{"id":"https://openalex.org/W4402926610","doi":"https://doi.org/10.1186/s12911-024-02661-6","title":"Coding rules for uncertain and \u201cruled out\u201d diagnoses in ICD-10 and ICD-11","display_name":"Coding rules for uncertain and \u201cruled out\u201d diagnoses in ICD-10 and ICD-11","publication_year":2024,"publication_date":"2024-09-27","ids":{"openalex":"https://openalex.org/W4402926610","doi":"https://doi.org/10.1186/s12911-024-02661-6","pmid":"https://pubmed.ncbi.nlm.nih.gov/39334213"},"language":"en","primary_location":{"id":"doi:10.1186/s12911-024-02661-6","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12911-024-02661-6","pdf_url":"https://link.springer.com/content/pdf/10.1186/s12911-024-02661-6.pdf","source":{"id":"https://openalex.org/S107516304","display_name":"BMC Medical Informatics and Decision Making","issn_l":"1472-6947","issn":["1472-6947"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Medical Informatics and Decision Making","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://link.springer.com/content/pdf/10.1186/s12911-024-02661-6.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5074590171","display_name":"Oluseun Atolagbe","orcid":null},"institutions":[{"id":"https://openalex.org/I84218800","display_name":"University of California, Davis","ror":"https://ror.org/05rrcem69","country_code":"US","type":"education","lineage":["https://openalex.org/I84218800"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Oluseun O. Atolagbe","raw_affiliation_strings":["Health Information Management Department, University of California Davis Health, Sacramento, CA, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Information Management Department, University of California Davis Health, Sacramento, CA, USA","institution_ids":["https://openalex.org/I84218800"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5007567679","display_name":"Patrick S. Romano","orcid":"https://orcid.org/0000-0001-6749-3979"},"institutions":[{"id":"https://openalex.org/I2803209242","display_name":"University of California System","ror":"https://ror.org/00pjdza24","country_code":"US","type":"education","lineage":["https://openalex.org/I2803209242"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Patrick S. Romano","raw_affiliation_strings":["Departments of Internal Medicine and Pediatrics, and Center for Healthcare Policy and Research, University of California Davis Health, Sacramento, CA, USA. psromano@ucdavis.edu"],"raw_orcid":"https://orcid.org/0000-0001-6749-3979","affiliations":[{"raw_affiliation_string":"Departments of Internal Medicine and Pediatrics, and Center for Healthcare Policy and Research, University of California Davis Health, Sacramento, CA, USA. psromano@ucdavis.edu","institution_ids":["https://openalex.org/I2803209242"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5052576941","display_name":"Danielle A. Southern","orcid":"https://orcid.org/0000-0002-0006-0033"},"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"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"Danielle A. Southern","raw_affiliation_strings":["Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Centre for Health Informatics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada","institution_ids":["https://openalex.org/I168635309"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5018778878","display_name":"Wachira Wongtanasarasin","orcid":"https://orcid.org/0000-0002-1418-0036"},"institutions":[{"id":"https://openalex.org/I48076826","display_name":"Chiang Mai University","ror":"https://ror.org/05m2fqn25","country_code":"TH","type":"education","lineage":["https://openalex.org/I48076826"]}],"countries":["TH"],"is_corresponding":false,"raw_author_name":"Wachira Wongtanasarasin","raw_affiliation_strings":["Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand","institution_ids":["https://openalex.org/I48076826"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5079057011","display_name":"William A. Ghali","orcid":null},"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"]}],"countries":["CA"],"is_corresponding":false,"raw_author_name":"William A. Ghali","raw_affiliation_strings":["Office of Vice President of Research, University of Calgary, Calgary, AB, Canada"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Office of Vice President of Research, University of Calgary, Calgary, AB, Canada","institution_ids":["https://openalex.org/I168635309"]}]}],"institutions":[],"countries_distinct_count":3,"institutions_distinct_count":4,"corresponding_author_ids":["https://openalex.org/A5007567679"],"corresponding_institution_ids":["https://openalex.org/I2803209242"],"apc_list":{"value":2690,"currency":"USD","value_usd":2690},"apc_paid":{"value":2690,"currency":"USD","value_usd":2690},"fwci":3.8516,"has_fulltext":true,"cited_by_count":7,"citation_normalized_percentile":{"value":0.94265538,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":97,"max":99},"biblio":{"volume":"21","issue":"S6","first_page":"386","last_page":"386"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T14400","display_name":"Medical Coding and Health Information","score":0.9998999834060669,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T14400","display_name":"Medical Coding and Health Information","score":0.9998999834060669,"subfield":{"id":"https://openalex.org/subfields/3605","display_name":"Health Information Management"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12246","display_name":"Chronic Disease Management Strategies","score":0.9620000123977661,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"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/T12918","display_name":"Healthcare Systems and Technology","score":0.9259999990463257,"subfield":{"id":"https://openalex.org/subfields/1407","display_name":"Organizational Behavior and Human Resource Management"},"field":{"id":"https://openalex.org/fields/14","display_name":"Business, Management and Accounting"},"domain":{"id":"https://openalex.org/domains/2","display_name":"Social Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/icd-10","display_name":"ICD-10","score":0.7522069215774536},{"id":"https://openalex.org/keywords/coding","display_name":"Coding (social sciences)","score":0.7515772581100464},{"id":"https://openalex.org/keywords/medical-diagnosis","display_name":"Medical diagnosis","score":0.723781943321228},{"id":"https://openalex.org/keywords/documentation","display_name":"Documentation","score":0.6153203845024109},{"id":"https://openalex.org/keywords/health-informatics","display_name":"Health informatics","score":0.5881357789039612},{"id":"https://openalex.org/keywords/diagnosis-code","display_name":"Diagnosis code","score":0.42691951990127563},{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.4098815321922302},{"id":"https://openalex.org/keywords/medicine","display_name":"Medicine","score":0.3913966417312622},{"id":"https://openalex.org/keywords/data-science","display_name":"Data science","score":0.3215438425540924},{"id":"https://openalex.org/keywords/public-health","display_name":"Public health","score":0.14547857642173767},{"id":"https://openalex.org/keywords/nursing","display_name":"Nursing","score":0.10211583971977234},{"id":"https://openalex.org/keywords/sociology","display_name":"Sociology","score":0.08763059973716736},{"id":"https://openalex.org/keywords/pathology","display_name":"Pathology","score":0.08713722229003906}],"concepts":[{"id":"https://openalex.org/C2781116378","wikidata":"https://www.wikidata.org/wiki/Q45127","display_name":"ICD-10","level":2,"score":0.7522069215774536},{"id":"https://openalex.org/C179518139","wikidata":"https://www.wikidata.org/wiki/Q5140297","display_name":"Coding (social sciences)","level":2,"score":0.7515772581100464},{"id":"https://openalex.org/C534262118","wikidata":"https://www.wikidata.org/wiki/Q177719","display_name":"Medical diagnosis","level":2,"score":0.723781943321228},{"id":"https://openalex.org/C56666940","wikidata":"https://www.wikidata.org/wiki/Q788790","display_name":"Documentation","level":2,"score":0.6153203845024109},{"id":"https://openalex.org/C145642194","wikidata":"https://www.wikidata.org/wiki/Q870895","display_name":"Health informatics","level":3,"score":0.5881357789039612},{"id":"https://openalex.org/C45827449","wikidata":"https://www.wikidata.org/wiki/Q5270338","display_name":"Diagnosis code","level":3,"score":0.42691951990127563},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.4098815321922302},{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.3913966417312622},{"id":"https://openalex.org/C2522767166","wikidata":"https://www.wikidata.org/wiki/Q2374463","display_name":"Data science","level":1,"score":0.3215438425540924},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.14547857642173767},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.10211583971977234},{"id":"https://openalex.org/C144024400","wikidata":"https://www.wikidata.org/wiki/Q21201","display_name":"Sociology","level":0,"score":0.08763059973716736},{"id":"https://openalex.org/C142724271","wikidata":"https://www.wikidata.org/wiki/Q7208","display_name":"Pathology","level":1,"score":0.08713722229003906},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.0},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.0},{"id":"https://openalex.org/C199360897","wikidata":"https://www.wikidata.org/wiki/Q9143","display_name":"Programming language","level":1,"score":0.0},{"id":"https://openalex.org/C36289849","wikidata":"https://www.wikidata.org/wiki/Q34749","display_name":"Social science","level":1,"score":0.0}],"mesh":[{"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":"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":"D038801","descriptor_name":"International Classification of Diseases","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D038801","descriptor_name":"International Classification of Diseases","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D038801","descriptor_name":"International Classification of Diseases","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D038801","descriptor_name":"International Classification of Diseases","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D038801","descriptor_name":"International Classification of Diseases","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D038801","descriptor_name":"International Classification of Diseases","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D038801","descriptor_name":"International Classification of Diseases","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D059019","descriptor_name":"Clinical Coding","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D059019","descriptor_name":"Clinical Coding","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D059019","descriptor_name":"Clinical Coding","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D059019","descriptor_name":"Clinical Coding","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D059019","descriptor_name":"Clinical Coding","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D059019","descriptor_name":"Clinical Coding","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true},{"descriptor_ui":"D059019","descriptor_name":"Clinical Coding","qualifier_ui":"Q000592","qualifier_name":"standards","is_major_topic":true}],"locations_count":5,"locations":[{"id":"doi:10.1186/s12911-024-02661-6","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12911-024-02661-6","pdf_url":"https://link.springer.com/content/pdf/10.1186/s12911-024-02661-6.pdf","source":{"id":"https://openalex.org/S107516304","display_name":"BMC Medical Informatics and Decision Making","issn_l":"1472-6947","issn":["1472-6947"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Medical Informatics and Decision Making","raw_type":"journal-article"},{"id":"pmid:39334213","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/39334213","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":"BMC medical informatics and decision making","raw_type":null},{"id":"pmh:oai:pubmedcentral.nih.gov:11430383","is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11430383","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11430383/pdf/12911_2024_Article_2661.pdf","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":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"BMC Med Inform Decis Mak","raw_type":"Text"},{"id":"pmh:oai:doaj.org/article:4183b303dae448a3ae7d6d6a7160f64d","is_oa":false,"landing_page_url":"https://doaj.org/article/4183b303dae448a3ae7d6d6a7160f64d","pdf_url":null,"source":{"id":"https://openalex.org/S4306401280","display_name":"DOAJ (DOAJ: Directory of Open Access Journals)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"BMC Medical Informatics and Decision Making, Vol 21, Iss S6, Pp 1-9 (2024)","raw_type":"article"},{"id":"pmh:oai:escholarship.org:ark:/13030/qt0xw8v6rg","is_oa":true,"landing_page_url":"https://escholarship.org/uc/item/0xw8v6rg","pdf_url":null,"source":{"id":"https://openalex.org/S4306400115","display_name":"eScholarship (California Digital Library)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I2801248553","host_organization_name":"California Digital Library","host_organization_lineage":["https://openalex.org/I2801248553"],"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":"BMC Medical Informatics and Decision Making, vol 21, iss Suppl 6","raw_type":"article"}],"best_oa_location":{"id":"doi:10.1186/s12911-024-02661-6","is_oa":true,"landing_page_url":"https://doi.org/10.1186/s12911-024-02661-6","pdf_url":"https://link.springer.com/content/pdf/10.1186/s12911-024-02661-6.pdf","source":{"id":"https://openalex.org/S107516304","display_name":"BMC Medical Informatics and Decision Making","issn_l":"1472-6947","issn":["1472-6947"],"is_oa":true,"is_in_doaj":true,"is_core":true,"host_organization":"https://openalex.org/P4310320256","host_organization_name":"BioMed Central","host_organization_lineage":["https://openalex.org/P4310320256","https://openalex.org/P4310319965"],"host_organization_lineage_names":["BioMed Central","Springer Nature"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"BMC Medical Informatics and Decision Making","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.5299999713897705,"id":"https://metadata.un.org/sdg/17","display_name":"Partnerships for the goals"}],"awards":[{"id":"https://openalex.org/G3753627335","display_name":null,"funder_award_id":"R13 HS027288","funder_id":"https://openalex.org/F4320332177","funder_display_name":"Agency for Healthcare Research and Quality"},{"id":"https://openalex.org/G4704671172","display_name":null,"funder_award_id":"R13HS027288","funder_id":"https://openalex.org/F4320332177","funder_display_name":"Agency for Healthcare Research and Quality"},{"id":"https://openalex.org/G7411022331","display_name":null,"funder_award_id":"R13 HS024891","funder_id":"https://openalex.org/F4320332177","funder_display_name":"Agency for Healthcare Research and Quality"}],"funders":[{"id":"https://openalex.org/F4320332177","display_name":"Agency for Healthcare Research and Quality","ror":"https://ror.org/03jmfdf59"},{"id":"https://openalex.org/F4320334506","display_name":"Canadian Institutes of Health Research","ror":"https://ror.org/01gavpb45"}],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4402926610.pdf","grobid_xml":"https://content.openalex.org/works/W4402926610.grobid-xml"},"referenced_works_count":7,"referenced_works":["https://openalex.org/W2154141495","https://openalex.org/W2278827321","https://openalex.org/W2318106356","https://openalex.org/W3131282271","https://openalex.org/W3145864269","https://openalex.org/W4280628103","https://openalex.org/W4302767823"],"related_works":["https://openalex.org/W2791484311","https://openalex.org/W2333798660","https://openalex.org/W2406037887","https://openalex.org/W4377564205","https://openalex.org/W72816711","https://openalex.org/W4382371015","https://openalex.org/W57843728","https://openalex.org/W2073015584","https://openalex.org/W4292539280","https://openalex.org/W2802989430"],"abstract_inverted_index":{"The":[0,70],"International":[1],"Classification":[2],"of":[3,20,26,33,72,87,108,134,137],"Diseases,":[4],"11th":[5],"Revision":[6],"(ICD-11)":[7],"has":[8],"significantly":[9],"improved":[10],"the":[11,21,85,96,129,135],"ability":[12],"to":[13,76],"navigate":[14],"coding":[15,32,56,79,118],"challenges":[16,80],"beyond":[17],"prior":[18],"iterations":[19],"ICD.":[22],"Commonly":[23],"encountered":[24],"sources":[25],"complexity":[27],"in":[28,52,65,95],"clinical":[29,63,89,124],"documentation":[30],"include":[31],"uncertain":[34,109],"and":[35,43,57,60,91,110,140],"\"ruled":[36,61,111],"out\"":[37,62,112],"diagnoses.":[38],"Assessing":[39],"official":[40],"international":[41,115],"guidelines":[42],"rules,":[44],"this":[45],"paper":[46],"documents":[47],"extensive":[48],"variation":[49],"across":[50],"countries":[51],"existing":[53],"practices":[54],"for":[55,120,131],"reporting":[58],"unconfirmed":[59],"concepts":[64,136],"ICD-10":[66],"(and":[67],"modifications":[68],"thereof).":[69],"design":[71],"ICD-11":[73,97,100],"is":[74],"intended":[75],"mitigate":[77],"these":[78,121],"by":[81],"introducing":[82],"postcoordination,":[83],"expanding":[84],"range":[86],"codable":[88],"concepts,":[90],"offering":[92],"clearer":[93],"guidance":[94],"Reference":[98],"Guide.":[99],"offers":[101],"substantial":[102],"progress":[103],"towards":[104],"more":[105],"precise":[106],"capture":[107],"diagnoses,":[113],"including":[114],"consensus":[116],"on":[117],"rules":[119],"historically":[122],"challenging":[123],"concepts.":[125],"However,":[126],"we":[127],"identify":[128],"need":[130],"further":[132],"clarification":[133],"\"provisional":[138],"diagnosis\"":[139],"\"differential":[141],"diagnosis.\"":[142]},"counts_by_year":[{"year":2026,"cited_by_count":3},{"year":2025,"cited_by_count":4}],"updated_date":"2026-07-23T08:03:31.855105","created_date":"2025-10-10T00:00:00"}