{"id":"https://openalex.org/W7204544950","doi":"https://doi.org/10.21203/rs.3.rs-10844819/v1","title":"Diagnostic Performance of a Combined KLK2, miR-21, PSA, CRP, Albumin, AGR, and GGT Biomarker Panel for Distinguishing Prostate Cancer from Benign Prostatic Hyperplasia in Nigerian Men","display_name":"Diagnostic Performance of a Combined KLK2, miR-21, PSA, CRP, Albumin, AGR, and GGT Biomarker Panel for Distinguishing Prostate Cancer from Benign Prostatic Hyperplasia in Nigerian Men","publication_year":2026,"publication_date":"2026-08-28","ids":{"openalex":"https://openalex.org/W7204544950","doi":"https://doi.org/10.21203/rs.3.rs-10844819/v1"},"language":"en","primary_location":{"id":"doi:10.21203/rs.3.rs-10844819/v1","doi":"https://doi.org/10.21203/rs.3.rs-10844819/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10844819/v1","pdf_url":"https://www.researchsquare.com/article/rs-10844819/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"volume":null,"type":"preprint","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://www.researchsquare.com/article/rs-10844819/latest.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5124008809","display_name":"Saheed Ayodeji Adekola","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210149225","display_name":"Edo State University Uzairue","ror":"https://ror.org/049ajby27","country_code":"NG","type":"education","lineage":["https://openalex.org/I4210149225"]},{"id":"https://openalex.org/I8033065","display_name":"University of Abuja","ror":"https://ror.org/007e69832","country_code":"NG","type":"education","lineage":["https://openalex.org/I8033065"]}],"countries":["NG"],"is_corresponding":true,"raw_author_name":"Saheed Ayodeji Adekola","raw_affiliation_strings":["Edo State University Uzairue","University of Abuja"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Edo State University Uzairue","institution_ids":["https://openalex.org/I4210149225"]},{"raw_affiliation_string":"University of Abuja","institution_ids":["https://openalex.org/I8033065"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5074043424","display_name":"Mathew Folaranmi Olaniyan","orcid":"https://orcid.org/0000-0003-1119-3461","observed_orcids":["https://orcid.org/0000-0003-1119-3461"]},"institutions":[{"id":"https://openalex.org/I4210149225","display_name":"Edo State University Uzairue","ror":"https://ror.org/049ajby27","country_code":"NG","type":"education","lineage":["https://openalex.org/I4210149225"]}],"countries":["NG"],"is_corresponding":false,"raw_author_name":"Mathew Folaranmi Olaniyan","raw_affiliation_strings":["Edo State University Uzairue"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Edo State University Uzairue","institution_ids":["https://openalex.org/I4210149225"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5148502641","display_name":"Odeyemi Bola Odegbemi","orcid":null,"observed_orcids":[]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Odeyemi Bola Odegbemi","raw_affiliation_strings":["Nigerian Navy College of Health Sciences,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Nigerian Navy College of Health Sciences,","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5124013007","display_name":"Mustapha Umar Bakare","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210128271","display_name":"University of Abuja Teaching Hospital","ror":"https://ror.org/03jza6h92","country_code":"NG","type":"healthcare","lineage":["https://openalex.org/I4210128271"]}],"countries":["NG"],"is_corresponding":false,"raw_author_name":"Mustapha Umar Bakare","raw_affiliation_strings":["University of Abuja Teaching Hospital"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Abuja Teaching Hospital","institution_ids":["https://openalex.org/I4210128271"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5015692054","display_name":"Bukhari Isah Shuaib","orcid":"https://orcid.org/0000-0003-3820-3631","observed_orcids":["https://orcid.org/0000-0003-3820-3631"]},"institutions":[{"id":"https://openalex.org/I4210149225","display_name":"Edo State University Uzairue","ror":"https://ror.org/049ajby27","country_code":"NG","type":"education","lineage":["https://openalex.org/I4210149225"]}],"countries":["NG"],"is_corresponding":false,"raw_author_name":"Bukhari Isah Shuaibu","raw_affiliation_strings":["Edo State University Uzairue"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Edo State University Uzairue","institution_ids":["https://openalex.org/I4210149225"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5124007812","display_name":"Sodiq Adetunji Adekola","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210149225","display_name":"Edo State University Uzairue","ror":"https://ror.org/049ajby27","country_code":"NG","type":"education","lineage":["https://openalex.org/I4210149225"]},{"id":"https://openalex.org/I8033065","display_name":"University of Abuja","ror":"https://ror.org/007e69832","country_code":"NG","type":"education","lineage":["https://openalex.org/I8033065"]}],"countries":["NG"],"is_corresponding":false,"raw_author_name":"Sodiq Adetunji Adekola","raw_affiliation_strings":["Edo State University Uzairue","University of Abuja"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Edo State University Uzairue","institution_ids":["https://openalex.org/I4210149225"]},{"raw_affiliation_string":"University of Abuja","institution_ids":["https://openalex.org/I8033065"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5021223664","display_name":"Idris Nasir Abdullahi","orcid":"https://orcid.org/0000-0002-5511-1272","observed_orcids":["https://orcid.org/0000-0002-5511-1272"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Idris Nasir Abdullahi","raw_affiliation_strings":["University of Madrid,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"University of Madrid,","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5004739022","display_name":"Musa Abidemi Muhibi","orcid":"https://orcid.org/0000-0001-8413-4994","observed_orcids":["https://orcid.org/0000-0001-8413-4994"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Musa Abidemi Muhibi","raw_affiliation_strings":["Federal University of Health Science"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Federal University of Health Science","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5113588238","display_name":"Dolapo Pius Oparinde","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I45230691","display_name":"Ladoke Akintola University of Technology","ror":"https://ror.org/043hyzt56","country_code":"NG","type":"education","lineage":["https://openalex.org/I45230691"]}],"countries":["NG"],"is_corresponding":false,"raw_author_name":"Dolapo Pius Oparinde","raw_affiliation_strings":["Ladoke Akintola University of Technology"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Ladoke Akintola University of Technology","institution_ids":["https://openalex.org/I45230691"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":4,"corresponding_author_ids":["https://openalex.org/A5124008809"],"corresponding_institution_ids":["https://openalex.org/I4210149225","https://openalex.org/I8033065"],"apc_list":null,"apc_paid":null,"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":null,"issue":null,"first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10124","display_name":"Prostate Cancer Diagnosis and Treatment","score":0.9672999978065491,"subfield":{"id":"https://openalex.org/subfields/2748","display_name":"Urology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10124","display_name":"Prostate Cancer Diagnosis and Treatment","score":0.9672999978065491,"subfield":{"id":"https://openalex.org/subfields/2748","display_name":"Urology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11355","display_name":"Inflammatory Biomarkers in Disease Prognosis","score":0.01940000057220459,"subfield":{"id":"https://openalex.org/subfields/2730","display_name":"Oncology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10543","display_name":"Prostate Cancer Treatment and Research","score":0.00419999985024333,"subfield":{"id":"https://openalex.org/subfields/1306","display_name":"Cancer Research"},"field":{"id":"https://openalex.org/fields/13","display_name":"Biochemistry, Genetics and Molecular Biology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/prostate-cancer","display_name":"prostate cancer","score":0.9649999737739563},{"id":"https://openalex.org/keywords/benign-prostatic-hyperplasia","display_name":"benign prostatic hyperplasia","score":1.0},{"id":"https://openalex.org/keywords/prostate-specific-antigen","display_name":"prostate-specific antigen","score":0.8090000152587891},{"id":"https://openalex.org/keywords/klk2","display_name":"KLK2","score":0.9129999876022339},{"id":"https://openalex.org/keywords/mir-21","display_name":"miR-21","score":0.9670000076293945},{"id":"https://openalex.org/keywords/circulating-micrornas","display_name":"circulating microRNAs","score":0.8510000109672546},{"id":"https://openalex.org/keywords/c-reactive-protein","display_name":"C-reactive protein","score":0.9900000095367432},{"id":"https://openalex.org/keywords/gamma-glutamyl-transferase","display_name":"gamma-glutamyl transferase","score":0.9309999942779541},{"id":"https://openalex.org/keywords/albumin-to-globulin-ratio","display_name":"albumin/globulin ratio","score":0.9739999771118164},{"id":"https://openalex.org/keywords/serum-biomarker-panel","display_name":"serum biomarker panel","score":0.8339999914169312},{"id":"https://openalex.org/keywords/diagnostic-accuracy","display_name":"diagnostic accuracy","score":0.8769999742507935},{"id":"https://openalex.org/keywords/african-men","display_name":"African men","score":0.4970000088214874},{"id":"https://openalex.org/keywords/nigerian-men","display_name":"Nigerian men","score":0.7919999957084656},{"id":"https://openalex.org/keywords/prostate-cancer-screening","display_name":"prostate cancer screening","score":0.5529999732971191}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8794000148773193},{"id":"https://openalex.org/C2780192828","wikidata":"https://www.wikidata.org/wiki/Q181257","display_name":"Prostate cancer","level":3,"score":0.7552000284194946},{"id":"https://openalex.org/C2781197716","wikidata":"https://www.wikidata.org/wiki/Q864574","display_name":"Biomarker","level":2,"score":0.6848000288009644},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.6000000238418579},{"id":"https://openalex.org/C58471807","wikidata":"https://www.wikidata.org/wiki/Q327120","display_name":"Receiver operating characteristic","level":2,"score":0.5954999923706055},{"id":"https://openalex.org/C2777562237","wikidata":"https://www.wikidata.org/wiki/Q835051","display_name":"Hyperplasia","level":2,"score":0.5874999761581421},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.5648000240325928},{"id":"https://openalex.org/C2781406297","wikidata":"https://www.wikidata.org/wiki/Q409450","display_name":"Prostate-specific antigen","level":4,"score":0.5187000036239624},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.515500009059906},{"id":"https://openalex.org/C151956035","wikidata":"https://www.wikidata.org/wiki/Q1132755","display_name":"Logistic regression","level":2,"score":0.5038999915122986},{"id":"https://openalex.org/C2776235491","wikidata":"https://www.wikidata.org/wiki/Q9625","display_name":"Prostate","level":3,"score":0.4982999861240387},{"id":"https://openalex.org/C76318530","wikidata":"https://www.wikidata.org/wiki/Q16833590","display_name":"Area under the curve","level":2,"score":0.4422999918460846},{"id":"https://openalex.org/C144301174","wikidata":"https://www.wikidata.org/wiki/Q7893852","display_name":"Univariate analysis","level":3,"score":0.41929998993873596},{"id":"https://openalex.org/C90924648","wikidata":"https://www.wikidata.org/wiki/Q120569","display_name":"Gastroenterology","level":1,"score":0.36469998955726624},{"id":"https://openalex.org/C126894567","wikidata":"https://www.wikidata.org/wiki/Q105650","display_name":"Urology","level":1,"score":0.35370001196861267},{"id":"https://openalex.org/C3020132585","wikidata":"https://www.wikidata.org/wiki/Q2671652","display_name":"Diagnostic accuracy","level":2,"score":0.304500013589859},{"id":"https://openalex.org/C87874733","wikidata":"https://www.wikidata.org/wiki/Q18039844","display_name":"PCA3","level":4,"score":0.30300000309944153},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.298799991607666},{"id":"https://openalex.org/C147483822","wikidata":"https://www.wikidata.org/wiki/Q103537","display_name":"Antigen","level":2,"score":0.29490000009536743},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.28209999203681946},{"id":"https://openalex.org/C2781447364","wikidata":"https://www.wikidata.org/wiki/Q584992","display_name":"Tumor marker","level":3,"score":0.2782000005245209},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.27649998664855957},{"id":"https://openalex.org/C29456083","wikidata":"https://www.wikidata.org/wiki/Q1221899","display_name":"Gynecology","level":1,"score":0.27320000529289246}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.21203/rs.3.rs-10844819/v1","doi":"https://doi.org/10.21203/rs.3.rs-10844819/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10844819/v1","pdf_url":"https://www.researchsquare.com/article/rs-10844819/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"}],"best_oa_location":{"id":"doi:10.21203/rs.3.rs-10844819/v1","doi":"https://doi.org/10.21203/rs.3.rs-10844819/v1","is_oa":true,"landing_page_url":"https://doi.org/10.21203/rs.3.rs-10844819/v1","pdf_url":"https://www.researchsquare.com/article/rs-10844819/latest.pdf","source":{"id":"https://openalex.org/S4306525896","display_name":"Research Square","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"Research Square","raw_type":"posted-content"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7204544950.pdf","grobid_xml":"https://content.openalex.org/works/W7204544950.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2885770817","https://openalex.org/W4361800285","https://openalex.org/W3183994644","https://openalex.org/W4417362025","https://openalex.org/W4303457079","https://openalex.org/W2546662350","https://openalex.org/W1949694649","https://openalex.org/W7143827400","https://openalex.org/W2741004660","https://openalex.org/W2791281934"],"abstract_inverted_index":{"Abstract":[0],"Background:":[1],"Prostate-specific":[2],"antigen":[3],"(PSA)":[4],"has":[5,71],"limited":[6],"specificity":[7,215],"for":[8,61,343,402],"distinguishing":[9,62,344],"prostate":[10,86,345],"cancer":[11,87,177,201,246,346,380],"from":[12,64,98,123,347,381],"benign":[13],"prostatic":[14,66,349],"hyperplasia":[15],"(BPH)":[16],"in":[17,68,101,260],"African":[18],"populations,":[19],"where":[20],"high":[21,26],"baseline":[22],"PSA":[23,59,204,284,291,304,337],"and":[24,53,92,109,120,125,140,152,179,188,230,240,270,279,293,325,351,358,364,369,378,387],"a":[25,35,147,261,299,329,388],"background":[27],"prevalence":[28],"of":[29,38,137,141,176,235],"BPH":[30,90,199,382],"inflate":[31],"false-positive":[32],"results.":[33],"Whether":[34],"combined":[36,144,296],"panel":[37,297],"PSA,":[39,105,186,236,268],"Kallikrein-related":[40],"peptidase":[41],"2":[42],"(KLK2),":[43],"miR-21,":[44,238,277,315,356],"C-reactive":[45],"protein":[46],"(CRP),":[47],"albumin,":[48,108],"the":[49,134,157,166,207,280,294],"albumin-to-globulin":[50],"ratio":[51],"(AGR),":[52],"gamma-glutamyl":[54],"transferase":[55],"(GGT)":[56],"improves":[57],"on":[58,248,383,394],"alone":[60,205,305,338],"malignant":[63],"non-malignant":[65,148,348],"disease":[67],"Nigerian":[69,335],"men":[70,82],"not":[72,286,362],"been":[73],"established.":[74],"Methods:":[75],"In":[76,332],"this":[77,333],"cross-sectional":[78],"case-control":[79],"study,":[80],"90":[81],"(30":[83],"histologically":[84],"confirmed":[85],"cases,":[88,91],"30":[89,93],"healthy":[94,153],"controls)":[95],"were":[96,111],"recruited":[97],"four":[99],"hospitals":[100],"Abuja,":[102],"Nigeria.":[103],"Serum":[104],"KLK2,":[106,187,237,269,276,314,355],"CRP,":[107,239,278,316,357],"GGT":[110,224,241],"measured":[112],"by":[113,117],"immunoassay,":[114],"circulating":[115],"miR-21":[116,227],"quantitative":[118],"PCR,":[119],"AGR":[121,231],"calculated":[122],"albumin":[124],"globulin.":[126],"Receiver":[127],"operating":[128],"characteristic":[129],"(ROC)":[130],"curve":[131,167],"analysis":[132,250],"established":[133],"diagnostic":[135,209,288,341,376],"accuracy":[136,210,289,342],"each":[138,190],"biomarker":[139],"five":[142],"incremental":[143],"models":[145],"against":[146],"reference":[149],"group":[150,196],"(BPH":[151],"controls":[154],"combined),":[155],"with":[156,245,283,354],"DeLong":[158],"test":[159],"used":[160],"to":[161],"compare":[162],"correlated":[163],"areas":[164],"under":[165],"(AUC).":[168],"Firth's":[169],"penalized":[170],"logistic":[171],"regression":[172],"identified":[173],"independent":[174],"predictors":[175],"status,":[178],"five-fold":[180],"cross-validation":[181],"assessed":[182],"model":[183,312,391],"stability.":[184],"Results:":[185],"CRP":[189,221,271,370],"differed":[191],"significantly":[192,300],"across":[193],"every":[194],"pairwise":[195,385],"comparison,":[197,386],"including":[198],"versus":[200],"(all":[202,251],"p<0.01).":[203],"achieved":[206,298,319,339],"highest":[208],"(AUC":[211,219,222,225,228,232,323],"0.990;":[212],"sensitivity":[213],"93.3%,":[214],"100.0%),":[216],"exceeding":[217],"KLK2":[218,368],"0.913),":[220],"0.868),":[223],"0.721),":[226],"0.688),":[229],"0.502).":[233],"Each":[234],"was":[242,326],"independently":[243,374],"associated":[244],"status":[247],"univariate":[249],"p<0.05),":[252],"but":[253],"none":[254],"retained":[255],"significance":[256],"after":[257],"mutual":[258],"adjustment":[259],"multivariable":[262],"model,":[263],"reflecting":[264],"strong":[265,320],"intercorrelation":[266],"among":[267],"(Spearman":[272],"rho":[273],"0.78-0.81).":[274],"Combining":[275],"biochemical":[281,359],"markers":[282,360],"did":[285,361],"improve":[287],"over":[290],"alone,":[292],"full":[295],"lower":[301],"AUC":[302],"than":[303],"(DeLong":[306],"test,":[307],"p=0.029).":[308],"A":[309],"reduced":[310,389],"five-variable":[311],"(PSA,":[313],"age)":[317],"nonetheless":[318,371],"internal":[321],"discrimination":[322],"0.901)":[324],"translated":[327],"into":[328],"nomogram.":[330],"Conclusions:":[331],"late-presenting":[334],"cohort,":[336],"near-ceiling":[340],"disease,":[350],"combining":[352],"it":[353],"improve,":[363],"numerically":[365],"reduced,":[366],"accuracy.":[367],"carry":[372],"genuine,":[373],"significant":[375],"information":[377],"distinguished":[379],"direct":[384],"composite":[390],"built":[392],"entirely":[393],"locally":[395],"available":[396],"assays":[397],"may":[398],"hold":[399],"feasibility-stage":[400],"value":[401],"earlier-presenting":[403],"or":[404],"grey-zone":[405],"patients,":[406],"pending":[407],"external":[408],"validation.":[409]},"counts_by_year":[],"updated_date":"2026-11-12T12:28:57.059296","created_date":"2026-08-29T00:00:00"}