{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T15:22:40Z","timestamp":1774452160505,"version":"3.50.1"},"reference-count":58,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T00:00:00Z","timestamp":1661385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Healthcare"],"abstract":"<jats:p>Thyroid cancer (TC) is the most common malignancy of the endocrine system that affects the thyroid gland. It is usually treatable and, in most cases, curable. The central issues are how to improve knowledge on TC, to accurately identify cases at an early stage that can benefit from effective intervention, optimise therapy, and reduce the risk of overdiagnosis and unnecessary treatment. Questions remain about management, about treating all patients in referral centres, and about which treatment should be proposed to any individual patient and how this can be optimised. The European Alliance for Personalised Medicine (EAPM) hosted an expert panel discussion to elucidate some of the challenges, and to identify possible steps towards effective responses at the EU and member state level, particularly in the context of the opportunities in the European Union\u2019s evolving initiatives\u2014notably its Beating Cancer Plan, its Cancer Mission, and its research funding programmes. Recommendations emerging from the panel focus on improved infrastructure and funding, and on promoting multi-stakeholder collaboration between national and European initiatives to complement, support, and mutually reinforce efforts to improve patient care.<\/jats:p>","DOI":"10.3390\/healthcare10091621","type":"journal-article","created":{"date-parts":[[2022,8,25]],"date-time":"2022-08-25T21:28:12Z","timestamp":1661462892000},"page":"1621","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Tackling Thyroid Cancer in Europe\u2014The Challenges and Opportunities"],"prefix":"10.3390","volume":"10","author":[{"given":"Denis","family":"Horgan","sequence":"first","affiliation":[{"name":"European Alliance for Personalised Medicine, 1040 Brussels, Belgium"}]},{"given":"Dagmar","family":"F\u00fchrer-Sakel","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetes and Metabolism, Endocrine Tumour Center at West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, 45122 Duisburg, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9607-6998","authenticated-orcid":false,"given":"Paula","family":"Soares","sequence":"additional","affiliation":[{"name":"Instituto de Inova\u00e7\u00e3o e Investiga\u00e7\u00e3o em Sa\u00fade\/Institute of Molecular Pathology and Immunology of University of Porto (I3S\/IPATIMUP), 4200-465 Porto, Portugal"},{"name":"Faculty of Medicine of the University of Porto, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1500-4058","authenticated-orcid":false,"given":"Clara V.","family":"Alvarez","sequence":"additional","affiliation":[{"name":"Neoplasia & Endocrine Differentiation, Centro de Investigaci\u00f3n en Medicina Molecular y Enfermedades Cr\u00f3nicas (CIMUS), University of Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain"},{"name":"Instituto de Investigacion Sanitaria (IDIS), 15706 Santiago de Compostela, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5372-0982","authenticated-orcid":false,"given":"Laura","family":"Fugazzola","sequence":"additional","affiliation":[{"name":"Division of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy"},{"name":"Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9603-0460","authenticated-orcid":false,"given":"Romana T.","family":"Netea-Maier","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Internal Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9811-9584","authenticated-orcid":false,"given":"Barbara","family":"Jarzab","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrine Oncology, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-102 Gliwice, Poland"}]},{"given":"Marta","family":"Kozaric","sequence":"additional","affiliation":[{"name":"European Alliance for Personalised Medicine, 1040 Brussels, Belgium"}]},{"given":"Beate","family":"Bartes","sequence":"additional","affiliation":[{"name":"Association Vivre sans Thyro\u00efde, 31490 L\u00e9guevin, France"}]},{"given":"James","family":"Schuster-Bruce","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Saint George\u2019s University Hospitals NHS Foundation Trust, London SW17 0QT, UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6163-200X","authenticated-orcid":false,"given":"Luigino","family":"Dal Maso","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO), 33081 Aviano, Italy"}]},{"given":"Martin","family":"Schlumberger","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Endocrine Oncology, Institut Gustave Roussy, Universit\u00e9 Paris Saclay, 94805 Villejuif, France"}]},{"given":"Furio","family":"Pacini","sequence":"additional","affiliation":[{"name":"Section of Endocrinology, University of Siena, 53100 Siena, Italy"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,25]]},"reference":[{"key":"ref_1","unstructured":"NHS (2022, June 01). Thyroid cancer, Diagnosis [WWW Document]. Available online: https:\/\/www.nhs.uk\/conditions\/thyroid-cancer\/diagnosis\/."},{"key":"ref_2","unstructured":"American Cancer Society (2022, June 01). What is Thyroid Cancer [WWW Document]. Who. Available online: http:\/\/www.cancer.org\/cancer\/thyroidcancer\/detailedguide\/thyroid-cancer-what-is-thyroid-cancer."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1001\/jama.2017.2719","article-title":"Trends in Thyroid Cancer Incidence and Mortality in the United States, 1974\u20132013","volume":"317","author":"Lim","year":"2017","journal-title":"JAMA-J. Am. Med. Assoc."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1038\/bjc.2016.304","article-title":"Cancer incidence and mortality projections in the UK until 2035","volume":"115","author":"Smittenaar","year":"2016","journal-title":"Br. J. Cancer"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_6","unstructured":"American Cancer Society (2022, August 19). Key Statistics for Thyroid Cancer [WWW Document]. American Cancer Society. Available online: https:\/\/www.cancer.org\/cancer\/thyroid-cancer\/about\/key-statistics.html."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/S2213-8587(22)00035-3","article-title":"The epidemiological landscape of thyroid cancer worldwide: GLOBOCAN estimates for incidence and mortality rates in 2020","volume":"10","author":"Pizzato","year":"2022","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_8","unstructured":"American Cancer Society (2022, June 01). Thyroid Cancer Survival Rates, by Type and Stage [WWW Document]. Available online: https:\/\/www.cancer.org\/cancer\/thyroid-cancer\/detection-diagnosis-staging\/survival-rates.html."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Khosravi, M.H., Kouhi, A., Saeedi, M., Bagherihagh, A., and Amirzade-Iranaq, M.H. (2017). Thyroid Cancers: Considerations, Classifications, and Managements. Diagnosis and Management of Head and Neck Cancer, IntechOpen.","DOI":"10.5772\/intechopen.70128"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1038\/s41574-020-00448-z","article-title":"Current practice in patients with differentiated thyroid cancer","volume":"17","author":"Schlumberger","year":"2020","journal-title":"Nat. Rev. Endocrinol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1016\/j.path.2019.08.002","article-title":"Molecular Alterations in Thyroid Carcinoma","volume":"12","author":"Xu","year":"2019","journal-title":"Surg. Pathol. Clin."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Nyl\u00e9n, C., Mechera, R., Mar\u00e9chal-Ross, I., Tsang, V., Chou, A., Gill, A.J., Clifton-Bligh, R.J., Robinson, B.G., Sywak, M.S., and Sidhu, S.B. (2020). Molecular Markers Guiding Thyroid Cancer Management. Cancers, 12.","DOI":"10.3390\/cancers12082164"},{"key":"ref_13","first-page":"1","article-title":"Propelling Health Care into the Twenties","volume":"5","author":"Horgan","year":"2020","journal-title":"Biomed. Hub"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1056\/NEJMp1604412","article-title":"Worldwide Thyroid-Cancer Epidemic? The Increasing Impact of Overdiagnosis","volume":"375","author":"Vaccarella","year":"2016","journal-title":"New Engl. J. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.2967\/jnumed.117.192559","article-title":"Controversial Issues in Thyroid Cancer Management","volume":"59","author":"Tuttle","year":"2018","journal-title":"J. Nucl. Med."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Jegerlehner, S., Bulliard, J.-L., Aujesky, D., Rodondi, N., Germann, S., Konzelmann, I., Chiolero, A., Mousavi, M., Camey, B., and Bouchardy, C. (2017). Overdiagnosis and overtreatment of thyroid cancer: A population-based temporal trend study. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0179387"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"22","DOI":"10.17925\/USE.2017.13.01.22","article-title":"Ensuring Quality in Thyroid Cancer Surgery","volume":"13","author":"Bates","year":"2017","journal-title":"US Endocrinol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1007\/s12020-020-02418-x","article-title":"Personalized management of differentiated thyroid cancer in real life\u2013practical guidance from a multidisciplinary panel of experts","volume":"70","author":"Barbaro","year":"2020","journal-title":"Endocrine"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1507\/endocrj.EJ20-0025","article-title":"The revised clinical practice guidelines on the management of thyroid tumors by the Japan Associations of Endocrine Surgeons: Core questions and recommendations for treatments of thyroid cancer","volume":"67","author":"Ito","year":"2020","journal-title":"Endocr. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1089\/thy.2021.0531","article-title":"Thyroidectomies in Italy: A population-based national analysis from 2001 to 2018","volume":"32","author":"Pierannunzio","year":"2022","journal-title":"Thyroid"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"571421","DOI":"10.3389\/fendo.2020.571421","article-title":"Early Diagnosis of Low-Risk Papillary Thyroid Cancer Results Rather in Overtreatment Than a Better Survival","volume":"11","author":"Krajewska","year":"2020","journal-title":"Front. Endocrinol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1097\/PAS.0000000000001522","article-title":"Thyroid Papillary Microtumor: Validation of the (updated) porto proposal assessing sex hormone receptor expression and mutational BRAF gene status","volume":"44","author":"Aliyev","year":"2020","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_23","unstructured":"Siderova, M. (2022, July 19). Thyroid Cancer: Diagnosis, Treatment and Follow-Up. Available online: https:\/\/www.intechopen.com\/chapters\/61460."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1016\/j.ejso.2017.07.004","article-title":"Post-treatment surveillance of thyroid cancer","volume":"44","author":"Wang","year":"2017","journal-title":"Eur. J. Surg. Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"569041","DOI":"10.3389\/fendo.2020.569041","article-title":"Radiation Exposure to the Thyroid After the Chernobyl Accident","volume":"11","author":"Drozdovitch","year":"2021","journal-title":"Front. Endocrinol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1499","DOI":"10.1210\/jcem.87.4.8274","article-title":"Diagnostic 131-Iodine Whole-Body Scan May Be Avoided in Thyroid Cancer Patients Who Have Undetectable Stimulated Serum Tg Levels After Initial Treatment","volume":"87","author":"Pacini","year":"2002","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/S2213-8587(16)30112-7","article-title":"Radiation and risk of thyroid cancer: Fukushima and Chernobyl","volume":"4","author":"Takamura","year":"2016","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1856","DOI":"10.1093\/annonc\/mdz400","article-title":"Thyroid cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up","volume":"30","author":"Filetti","year":"2019","journal-title":"Ann. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1016\/j.annonc.2022.04.009","article-title":"ESMO Clinical Practice Guideline update on the use of systemic therapy in advanced thyroid cancer","volume":"33","author":"Filetti","year":"2022","journal-title":"Ann. Oncol."},{"key":"ref_30","unstructured":"ETA (2022, June 01). ETA Guidelines [WWW Document]. Available online: https:\/\/www.eurothyroid.com\/guidelines\/eta_guidelines.html."},{"key":"ref_31","first-page":"73","article-title":"Kinase Inhibitors in the Treatment of Thyroid Cancer: Institutional Experience","volume":"59","author":"Kuna","year":"2020","journal-title":"Acta Clin. Croat."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Ragusa, F., Ferrari, S.M., Elia, G., Paparo, S.R., Balestri, E., Botrini, C., Patrizio, A., Mazzi, V., Guglielmi, G., and Foddis, R. (2022). Combination Strategies Involving Immune Checkpoint Inhibitors and Tyrosine Kinase or BRAF Inhibitors in Aggressive Thyroid Cancer. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23105731"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e025820","DOI":"10.1136\/bmjopen-2018-025820","article-title":"Public perceptions of changing the terminology for low-risk thyroid cancer: A qualitative focus group study","volume":"9","author":"Nickel","year":"2019","journal-title":"BMJ Open"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e000359","DOI":"10.1136\/esmoopen-2018-000359","article-title":"Management of recurrent or metastatic thyroid cancer","volume":"3","author":"Tahara","year":"2018","journal-title":"ESMO Open"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"S2","DOI":"10.1016\/j.ijsu.2017.02.064","article-title":"Genetics of medullary thyroid cancer: An overview","volume":"41","author":"Accardo","year":"2017","journal-title":"Int. J. Surg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1111\/his.13380","article-title":"Molecular pathology of thyroid tumours of follicular cells: A review of genetic alterations and their clinicopathological relevance","volume":"72","author":"Acquaviva","year":"2017","journal-title":"Histopathology"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.cell.2014.09.050","article-title":"Integrated Genomic Characterization of Papillary Thyroid Carcinoma","volume":"159","author":"Agrawal","year":"2014","journal-title":"Cell"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1089\/thy.2016.0254","article-title":"Molecular Pathology of Anaplastic Thyroid Carcinomas: A Retrospective Study of 144 Cases","volume":"27","author":"Bonhomme","year":"2017","journal-title":"Thyroid"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1038\/s41571-018-0113-0","article-title":"NTRK fusion-positive cancers and TRK inhibitor therapy","volume":"15","author":"Cocco","year":"2018","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_40","first-page":"768","article-title":"New directions in the systemic treatment of metastatic thyroid cancer","volume":"23","author":"Higgins","year":"2009","journal-title":"Oncology"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3803\/EnM.2019.34.1.1","article-title":"Genomic Characterization of Differentiated Thyroid Carcinoma","volume":"34","author":"Song","year":"2019","journal-title":"Endocrinol. Metab."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1888","DOI":"10.1001\/jama.2017.0562","article-title":"Screening for thyroid cancer: Updated evidence report and systematic review for the US preventive services task force","volume":"317","author":"Lin","year":"2017","journal-title":"JAMA-J. Am. Med. Assoc."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1002\/cam4.184","article-title":"Access, excess, and overdiagnosis: The case for thyroid cancer","volume":"3","author":"Hall","year":"2014","journal-title":"Cancer Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.jcpo.2017.12.008","article-title":"From here to 2025: Personalised medicine and healthcare for an immediate future","volume":"16","author":"Horgan","year":"2018","journal-title":"J. Cancer Policy"},{"key":"ref_45","first-page":"1","article-title":"Bringing Greater Accuracy to Europe\u2019s Healthcare Systems: The Unexploited Potential of Biomarker Testing in Oncology","volume":"5","author":"Horgan","year":"2020","journal-title":"Biomed. Hub"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"S1206","DOI":"10.1016\/j.annonc.2021.08.896","article-title":"1750P Molecular genotyping in refractory thyroid cancers: Results of a European survey","volume":"32","author":"Fugazzola","year":"2021","journal-title":"Ann. Oncol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"S1208","DOI":"10.1016\/j.annonc.2021.08.900","article-title":"1754P Current picture of Anaplastic Thyroid Cancer patients\u2019 care and meetable needs: A survey of 94 institutions from the EORTC Endocrine and Head and Neck Cancer Groups","volume":"32","author":"Locati","year":"2021","journal-title":"Ann. Oncol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1159\/000500539","article-title":"Risk of Thyroid Cancer in 1,504 Patients Referred for Thyroid Surgery with Assumed Benign Histology","volume":"8","author":"Gram","year":"2019","journal-title":"Eur. Thyroid J."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1089\/thy.2004.14.1056","article-title":"Increased incidence of thyroid carcinoma in france: A true epidemic or thyroid nodule management effects? Report from the french thyroid cancer committee","volume":"14","author":"Leenhardt","year":"2004","journal-title":"Thyroid."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1111\/cyt.12981","article-title":"The utility of ThyroSeq \u00ae in the management of indeterminate thyroid nodules by fine-needle aspiration","volume":"32","author":"Li","year":"2021","journal-title":"Cytopathology"},{"key":"ref_51","unstructured":"(2022, June 01). Vivre Sans Thyro\u00efde. Available online: https:\/\/www.forum-thyroide.net\/."},{"key":"ref_52","first-page":"84","article-title":"Rising incidence of papillary thyroid carcinoma in Germany","volume":"57","author":"Batzler","year":"2014","journal-title":"Bundesgesundheitsblatt. Gesund-Heitsforschung Gesundh."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.ejca.2018.01.083","article-title":"The impact of overdiagnosis on thyroid cancer epidemic in Italy, 1998\u20132012","volume":"94","author":"Panato","year":"2018","journal-title":"Eur. J. Cancer"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"3872","DOI":"10.1245\/s10434-020-08470-1","article-title":"Surgical Complications and Referral Patterns in 567 Patients with Differentiated Thyroid Cancer in the Northern Region of the Netherlands: A Population-Based Study To-wards Clinical Management Implementation","volume":"27","author":"Weistra","year":"2020","journal-title":"Ann. Surg. Oncol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1007\/s12094-015-1465-x","article-title":"Consensus on management of advanced medullary thyroid carcinoma on behalf of the Working Group of Thyroid Cancer of the Spanish Society of Endocrinology (SEEN) and the Spanish Task Force Group for Orphan and Infrequent Tumors (GETHI)","volume":"18","author":"Grande","year":"2015","journal-title":"Clin. Transl. Oncol."},{"key":"ref_56","unstructured":"RORENO (2022, June 01). [WWW Document]. Available online: https:\/\/www.ipoporto.pt\/dev\/wp-content\/uploads\/2019\/03\/registo-oncol%C3%B3gico-norte.pdf."},{"key":"ref_57","unstructured":"Endo-ERN (2022, June 02). Introduction [WWW Document]. Available online: https:\/\/endo-ern.eu\/specific-expertise\/thyroid\/introduction\/."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1530\/EJE-20-0197","article-title":"An overview of clinical activities in Endo-ERN: The need for alignment of future network criteria","volume":"183","author":"Bruin","year":"2020","journal-title":"Eur. J. Endocrinol."}],"container-title":["Healthcare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9032\/10\/9\/1621\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:15:22Z","timestamp":1760141722000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9032\/10\/9\/1621"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,25]]},"references-count":58,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2022,9]]}},"alternative-id":["healthcare10091621"],"URL":"https:\/\/doi.org\/10.3390\/healthcare10091621","relation":{},"ISSN":["2227-9032"],"issn-type":[{"value":"2227-9032","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,25]]}}}