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Article ; Online: Lung Function and Respiratory Morbidity Among Informal Workers Exposed to Cement Dust: A Comparative Cross-Sectional Study.

Dushyant, Kumar / Walia, Gagandeep Kaur / Devasenapathy, Niveditha

2023 Volume 89, Issue 1, Page(s) 47

Abstract: Background: Cement dust is a significant source of occupational exposure affecting lung function and respiratory health. A higher burden of respiratory morbidity is known among factory workers involved in cement production. Globally or from India, there ...

Abstract	Background: Cement dust is a significant source of occupational exposure affecting lung function and respiratory health. A higher burden of respiratory morbidity is known among factory workers involved in cement production. Globally or from India, there are no estimates of this burden from informal workers exposed to cement dust. Objective: To assess difference in lung function and respiratory symptoms among informal workers exposed to cement and those unexposed, using a comparative community based cross-sectional study from purposively selected areas in Delhi, India. Methods: Using a portable spirometer we measured lung function and collected respiratory symptoms from conveniently sampled informal workers (n = 100) exposed to cement dust, 50 indoor informal workers (tailors), and 50 outdoor (vegetable) vendors. Regression analyses were performed to compare respiratory symptom score and lung function parameters, adjusted for age, body mass index, smoking, socioeconomic status, and years of occupational exposure. Findings: Exposed workers had significantly lower lung function (PEF = -750 ml/s and -810 ml/s and FEV1/FVC (%) = -3.87 and -2.11) compared to indoor and outdoor groups, with three times higher chronic respiratory symptoms when compared to the unexposed groups. The cement dust exposure was observed to be associated with PEF (mean difference (MD) = -0.75L, 95%CI = -1.36 to -0.15, p = 0.01), %FEV1/FVC (MD = -3.87, 95%CI = -6.77 to -0.96, p = 0.03) and respiratory symptoms (p < 0.001). Conclusion: This study generates evidence regarding the respiratory burden of occupational exposure among vulnerable informal workers. There is an urgent need for policy reforms to safeguard health from occupational exposures, especially among informal workers.
MeSH term(s)	Humans ; Cross-Sectional Studies ; Dust ; Occupational Diseases/chemically induced ; Occupational Diseases/epidemiology ; Occupational Exposure/adverse effects ; Lung ; Morbidity
Chemical Substances	Dust
Language	English
Publishing date	2023-07-04
Publishing country	United States
Document type	Journal Article
ZDB-ID	2821756-1
ISSN	2214-9996 ; 2214-9996
ISSN (online)	2214-9996
ISSN	2214-9996
DOI	10.5334/aogh.4089
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Article ; Online: Mobile and Computer-Based Applications for Rehabilitation Monitoring and Self-Management After Knee Arthroplasty: Scoping Review.

Pritwani, Sabhya / Shrivastava, Purnima / Pandey, Shruti / Kumar, Ajit / Malhotra, Rajesh / Maddison, Ralph / Devasenapathy, Niveditha

JMIR mHealth and uHealth

2024 Volume 12, Page(s) e47843

Abstract: Background: Successful post-knee replacement rehabilitation requires adequate access to health information, social support, and periodic monitoring by a health professional. Mobile health (mHealth) and computer-based technologies are used for ... ...

Abstract	Background: Successful post-knee replacement rehabilitation requires adequate access to health information, social support, and periodic monitoring by a health professional. Mobile health (mHealth) and computer-based technologies are used for rehabilitation and remote monitoring. The extent of technology use and its function in post-knee replacement rehabilitation care in low and middle-income settings are unknown. Objective: To inform future mHealth intervention development, we conducted a scoping review to map the features and functionality of existing technologies and determine users' perspectives on telerehabilitation and technology for self-management. Methods: We followed the Joanna Briggs Institute methodology for scoping reviews. We searched the Embase, Medline, PsycINFO via OVID, and Cochrane Central Register of Controlled Trials databases for manuscripts published from 2001 onward. We included original research articles reporting the use of mobile or computer-based technologies by patients, health care providers, researchers, or family members. Studies were divided into the following 3 categories based on the purpose: validation studies, clinical evaluation, and end user feedback. We extracted general information on study design, technology features, proposed function, and perspectives of health care providers and patients. The protocol for this review is accessible in the Open Science Framework. Results: Of the 5960 articles, 158 that reported from high-income settings contributed to the qualitative summary (64 studies on mHealth or telerehabilitation programs, 28 validation studies, 38 studies describing users' perceptions). The highest numbers of studies were from Europe or the United Kingdom and North America regarding the use of a mobile app with or without wearables and reported mainly in the last decade. No studies were from low and middle-income settings. The primary functions of technology for remote rehabilitation were education to aid recovery and enable regular, appropriate exercises; monitoring progress of pain (n=19), activity (n=20), and exercise adherence (n=30); 1 or 2-way communication with health care professionals to facilitate the continuum of care (n=51); and goal setting (n=23). Assessment of range of motion (n=16) and gait analysis (n=10) were the commonly validated technologies developed to incorporate into a future rehabilitation program. Few studies (n=14) reported end user involvement during the development stage. We summarized the reasons for satisfaction and dissatisfaction among users across various technologies. Conclusions: Several existing mobile and computer-based technologies facilitate post-knee replacement rehabilitation care for patients and health care providers. However, they are limited to high-income settings and may not be extrapolated to low-income settings. A systematic needs assessment of patients undergoing knee replacement and health care providers involved in rehabilitation, involving end users at all stages of development and evaluation, with clear reporting of the development and clinical evaluation can make post-knee replacement rehabilitation care in resource-poor settings accessible and cost-effective.
MeSH term(s)	Humans ; Arthroplasty, Replacement, Knee ; Self-Management ; Telemedicine ; Telerehabilitation/methods ; Mobile Applications
Language	English
Publishing date	2024-01-26
Publishing country	Canada
Document type	Journal Article ; Review
ZDB-ID	2719220-9
ISSN	2291-5222 ; 2291-5222
ISSN (online)	2291-5222
ISSN	2291-5222
DOI	10.2196/47843
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Article ; Online: Frailty among middle-aged and older women and men in India: findings from wave 1 of the longitudinal Ageing study in India.

Ghosh, Arpita / Kundu, Monica / Devasenapathy, Niveditha / Woodward, Mark / Jha, Vivekanand

BMJ open

2023 Volume 13, Issue 7, Page(s) e071842

Abstract: Objectives: Few studies have examined frailty in Indian adults, despite an increasing population of older adults and an escalating burden of chronic diseases. We aimed to study the prevalence and correlates of frailty in middle-aged and older Indian ... ...

Abstract	Objectives: Few studies have examined frailty in Indian adults, despite an increasing population of older adults and an escalating burden of chronic diseases. We aimed to study the prevalence and correlates of frailty in middle-aged and older Indian adults. Setting: Cross-sectional data from Wave 1 of Longitudinal Ageing Study in India, conducted in 2017-2018 across all states and union territories, were used. Participants: The final analytical sample included 57 649 participants aged 45 years and above who had information on frailty status. Primary outcome measure: The deficits accumulation approach to measuring frailty was employed, creating a frailty index between 0 and 1, based on 40 deficits. Individuals with a frailty index of 0.25 or more were defined as 'frail'. Results: Prevalence of frailty among 45+ adults was 30%. 60+ women were two times as likely to be frail compared with 60+ men, after adjusting for a wide range of sociodemographic, economic and lifestyle factors. The sex difference was more pronounced in adults aged 45-59 years. Odds of hospitalisation in the last 12 months, and having falls in the past 2 years, were two times as high in frail adults compared with non-frail adults. Frail middle-aged and older adults had 33% and 39% higher odds, respectively, of having poor cognition than non-frail adults. The relative increase was higher in women for all three outcomes, although not statistically significant. Conclusions: There needs to be careful consideration of sex differences when addressing frailty, particularly for optimising frailty interventions. Frailty, although typically assessed in older adults, was shown in this study to be also prevalent and associated with adverse outcomes in middle-aged Indian adults. More research into assessment of frailty in younger populations, its trajectory and correlates may help develop public health measures for prevention of frailty.
MeSH term(s)	Aged ; Middle Aged ; Humans ; Female ; Male ; Frailty/epidemiology ; Frail Elderly ; Cross-Sectional Studies ; Aging ; Longitudinal Studies ; Geriatric Assessment ; Prevalence
Language	English
Publishing date	2023-07-31
Publishing country	England
Document type	Journal Article ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2023-071842
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Article ; Online: Challenges in rehabilitation and continuum of care provision after knee replacement: a mixed-methods study from a low- and middle-income country.

Pritwani, Sabhya / Pandey, Shruti / Shrivastava, Purnima / Kumar, Ajit / Malhotra, Rajesh / Maddison, Ralph / Devasenapathy, Niveditha

Disability and rehabilitation

2023 , Page(s) 1–11

Abstract: Purpose: Continuum-of-care is crucial following knee replacement. This is an understudied area in the context of low- and middle-income countries. We report findings of a mixed-methods study conducted to understand patient's postoperative experiences in ...

Abstract	Purpose: Continuum-of-care is crucial following knee replacement. This is an understudied area in the context of low- and middle-income countries. We report findings of a mixed-methods study conducted to understand patient's postoperative experiences in following unsupervised home-based physiotherapy protocols and healthcare provider's experiences in providing rehabilitation care. Methods: Consecutive adults ( Results: Patients were motivated to do exercises and valued family support during the recovery period. However, they desired physiotherapy support, especially during the early recovery period due to post-operative pain. Healthcare providers reported poor adherence with the exercise regimen and desired a mechanism to monitor patient progress after discharge. Patients and health care providers identified accessibility to rehabilitation centre as a major barrier in availing affordable and reliable physiotherapy services. Conclusion: There is a need for a continuum of care to improve patient experience during recovery and for health care providers to monitor progress and provide personalised progressive exercise therapy.
Language	English
Publishing date	2023-07-17
Publishing country	England
Document type	Journal Article
ZDB-ID	1104775-6
ISSN	1464-5165 ; 0963-8288
ISSN (online)	1464-5165
ISSN	0963-8288
DOI	10.1080/09638288.2023.2236012
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Article ; Online: Is It Worth Delaying Total Knee Replacement as Late as Possible? A Cost-Effectiveness Analysis Using a Markov Model in the Indian Setting.

George, Jaiben / Gautam, Deepak / Devasenapathy, Niveditha / Malhotra, Rajesh

Value in health regional issues

2021 Volume 24, Page(s) 173–180

Abstract: Background: Total knee replacement (TKR) is often delayed in younger patients in an attempt to prolong the longevity of the prosthesis and avoid the risk of revision. But delaying a TKR might compromise the quality of life of young patients who are ... ...

Abstract	Background: Total knee replacement (TKR) is often delayed in younger patients in an attempt to prolong the longevity of the prosthesis and avoid the risk of revision. But delaying a TKR might compromise the quality of life of young patients who are otherwise active and healthy. Methods: We built a Markov decision model to study the simulated clinical course of a 50-year-old patient with severe unilateral knee osteoarthritis who could be either treated with conservative therapies or with a TKR at some point in time. An Indian healthcare payer perspective model was used, and lifetime costs (in Indian rupees), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER) were calculated. Results: In the base case scenario, patients who did not receive a TKR had a total lifetime cost of ₹216 709 and accumulated 13.59 QALYS in their lifetime. Those who received a TKR without delay (at age 50) accumulated 16.71 QALYS in their lifetime with an ICER of ₹9789 per QALY. When TKR was delayed, the total QALYs decreased, and ICER increased with each year of delay. But the cumulative risk of revision decreased from 27.4% when TKR was performed at 50 years to 10.0% when TKR was done at 70 years. Conclusion: Our analysis found that TKR is a cost-effective procedure when the healthcare payer is willing to pay at least ₹9789 ($132) per QALY. The results also suggested that an early TKR is preferred to a delayed TKR despite the higher incidence of revisions.
MeSH term(s)	Arthroplasty, Replacement, Knee ; Cost-Benefit Analysis ; Humans ; Middle Aged ; Osteoarthritis, Knee/surgery ; Quality of Life ; Quality-Adjusted Life Years
Language	English
Publishing date	2021-04-05
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2679127-4
ISSN	2212-1102 ; 2212-1099
ISSN (online)	2212-1102
ISSN	2212-1099
DOI	10.1016/j.vhri.2020.12.009
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Article ; Online: Prevalence and factors associated with frailty among community-dwelling older people in rural Thanjavur district of South India: a cross-sectional study.

Kendhapedi, Kirubakaran Kesavan / Devasenapathy, Niveditha

BMJ open

2019 Volume 9, Issue 10, Page(s) e032904

Abstract: Objective: There is sparse data on the prevalence of frailty from rural parts of India. Our aim was to estimate prevalence of frailty among community-dwelling older people in rural South Indian population and explore socio-demographic factors associated ...

Abstract	Objective: There is sparse data on the prevalence of frailty from rural parts of India. Our aim was to estimate prevalence of frailty among community-dwelling older people in rural South Indian population and explore socio-demographic factors associated with frailty. We further explored the associations between frailty with fear of falling and falls. Design: Community based cross-sectional study. Setting: Four villages in Thanjavur district of Southern India. Participants: Random sample of adults aged 60 years and above from four villages. Methods: We sampled community-dwelling older adults from the electoral list of four villages using stratified random sampling. We report prevalence of frailty as defined by physical definition (Fried's Phenotype), accumulation of deficits (Frailty Index) and multi-domain definition (Tilburg Frailty Indicator). We report proportion of agreement of frailty status between the frailty tools. We used logistic regressions with robust SEs to examine the associations between socio-demographic determinants with frailty and the association between frailty with fear of falling and falls. Results: Among the 408 participants, the weighted (non-response and poststratification for sex) prevalence and 95% CI of frailty was 28% (18.9 to 28.1) for physical definition, 59% (53.9 to 64.3) for accumulation of deficits and 63% (57.4 to 67.6) for multi-domain definition. Frailty Index and Tilburg Frailty Indicator had good agreement (80%). Age, female, lower education, lower socioeconomic status, minimum physical activity in routine work were independently associated with frailty irrespective of the frailty definitions. Frail elderly had higher odds of falls as well as fear of falling compared with non-frail, irrespective of the definitions. Conclusion: Prevalence of frailty among older people in rural Thanjavur district of South India was high compared with low-income and middle-income countries. Understanding the modifiable determinants of frailty can provide a valuable reference for future prevention and intervention.
MeSH term(s)	Accidental Falls/statistics & numerical data ; Aged ; Cross-Sectional Studies ; Fear ; Female ; Frailty/epidemiology ; Humans ; Independent Living ; India/epidemiology ; Male ; Middle Aged ; Prevalence ; Rural Health
Language	English
Publishing date	2019-10-11
Publishing country	England
Document type	Journal Article
ZDB-ID	2599832-8
ISSN	2044-6055 ; 2044-6055
ISSN (online)	2044-6055
ISSN	2044-6055
DOI	10.1136/bmjopen-2019-032904
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Article ; Online: Poor awareness of diabetes self-care among diabetics

Gurkirat Kaur / Shomik Ray / Niveditha Devasenapathy

International Journal of Noncommunicable Diseases, Vol 5, Iss 3, Pp 131-

Cross-sectional study from an urban poor settlement in Delhi

2020 Volume 137

Abstract: Introduction: Lack of awareness about self-care and misconceptions about diabetes could have a negative impact on diabetes management. We aimed to assess the knowledge, attitude, and practices about diabetes self-care among diabetic individuals. Subject ... ...

Abstract	Introduction: Lack of awareness about self-care and misconceptions about diabetes could have a negative impact on diabetes management. We aimed to assess the knowledge, attitude, and practices about diabetes self-care among diabetic individuals. Subject and Methods: We undertook a community-based quantitative survey in an urban poor colony of West Delhi. Using structured questionnaires, we collected the information on sociodemographic profile, knowledge, and perception regarding diabetes self-care and related expenses, from all consenting self-reported diabetic individuals. Results: Out of 198 individuals with diabetes from 543 households, 106 completed the interview. The mean age was 53 years, with a median of 5 years since the diagnosis. Equal numbers sought care from the private and government facilities with median expenses on diabetes care being INR 855 (INR 0-3900) per month. Many (28.7%) availed blood glucose tests from nearby government sponsored Mohalla clinic and none had tested hemoglobin A1C. Most (86.7%) were aware of eye complications due to diabetes and least (8.5%) about neuropathic and vascular complications. We found misconceptions regarding medications and physical activity. Perceived ability of following prescribed medications were better than hypoglycemia management and foot-care. Higher perception score was independently associated with the duration of diabetes, higher socioeconomic status, literacy, and those availing government facilities. Most clinic visits involved the prescription of medications and diagnostics without much emphasis on the lifestyle modifications. Conclusion: Diabetics living in the urban poor settlements have accessibility to medicines and diagnostics. However, there exists misperception regarding diabetes self-care that needs to be addressed through counseling during outpatient clinic visits and effective use of mass media.
Keywords	diabetes mellitus ; perception ; self-management ; Specialties of internal medicine ; RC581-951
Subject code	571
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
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Article ; Online: Use and assessment of knowledge of Vitamin K antagonist therapy in cardiac patients

Nandini Pattnaik / Anwar Hussain Ansari / Praloy Chakraborty / Niveditha Devasenapathy

Journal of the Practice of Cardiovascular Sciences, Vol 7, Iss 2, Pp 158-

A Tertiary Care Hospital-based survey

2021 Volume 167

Abstract: Background: Safety and efficacy of Vitamin K antagonists (VKAs), the most widely used oral anticoagulant (OAC), is monitored by therapeutic international normalized ratio (INR). The current study was conducted to evaluate the proportion of patients ... ...

Abstract	Background: Safety and efficacy of Vitamin K antagonists (VKAs), the most widely used oral anticoagulant (OAC), is monitored by therapeutic international normalized ratio (INR). The current study was conducted to evaluate the proportion of patients achieving therapeutic range INR and assessment of the knowledge, and awareness among patients regarding OAC therapy, as well as identification of the challenges in the monitoring of INR. Materials and Methods: This hospital-based, single-center cross-sectional study was conducted at a tertiary care hospital in Delhi. Patients on anticoagulation with VKAs were interviewed and their records were reviewed. Information on sociodemographic characteristics, history of cardiac illness, INR range, knowledge, and awareness regarding VKA therapy were analyzed. Data management was done via CSPro and statistical analysis via STATA 13.0. Results: A total of 86 patients were evaluated. The mean age of the study participants was 49 ± 14.9 years. Only 29.1% of the study group achieved therapeutic INR. Overall awareness and knowledge regarding the need for VKA therapy, ideal INR range, complications of poor monitoring, and dietary restrictions were in the range of 31%–48%. Conclusion: Poor INR control is prevalent in Indian patients on VKAs therapy. Although the future practice may move toward newer anticoagulants, a substantial proportion of our population may still need VKAs. Hence, there is a need for improving the knowledge and awareness of patients on VKA therapy to improve therapeutic effectiveness.
Keywords	atrial fibrillation ; mechanical prosthetic heart valve ; newer oral anticoagulants ; oral anticoagulant ; therapeutic international normalized ratio ; Medicine ; R ; Surgery ; RD1-811 ; Diseases of the circulatory (Cardiovascular) system ; RC666-701
Subject code	610
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
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Article ; Online: Challenges in Timely Pharmacological Reperfusion Therapy of Acute ST-Elevation Myocardial Infarction Patients

Prakriti Snehil / Anwar Hussain Ansari / Praloy Chakraborty / Niveditha Devasenapathy

Journal of Clinical and Diagnostic Research, Vol 15, Iss 9, Pp OC25-OC

A Cross-sectional Study

2021 Volume 31

Abstract: Introduction: Acute ST-Elevation Myocardial Infarction (STEMI) is the most severe presentation of an Acute Coronary Syndrome (ACS) resulting from sudden occlusion of one of the major epicardial coronary arteries resulting in myocardial injury and ... ...

Abstract	Introduction: Acute ST-Elevation Myocardial Infarction (STEMI) is the most severe presentation of an Acute Coronary Syndrome (ACS) resulting from sudden occlusion of one of the major epicardial coronary arteries resulting in myocardial injury and necrosis within minutes to few hours. Despite Primary Percutaneous Coronary Intervention (PPCI) being the gold standard, thrombolytic therapy is still the most common form of reperfusion therapy in eligible patients of acute STEMI even in large metropolitan cities in India. Aim: To find the proportion of STEMI patients receiving thrombolytic therapy within four hours of the onset of symptoms and within 30 minutes of reaching the hospital and to explore factors related to Pain-To-Door (P2D) delay. Materials and Methods: This was a single-centre cross-sectional observational study of 147 STEMI patients conducted at a tertiary care hospital in the National Capital Territory (India). from February to May 2017. Ethical clearance was obtained from the Institute’s Ethics Committee. All patients were interviewed and their medical records reviewed. Factors related to delay in reaching hospital and association of patient characteristics with those receiving thrombolytic therapy were explored using univariable and multivariable logistic regression. Results: Mean age of the study population was 52.1±13.1 years and 121 (82.3%) were men. Median P2D time was 4.7 hours (IQR2.2-17.0). Overall, 64 (43.5%) of 147 patients reached the hospital within four hours of chest pain. Only 5 (3.4%) patients availed ambulance to reach the hospital. Distance from the hospital, seeking care elsewhere and delay in reaction to symptom were reasons for the delay (>4 hours). Median Door-To-Needle (D2N) time was 45.9 minutes (IQR- 30.6-61.2). Patients who reached the hospital at night were more likely to be thrombolysed after adjusting for time to reach the hospital. Conclusion: Significant P2D and Door-To-Balloon (D2B) delays still exist in large metro cities in India. Action is needed both at the population level as well as system level to reduce these delays.
Keywords	door-to-needle time ; pain-to-door time ; primary percutaneous coronary intervention ; thrombolysis ; Medicine ; R
Subject code	610
Language	English
Publishing date	2021-09-01T00:00:00Z
Publisher	JCDR Research and Publications Private Limited
Document type	Article ; Online
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Article ; Online: An extension minimal important difference credibility item addressing construct proximity is a reliable alternative to the correlation item.

Wang, Yuting / Devji, Tahira / Carrasco-Labra, Alonso / Qasim, Anila / Hao, Qiukui / Kum, Elena / Devasenapathy, Niveditha / King, Madeleine T / Terluin, Berend / Terwee, Caroline B / Walsh, Michael / Furukawa, Toshi A / Tsujimoto, Yasushi / Guyatt, Gordon H

Journal of clinical epidemiology

2023 Volume 157, Page(s) 46–52

Abstract: Objectives: Minimal important difference (MID), the smallest change or difference that patients perceive as important, aids interpretation of change in patient-reported outcome measure (PROM) scores. A credibility instrument that assesses the ... ...

Abstract	Objectives: Minimal important difference (MID), the smallest change or difference that patients perceive as important, aids interpretation of change in patient-reported outcome measure (PROM) scores. A credibility instrument that assesses the methodological rigor of an anchor-based MID includes one core item addressing the correlation between the PROM and the anchor. However, the majority of MID studies in the literature fail to report the correlation. To address this issue, we extended the anchor-based MID credibility instrument by adding an item addressing construct proximity as an alternative to the correlation item. Study design and setting: Informed by an MID methodological survey, we added an alternative item-a subjective assessment of similarity of the constructs (i.e., construct proximity) between PROM and anchor-to the correlation item and generated principles for the assessment. We sampled 101 MIDs and analyzed the assessments performed by each pair of raters. By calculating weighted Cohen's kappa, we assessed the reliability of the assessments. Results: Construct proximity assessment is based on the anticipated association between the anchor and PROM constructs: the closer the anticipated association, the higher the rating. Our detailed principles address the most frequently used anchors: transition ratings, measures of satisfaction, other PROMs, and clinical measures. The assessments showed acceptable agreement (weighted kappa 0.74, 95% CI 0.55-0.94) between raters. Conclusion: In the absence of a reported correlation coefficient, construct proximity assessment provides a useful alternative in the credibility assessment of anchor-based MID estimates.
MeSH term(s)	Humans ; Quality of Life ; Reproducibility of Results ; Surveys and Questionnaires ; Patient Reported Outcome Measures
Language	English
Publishing date	2023-03-05
Publishing country	United States
Document type	Journal Article
ZDB-ID	639306-8
ISSN	1878-5921 ; 0895-4356
ISSN (online)	1878-5921
ISSN	0895-4356
DOI	10.1016/j.jclinepi.2023.03.001
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