180-00010","article-title":"Transitional care: Focusing on patient-centered outcomes and simplicity.","volume":"157","author":"Bray-Hall","year":"2012","journal-title":"Ann Intern Med"},{"key":"B25-20230813","doi-asserted-by":"crossref","first-page":"e75","DOI":"10.1161\/CIRCOUTCOMES.112.969717","article-title":"Shared decision making: A path toward improved patient-centered outcomes.","volume":"5","author":"Spatz","year":"2012","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"B26-20230813","doi-asserted-by":"crossref","first-page":"471","DOI":"10.1016\/j.jval.2014.02.012","article-title":"Patient-centeredness in the design of clinical trials.","volume":"17","author":"Mullins","year":"2014","journal-title":"Value Health"},{"key":"B27-20230813","doi-asserted-by":"crossref","first-page":"2621","DOI":"10.1681\/ASN.2014101017","article-title":"Maintenance dialysis throughout the world in years 1990 and 2010.","volume":"26","author":"Thomas","year":"2015","journal-title":"J Am Soc Nephrol"},{"key":"B28-20230813","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1038\/ki.2013.252","article-title":"Worldwide, mortality risk is high soon after initiation of hemodialysis.","volume":"85","author":"Robinson","year":"2014","journal-title":"Kidney Int"},{"key":"B29-20230813","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1093\/ndt\/gft528","article-title":"The role of economies of scale in the cost of dialysis across the world: A macroeconomic perspective.","volume":"29","author":"Karopadi","year":"2014","journal-title":"Nephrol Dial Transplant"},{"key":"B30-20230813","doi-asserted-by":"crossref","first-page":"e1001307","DOI":"10.1371\/journal.pmed.1001307","article-title":"A systematic review and meta-analysis of utility-based quality of life in chronic kidney disease treatments.","volume":"9","author":"Wyld","year":"2012","journal-title":"PLoS Med"},{"issue":"Suppl 1","key":"B31-20230813","first-page":"S1","article-title":"Excerpts from the United States Renal Data System 2007 annual data report.","volume":"51","author":"Collins","year":"2008","journal-title":"Am J Kidney Dis"},{"key":"B32-20230813","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1053\/j.ajkd.2015.04.015","article-title":"Comorbidity ascertainment from the ESRD medical evidence report and medicare claims around dialysis initiation: A comparison using US Renal Data System data.","volume":"66","author":"Krishnan","year":"2015","journal-title":"Am J Kidney Dis"},{"key":"B33-20230813","doi-asserted-by":"crossref","first-page":"3270","DOI":"10.1097\/01.ASN.0000100127.54107.57","article-title":"Association of comorbid conditions and mortality in hemodialysis patients in Europe, Japan, and the United States: The Dialysis Outcomes and Practice Patterns Study (DOPPS).","volume":"14","author":"Goodkin","year":"2003","journal-title":"J Am Soc Nephrol"},{"key":"B34-20230813","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1053\/j.ajkd.2008.03.020","article-title":"Mortality risk for dialysis patients with different levels of serum calcium, phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Study (DOPPS).","volume":"52","author":"Tentori","year":"2008","journal-title":"Am J Kidney Dis"},{"key":"B35-20230813","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1016\/j.jvs.2016.01.053","article-title":"Outcomes of vascular access for hemodialysis: A systematic review and meta-analysis.","volume":"64","author":"Almasri","year":"2016","journal-title":"J Vasc Surg"},{"key":"B36-20230813","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1111\/sdi.12326","article-title":"Prioritizing patient-centered care implementation and research for patients with kidney disease.","volume":"28","author":"Cavanaugh","year":"2015","journal-title":"Semin Dial"},{"key":"B37-20230813","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): A 32-item checklist for interviews and focus groups.","volume":"19","author":"Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"key":"B38-20230813","doi-asserted-by":"crossref","first-page":"5963","DOI":"10.1158\/1078-0432.CCR-10-1962","article-title":"Evaluating patient-centered outcomes in the randomized controlled trial and beyond: Informing the future with lessons from the past.","volume":"16","author":"Booth","year":"2010","journal-title":"Clin Cancer Res"},{"key":"B39-20230813","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.pec.2005.08.001","article-title":"The moral nature of patient-centeredness: Is it \u201cjust the right thing to do\u201d?","volume":"62","author":"Duggan","year":"2006","journal-title":"Patient Educ Couns"},{"key":"B41-20230813","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1053\/j.ajkd.2015.05.020","article-title":"Patient-reported outcome instruments for physical symptoms among patients recieving maintenance dialysis: A systematic review.","volume":"66","author":"Flythe","year":"2015","journal-title":"Am J Kidney Dis"},{"key":"B43-20230813","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1001\/jamainternmed.2015.7412","article-title":"Timing of initiation of maintenance dialysis: A qualitative analysis of the electronic medical records of a national cohort of patients from the department of veterans affairs.","volume":"176","author":"Wong","year":"2016","journal-title":"JAMA Intern Med"},{"key":"B44-20230813","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1111\/j.1525-139X.2012.01110.x","article-title":"Measurement of health-related quality of life in the care of patients with ESRD: Isn\u2019t this the metric that matters?","volume":"25","author":"Naik","year":"2012","journal-title":"Semin Dial"},{"key":"B45-20230813","doi-asserted-by":"crossref","first-page":"888","DOI":"10.2215\/CJN.07410714","article-title":"How the ESRD quality incentive program could potentially improve quality of life for patients on dialysis.","volume":"10","author":"Moss","year":"2015","journal-title":"Clin J Am Soc Nephrol"},{"key":"B46-20230813","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1111\/sdi.12063","article-title":"The weather and quality of life in ESRD patients: Everybody talks about it, but does anybody do anything about it?","volume":"26","author":"Kimmel","year":"2013","journal-title":"Semin Dial"},{"key":"B47-20230813","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1093\/intqhc\/mzw028","article-title":"Qualitative analysis of US Department of Veterans Affairs mental health clinician perspectives on patient-centered care.","volume":"28","author":"Dobscha","year":"2016","journal-title":"Int J Qual Health Care"},{"key":"B48-20230813","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1111\/nep.12206","article-title":"Knowledge deficit of patients with stage 1-4 CKD: A focus group study.","volume":"19","author":"Lopez-Vargas","year":"2014","journal-title":"Nephrology (Carlton)"},{"key":"B49-20230813","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1053\/j.ajkd.2016.02.037","article-title":"Patient and caregiver priorities for outcomes in hemodialysis: An international nominal group technique study.","volume":"68","author":"Urquhart-Secord","year":"2016","journal-title":"Am J Kidney Dis"},{"key":"B50-20230813","doi-asserted-by":"crossref","first-page":"c112","DOI":"10.1136\/bmj.c112","article-title":"The views of patients and carers in treatment decision making for chronic kidney disease: Systematic review and thematic synthesis of qualitative studies.","volume":"340","author":"Morton","year":"2010","journal-title":"BMJ"},{"key":"B51-20230813","doi-asserted-by":"crossref","first-page":"4038","DOI":"10.1093\/ndt\/gfr177","article-title":"Characteristics of dialysis important to patients and family caregivers: A mixed methods approach.","volume":"26","author":"Morton","year":"2011","journal-title":"Nephrol Dial Transplant"},{"key":"B52-20230813","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1093\/ndt\/gfv330","article-title":"Patient and caregiver values, beliefs and experiences when considering home dialysis as a treatment option: A semi-structured interview study.","volume":"31","author":"Walker","year":"2016","journal-title":"Nephrol Dial Transplant"},{"key":"B53-20230813","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1111\/hdi.12424","article-title":"The economic considerations of patients and caregivers in choice of dialysis modality.","volume":"20","author":"Walker","year":"2016","journal-title":"Hemodial Int"},{"key":"B54-20230813","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.2215\/CJN.03280314","article-title":"Patient-stated preferences regarding volume-related risk mitigation strategies for hemodialysis.","volume":"9","author":"Flythe","year":"2014","journal-title":"Clin J Am Soc Nephrol"},{"key":"B55-20230813","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1053\/j.ajkd.2015.02.341","article-title":"Research priorities in CKD: Report of a national workshop conducted in Australia.","volume":"66","author":"Tong","year":"2015","journal-title":"Am J Kidney Dis"},{"key":"B56-20230813","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.2215\/CJN.01610214","article-title":"Setting research priorities for patients on or nearing dialysis.","volume":"9","author":"Manns","year":"2014","journal-title":"Clin J Am Soc Nephrol"},{"key":"B57-20230813","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1186\/s13063-015-0895-7","article-title":"Standardised outcomes in nephrology - Haemodialysis (SONG-HD): Study protocol for establishing a core outcome set in haemodialysis.","volume":"16","author":"Tong","year":"2015","journal-title":"Trials"},{"key":"B59-20230813","article-title":"Establishing core outcomes domains in hemodialysis: Report of the Standardized outcomes in nephrology-hemodialysis (SONG-HD) consensus workshop [published online ahead of print August 3, 2016].","author":"Tong","journal-title":"Am J Kidney Dis"},{"key":"B60-20230813","doi-asserted-by":"crossref","first-page":"2215","DOI":"10.1001\/jama.2013.4929","article-title":"The future of quality measurement for improvement and accountability.","volume":"309","author":"Conway","year":"2013","journal-title":"JAMA"},{"key":"B62-20230813","doi-asserted-by":"crossref","first-page":"1605","DOI":"10.1093\/ndt\/gfv209","article-title":"How to routinely collect data on patient-reported outcome and experience measures in renal registries in Europe: An expert consensus meeting.","volume":"30","author":"Breckenridge","year":"2015","journal-title":"Nephrol Dial Transplant"}],"container-title":["Clinical Journal of the American Society of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01277230-201703000-00013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T13:36:34Z","timestamp":1786368994000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01277230-201703000-00013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,2,21]]},"references-count":55,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.2215\/cjn.08370816","relation":{},"ISSN":["1555-9041","1555-905X"],"issn-type":[{"value":"1555-9041","type":"print"},{"value":"1555-905X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,2,21]]}}}