The Use of Decision Modelling to Inform Timely Policy Decisions on Cardiac Resource Capacity During the COVID-19 Pandemic.
Identifieur interne : 000228 ( Main/Corpus ); précédent : 000227; suivant : 000229The Use of Decision Modelling to Inform Timely Policy Decisions on Cardiac Resource Capacity During the COVID-19 Pandemic.
Auteurs : Derrick Y. Tam ; David Naimark ; Madhu K. Natarajan ; Graham Woodward ; Garth Oakes ; Mirna Rahal ; Kali Barrett ; Yasin A. Khan ; Raphael Ximenes ; Stephen Mac ; Beate Sander ; Harindra C. WijeysunderaSource :
- The Canadian journal of cardiology [ 1916-7075 ] ; 2020.
Abstract
In Ontario on March 16, 2020, a directive was issued to all acute care hospitals to halt nonessential procedures in anticipation of a potential surge in COVID-19 patients. This included scheduled outpatient cardiac surgical and interventional procedures that required the use of intensive care units, ventilators, and skilled critical care personnel, given that these procedures would draw from the same pool of resources required for critically ill COVID-19 patients. We adapted the COVID-19 Resource Estimator (CORE) decision analytic model by adding a cardiac component to determine the impact of various policy decisions on the incremental waitlist growth and estimated waitlist mortality for 3 key groups of cardiovascular disease patients: coronary artery disease, valvular heart disease, and arrhythmias. We provided predictions based on COVID-19 epidemiology available in real-time, in 3 phases. First, in the initial crisis phase, in a worst case scenario, we showed that the potential number of waitlist related cardiac deaths would be orders of magnitude less than those who would die of COVID-19 if critical cardiac care resources were diverted to the care of COVID-19 patients. Second, with better local epidemiology data, we predicted that across 5 regions of Ontario, there may be insufficient resources to resume all elective outpatient cardiac procedures. Finally in the recovery phase, we showed that the estimated incremental growth in waitlist for all cardiac procedures is likely substantial. These outputs informed timely data-driven decisions during the COVID-19 pandemic regarding the provision of cardiovascular care.
DOI: 10.1016/j.cjca.2020.05.024
PubMed: 32447059
PubMed Central: PMC7241392
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Tam</name><affiliation><nlm:affiliation>Division of Cardiac Surgery, Department of Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Naimark, David" sort="Naimark, David" uniqKey="Naimark D" first="David" last="Naimark">David Naimark</name><affiliation><nlm:affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Natarajan, Madhu K" sort="Natarajan, Madhu K" uniqKey="Natarajan M" first="Madhu K" last="Natarajan">Madhu K. Natarajan</name><affiliation><nlm:affiliation>Division of Cardiology, Hamilton Health Sciences, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Woodward, Graham" sort="Woodward, Graham" uniqKey="Woodward G" first="Graham" last="Woodward">Graham Woodward</name><affiliation><nlm:affiliation>CorHealth Ontario, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Oakes, Garth" sort="Oakes, Garth" uniqKey="Oakes G" first="Garth" last="Oakes">Garth Oakes</name><affiliation><nlm:affiliation>CorHealth Ontario, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Rahal, Mirna" sort="Rahal, Mirna" uniqKey="Rahal M" first="Mirna" last="Rahal">Mirna Rahal</name><affiliation><nlm:affiliation>CorHealth Ontario, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Barrett, Kali" sort="Barrett, Kali" uniqKey="Barrett K" first="Kali" last="Barrett">Kali Barrett</name><affiliation><nlm:affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, University of Toronto, Toronto, Ontario, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Khan, Yasin A" sort="Khan, Yasin A" uniqKey="Khan Y" first="Yasin A" last="Khan">Yasin A. Khan</name><affiliation><nlm:affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, University of Toronto, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Ximenes, Raphael" sort="Ximenes, Raphael" uniqKey="Ximenes R" first="Raphael" last="Ximenes">Raphael Ximenes</name><affiliation><nlm:affiliation>COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, University of Toronto, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Mac, Stephen" sort="Mac, Stephen" uniqKey="Mac S" first="Stephen" last="Mac">Stephen Mac</name><affiliation><nlm:affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, University of Toronto, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Sander, Beate" sort="Sander, Beate" uniqKey="Sander B" first="Beate" last="Sander">Beate Sander</name><affiliation><nlm:affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, University of Toronto, Toronto, Ontario, Canada; Public Health Ontario, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Wijeysundera, Harindra C" sort="Wijeysundera, Harindra C" uniqKey="Wijeysundera H" first="Harindra C" last="Wijeysundera">Harindra C. Wijeysundera</name><affiliation><nlm:affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Division of Cardiology, Department of Medicine, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. Electronic address: harindra.wijeysundera@sunnybrook.ca.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32447059</idno><idno type="pmid">32447059</idno><idno type="doi">10.1016/j.cjca.2020.05.024</idno><idno type="pmc">PMC7241392</idno><idno type="wicri:Area/Main/Corpus">000228</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000228</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">The Use of Decision Modelling to Inform Timely Policy Decisions on Cardiac Resource Capacity During the COVID-19 Pandemic.</title><author><name sortKey="Tam, Derrick Y" sort="Tam, Derrick Y" uniqKey="Tam D" first="Derrick Y" last="Tam">Derrick Y. Tam</name><affiliation><nlm:affiliation>Division of Cardiac Surgery, Department of Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Naimark, David" sort="Naimark, David" uniqKey="Naimark D" first="David" last="Naimark">David Naimark</name><affiliation><nlm:affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Natarajan, Madhu K" sort="Natarajan, Madhu K" uniqKey="Natarajan M" first="Madhu K" last="Natarajan">Madhu K. Natarajan</name><affiliation><nlm:affiliation>Division of Cardiology, Hamilton Health Sciences, Hamilton, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Woodward, Graham" sort="Woodward, Graham" uniqKey="Woodward G" first="Graham" last="Woodward">Graham Woodward</name><affiliation><nlm:affiliation>CorHealth Ontario, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Oakes, Garth" sort="Oakes, Garth" uniqKey="Oakes G" first="Garth" last="Oakes">Garth Oakes</name><affiliation><nlm:affiliation>CorHealth Ontario, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Rahal, Mirna" sort="Rahal, Mirna" uniqKey="Rahal M" first="Mirna" last="Rahal">Mirna Rahal</name><affiliation><nlm:affiliation>CorHealth Ontario, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Barrett, Kali" sort="Barrett, Kali" uniqKey="Barrett K" first="Kali" last="Barrett">Kali Barrett</name><affiliation><nlm:affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, University of Toronto, Toronto, Ontario, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Khan, Yasin A" sort="Khan, Yasin A" uniqKey="Khan Y" first="Yasin A" last="Khan">Yasin A. Khan</name><affiliation><nlm:affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, University of Toronto, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Ximenes, Raphael" sort="Ximenes, Raphael" uniqKey="Ximenes R" first="Raphael" last="Ximenes">Raphael Ximenes</name><affiliation><nlm:affiliation>COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, University of Toronto, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Mac, Stephen" sort="Mac, Stephen" uniqKey="Mac S" first="Stephen" last="Mac">Stephen Mac</name><affiliation><nlm:affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, University of Toronto, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Sander, Beate" sort="Sander, Beate" uniqKey="Sander B" first="Beate" last="Sander">Beate Sander</name><affiliation><nlm:affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, University of Toronto, Toronto, Ontario, Canada; Public Health Ontario, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Wijeysundera, Harindra C" sort="Wijeysundera, Harindra C" uniqKey="Wijeysundera H" first="Harindra C" last="Wijeysundera">Harindra C. Wijeysundera</name><affiliation><nlm:affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Division of Cardiology, Department of Medicine, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. Electronic address: harindra.wijeysundera@sunnybrook.ca.</nlm:affiliation></affiliation></author></analytic><series><title level="j">The Canadian journal of cardiology</title><idno type="eISSN">1916-7075</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In Ontario on March 16, 2020, a directive was issued to all acute care hospitals to halt nonessential procedures in anticipation of a potential surge in COVID-19 patients. This included scheduled outpatient cardiac surgical and interventional procedures that required the use of intensive care units, ventilators, and skilled critical care personnel, given that these procedures would draw from the same pool of resources required for critically ill COVID-19 patients. We adapted the COVID-19 Resource Estimator (CORE) decision analytic model by adding a cardiac component to determine the impact of various policy decisions on the incremental waitlist growth and estimated waitlist mortality for 3 key groups of cardiovascular disease patients: coronary artery disease, valvular heart disease, and arrhythmias. We provided predictions based on COVID-19 epidemiology available in real-time, in 3 phases. First, in the initial crisis phase, in a worst case scenario, we showed that the potential number of waitlist related cardiac deaths would be orders of magnitude less than those who would die of COVID-19 if critical cardiac care resources were diverted to the care of COVID-19 patients. Second, with better local epidemiology data, we predicted that across 5 regions of Ontario, there may be insufficient resources to resume all elective outpatient cardiac procedures. Finally in the recovery phase, we showed that the estimated incremental growth in waitlist for all cardiac procedures is likely substantial. These outputs informed timely data-driven decisions during the COVID-19 pandemic regarding the provision of cardiovascular care.</div></front></TEI><pubmed><MedlineCitation Status="Publisher" Owner="NLM"><PMID Version="1">32447059</PMID><DateRevised><Year>2020</Year><Month>07</Month><Day>20</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1916-7075</ISSN><JournalIssue CitedMedium="Internet"><PubDate><Year>2020</Year><Month>May</Month><Day>21</Day></PubDate></JournalIssue><Title>The Canadian journal of cardiology</Title><ISOAbbreviation>Can J Cardiol</ISOAbbreviation></Journal><ArticleTitle>The Use of Decision Modelling to Inform Timely Policy Decisions on Cardiac Resource Capacity During the COVID-19 Pandemic.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">S0828-282X(20)30503-1</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.cjca.2020.05.024</ELocationID><Abstract><AbstractText>In Ontario on March 16, 2020, a directive was issued to all acute care hospitals to halt nonessential procedures in anticipation of a potential surge in COVID-19 patients. This included scheduled outpatient cardiac surgical and interventional procedures that required the use of intensive care units, ventilators, and skilled critical care personnel, given that these procedures would draw from the same pool of resources required for critically ill COVID-19 patients. We adapted the COVID-19 Resource Estimator (CORE) decision analytic model by adding a cardiac component to determine the impact of various policy decisions on the incremental waitlist growth and estimated waitlist mortality for 3 key groups of cardiovascular disease patients: coronary artery disease, valvular heart disease, and arrhythmias. We provided predictions based on COVID-19 epidemiology available in real-time, in 3 phases. First, in the initial crisis phase, in a worst case scenario, we showed that the potential number of waitlist related cardiac deaths would be orders of magnitude less than those who would die of COVID-19 if critical cardiac care resources were diverted to the care of COVID-19 patients. Second, with better local epidemiology data, we predicted that across 5 regions of Ontario, there may be insufficient resources to resume all elective outpatient cardiac procedures. Finally in the recovery phase, we showed that the estimated incremental growth in waitlist for all cardiac procedures is likely substantial. These outputs informed timely data-driven decisions during the COVID-19 pandemic regarding the provision of cardiovascular care.</AbstractText><CopyrightInformation>Copyright © 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Tam</LastName><ForeName>Derrick Y</ForeName><Initials>DY</Initials><AffiliationInfo><Affiliation>Division of Cardiac Surgery, Department of Surgery, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Naimark</LastName><ForeName>David</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Division of Nephrology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Natarajan</LastName><ForeName>Madhu K</ForeName><Initials>MK</Initials><AffiliationInfo><Affiliation>Division of Cardiology, Hamilton Health Sciences, Hamilton, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Woodward</LastName><ForeName>Graham</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>CorHealth Ontario, Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Oakes</LastName><ForeName>Garth</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>CorHealth Ontario, Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rahal</LastName><ForeName>Mirna</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>CorHealth Ontario, Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Barrett</LastName><ForeName>Kali</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, University of Toronto, Toronto, Ontario, Canada; Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Khan</LastName><ForeName>Yasin A</ForeName><Initials>YA</Initials><AffiliationInfo><Affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, University of Toronto, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ximenes</LastName><ForeName>Raphael</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, University of Toronto, Toronto, Ontario, Canada; University Health Network, Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mac</LastName><ForeName>Stephen</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, University of Toronto, Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sander</LastName><ForeName>Beate</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; COVID-19 Modelling Collaborative, University of Toronto, Toronto, Ontario, Canada; Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, University of Toronto, Toronto, Ontario, Canada; Public Health Ontario, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wijeysundera</LastName><ForeName>Harindra C</ForeName><Initials>HC</Initials><AffiliationInfo><Affiliation>Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Division of Cardiology, Department of Medicine, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada. Electronic address: harindra.wijeysundera@sunnybrook.ca.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>05</Month><Day>21</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Can J Cardiol</MedlineTA><NlmUniqueID>8510280</NlmUniqueID><ISSNLinking>0828-282X</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>04</Month><Day>27</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>05</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>05</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>5</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>5</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>5</Month><Day>25</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>aheadofprint</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32447059</ArticleId><ArticleId IdType="pii">S0828-282X(20)30503-1</ArticleId><ArticleId IdType="doi">10.1016/j.cjca.2020.05.024</ArticleId><ArticleId IdType="pmc">PMC7241392</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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