Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update).
Identifieur interne : 000112 ( Main/Corpus ); précédent : 000111; suivant : 000113Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update).
Auteurs : Neil Bhattacharyya ; Samuel P. Gubbels ; Seth R. Schwartz ; Jonathan A. Edlow ; Hussam El-Kashlan ; Terry Fife ; Janene M. Holmberg ; Kathryn Mahoney ; Deena B. Hollingsworth ; Richard Roberts ; Michael D. Seidman ; Robert W Prasaad Steiner ; Betty Tsai Do ; Courtney C J. Voelker ; Richard W. Waguespack ; Maureen D. CorriganSource :
- Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [ 1097-6817 ] ; 2017.
English descriptors
- KwdEn :
- MESH :
- diagnosis : Benign Paroxysmal Positional Vertigo.
- methods : Patient Positioning.
- prevention & control : Benign Paroxysmal Positional Vertigo.
- therapy : Benign Paroxysmal Positional Vertigo.
- Diagnosis, Differential, Humans.
Abstract
Objective This update of a 2008 guideline from the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations to benign paroxysmal positional vertigo (BPPV), defined as a disorder of the inner ear characterized by repeated episodes of positional vertigo. Changes from the prior guideline include a consumer advocate added to the update group; new evidence from 2 clinical practice guidelines, 20 systematic reviews, and 27 randomized controlled trials; enhanced emphasis on patient education and shared decision making; a new algorithm to clarify action statement relationships; and new and expanded recommendations for the diagnosis and management of BPPV. Purpose The primary purposes of this guideline are to improve the quality of care and outcomes for BPPV by improving the accurate and efficient diagnosis of BPPV, reducing the inappropriate use of vestibular suppressant medications, decreasing the inappropriate use of ancillary testing such as radiographic imaging, and increasing the use of appropriate therapeutic repositioning maneuvers. The guideline is intended for all clinicians who are likely to diagnose and manage patients with BPPV, and it applies to any setting in which BPPV would be identified, monitored, or managed. The target patient for the guideline is aged ≥18 years with a suspected or potential diagnosis of BPPV. The primary outcome considered in this guideline is the resolution of the symptoms associated with BPPV. Secondary outcomes considered include an increased rate of accurate diagnoses of BPPV, a more efficient return to regular activities and work, decreased use of inappropriate medications and unnecessary diagnostic tests, reduction in recurrence of BPPV, and reduction in adverse events associated with undiagnosed or untreated BPPV. Other outcomes considered include minimizing costs in the diagnosis and treatment of BPPV, minimizing potentially unnecessary return physician visits, and maximizing the health-related quality of life of individuals afflicted with BPPV. Action Statements The update group made strong recommendations that clinicians should (1) diagnose posterior semicircular canal BPPV when vertigo associated with torsional, upbeating nystagmus is provoked by the Dix-Hallpike maneuver, performed by bringing the patient from an upright to supine position with the head turned 45° to one side and neck extended 20° with the affected ear down, and (2) treat, or refer to a clinician who can treat, patients with posterior canal BPPV with a canalith repositioning procedure. The update group made a strong recommendation against postprocedural postural restrictions after canalith repositioning procedure for posterior canal BPPV. The update group made recommendations that the clinician should (1) perform, or refer to a clinician who can perform, a supine roll test to assess for lateral semicircular canal BPPV if the patient has a history compatible with BPPV and the Dix-Hallpike test exhibits horizontal or no nystagmus; (2) differentiate, or refer to a clinician who can differentiate, BPPV from other causes of imbalance, dizziness, and vertigo; (3) assess patients with BPPV for factors that modify management, including impaired mobility or balance, central nervous system disorders, a lack of home support, and/or increased risk for falling; (4) reassess patients within 1 month after an initial period of observation or treatment to document resolution or persistence of symptoms; (5) evaluate, or refer to a clinician who can evaluate, patients with persistent symptoms for unresolved BPPV and/or underlying peripheral vestibular or central nervous system disorders; and (6) educate patients regarding the impact of BPPV on their safety, the potential for disease recurrence, and the importance of follow-up. The update group made recommendations against (1) radiographic imaging for a patient who meets diagnostic criteria for BPPV in the absence of additional signs and/or symptoms inconsistent with BPPV that warrant imaging, (2) vestibular testing for a patient who meets diagnostic criteria for BPPV in the absence of additional vestibular signs and/or symptoms inconsistent with BPPV that warrant testing, and (3) routinely treating BPPV with vestibular suppressant medications such as antihistamines and/or benzodiazepines. The guideline update group provided the options that clinicians may offer (1) observation with follow-up as initial management for patients with BPPV and (2) vestibular rehabilitation, either self-administered or with a clinician, in the treatment of BPPV.
DOI: 10.1177/0194599816689667
PubMed: 28248609
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pubmed:28248609Le document en format XML
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</affiliation>
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<author><name sortKey="Waguespack, Richard W" sort="Waguespack, Richard W" uniqKey="Waguespack R" first="Richard W" last="Waguespack">Richard W. Waguespack</name>
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</affiliation>
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<author><name sortKey="Gubbels, Samuel P" sort="Gubbels, Samuel P" uniqKey="Gubbels S" first="Samuel P" last="Gubbels">Samuel P. Gubbels</name>
<affiliation><nlm:affiliation>2 Department of Otolaryngology, School of Medicine and Public Health, University of Colorado, Aurora, Colorado, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Schwartz, Seth R" sort="Schwartz, Seth R" uniqKey="Schwartz S" first="Seth R" last="Schwartz">Seth R. Schwartz</name>
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</affiliation>
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<author><name sortKey="Edlow, Jonathan A" sort="Edlow, Jonathan A" uniqKey="Edlow J" first="Jonathan A" last="Edlow">Jonathan A. Edlow</name>
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</affiliation>
</author>
<author><name sortKey="El Kashlan, Hussam" sort="El Kashlan, Hussam" uniqKey="El Kashlan H" first="Hussam" last="El-Kashlan">Hussam El-Kashlan</name>
<affiliation><nlm:affiliation>5 Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Fife, Terry" sort="Fife, Terry" uniqKey="Fife T" first="Terry" last="Fife">Terry Fife</name>
<affiliation><nlm:affiliation>6 Barrow Neurological Institute and College of Medicine, University of Arizona, Phoenix, Arizona, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Holmberg, Janene M" sort="Holmberg, Janene M" uniqKey="Holmberg J" first="Janene M" last="Holmberg">Janene M. Holmberg</name>
<affiliation><nlm:affiliation>7 Intermountain Hearing and Balance Center, Salt Lake City, Utah, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Mahoney, Kathryn" sort="Mahoney, Kathryn" uniqKey="Mahoney K" first="Kathryn" last="Mahoney">Kathryn Mahoney</name>
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</affiliation>
</author>
<author><name sortKey="Hollingsworth, Deena B" sort="Hollingsworth, Deena B" uniqKey="Hollingsworth D" first="Deena B" last="Hollingsworth">Deena B. Hollingsworth</name>
<affiliation><nlm:affiliation>9 Ear, Nose & Throat Specialists of Northern Virginia, PC, Arlington, Virginia, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Roberts, Richard" sort="Roberts, Richard" uniqKey="Roberts R" first="Richard" last="Roberts">Richard Roberts</name>
<affiliation><nlm:affiliation>10 Alabama Hearing and Balance Associates, Inc, Birmingham, Alabama, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Seidman, Michael D" sort="Seidman, Michael D" uniqKey="Seidman M" first="Michael D" last="Seidman">Michael D. Seidman</name>
<affiliation><nlm:affiliation>11 Department of Otolaryngology-Head and Neck Surgery, College of Medicine, University of Central Florida, Orlando, Florida, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Steiner, Robert W Prasaad" sort="Steiner, Robert W Prasaad" uniqKey="Steiner R" first="Robert W Prasaad" last="Steiner">Robert W Prasaad Steiner</name>
<affiliation><nlm:affiliation>12 Department of Health Management and Systems Science and Department of Family and Geriatric Medicine, School of Public Health and Information Science, University of Louisville, Louisville, Kentucky, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Do, Betty Tsai" sort="Do, Betty Tsai" uniqKey="Do B" first="Betty Tsai" last="Do">Betty Tsai Do</name>
<affiliation><nlm:affiliation>13 Department of Otorhinolaryngology, Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Voelker, Courtney C J" sort="Voelker, Courtney C J" uniqKey="Voelker C" first="Courtney C J" last="Voelker">Courtney C J. Voelker</name>
<affiliation><nlm:affiliation>14 Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.</nlm:affiliation>
</affiliation>
</author>
<author><name sortKey="Waguespack, Richard W" sort="Waguespack, Richard W" uniqKey="Waguespack R" first="Richard W" last="Waguespack">Richard W. Waguespack</name>
<affiliation><nlm:affiliation>15 Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama, USA.</nlm:affiliation>
</affiliation>
</author>
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<term>Benign Paroxysmal Positional Vertigo (therapy)</term>
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<front><div type="abstract" xml:lang="en">Objective This update of a 2008 guideline from the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations to benign paroxysmal positional vertigo (BPPV), defined as a disorder of the inner ear characterized by repeated episodes of positional vertigo. Changes from the prior guideline include a consumer advocate added to the update group; new evidence from 2 clinical practice guidelines, 20 systematic reviews, and 27 randomized controlled trials; enhanced emphasis on patient education and shared decision making; a new algorithm to clarify action statement relationships; and new and expanded recommendations for the diagnosis and management of BPPV. Purpose The primary purposes of this guideline are to improve the quality of care and outcomes for BPPV by improving the accurate and efficient diagnosis of BPPV, reducing the inappropriate use of vestibular suppressant medications, decreasing the inappropriate use of ancillary testing such as radiographic imaging, and increasing the use of appropriate therapeutic repositioning maneuvers. The guideline is intended for all clinicians who are likely to diagnose and manage patients with BPPV, and it applies to any setting in which BPPV would be identified, monitored, or managed. The target patient for the guideline is aged ≥18 years with a suspected or potential diagnosis of BPPV. The primary outcome considered in this guideline is the resolution of the symptoms associated with BPPV. Secondary outcomes considered include an increased rate of accurate diagnoses of BPPV, a more efficient return to regular activities and work, decreased use of inappropriate medications and unnecessary diagnostic tests, reduction in recurrence of BPPV, and reduction in adverse events associated with undiagnosed or untreated BPPV. Other outcomes considered include minimizing costs in the diagnosis and treatment of BPPV, minimizing potentially unnecessary return physician visits, and maximizing the health-related quality of life of individuals afflicted with BPPV. Action Statements The update group made strong recommendations that clinicians should (1) diagnose posterior semicircular canal BPPV when vertigo associated with torsional, upbeating nystagmus is provoked by the Dix-Hallpike maneuver, performed by bringing the patient from an upright to supine position with the head turned 45° to one side and neck extended 20° with the affected ear down, and (2) treat, or refer to a clinician who can treat, patients with posterior canal BPPV with a canalith repositioning procedure. The update group made a strong recommendation against postprocedural postural restrictions after canalith repositioning procedure for posterior canal BPPV. The update group made recommendations that the clinician should (1) perform, or refer to a clinician who can perform, a supine roll test to assess for lateral semicircular canal BPPV if the patient has a history compatible with BPPV and the Dix-Hallpike test exhibits horizontal or no nystagmus; (2) differentiate, or refer to a clinician who can differentiate, BPPV from other causes of imbalance, dizziness, and vertigo; (3) assess patients with BPPV for factors that modify management, including impaired mobility or balance, central nervous system disorders, a lack of home support, and/or increased risk for falling; (4) reassess patients within 1 month after an initial period of observation or treatment to document resolution or persistence of symptoms; (5) evaluate, or refer to a clinician who can evaluate, patients with persistent symptoms for unresolved BPPV and/or underlying peripheral vestibular or central nervous system disorders; and (6) educate patients regarding the impact of BPPV on their safety, the potential for disease recurrence, and the importance of follow-up. The update group made recommendations against (1) radiographic imaging for a patient who meets diagnostic criteria for BPPV in the absence of additional signs and/or symptoms inconsistent with BPPV that warrant imaging, (2) vestibular testing for a patient who meets diagnostic criteria for BPPV in the absence of additional vestibular signs and/or symptoms inconsistent with BPPV that warrant testing, and (3) routinely treating BPPV with vestibular suppressant medications such as antihistamines and/or benzodiazepines. The guideline update group provided the options that clinicians may offer (1) observation with follow-up as initial management for patients with BPPV and (2) vestibular rehabilitation, either self-administered or with a clinician, in the treatment of BPPV.</div>
</front>
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<Title>Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery</Title>
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<ArticleTitle>Clinical Practice Guideline: Benign Paroxysmal Positional Vertigo (Update).</ArticleTitle>
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<Abstract><AbstractText>Objective This update of a 2008 guideline from the American Academy of Otolaryngology-Head and Neck Surgery Foundation provides evidence-based recommendations to benign paroxysmal positional vertigo (BPPV), defined as a disorder of the inner ear characterized by repeated episodes of positional vertigo. Changes from the prior guideline include a consumer advocate added to the update group; new evidence from 2 clinical practice guidelines, 20 systematic reviews, and 27 randomized controlled trials; enhanced emphasis on patient education and shared decision making; a new algorithm to clarify action statement relationships; and new and expanded recommendations for the diagnosis and management of BPPV. Purpose The primary purposes of this guideline are to improve the quality of care and outcomes for BPPV by improving the accurate and efficient diagnosis of BPPV, reducing the inappropriate use of vestibular suppressant medications, decreasing the inappropriate use of ancillary testing such as radiographic imaging, and increasing the use of appropriate therapeutic repositioning maneuvers. The guideline is intended for all clinicians who are likely to diagnose and manage patients with BPPV, and it applies to any setting in which BPPV would be identified, monitored, or managed. The target patient for the guideline is aged ≥18 years with a suspected or potential diagnosis of BPPV. The primary outcome considered in this guideline is the resolution of the symptoms associated with BPPV. Secondary outcomes considered include an increased rate of accurate diagnoses of BPPV, a more efficient return to regular activities and work, decreased use of inappropriate medications and unnecessary diagnostic tests, reduction in recurrence of BPPV, and reduction in adverse events associated with undiagnosed or untreated BPPV. Other outcomes considered include minimizing costs in the diagnosis and treatment of BPPV, minimizing potentially unnecessary return physician visits, and maximizing the health-related quality of life of individuals afflicted with BPPV. Action Statements The update group made strong recommendations that clinicians should (1) diagnose posterior semicircular canal BPPV when vertigo associated with torsional, upbeating nystagmus is provoked by the Dix-Hallpike maneuver, performed by bringing the patient from an upright to supine position with the head turned 45° to one side and neck extended 20° with the affected ear down, and (2) treat, or refer to a clinician who can treat, patients with posterior canal BPPV with a canalith repositioning procedure. The update group made a strong recommendation against postprocedural postural restrictions after canalith repositioning procedure for posterior canal BPPV. The update group made recommendations that the clinician should (1) perform, or refer to a clinician who can perform, a supine roll test to assess for lateral semicircular canal BPPV if the patient has a history compatible with BPPV and the Dix-Hallpike test exhibits horizontal or no nystagmus; (2) differentiate, or refer to a clinician who can differentiate, BPPV from other causes of imbalance, dizziness, and vertigo; (3) assess patients with BPPV for factors that modify management, including impaired mobility or balance, central nervous system disorders, a lack of home support, and/or increased risk for falling; (4) reassess patients within 1 month after an initial period of observation or treatment to document resolution or persistence of symptoms; (5) evaluate, or refer to a clinician who can evaluate, patients with persistent symptoms for unresolved BPPV and/or underlying peripheral vestibular or central nervous system disorders; and (6) educate patients regarding the impact of BPPV on their safety, the potential for disease recurrence, and the importance of follow-up. The update group made recommendations against (1) radiographic imaging for a patient who meets diagnostic criteria for BPPV in the absence of additional signs and/or symptoms inconsistent with BPPV that warrant imaging, (2) vestibular testing for a patient who meets diagnostic criteria for BPPV in the absence of additional vestibular signs and/or symptoms inconsistent with BPPV that warrant testing, and (3) routinely treating BPPV with vestibular suppressant medications such as antihistamines and/or benzodiazepines. The guideline update group provided the options that clinicians may offer (1) observation with follow-up as initial management for patients with BPPV and (2) vestibular rehabilitation, either self-administered or with a clinician, in the treatment of BPPV.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Bhattacharyya</LastName>
<ForeName>Neil</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>1 Department of Otolaryngology, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Gubbels</LastName>
<ForeName>Samuel P</ForeName>
<Initials>SP</Initials>
<AffiliationInfo><Affiliation>2 Department of Otolaryngology, School of Medicine and Public Health, University of Colorado, Aurora, Colorado, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Schwartz</LastName>
<ForeName>Seth R</ForeName>
<Initials>SR</Initials>
<AffiliationInfo><Affiliation>3 Department of Otolaryngology, Virginia Mason Medical Center, Seattle, Washington, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Edlow</LastName>
<ForeName>Jonathan A</ForeName>
<Initials>JA</Initials>
<AffiliationInfo><Affiliation>4 Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>El-Kashlan</LastName>
<ForeName>Hussam</ForeName>
<Initials>H</Initials>
<AffiliationInfo><Affiliation>5 Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Fife</LastName>
<ForeName>Terry</ForeName>
<Initials>T</Initials>
<AffiliationInfo><Affiliation>6 Barrow Neurological Institute and College of Medicine, University of Arizona, Phoenix, Arizona, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Holmberg</LastName>
<ForeName>Janene M</ForeName>
<Initials>JM</Initials>
<AffiliationInfo><Affiliation>7 Intermountain Hearing and Balance Center, Salt Lake City, Utah, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Mahoney</LastName>
<ForeName>Kathryn</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>8 Vestibular Disorders Association, Portland, Oregon, USA.</Affiliation>
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<Author ValidYN="Y"><LastName>Hollingsworth</LastName>
<ForeName>Deena B</ForeName>
<Initials>DB</Initials>
<AffiliationInfo><Affiliation>9 Ear, Nose & Throat Specialists of Northern Virginia, PC, Arlington, Virginia, USA.</Affiliation>
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<Initials>R</Initials>
<AffiliationInfo><Affiliation>10 Alabama Hearing and Balance Associates, Inc, Birmingham, Alabama, USA.</Affiliation>
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<ForeName>Michael D</ForeName>
<Initials>MD</Initials>
<AffiliationInfo><Affiliation>11 Department of Otolaryngology-Head and Neck Surgery, College of Medicine, University of Central Florida, Orlando, Florida, USA.</Affiliation>
</AffiliationInfo>
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<ForeName>Robert W Prasaad</ForeName>
<Initials>RW</Initials>
<AffiliationInfo><Affiliation>12 Department of Health Management and Systems Science and Department of Family and Geriatric Medicine, School of Public Health and Information Science, University of Louisville, Louisville, Kentucky, USA.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Do</LastName>
<ForeName>Betty Tsai</ForeName>
<Initials>BT</Initials>
<AffiliationInfo><Affiliation>13 Department of Otorhinolaryngology, Health Sciences Center, University of Oklahoma, Oklahoma City, Oklahoma, USA.</Affiliation>
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<Author ValidYN="Y"><LastName>Voelker</LastName>
<ForeName>Courtney C J</ForeName>
<Initials>CC</Initials>
<AffiliationInfo><Affiliation>14 Department of Otolaryngology-Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.</Affiliation>
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<ForeName>Richard W</ForeName>
<Initials>RW</Initials>
<AffiliationInfo><Affiliation>15 Department of Otolaryngology, University of Alabama at Birmingham, Birmingham, Alabama, USA.</Affiliation>
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<ForeName>Maureen D</ForeName>
<Initials>MD</Initials>
<AffiliationInfo><Affiliation>16 American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D017065">Practice Guideline</PublicationType>
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<MedlineJournalInfo><Country>England</Country>
<MedlineTA>Otolaryngol Head Neck Surg</MedlineTA>
<NlmUniqueID>8508176</NlmUniqueID>
<ISSNLinking>0194-5998</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D065635" MajorTopicYN="Y">Benign Paroxysmal Positional Vertigo</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName>
<QualifierName UI="Q000517" MajorTopicYN="N">prevention & control</QualifierName>
<QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D003937" MajorTopicYN="N">Diagnosis, Differential</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D056888" MajorTopicYN="N">Patient Positioning</DescriptorName>
<QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName>
</MeshHeading>
</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">BPPV</Keyword>
<Keyword MajorTopicYN="Y">benign paroxysmal positional vertigo</Keyword>
</KeywordList>
</MedlineCitation>
<PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2017</Year>
<Month>3</Month>
<Day>2</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="pubmed"><Year>2017</Year>
<Month>3</Month>
<Day>2</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2017</Year>
<Month>7</Month>
<Day>4</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">28248609</ArticleId>
<ArticleId IdType="doi">10.1177/0194599816689667</ArticleId>
</ArticleIdList>
</PubmedData>
</pubmed>
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