{"id":"https://openalex.org/W4410152395","doi":"https://doi.org/10.1093/jamia/ocaf056","title":"A comparative analysis of privacy-preserving large language models for automated echocardiography report analysis","display_name":"A comparative analysis of privacy-preserving large language models for automated echocardiography report analysis","publication_year":2025,"publication_date":"2025-03-18","ids":{"openalex":"https://openalex.org/W4410152395","doi":"https://doi.org/10.1093/jamia/ocaf056","pmid":"https://pubmed.ncbi.nlm.nih.gov/40334045"},"language":"en","primary_location":{"id":"doi:10.1093/jamia/ocaf056","is_oa":false,"landing_page_url":"https://doi.org/10.1093/jamia/ocaf056","pdf_url":null,"source":{"id":"https://openalex.org/S129839026","display_name":"Journal of the American Medical Informatics Association","issn_l":"1067-5027","issn":["1067-5027","1527-974X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12257941/","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5053206078","display_name":"Elham Mahmoudi","orcid":"https://orcid.org/0000-0002-9746-8165"},"institutions":[{"id":"https://openalex.org/I1330342723","display_name":"Mayo Clinic","ror":"https://ror.org/02qp3tb03","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1330342723"]},{"id":"https://openalex.org/I4210125099","display_name":"Mayo Clinic in Arizona","ror":"https://ror.org/03jp40720","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1330342723","https://openalex.org/I4210125099"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Elham Mahmoudi","raw_affiliation_strings":["Department of Cardiovascular Medicine, Mayo Clinic Rochester , Rochester, MN 55905,","Department of Radiology, Radiology Informatics Lab, Mayo Clinic , Rochester, MN 55905,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Cardiovascular Medicine, Mayo Clinic Rochester , Rochester, MN 55905,","institution_ids":["https://openalex.org/I1330342723"]},{"raw_affiliation_string":"Department of Radiology, Radiology Informatics Lab, Mayo Clinic , Rochester, MN 55905,","institution_ids":["https://openalex.org/I4210125099"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5026759531","display_name":"Sanaz Vahdati","orcid":"https://orcid.org/0000-0002-1026-2501"},"institutions":[{"id":"https://openalex.org/I4210125099","display_name":"Mayo Clinic in Arizona","ror":"https://ror.org/03jp40720","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1330342723","https://openalex.org/I4210125099"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Sanaz Vahdati","raw_affiliation_strings":["Department of Radiology, Radiology Informatics Lab, Mayo Clinic , Rochester, MN 55905,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Radiology, Radiology Informatics Lab, Mayo Clinic , Rochester, MN 55905,","institution_ids":["https://openalex.org/I4210125099"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5033000845","display_name":"Chieh\u2010Ju Chao","orcid":"https://orcid.org/0000-0001-6155-0266"},"institutions":[{"id":"https://openalex.org/I1330342723","display_name":"Mayo Clinic","ror":"https://ror.org/02qp3tb03","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1330342723"]},{"id":"https://openalex.org/I4210125099","display_name":"Mayo Clinic in Arizona","ror":"https://ror.org/03jp40720","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1330342723","https://openalex.org/I4210125099"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Chieh-Ju Chao","raw_affiliation_strings":["Department of Cardiovascular Medicine, Mayo Clinic Rochester , Rochester, MN 55905,","Department of Radiology, Radiology Informatics Lab, Mayo Clinic , Rochester, MN 55905,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Cardiovascular Medicine, Mayo Clinic Rochester , Rochester, MN 55905,","institution_ids":["https://openalex.org/I1330342723"]},{"raw_affiliation_string":"Department of Radiology, Radiology Informatics Lab, Mayo Clinic , Rochester, MN 55905,","institution_ids":["https://openalex.org/I4210125099"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5041981029","display_name":"Bardia Khosravi","orcid":"https://orcid.org/0000-0002-8024-339X"},"institutions":[{"id":"https://openalex.org/I4210125099","display_name":"Mayo Clinic in Arizona","ror":"https://ror.org/03jp40720","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1330342723","https://openalex.org/I4210125099"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Bardia Khosravi","raw_affiliation_strings":["Department of Radiology, Radiology Informatics Lab, Mayo Clinic , Rochester, MN 55905,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Radiology, Radiology Informatics Lab, Mayo Clinic , Rochester, MN 55905,","institution_ids":["https://openalex.org/I4210125099"]}]},{"author_position":"middle","author":{"id":null,"display_name":"Ajay Misra","orcid":null},"institutions":[{"id":"https://openalex.org/I4210125099","display_name":"Mayo Clinic in Arizona","ror":"https://ror.org/03jp40720","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1330342723","https://openalex.org/I4210125099"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Ajay Misra","raw_affiliation_strings":["Department of Radiology, Radiology Informatics Lab, Mayo Clinic , Rochester, MN 55905,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Radiology, Radiology Informatics Lab, Mayo Clinic , Rochester, MN 55905,","institution_ids":["https://openalex.org/I4210125099"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5001963115","display_name":"Francisco L\u00f3pez-Jim\u00e9nez","orcid":"https://orcid.org/0000-0001-5788-9734"},"institutions":[{"id":"https://openalex.org/I1330342723","display_name":"Mayo Clinic","ror":"https://ror.org/02qp3tb03","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1330342723"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Francisco Lopez-Jimenez","raw_affiliation_strings":["Department of Cardiovascular Medicine, Mayo Clinic Rochester , Rochester, MN 55905,"],"raw_orcid":"https://orcid.org/0000-0001-5788-9734","affiliations":[{"raw_affiliation_string":"Department of Cardiovascular Medicine, Mayo Clinic Rochester , Rochester, MN 55905,","institution_ids":["https://openalex.org/I1330342723"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5008832314","display_name":"Bradley J. Erickson","orcid":"https://orcid.org/0000-0001-7926-6095"},"institutions":[{"id":"https://openalex.org/I4210125099","display_name":"Mayo Clinic in Arizona","ror":"https://ror.org/03jp40720","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I1330342723","https://openalex.org/I4210125099"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Bradley J Erickson","raw_affiliation_strings":["Department of Radiology, Radiology Informatics Lab, Mayo Clinic , Rochester, MN 55905,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Radiology, Radiology Informatics Lab, Mayo Clinic , Rochester, MN 55905,","institution_ids":["https://openalex.org/I4210125099"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":7,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":{"value":3967,"currency":"USD","value_usd":3967},"apc_paid":null,"fwci":0.8863,"has_fulltext":false,"cited_by_count":2,"citation_normalized_percentile":{"value":0.7812242,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":95,"max":96},"biblio":{"volume":"32","issue":"7","first_page":"1120","last_page":"1129"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.4156999886035919,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"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/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.4156999886035919,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"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/T13702","display_name":"Machine Learning in Healthcare","score":0.10130000114440918,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T10028","display_name":"Topic Modeling","score":0.061000000685453415,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.636957585811615},{"id":"https://openalex.org/keywords/natural-language-processing","display_name":"Natural language processing","score":0.350439190864563},{"id":"https://openalex.org/keywords/artificial-intelligence","display_name":"Artificial intelligence","score":0.3481307625770569}],"concepts":[{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.636957585811615},{"id":"https://openalex.org/C204321447","wikidata":"https://www.wikidata.org/wiki/Q30642","display_name":"Natural language processing","level":1,"score":0.350439190864563},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.3481307625770569}],"mesh":[{"descriptor_ui":"D000098342","descriptor_name":"Large Language Models","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000098342","descriptor_name":"Large Language Models","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000098342","descriptor_name":"Large Language Models","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000098342","descriptor_name":"Large Language Models","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003219","descriptor_name":"Confidentiality","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D003219","descriptor_name":"Confidentiality","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D003219","descriptor_name":"Confidentiality","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D003219","descriptor_name":"Confidentiality","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D004452","descriptor_name":"Echocardiography","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D004452","descriptor_name":"Echocardiography","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D004452","descriptor_name":"Echocardiography","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D004452","descriptor_name":"Echocardiography","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D006349","descriptor_name":"Heart Valve Diseases","qualifier_ui":"Q000000981","qualifier_name":"diagnostic imaging","is_major_topic":true},{"descriptor_ui":"D006349","descriptor_name":"Heart Valve Diseases","qualifier_ui":"Q000000981","qualifier_name":"diagnostic imaging","is_major_topic":true},{"descriptor_ui":"D006349","descriptor_name":"Heart Valve Diseases","qualifier_ui":"Q000000981","qualifier_name":"diagnostic imaging","is_major_topic":true},{"descriptor_ui":"D006349","descriptor_name":"Heart Valve Diseases","qualifier_ui":"Q000000981","qualifier_name":"diagnostic imaging","is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009323","descriptor_name":"Natural Language Processing","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D009323","descriptor_name":"Natural Language Processing","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D009323","descriptor_name":"Natural Language Processing","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D009323","descriptor_name":"Natural Language Processing","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D011381","descriptor_name":"Programming Languages","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D011381","descriptor_name":"Programming Languages","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D011381","descriptor_name":"Programming Languages","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D011381","descriptor_name":"Programming Languages","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D016247","descriptor_name":"Information Storage and Retrieval","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D016247","descriptor_name":"Information Storage and Retrieval","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D016247","descriptor_name":"Information Storage and Retrieval","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D016247","descriptor_name":"Information Storage and Retrieval","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1093/jamia/ocaf056","is_oa":false,"landing_page_url":"https://doi.org/10.1093/jamia/ocaf056","pdf_url":null,"source":{"id":"https://openalex.org/S129839026","display_name":"Journal of the American Medical Informatics Association","issn_l":"1067-5027","issn":["1067-5027","1527-974X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association","raw_type":"journal-article"},{"id":"pmid:40334045","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/40334045","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association : JAMIA","raw_type":null},{"id":"pmh:oai:pubmedcentral.nih.gov:12257941","is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12257941/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"J Am Med Inform Assoc","raw_type":"Text"}],"best_oa_location":{"id":"pmh:oai:pubmedcentral.nih.gov:12257941","is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC12257941/","pdf_url":null,"source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"J Am Med Inform Assoc","raw_type":"Text"},"sustainable_development_goals":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":18,"referenced_works":["https://openalex.org/W2338526423","https://openalex.org/W2342434602","https://openalex.org/W3087781820","https://openalex.org/W3129922404","https://openalex.org/W3137307716","https://openalex.org/W3164323420","https://openalex.org/W3211024994","https://openalex.org/W4226278401","https://openalex.org/W4294579032","https://openalex.org/W4387472906","https://openalex.org/W4388633644","https://openalex.org/W4389490684","https://openalex.org/W4390700469","https://openalex.org/W4390919701","https://openalex.org/W4391050741","https://openalex.org/W4395026179","https://openalex.org/W4396519801","https://openalex.org/W6810738896"],"related_works":["https://openalex.org/W4391375266","https://openalex.org/W2899084033","https://openalex.org/W2748952813","https://openalex.org/W2390279801","https://openalex.org/W4391913857","https://openalex.org/W2358668433","https://openalex.org/W4396701345","https://openalex.org/W2376932109","https://openalex.org/W2001405890","https://openalex.org/W3204019825"],"abstract_inverted_index":{"BACKGROUND:":[0],"Automated":[1],"data":[2],"extraction":[3],"from":[4,56,63,114,178],"echocardiography":[5,225],"reports":[6,55],"could":[7],"facilitate":[8],"large-scale":[9],"registry":[10,232],"creation":[11],"and":[12,34,61,74,82,90,122,130,136,143,234],"clinical":[13],"surveillance":[14],"of":[15,24,36,165,220,231],"valvular":[16],"heart":[17],"diseases":[18],"(VHD).":[19],"We":[20],"evaluated":[21,95],"the":[22,125,189,204,210,217,229],"performance":[23,127,219,250],"open-source":[25,221],"large":[26],"language":[27],"models":[28,147,173,239],"(LLMs)":[29],"guided":[30,77],"by":[31,78,200],"prompt":[32,59,79,211,244],"instructions":[33,80],"chain":[35],"thought":[37,166],"(CoT)":[38],"for":[39,58,65,110,132,138,151,159,171,223],"this":[40],"task.":[41],"METHODS:":[42],"From":[43],"consecutive":[44],"transthoracic":[45],"echocardiographies":[46],"performed":[47],"in":[48,203],"our":[49],"center,":[50],"we":[51],"utilized":[52],"200":[53],"random":[54],"2019":[57],"optimization":[60],"1000":[62],"2023":[64],"evaluation.":[66],"Five":[67],"instruction-tuned":[68],"LLMs":[69,222],"(Qwen2.0-72B,":[70],"Llama3.0-70B,":[71],"Mixtral8-46.7B,":[72],"Llama3.0-8B,":[73],"Phi3.0-3.8B)":[75],"were":[76,192],"with":[81,228,251],"without":[83],"CoT":[84,119,187],"to":[85,180,195,208],"classify":[86],"prosthetic":[87,139,160],"valve":[88,161],"presence":[89],"VHD":[91,133,152],"severity.":[92,116],"Performance":[93],"was":[94,107],"using":[96],"classification":[97],"metrics":[98],"against":[99],"expert-labeled":[100],"ground":[101],"truth.":[102],"Mean":[103],"squared":[104],"error":[105],"(MSE)":[106],"also":[108],"calculated":[109],"predicted":[111],"severity's":[112],"deviation":[113],"actual":[115],"RESULTS:":[117],"With":[118],"prompting,":[120],"Llama3.0-70B":[121],"Qwen2.0":[123],"achieved":[124,240],"highest":[126],"(accuracy:":[128],"99.1%":[129],"98.9%":[131],"severity;":[134],"100%":[135],"99.9%":[137],"valve;":[140],"MSE:":[141],"0.02":[142],"0.05,":[144],"respectively).":[145],"Smaller":[146],"showed":[148],"lower":[149],"accuracy":[150,158,170,242],"severity":[153],"(54.1%-85.9%)":[154],"but":[155],"maintained":[156],"high":[157],"detection":[162],"(>96%).":[163],"Chain":[164],"reasoning":[167],"yielded":[168],"higher":[169],"larger":[172,238],"while":[174],"increasing":[175],"processing":[176],"time":[177],"2-25":[179],"67-154":[181],"seconds":[182],"per":[183],"report.":[184],"Based":[185],"on":[186],"reasonings,":[188],"wrong":[190],"predictions":[191],"mainly":[193],"due":[194],"model":[196],"outputs":[197],"being":[198],"influenced":[199],"irrelevant":[201],"information":[202],"text":[205],"or":[206],"failure":[207],"follow":[209],"instructions.":[212],"CONCLUSIONS:":[213],"Our":[214],"study":[215],"demonstrates":[216],"near-perfect":[218],"automated":[224],"report":[226],"interpretation":[227],"purpose":[230],"formation":[233],"disease":[235],"surveillance.":[236],"While":[237],"exceptional":[241],"through":[243],"optimization,":[245],"practical":[246],"implementation":[247],"requires":[248],"balancing":[249],"computational":[252],"efficiency.":[253]},"counts_by_year":[{"year":2025,"cited_by_count":2}],"updated_date":"2026-06-11T09:08:48.828518","created_date":"2025-10-10T00:00:00"}
