{"id":"https://openalex.org/W7223263552","doi":"https://doi.org/10.3390/jcm15218232","title":"Risk Stratification and Patient Trajectories in CAPS: The Important Role of the Autoinflammatory Disease Damage Index","display_name":"Risk Stratification and Patient Trajectories in CAPS: The Important Role of the Autoinflammatory Disease Damage Index","publication_year":2026,"publication_date":"2026-10-22","ids":{"openalex":"https://openalex.org/W7223263552","doi":"https://doi.org/10.3390/jcm15218232"},"language":"en","primary_location":{"id":"doi:10.3390/jcm15218232","doi":"https://doi.org/10.3390/jcm15218232","is_oa":true,"landing_page_url":"https://doi.org/10.3390/jcm15218232","pdf_url":null,"source":{"id":"https://openalex.org/S2737969411","display_name":"Journal of Clinical Medicine","issn_l":"2077-0383","issn":["2077-0383"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","ki-jl-1","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Clinical Medicine","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.3390/jcm15218232","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5023635059","display_name":"\u00d6zlem \u015eat\u0131rer","orcid":"https://orcid.org/0000-0001-8748-7322","observed_orcids":["https://orcid.org/0000-0001-8748-7322"]},"institutions":[{"id":"https://openalex.org/I4210125796","display_name":"University Children's Hospital T\u00fcbingen","ror":"https://ror.org/03esvmb28","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I4210094118","https://openalex.org/I4210125796"]},{"id":"https://openalex.org/I4387153162","display_name":"ERN RITA","ror":"https://ror.org/0208ges23","country_code":"NL","type":"healthcare","lineage":["https://openalex.org/I1320481043","https://openalex.org/I2800387288","https://openalex.org/I4387153162","https://openalex.org/I4387155652"]},{"id":"https://openalex.org/I8087733","display_name":"University of T\u00fcbingen","ror":"https://ror.org/03a1kwz48","country_code":"DE","type":"education","lineage":["https://openalex.org/I8087733"]}],"countries":["DE","NL"],"is_corresponding":true,"raw_author_name":"\u00d6zlem Satirer","raw_affiliation_strings":["Division of Pediatric Rheumatology and Autoinflammation Reference Center Tuebingen (arcT), Department of Pediatrics, University Children\u2019s Hospital Tuebingen, Hoppe-Seyler-Strasse 1, 72076 Tuebingen, Germany","European Reference Network for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases, ERN-RITA Coordinating Office, 3584 CX Utrecht, The Netherlands"],"raw_orcid":"https://orcid.org/0000-0001-8748-7322","affiliations":[{"raw_affiliation_string":"Division of Pediatric Rheumatology and Autoinflammation Reference Center Tuebingen (arcT), Department of Pediatrics, University Children\u2019s Hospital Tuebingen, Hoppe-Seyler-Strasse 1, 72076 Tuebingen, Germany","institution_ids":["https://openalex.org/I4210125796","https://openalex.org/I8087733"]},{"raw_affiliation_string":"European Reference Network for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases, ERN-RITA Coordinating Office, 3584 CX Utrecht, The Netherlands","institution_ids":["https://openalex.org/I4387153162"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5159352615","display_name":"Marie Bogensch\u00fctz","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I4210125796","display_name":"University Children's Hospital T\u00fcbingen","ror":"https://ror.org/03esvmb28","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I4210094118","https://openalex.org/I4210125796"]},{"id":"https://openalex.org/I8087733","display_name":"University of T\u00fcbingen","ror":"https://ror.org/03a1kwz48","country_code":"DE","type":"education","lineage":["https://openalex.org/I8087733"]}],"countries":["DE"],"is_corresponding":false,"raw_author_name":"Marie Bogensch\u00fctz","raw_affiliation_strings":["Division of Pediatric Rheumatology and Autoinflammation Reference Center Tuebingen (arcT), Department of Pediatrics, University Children\u2019s Hospital Tuebingen, Hoppe-Seyler-Strasse 1, 72076 Tuebingen, Germany"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Division of Pediatric Rheumatology and Autoinflammation Reference Center Tuebingen (arcT), Department of Pediatrics, University Children\u2019s Hospital Tuebingen, Hoppe-Seyler-Strasse 1, 72076 Tuebingen, Germany","institution_ids":["https://openalex.org/I4210125796","https://openalex.org/I8087733"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5038335245","display_name":"Susanne M. Benseler","orcid":"https://orcid.org/0000-0001-5756-3638","observed_orcids":["https://orcid.org/0000-0001-5756-3638","https://orcid.org/0000-0002-3543-5640","https://orcid.org/0000-0002-8754-8903"]},"institutions":[{"id":"https://openalex.org/I168635309","display_name":"University of Calgary","ror":"https://ror.org/03yjb2x39","country_code":"CA","type":"education","lineage":["https://openalex.org/I168635309"]},{"id":"https://openalex.org/I2802127220","display_name":"Alberta Children's Hospital","ror":"https://ror.org/00sx29x36","country_code":"CA","type":"healthcare","lineage":["https://openalex.org/I2802127220"]},{"id":"https://openalex.org/I3017411684","display_name":"Children's Health Ireland at Crumlin","ror":"https://ror.org/025qedy81","country_code":"IE","type":"healthcare","lineage":["https://openalex.org/I3017411684"]},{"id":"https://openalex.org/I4387153162","display_name":"ERN RITA","ror":"https://ror.org/0208ges23","country_code":"NL","type":"healthcare","lineage":["https://openalex.org/I1320481043","https://openalex.org/I2800387288","https://openalex.org/I4387153162","https://openalex.org/I4387155652"]},{"id":"https://openalex.org/I4389425471","display_name":"Alberta Children's Hospital Research Institute","ror":"https://ror.org/00gmyvv50","country_code":"CA","type":"facility","lineage":["https://openalex.org/I168635309","https://openalex.org/I4389425471"]}],"countries":["CA","IE","NL"],"is_corresponding":false,"raw_author_name":"Susanne M. Benseler","raw_affiliation_strings":["Children\u2019s Health Ireland, D12 N512 Dublin, Ireland","European Reference Network for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases, ERN-RITA Coordinating Office, 3584 CX Utrecht, The Netherlands","Rheumatology, Department of Pediatrics, Alberta Children\u2019s Hospital (ACH), ACH Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T3B 6A8, Canada"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Children\u2019s Health Ireland, D12 N512 Dublin, Ireland","institution_ids":["https://openalex.org/I3017411684"]},{"raw_affiliation_string":"European Reference Network for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases, ERN-RITA Coordinating Office, 3584 CX Utrecht, The Netherlands","institution_ids":["https://openalex.org/I4387153162"]},{"raw_affiliation_string":"Rheumatology, Department of Pediatrics, Alberta Children\u2019s Hospital (ACH), ACH Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T3B 6A8, Canada","institution_ids":["https://openalex.org/I168635309","https://openalex.org/I2802127220","https://openalex.org/I4389425471"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5051230084","display_name":"Jasmin Beate Kuemmerle-Deschner","orcid":"https://orcid.org/0000-0002-6365-6598","observed_orcids":["https://orcid.org/0000-0002-6365-6598"]},"institutions":[{"id":"https://openalex.org/I4210125796","display_name":"University Children's Hospital T\u00fcbingen","ror":"https://ror.org/03esvmb28","country_code":"DE","type":"healthcare","lineage":["https://openalex.org/I4210094118","https://openalex.org/I4210125796"]},{"id":"https://openalex.org/I4387153162","display_name":"ERN RITA","ror":"https://ror.org/0208ges23","country_code":"NL","type":"healthcare","lineage":["https://openalex.org/I1320481043","https://openalex.org/I2800387288","https://openalex.org/I4387153162","https://openalex.org/I4387155652"]},{"id":"https://openalex.org/I8087733","display_name":"University of T\u00fcbingen","ror":"https://ror.org/03a1kwz48","country_code":"DE","type":"education","lineage":["https://openalex.org/I8087733"]}],"countries":["DE","NL"],"is_corresponding":false,"raw_author_name":"Jasmin B. Kuemmerle-Deschner","raw_affiliation_strings":["Division of Pediatric Rheumatology and Autoinflammation Reference Center Tuebingen (arcT), Department of Pediatrics, University Children\u2019s Hospital Tuebingen, Hoppe-Seyler-Strasse 1, 72076 Tuebingen, Germany","European Reference Network for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases, ERN-RITA Coordinating Office, 3584 CX Utrecht, The Netherlands"],"raw_orcid":"https://orcid.org/0000-0002-6365-6598","affiliations":[{"raw_affiliation_string":"Division of Pediatric Rheumatology and Autoinflammation Reference Center Tuebingen (arcT), Department of Pediatrics, University Children\u2019s Hospital Tuebingen, Hoppe-Seyler-Strasse 1, 72076 Tuebingen, Germany","institution_ids":["https://openalex.org/I4210125796","https://openalex.org/I8087733"]},{"raw_affiliation_string":"European Reference Network for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases, ERN-RITA Coordinating Office, 3584 CX Utrecht, The Netherlands","institution_ids":["https://openalex.org/I4387153162"]}]}],"institutions":[],"countries_distinct_count":4,"institutions_distinct_count":7,"corresponding_author_ids":["https://openalex.org/A5023635059"],"corresponding_institution_ids":["https://openalex.org/I4210125796","https://openalex.org/I4387153162","https://openalex.org/I8087733"],"apc_list":{"value":2600,"currency":"CHF","value_usd":3137},"apc_paid":{"value":2600,"currency":"CHF","value_usd":3137},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.68522952,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"15","issue":"21","first_page":"8232","last_page":"8232"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11078","display_name":"Inflammasome and immune disorders","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/1312","display_name":"Molecular Biology"},"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"}},"topics":[{"id":"https://openalex.org/T11078","display_name":"Inflammasome and immune disorders","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/1312","display_name":"Molecular Biology"},"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"}},{"id":"https://openalex.org/T11616","display_name":"Autoimmune and Inflammatory Disorders Research","score":0.0007999999797903001,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"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/T11725","display_name":"Immunodeficiency and Autoimmune Disorders","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2403","display_name":"Immunology"},"field":{"id":"https://openalex.org/fields/24","display_name":"Immunology and Microbiology"},"domain":{"id":"https://openalex.org/domains/1","display_name":"Life Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/cryopyrin-associated-periodic-syndromes","display_name":"cryopyrin-associated periodic syndromes","score":0.9959999918937683},{"id":"https://openalex.org/keywords/risk-stratification","display_name":"risk stratification","score":0.8930000066757202},{"id":"https://openalex.org/keywords/treat-to-target","display_name":"treat-to-target","score":0.722000002861023},{"id":"https://openalex.org/keywords/pediatric-patients","display_name":"pediatric patients","score":0.7350000143051147},{"id":"https://openalex.org/keywords/sensorineural-hearing-loss","display_name":"sensorineural hearing loss","score":0.8109999895095825},{"id":"https://openalex.org/keywords/disease-activity","display_name":"disease activity","score":0.46299999952316284},{"id":"https://openalex.org/keywords/outcome-monitoring","display_name":"outcome monitoring","score":0.3959999978542328}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9620000123977661},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.5827999711036682},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.5612999796867371},{"id":"https://openalex.org/C3020404979","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk stratification","level":2,"score":0.5371999740600586},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.4171000123023987},{"id":"https://openalex.org/C12174686","wikidata":"https://www.wikidata.org/wiki/Q1058438","display_name":"Risk assessment","level":2,"score":0.39480000734329224},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.3781999945640564},{"id":"https://openalex.org/C2777895361","wikidata":"https://www.wikidata.org/wiki/Q1758614","display_name":"Longitudinal study","level":2,"score":0.33719998598098755},{"id":"https://openalex.org/C30036603","wikidata":"https://www.wikidata.org/wiki/Q17125150","display_name":"Severity of illness","level":2,"score":0.33250001072883606},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.33059999346733093},{"id":"https://openalex.org/C2777767895","wikidata":"https://www.wikidata.org/wiki/Q4691924","display_name":"Age of onset","level":3,"score":0.3197999894618988},{"id":"https://openalex.org/C205545832","wikidata":"https://www.wikidata.org/wiki/Q17156455","display_name":"Young adult","level":2,"score":0.30070000886917114},{"id":"https://openalex.org/C2994039464","wikidata":"https://www.wikidata.org/wiki/Q217690","display_name":"Cumulative risk","level":2,"score":0.28529998660087585},{"id":"https://openalex.org/C2776914184","wikidata":"https://www.wikidata.org/wiki/Q101991","display_name":"Inflammation","level":2,"score":0.26829999685287476},{"id":"https://openalex.org/C88879693","wikidata":"https://www.wikidata.org/wiki/Q217690","display_name":"Cumulative incidence","level":3,"score":0.2676999866962433},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.2646999955177307},{"id":"https://openalex.org/C201903717","wikidata":"https://www.wikidata.org/wiki/Q1778788","display_name":"Cohort study","level":2,"score":0.2567000091075897},{"id":"https://openalex.org/C50440223","wikidata":"https://www.wikidata.org/wiki/Q1475848","display_name":"Risk factor","level":2,"score":0.2563000023365021},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.25369998812675476},{"id":"https://openalex.org/C61511704","wikidata":"https://www.wikidata.org/wiki/Q1671857","display_name":"Incidence (geometry)","level":2,"score":0.25270000100135803}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.3390/jcm15218232","doi":"https://doi.org/10.3390/jcm15218232","is_oa":true,"landing_page_url":"https://doi.org/10.3390/jcm15218232","pdf_url":null,"source":{"id":"https://openalex.org/S2737969411","display_name":"Journal of Clinical Medicine","issn_l":"2077-0383","issn":["2077-0383"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","ki-jl-1","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Clinical Medicine","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.3390/jcm15218232","doi":"https://doi.org/10.3390/jcm15218232","is_oa":true,"landing_page_url":"https://doi.org/10.3390/jcm15218232","pdf_url":null,"source":{"id":"https://openalex.org/S2737969411","display_name":"Journal of Clinical Medicine","issn_l":"2077-0383","issn":["2077-0383"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","ki-jl-1","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Clinical Medicine","raw_type":"journal-article"},"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","score":1.0,"display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/observational-study","display_name":"Observational Study"}],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":15,"referenced_works":["https://openalex.org/W1982144458","https://openalex.org/W1996830451","https://openalex.org/W2051978340","https://openalex.org/W2077923057","https://openalex.org/W2101548148","https://openalex.org/W2110348886","https://openalex.org/W2149374693","https://openalex.org/W2527759663","https://openalex.org/W2548885112","https://openalex.org/W2736161417","https://openalex.org/W2885442772","https://openalex.org/W2940679238","https://openalex.org/W3007461053","https://openalex.org/W3116958836","https://openalex.org/W4281703831"],"related_works":["https://openalex.org/W6927618493","https://openalex.org/W2953166666","https://openalex.org/W4400387222","https://openalex.org/W2907335887","https://openalex.org/W2344943205","https://openalex.org/W3136060714","https://openalex.org/W2527759663","https://openalex.org/W4411428603","https://openalex.org/W3116958836","https://openalex.org/W2021157660"],"abstract_inverted_index":{"Objective:":[0],"Persistent":[1],"inflammation":[2],"in":[3,129,160,253],"cryopyrin-associated":[4],"periodic":[5],"syndromes":[6],"(CAPS)":[7],"causes":[8],"cumulative":[9,200],"organ":[10],"damage,":[11],"quantified":[12],"by":[13,230,236],"the":[14,22,66,73,82,112,192,226,231,242,251],"Autoinflammatory":[15],"Disease":[16],"Damage":[17],"Index":[18],"(ADDI).":[19],"We":[20],"evaluated":[21],"ADDI":[23,62,125,215,252],"for":[24],"risk":[25,29,95,171,216],"stratification":[26],"and":[27,54,80,85,93,122,143,185,204,208],"assessed":[28],"trajectories":[30],"under":[31],"treat-to-target":[32],"(T2T)":[33],"management.":[34],"Methods:":[35],"This":[36],"retrospective":[37],"analysis":[38],"of":[39,59,175,244,250],"prospectively":[40],"collected":[41],"single-centre":[42],"registry":[43],"data":[44],"included":[45],"consecutive":[46],"paediatric":[47,197],"patients":[48,86,100,130,162],"diagnosed":[49],"with":[50,56,131,206],"CAPS":[51],"between":[52],"2007":[53],"2024":[55],"\u226524":[57],"months":[58,71],"follow-up.":[60],"The":[61],"was":[63,202],"scored":[64],"at":[65,76,81,111,191,241],"initial":[67,113],"damage":[68,110,114,201,227],"assessment,":[69,115,245],"6":[70],"after":[72],"first":[74],"assessment":[75],"our":[77],"centre":[78],"(baseline),":[79],"last":[83,193],"visit,":[84],"were":[87,127,180],"assigned":[88],"to":[89,169,173,182],"predefined":[90],"mild,":[91],"moderate":[92,170],"severe":[94],"strata.":[96],"Results:":[97],"Of":[98],"71":[99],"(56%":[101],"female;":[102],"median":[103],"follow-up":[104],"7":[105],"years),":[106],"23":[107],"(32%)":[108],"had":[109],"most":[116],"frequently":[117],"auditory":[118],"(24%),":[119],"developmental":[120],"(14%)":[121],"ocular":[123],"(11%).":[124],"scores":[126],"higher":[128],"pathogenic/likely":[132],"pathogenic":[133],"NLRP3":[134,209],"variants":[135],"(median":[136],"2":[137],"vs.":[138],"0;":[139],"p":[140,153],"<":[141,154],"0.001)":[142],"increased":[144,188],"across":[145],"phenotypes":[146],"(FCAS":[147],"0,":[148,150],"MWS":[149],"CINCA/NOMID":[151],"9;":[152],"0.001).":[155],"Risk":[156],"strata":[157,217],"remained":[158,218],"unchanged":[159],"69":[161],"(97%).":[163],"Two":[164],"children":[165],"progressed":[166],"from":[167],"mild":[168],"due":[172],"progression":[174,228],"sensorineural":[176],"hearing":[177],"loss;":[178],"both":[179],"non-adherent":[181],"anti-IL-1":[183],"therapy,":[184],"neither":[186],"showed":[187],"disease":[189,238],"activity":[190,239],"visit.":[194],"Conclusions:":[195],"In":[196],"CAPS,":[198],"early":[199],"common":[203],"associated":[205],"phenotype":[207],"variant":[210],"pathogenicity.":[211],"Under":[212],"T2T":[213],"management,":[214],"largely":[219],"stable.":[220],"Although":[221],"based":[222],"on":[223],"few":[224],"patients,":[225],"captured":[229],"ADDI,":[232],"but":[233],"not":[234],"reflected":[235],"conventional":[237],"measures":[240],"time":[243],"supports":[246],"a":[247],"complementary":[248],"role":[249],"longitudinal":[254],"outcome":[255],"monitoring.":[256]},"counts_by_year":[],"updated_date":"2026-10-27T15:51:10.671819","created_date":"2026-10-24T00:00:00"}