Establishing key research questions for the implementation of artificial intelligence in colonoscopy: a modified Delphi method
Abstract Background Artificial intelligence (AI) research in colonoscopy is progressing rapidly but widespread clinical implementation is not yet a reality. We aimed to identify the top implementation research priorities. Methods An established modified Delphi approach for research priority settin...
Saved in:
Published in | Endoscopy Vol. 53; no. 9; pp. 893 - 901 |
---|---|
Main Authors | , , , , , , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Rüdigerstraße 14, 70469 Stuttgart, Germany
Georg Thieme Verlag KG
01.09.2021
|
Subjects | |
Online Access | Get full text |
ISSN | 0013-726X 1438-8812 |
DOI | 10.1055/a-1306-7590 |
Cover
Abstract | Abstract
Background
Artificial intelligence (AI) research in colonoscopy is progressing rapidly but widespread clinical implementation is not yet a reality. We aimed to identify the top implementation research priorities.
Methods
An established modified Delphi approach for research priority setting was used. Fifteen international experts, including endoscopists and translational computer scientists/engineers, from nine countries participated in an online survey over 9 months. Questions related to AI implementation in colonoscopy were generated as a long-list in the first round, and then scored in two subsequent rounds to identify the top 10 research questions.
Results
The top 10 ranked questions were categorized into five themes. Theme 1: clinical trial design/end points (4 questions), related to optimum trial designs for polyp detection and characterization, determining the optimal end points for evaluation of AI, and demonstrating impact on interval cancer rates. Theme 2: technological developments (3 questions), including improving detection of more challenging and advanced lesions, reduction of false-positive rates, and minimizing latency. Theme 3: clinical adoption/integration (1 question), concerning the effective combination of detection and characterization into one workflow. Theme 4: data access/annotation (1 question), concerning more efficient or automated data annotation methods to reduce the burden on human experts. Theme 5: regulatory approval (1 question), related to making regulatory approval processes more efficient.
Conclusions
This is the first reported international research priority setting exercise for AI in colonoscopy. The study findings should be used as a framework to guide future research with key stakeholders to accelerate the clinical implementation of AI in endoscopy. |
---|---|
AbstractList | Abstract
Background
Artificial intelligence (AI) research in colonoscopy is progressing rapidly but widespread clinical implementation is not yet a reality. We aimed to identify the top implementation research priorities.
Methods
An established modified Delphi approach for research priority setting was used. Fifteen international experts, including endoscopists and translational computer scientists/engineers, from nine countries participated in an online survey over 9 months. Questions related to AI implementation in colonoscopy were generated as a long-list in the first round, and then scored in two subsequent rounds to identify the top 10 research questions.
Results
The top 10 ranked questions were categorized into five themes. Theme 1: clinical trial design/end points (4 questions), related to optimum trial designs for polyp detection and characterization, determining the optimal end points for evaluation of AI, and demonstrating impact on interval cancer rates. Theme 2: technological developments (3 questions), including improving detection of more challenging and advanced lesions, reduction of false-positive rates, and minimizing latency. Theme 3: clinical adoption/integration (1 question), concerning the effective combination of detection and characterization into one workflow. Theme 4: data access/annotation (1 question), concerning more efficient or automated data annotation methods to reduce the burden on human experts. Theme 5: regulatory approval (1 question), related to making regulatory approval processes more efficient.
Conclusions
This is the first reported international research priority setting exercise for AI in colonoscopy. The study findings should be used as a framework to guide future research with key stakeholders to accelerate the clinical implementation of AI in endoscopy. BACKGROUND : Artificial intelligence (AI) research in colonoscopy is progressing rapidly but widespread clinical implementation is not yet a reality. We aimed to identify the top implementation research priorities. METHODS : An established modified Delphi approach for research priority setting was used. Fifteen international experts, including endoscopists and translational computer scientists/engineers, from nine countries participated in an online survey over 9 months. Questions related to AI implementation in colonoscopy were generated as a long-list in the first round, and then scored in two subsequent rounds to identify the top 10 research questions. RESULTS : The top 10 ranked questions were categorized into five themes. Theme 1: clinical trial design/end points (4 questions), related to optimum trial designs for polyp detection and characterization, determining the optimal end points for evaluation of AI, and demonstrating impact on interval cancer rates. Theme 2: technological developments (3 questions), including improving detection of more challenging and advanced lesions, reduction of false-positive rates, and minimizing latency. Theme 3: clinical adoption/integration (1 question), concerning the effective combination of detection and characterization into one workflow. Theme 4: data access/annotation (1 question), concerning more efficient or automated data annotation methods to reduce the burden on human experts. Theme 5: regulatory approval (1 question), related to making regulatory approval processes more efficient. CONCLUSIONS : This is the first reported international research priority setting exercise for AI in colonoscopy. The study findings should be used as a framework to guide future research with key stakeholders to accelerate the clinical implementation of AI in endoscopy. |
Author | Histace, Aymeric Berzin, Tyler M. Elson, Daniel S. Anderson, John T. Bisschops, Raf Bernal, Jorge Wang, Pu Chen, Peng-Jen Kudo, Shin-ei Stoyanov, Danail Karnes, William E. Eelbode, Tom Lovat, Laurence B. East, James E. Valdastri, Pietro Wallace, Michael B. Singh, Rajvinder Misawa, Masashi Byrne, Michael F. Ahmad, Omer F. Mori, Yuichi Gurudu, Suryakanth R. Repici, Alessandro |
Author_xml | – sequence: 1 givenname: Omer F. orcidid: 0000-0001-6498-481X surname: Ahmad fullname: Ahmad, Omer F. email: ofahmad123@gmail.com organization: Wellcome/EPSRC Centre for Interventional & Surgical Sciences – sequence: 2 givenname: Yuichi orcidid: 0000-0003-2262-0334 surname: Mori fullname: Mori, Yuichi organization: Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Oslo, Norway – sequence: 3 givenname: Masashi surname: Misawa fullname: Misawa, Masashi organization: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan – sequence: 4 givenname: Shin-ei orcidid: 0000-0002-2953-9603 surname: Kudo fullname: Kudo, Shin-ei organization: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan – sequence: 5 givenname: John T. orcidid: 0000-0002-6625-114X surname: Anderson fullname: Anderson, John T. organization: Department of Gastroenterology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK – sequence: 6 givenname: Jorge surname: Bernal fullname: Bernal, Jorge organization: Computer Science Department, Universitat Autonoma de Barcelona and Computer Vision Center, Barcelona, Spain – sequence: 7 givenname: Tyler M. surname: Berzin fullname: Berzin, Tyler M. organization: Center for Advanced Endoscopy, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA – sequence: 8 givenname: Raf orcidid: 0000-0002-9994-8226 surname: Bisschops fullname: Bisschops, Raf organization: Department of Gastroenterology and Hepatology, University Hospitals Leuven, TARGID KU Leuven, Leuven, Belgium – sequence: 9 givenname: Michael F. surname: Byrne fullname: Byrne, Michael F. organization: Division of Gastroenterology, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada – sequence: 10 givenname: Peng-Jen orcidid: 0000-0001-5400-905X surname: Chen fullname: Chen, Peng-Jen organization: Division of Gastroenterology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan – sequence: 11 givenname: James E. orcidid: 0000-0001-8035-3700 surname: East fullname: East, James E. organization: Oxford NIHR Biomedical Research Centre, University of Oxford, Oxford, UK – sequence: 12 givenname: Tom surname: Eelbode fullname: Eelbode, Tom organization: Medical Imaging Research Center, ESAT/PSI, KU Leuven, Leuven, Belgium – sequence: 13 givenname: Daniel S. surname: Elson fullname: Elson, Daniel S. organization: Department of Surgery and Cancer, Imperial College London, London, UK – sequence: 14 givenname: Suryakanth R. surname: Gurudu fullname: Gurudu, Suryakanth R. organization: Division of Gastroenterology and Hepatology, Mayo Clinic, Scottsdale, Arizona, USA – sequence: 15 givenname: Aymeric orcidid: 0000-0002-3029-4412 surname: Histace fullname: Histace, Aymeric organization: ETIS, Universite de Cergy-Pointoise, ENSEA, CNRS, Cergy-Pointoise Cedex, France – sequence: 16 givenname: William E. surname: Karnes fullname: Karnes, William E. organization: H. H. Chao Comprehensive Digestive Disease Center, Division of Gastroenterology & Hepatology, Department of Medicine, University of California, Irvine, California, USA – sequence: 17 givenname: Alessandro surname: Repici fullname: Repici, Alessandro organization: Humanitas University, Department of Biomedical Sciences, Pieve Emanuele, Milan, Italy – sequence: 18 givenname: Rajvinder surname: Singh fullname: Singh, Rajvinder organization: Department of Gastroenterology and Hepatology, Lyell McEwan Hospital, Adelaide, South Australia, Australia – sequence: 19 givenname: Pietro surname: Valdastri fullname: Valdastri, Pietro organization: School of Electronics and Electrical Engineering, University of Leeds, Leeds, UK – sequence: 20 givenname: Michael B. orcidid: 0000-0002-6446-5785 surname: Wallace fullname: Wallace, Michael B. organization: Division of Gastroenterology & Hepatology, Mayo Clinic, Jacksonville, Florida, USA – sequence: 21 givenname: Pu orcidid: 0000-0002-1234-309X surname: Wang fullname: Wang, Pu organization: Department of Gastroenterology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, China – sequence: 22 givenname: Danail surname: Stoyanov fullname: Stoyanov, Danail organization: Wellcome/EPSRC Centre for Interventional & Surgical Sciences, University College London, London, UK – sequence: 23 givenname: Laurence B. surname: Lovat fullname: Lovat, Laurence B. organization: Gastrointestinal Services, University College London Hospital, London, UK |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33167043$$D View this record in MEDLINE/PubMed |
BookMark | eNo1kD1PwzAQhi1UREthYkeekQJ2nDgxGyrlQ6rEAhKb5cSXxsWxQ-wOXfjtJCpMpzs9Or3vc45mzjtA6IqSW0ry_E4llBGeFLkgJ2hBM1YmZUnTGVoQQllSpPxzjs5D2E0rIfkZmjNGeUEytkA_6xBVZU1ojdviLzjgAQKooW7x9x5CNN4F3PgBxxaw6XoLHbiopjv2DVZDNI2pjbLYuAjWmi24eiQdrr31zofa94d7rHDn9UiCxo9g-9bgDmLr9QU6bZQNcPk3l-jjaf2-ekk2b8-vq4dNUueUx0RQoqAsRJ1BmqdClZwrTRuRZk0FJaFACU8rJSAHwliVUl2nuiiIFkxwQUu2RNfHv_2-6kDLfjCdGg7yX8QI3ByB2Jqxotz5_eDGRJISOVmWSk6W5WSZ_QIHPnCC |
CitedBy_id | crossref_primary_10_1055_a_1381_7849 crossref_primary_10_4108_ew_4219 crossref_primary_10_3390_robotics13030039 crossref_primary_10_3390_jcm10235708 crossref_primary_10_4253_wjge_v16_i3_126 crossref_primary_10_1007_s00784_024_05989_5 crossref_primary_10_1111_den_14187 crossref_primary_10_1016_j_gie_2024_11_042 crossref_primary_10_1007_s10140_024_02306_1 crossref_primary_10_11622_smedj_2022044 crossref_primary_10_1111_den_14500 crossref_primary_10_3748_wjg_v27_i35_5908 crossref_primary_10_1007_s10029_024_03139_0 crossref_primary_10_1055_a_1881_3178 crossref_primary_10_1016_j_acra_2022_10_026 crossref_primary_10_1177_17562848221132683 crossref_primary_10_1016_j_gie_2024_02_001 crossref_primary_10_1038_s41597_025_04535_6 crossref_primary_10_2196_42665 crossref_primary_10_3390_bioengineering10040404 crossref_primary_10_3390_diagnostics11061113 crossref_primary_10_1016_j_gie_2021_12_031 crossref_primary_10_3233_JIFS_219276 crossref_primary_10_1055_a_1384_0485 crossref_primary_10_5946_ce_2024_168 crossref_primary_10_1111_jgh_16491 crossref_primary_10_1136_gutjnl_2024_332820 crossref_primary_10_3390_medicina60010089 crossref_primary_10_1038_s41598_022_09954_8 crossref_primary_10_1053_j_gastro_2022_12_004 crossref_primary_10_1016_j_gie_2022_02_029 crossref_primary_10_1136_flgastro_2021_101994 crossref_primary_10_5946_ce_2023_036 crossref_primary_10_1111_jgh_16615 crossref_primary_10_1145_3480247 crossref_primary_10_23922_jarc_2023_070 crossref_primary_10_1055_a_1931_4332 crossref_primary_10_1038_s41746_024_01334_y |
ContentType | Journal Article |
Copyright | 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/) 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/). |
Copyright_xml | – notice: 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/) – notice: 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/). |
DBID | 0U6 CGR CUY CVF ECM EIF NPM |
DOI | 10.1055/a-1306-7590 |
DatabaseName | Thieme Connect Journals Open Access Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed |
DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) |
DatabaseTitleList | MEDLINE |
Database_xml | – sequence: 1 dbid: 0U6 name: Thieme Connect Journals Open Access url: http://open.thieme.com sourceTypes: Publisher – sequence: 2 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 3 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
DeliveryMethod | fulltext_linktorsrc |
Discipline | Medicine |
EISSN | 1438-8812 |
EndPage | 901 |
ExternalDocumentID | 33167043 10_1055_a_1306_7590 |
Genre | Journal Article |
GrantInformation_xml | – fundername: Engineering and Physical Sciences Research Council grantid: EP/P027938/1 – fundername: Engineering and Physical Sciences Research Council grantid: 203145Z/16/Z – fundername: Wellcome Trust grantid: 203145Z/16/Z – fundername: Wellcome Trust – fundername: Medical Research Council grantid: MC_PC_17180 |
GroupedDBID | --- 0R~ 0U6 123 4.4 53G 5RE 5~~ 6PF AAIWL AAWTL ABJNI ABOCM ABZLV ACGFO ACGFS ACKTL AENEX AEVEF AHRAW AHRSK AIVKU AJGCD AKJTW ALMA_UNASSIGNED_HOLDINGS BPGNG CS3 EJD EXEOM F5P FD8 H13 IY8 L7B N9A O9- P2P Q3R QTC RTC UDS .55 .GJ 1UC 3O- ACNUY AGCGI CGR CUY CVF EBS ECM EIF J5H NPM RIG ROL X7M ZGI ZXP |
ID | FETCH-LOGICAL-c516t-910ae879c4e2529a866ad1f924fbe801e1062ba9e5e033b21dc2d770d93969183 |
IEDL.DBID | 0U6 |
ISSN | 0013-726X |
IngestDate | Mon Jul 21 06:05:00 EDT 2025 Sun Nov 24 14:58:17 EST 2024 |
IsDoiOpenAccess | true |
IsOpenAccess | true |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 9 |
Language | English |
License | CC BY 4.0 2020. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/). |
LinkModel | DirectLink |
MergedId | FETCHMERGED-LOGICAL-c516t-910ae879c4e2529a866ad1f924fbe801e1062ba9e5e033b21dc2d770d93969183 |
ORCID | 0000-0002-2953-9603 0000-0002-6625-114X 0000-0002-9994-8226 0000-0002-6446-5785 0000-0002-1234-309X 0000-0003-2262-0334 0000-0001-5400-905X 0000-0001-8035-3700 0000-0001-6498-481X 0000-0002-3029-4412 |
OpenAccessLink | http://dx.doi.org/10.1055/a-1306-7590 |
PMID | 33167043 |
PageCount | 9 |
ParticipantIDs | pubmed_primary_33167043 thieme_journals_10_1055_a_1306_7590 |
PublicationCentury | 2000 |
PublicationDate | 2021-09-01 |
PublicationDateYYYYMMDD | 2021-09-01 |
PublicationDate_xml | – month: 09 year: 2021 text: 2021-09-01 day: 01 |
PublicationDecade | 2020 |
PublicationPlace | Rüdigerstraße 14, 70469 Stuttgart, Germany |
PublicationPlace_xml | – name: Rüdigerstraße 14, 70469 Stuttgart, Germany – name: Germany |
PublicationTitle | Endoscopy |
PublicationTitleAlternate | Endoscopy |
PublicationYear | 2021 |
Publisher | Georg Thieme Verlag KG |
Publisher_xml | – name: Georg Thieme Verlag KG |
References | 34438452 - Endoscopy. 2021 Sep;53(9):902-904. doi: 10.1055/a-1384-0485. |
References_xml | – reference: 34438452 - Endoscopy. 2021 Sep;53(9):902-904. doi: 10.1055/a-1384-0485. |
SSID | ssj0013005 |
Score | 2.5530539 |
Snippet | Abstract
Background
Artificial intelligence (AI) research in colonoscopy is progressing rapidly but widespread clinical implementation is not yet a reality.... BACKGROUND : Artificial intelligence (AI) research in colonoscopy is progressing rapidly but widespread clinical implementation is not yet a reality. We aimed... |
SourceID | pubmed thieme |
SourceType | Index Database Publisher |
StartPage | 893 |
SubjectTerms | Artificial Intelligence Colonoscopy Delphi Technique Humans Original article |
Title | Establishing key research questions for the implementation of artificial intelligence in colonoscopy: a modified Delphi method |
URI | http://dx.doi.org/10.1055/a-1306-7590 https://www.ncbi.nlm.nih.gov/pubmed/33167043 |
Volume | 53 |
hasFullText | 1 |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwjV3NS8MwFA8yRbyI384vAnoNpkmTtN5EN4aw4cHBbiVtXlnBrUPrwYt_uy9t58ZOXgoN6SXv6_f63vuFkDue61RkachsLg0LbShZGkSOKW0yjIBgbc2zPRzpwTh8majJqolms4Kv1L1l6GY1MyrGzHxbYIjziszHelUs4PzvogIj9KQdw9v4eC3E7FTTAmawFkj6B2S_RYD0sRHZIdmC-RHZHbY17mPy00PAtvw3RNHGaEvIM6W1D_d6QhFqUoRutJgt-7_9Oi1z6lWhYYWgxRrdJr5QT1A9L_0cyvcDtXRWOtwJjj7D-2Ja0OYy6RMy7vfengasvSWBZSrQFXorbiEycRaCUCK2kdbWBTnmVXkKGH8Akz6R2hgUcClTEbhMOGO4i2WsY7ToU9KZl3M4JxSXEL9JkM7lobEmchws4g1EXbmVkHfJWXOEyaKhwkikH6TnoeyS2-ZMk9YEPpO6uq1UYn3FTCdeBBf_2nVJ9oRvHKkbua5Ip_r4gmuM_FV6U8sdn6PX4S_NuKn9 |
linkProvider | Thieme |
linkToHtml | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwjV1LT8MwDI4QIOCCeDOekeAaLWuaZOWGYNOAbadN2q1KG1ertJdYOXDht-O0GUycODZKpcpx7M-1_ZmQe56pJEiTkJlMaBaaULCk0bRMKp2iBwRjSp7tXl91huHrSI48pdDSl1UW4xymwFJX6ZEWrtRiUbGfLuvgJbysj4vpxM-plXXD0BQrpmWE0fuW65Z0NPp8qH4TCpz_DDPQgRr5Vr0_L6-5oe3qK9acTfuA7HuUSB-rYz0kGzA7Ijs9nwc_Jl8tBHWr_0cU7yH1pD1jWtp5p0sU4ShFeEfz6apG3K3TeUadulTMETRfo-TEB-pIrGdz16vy-UANnc4t7gRLn2GyGOe0Gjh9Qobt1uCpw_wkBZbKhirQonEDTR2lIQQyiExTKWMbGcZeWQLoowADwyAxEUjgQiRBw6aB1ZrbSEQqwlt_SjZn8xmcE4pLiPEECGuzUBvdtBwMYhJEZpkRkNXIWSXCeFHRZcTCNdvzUNTIXSXTeHWIcZkBlzI2LqumYncEF__adUt2O4NeN-6-9N8uyV7gCk3Kwq8rslm8f8A1IoUiuSl14BvKkLpc |
linkToPdf | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwjV1LT8MwDI5goIkL4s14RoJrWNY0ycoNMSbe4sCk3aq0cbRJ7CFWDlz47ThtBhMnjrWiqnIc-0ttfybknDuVRXkWM-OEZrGJBctabcuk0jlGQDCm5Nl-ela3vfi-L_uhPXoWyiqLwRBGwHJf6ZEXvtRiWrGfzpoQNDxrTq0LY2pl0zD0xIppmfALlC-TlbLDG62b99RvToHzn3kGOlL90K335wULkWi1-pCFeNPdIOsBKNKramc3yRKMt0j9KaTCt8nXDeK6-S8kikeRBt6eAS1dvTcnioiUIsKjw9G8TNzL6cRRbzEVeQQdLrBy4gP1PNbjiW9X-bykho4mFleCpR14mw6GtJo5vUN63ZvX61sWhimwXLZUgU6NG2jrJI8hklFi2koZ23J4_XIZYJgCvBtGmUlAAhcii1o2j6zW3CYiUQke_F1SG0_GsE8oihDmCRDWulgb3bYcDMISBGfOCHANslepMJ1WjBmp8P32PBYNclbpNJ3vY1omwaVMjU-sqdRvwcG_Vp2S-kunmz7ePT8ckrXIl5qUpV9HpFa8f8AxYoUiOylN4BtlZbrv |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Establishing+key+research+questions+for+the+implementation+of+artificial+intelligence+in+colonoscopy%3A+a+modified+Delphi+method&rft.jtitle=Endoscopy&rft.au=Ahmad%2C+Omer+F.&rft.au=Mori%2C+Yuichi&rft.au=Misawa%2C+Masashi&rft.au=Kudo%2C+Shin-ei&rft.date=2021-09-01&rft.pub=Georg+Thieme+Verlag+KG&rft.issn=0013-726X&rft.eissn=1438-8812&rft.volume=53&rft.issue=9&rft.spage=893&rft.epage=901&rft_id=info:doi/10.1055%2Fa-1306-7590&rft.externalDBID=HTML_FULL_TEXT&rft.externalDocID=10_1055_a_1306_7590 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0013-726X&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0013-726X&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0013-726X&client=summon |