Published in 2020

The implications of an aging population and increased obesity for knee arthroplasty rates in Sweden: a register-based study

Overgaard, A., Frederiksen, P., Kristensen, L. E., Robertsson, O. & W-Dahl, A., dec. 2020, I: Acta Orthopaedica . 91, 6, s. 738-742 5 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Background and purpose - Total knee arthroplasty (TKA) has increased substantially in Sweden. We quantified the relative risk for TKA in the Swedish population for different BMI categories and age groups to investigate whether the continued increase in TKA is attributable to increased prevalence of obesity and elderly people in the population, and to put forward model predictions for coming needs for TKA. Patients and methods - We used the Swedish Nationwide Health Survey (SNHS) and the Swedish Knee Arthroplasty Register (SKAR) 2009-2015 to calculate the relative risk (RR) of TKA by age (middle-aged 45-64 years and elderly 65-84 years) and BMI (BMI 18.5-24.9 normal weight; BMI 25.0-29.9 overweight; BMI > 30 obese). The RR for TKA was applied to the demographic forecasts for the Swedish population as a forecasting model. Results - Population size increased 5.2% from 2009 to 2015 to 40,000 middle-aged and 250,000 elderly, and the prevalence of obesity increased from 16% to 18% in these 2 age categories. Compared with those of normal weight, the RR for TKA was 2.7 (95% CI 2.5-3.0) higher for the overweight and 7.3 (6.7-8.0) higher for the obese, aged 45-64. The corresponding figures for individuals aged 65-84 were 2.1 (2.0-2.2) and 4.0 (3.8-4.3) higher, respectively. The changes in the prevalence of obesity and an increase in the elderly population accounted for an estimated increase of 1,700 TKAs over the 7 years. Interpretation - The increase in obesity frequency and the rise in the population of middle-aged and elderly may, to some extent, explain the rise in TKA utilization in Sweden.

Originalsprog Engelsk
Tidsskrift Acta Orthopaedica
Vol/bind 91
Udgave nummer 6
Sider (fra-til) 738-742
Antal sider 5
ISSN 1745-3674
DOI
Status Udgivet - dec. 2020

The influence of transmitted and non-transmitted parental BMI-associated alleles on the risk of overweight in childhood

Schnurr, T. M., Morgen, C. S., Borisevich, D., Beaumont, R. N., Engelbrechtsen, L., Ängquist, L., Have, C. T., Freathy, R. M., Smith, G. D., Nohr, E. A., Hansen, T. & Sørensen, T. I. A., 1 dec. 2020, I: Scientific Reports. 10, 1, 4806.

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The patient's voice in the development of complex interventions

Beck, M., Simonÿ, C., Damsgaard, J. B., Missel, M. & Birkelund, R., 2020, I: Iris Journal of Nursing & Care. 3, 3

Publikation: Bidrag til tidsskriftReviewpeer review

The Relation between Red Meat and Whole-Grain Intake and the Colonic Mucosal Barrier: A Cross-Sectional Study

Jawhara, M., Sørensen, S. B., Heitmann, B. L., Halldórsson, Þ. I., Pedersen, A. K. & Andersen, V., 12 jun. 2020, I: Nutrients. 12, 6, s. 1-18 18 s., 1765.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

The Colonic Mucosal Barrier (CMB) is the site of interaction between the human body and the colonic microbiota. The mucus is the outer part of the CMB and is considered as the front-line defense of the colon. It separates the host epithelial lining from the colonic content, and it has previously been linked to health and diseases. In this study, we assessed the relationship between red meat and whole-grain intake and (1) the thickness of the colonic mucus (2) the expression of the predominant mucin gene in the human colon (MUC2). Patients referred to colonoscopy at the University Hospital of Southern Denmark- Sonderjylland were enrolled between June 2017 and December 2018, and lifestyle data was collected in a cross-sectional study design. Colonic biopsies, blood, urine, and fecal samples were collected. The colonic mucus and bacteria were visualized by immunostaining and fluorescence in situ hybridization techniques. We found a thinner mucus was associated with high red meat intake. Similarly, the results suggested a thinner mucus was associated with high whole-grain intake, albeit to a lesser extent than red meat. This is the first study assessing the association between red meat and whole-grain intake and the colonic mucus in humans. This study is approved by the Danish Ethics Committee (S-20160124) and the Danish Data Protecting Agency (2008-58-035). A study protocol was registered at clinical trials.gov under NCT04235348.

Originalsprog Engelsk
Artikelnummer 1765
Tidsskrift Nutrients
Vol/bind 12
Udgave nummer 6
Sider (fra-til) 1-18
Antal sider 18
ISSN 2072-6643
DOI
Status Udgivet - 12 jun. 2020

The Role of Vitamin D in the Development of Diabetes Post Gestational Diabetes Mellitus: A Systematic Literature Review

Keller, A., Varela Vazquez, C., Dangol, R., Damm, P., Heitmann, B. L. & Händel, M. N., 1 jun. 2020, I: Nutrients. 12, 6, s. 1-17 17 s., 1733.

Publikation: Bidrag til tidsskriftReviewpeer review

Women diagnosed with gestational diabetes mellitus (GDM) are more likely to later develop diabetes. Evidence from some previous reviews suggests that low vitamin D status during pregnancy increases the risk of developing GDM, but whether vitamin D during pregnancy also influences the risk of diabetes post GDM is less well studied. Thus, the aim of this systematic literature review was to summarize the current available literature on that topic. This review considered observational studies and randomized controlled trials (RCTs). Five databases were searched. The risk of bias of the included studies was assessed. A total of six studies were included: three observational studies and three RCTs. Findings were inconsistent across the six included studies. However, when considering RCTs only, the findings more strongly suggested that vitamin D supplementation during and after pregnancy did not have an influence on markers of diabetes development or diabetes development post GDM. This systematic review highlights inconsistent findings on the associations between vitamin D supplementation or concentration during and after pregnancy and markers of diabetes development or diabetes development post GDM; and although results from randomized interventional studies more strongly suggested no associations, the conclusion holds a high degree of uncertainty.

Originalsprog Engelsk
Artikelnummer 1733
Tidsskrift Nutrients
Vol/bind 12
Udgave nummer 6
Sider (fra-til) 1-17
Antal sider 17
ISSN 2072-6643
DOI
Status Udgivet - 1 jun. 2020

Treatment adherence and psychosocial impact of tinea capitis in families: Qualitative pilot study

Lindsø Andersen, P., Jemec, G. B. & Saunte, D. M. L., jul. 2020, I: Dermatologic Therapy. 33, 4, s. e13570

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Treatment effect sizes vary in randomized trials depending on the type of outcome measure

Berthelsen, D. B., Ginnerup-Nielsen, E., Juhl, C., Lund, H., Henriksen, M., Hróbjartsson, A., Nielsen, S. M., Voshaar, M. & Christensen, R., 23 mar. 2020, I : Journal of Clinical Epidemiology. 123, s. 27-38 12 s.

Publikation: Bidrag til tidsskriftReviewForskningpeer review

OBJECTIVE: To compare estimated treatment effects of physical therapy (PT) between patient-reported outcome measures (PROMs) and outcomes measured in other ways.

STUDY DESIGN AND SETTING: We selected randomized trials of PT with both a PROM and a non-PROM included in Cochrane systematic reviews (CSRs). Two reviewers independently extracted data and risk-of-bias assessments. Our primary outcome was the ratio of odds ratios (RORs), used to quantify how effect varies between PROMs and non-PROMs; an ROR > 1 indicates larger effect when assessed by using PROMs. We used REML-methods to estimate associations of trial characteristics with effects and between-trial heterogeneity.

RESULTS: From 90 relevant CSRs, 205 PT trials were included. The summary ROR across all the comparisons was not statistically significant (ROR, 0.88 [95% CI: 0.70-1.12]; P = 0.30); however, the heterogeneity was substantial (I2 = 88.1%). When stratifying non-PROMs further into clearly objective non-PROMs (e.g., biomarkers) and other non-PROMs (e.g., aerobic capacity), the PROMs appeared more favorable than did clearly objective non-PROMs (ROR, 1.92 [95% CI: 0.99-3.72]; P = 0.05).

CONCLUSION: Estimated treatment effects based on PROMs are generally comparable with treatment effects measured in other ways. However, in our study, PROMs indicate a more favorable treatment effect compared with treatment effects based on clearly objective outcomes.

Originalsprog Engelsk
Tidsskrift Journal of Clinical Epidemiology
Vol/bind 123
Sider (fra-til) 27-38
Antal sider 12
ISSN 0895-4356
DOI
Status E-pub ahead of print - 23 mar. 2020

Bibliografisk note

Copyright © 2020 Elsevier Inc. All rights reserved.

Types of occult cancer in stroke and the relation to smoking

Tybjerg, A. J., Babore, A. D., Olsen, T. S. & Andersen, K. K., nov. 2020, I: Acta Neurologica Scandinavica. 142, 5, s. 486-492 7 s.

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OBJECTIVES: Stroke is associated with a higher risk of occult cancer. We studied the types of occult cancer most often associated with stroke.

MATERIALS AND METHODS: All patients with incident stroke in Denmark 2003-2015 were identified through the Danish Stroke Registry (n = 85 893) and matched 1:10 on age and sex to the Danish background population without history of stroke (n = 858 740). Linking data to the Danish Cancer Registry, we determined the prevalence of occult cancer in stroke defined as the event of previously unknown cancer during a one-year follow-up in the stroke and the background population. We stratified cancers into the 15 most common cancers and into cancers related to and not related to smoking.

RESULTS: Prevalence (per 1000 person-years; stroke/background population) of smoking-related occult cancers (lung, colon, bladder rectum, pancreas, kidney, stomach, and head and neck) was 13.3/8.1 (P < .01) and of cancers not related to smoking (prostate, breast, melanoma, non-Hodgkin lymphoma, ovary, endometrial) it was 6.6/6.2 (P > .05). Among men with stroke prostate (5.8), lung (5.7), and colon cancers (2.9) were most frequent; among women, it was lung (4.7), breast(3.5), and colon cancer(2.8). Among men in the background population, prostate(5.4), lung (3.0), and colon cancers (2.1) were most frequent. Among women, it was breast (3.7), lung(2.1), and colon cancers (1.9).

CONCLUSION: Stroke patients' increased risk of occult cancer was predominantly for smoking-related cancers while there was no higher risk for the most frequent cancers unrelated to smoking, that is, prostate and breast cancers. Lung cancer is the dominant type of occult cancer in stroke.

Originalsprog Engelsk
Tidsskrift Acta Neurologica Scandinavica
Vol/bind 142
Udgave nummer 5
Sider (fra-til) 486-492
Antal sider 7
ISSN 0001-6314
DOI
Status Udgivet - nov. 2020

Bibliografisk note

© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Umbilical hidradenitis suppurativa symptoms: a case series and review of the literature

Kjærsgaard Andersen, R., Jemec, G. B. E. & Saunte, D. M., mar. 2020, I: Acta dermatovenerologica Alpina, Pannonica, et Adriatica. 29, 1, s. 3-6 4 s.

Publikation: Bidrag til tidsskriftReviewpeer review

Updates of the International Standards for Neurologic Classification of Spinal Cord Injury: 2015 and 2019

Kirshblum, S., Snider, B., Rupp, R., Read, M. S., International Standards Committee of ASIA and ISCoS & Biering-Sørensen, F., aug. 2020, I: Physical medicine and rehabilitation clinics of North America. 31, 3, s. 319-330 12 s.

Publikation: Bidrag til tidsskriftReviewpeer review

Use and reporting of outcome measures in randomized trials for anti-neutrophil cytoplasmic antibody-associated vasculitis: a systematic literature review

Monti, S., Quinn, K. A., Christensen, R., Jayne, D., Langford, C., Lanier, G. E., Mahr, A., Pagnoux, C., Viðarsdóttir, M. B., Merkel, P. A. & Tomasson, G., dec. 2020, I: Seminars in Arthritis and Rheumatism. 50, 6, s. 1314-1325 12 s.

Publikation: Bidrag til tidsskriftReviewpeer review

BACKGROUND: A comprehensive review of outcome measures used in randomized controlled trials (RCTs) of ANCA-associated vasculitis (AAV) could advance trial conductance for this disease.

METHODS: A systematic literature review of outcome measures (as specified in methods section as primary and/or secondary outcomes) in RCTs of AAV was conducted. Medline, Cochrane CENTRAL, and ClinicalTrials.gov were searched from inception until April 30, 2019 for RCTs enrolling patients with granulomatosis with polyangiitis and/or microscopic polyangiitis. Outcome measures were organized according to domains (e.g. disease activity) and instruments [e.g. Birmingham Vasculitis Activity Score (BVAS)].

RESULTS: Out of 1101 identified records, 68 RCTs were eligible. Disease activity was an outcome domain collected in 67 (98%) of the RCTs. The BVAS was the most widely used instrument for disease assessment but definitions for remissions and relapse varied for the purpose of primary endpoint definitions. Damage, most often assessed by the Vasculitis Damage Index, was an outcome in 30 (44%) of the RCTs. Mortality was specified as an outcome in 26 (38%) studies. The following outcome domains were assessed: patient-reported outcomes (PROs) in 28 (41%), drug exposure/safety in 58 (85%), and biomarkers [acute phase reactants, ANCA levels] in 24 (35%). Timing for outcome assessment differed substantially, with 3, 6, or 12 months being the most frequent time points.

CONCLUSION: Outcome measures used in trials in AAV commonly included vasculitis-specific tools for disease assessment, but with heterogeneity in endpoint-definitions and timing of assessments. Other core outcomes in AAV, including PROs, and damage measures, are often omitted in AAV trials.

Originalsprog Engelsk
Tidsskrift Seminars in Arthritis and Rheumatism
Vol/bind 50
Udgave nummer 6
Sider (fra-til) 1314-1325
Antal sider 12
ISSN 0049-0172
DOI
Status Udgivet - dec. 2020

Bibliografisk note

Copyright © 2020 Elsevier Inc. All rights reserved.

Use of composite outcomes facilitate core outcome set uptake in rheumatoid arthritis trials

Kirkham, J., Christensen, R. & Boers, M., feb. 2020, I: Annals of the Rheumatic Diseases. 79, 2, s. 301-302 2 s., 216256.

Publikation: Bidrag til tidsskriftLetterpeer review

Originalsprog Engelsk
Artikelnummer 216256
Tidsskrift Annals of the Rheumatic Diseases
Vol/bind 79
Udgave nummer 2
Sider (fra-til) 301-302
Antal sider 2
ISSN 0003-4967
DOI
Status Udgivet - feb. 2020

Using betahistine in the treatment of patients with Menière's disease: a meta-analysis with the current randomized-controlled evidence

Devantier, L., Hougaard, D., Händel, M. N., Liviu-Adelin Guldfred, F., Schmidt, J. H., Djurhuus, B. & Callesen, H. E., okt. 2020, I: Acta Oto-Laryngologica. 140, 10, s. 845-853 9 s.

Publikation: Bidrag til tidsskriftReviewpeer review

Background: Betahistine is used worldwide to treat patients with Menière's disease. However, despite it being used for decades, diverging opinions on the effect of betahistine on Menière's symptomatology still exist.Aims: The objective of this systematic review was to provide an overview and rate the certainty of the current evidence base regarding the use of betahistine to treat patients with Menière's disease.Materials and methods: A systematic literature search was conducted in October 2019. The search strategy was subdivided into searches for existing guidelines, systematic reviews and individual randomized controlled trials (RCT) investigating the usage of betahistine as compared to placebo, in patients with Ménière's disease. The primary outcome was the frequency of vertigo attack(s) and occurrence of serious adverse events.Results: We identified three relevant guidelines and three systematic reviews: however, neither included any relevant trials matching our inclusion criteria. An individual search for RCTs identified one trial. The results from this particular trial showed no difference in effects on symptoms following treatment with betahistine.Conclusions and Significance: There is a need for further well-conducted placebo RCTs. Currently, there is still a lack of substantial evidence supporting betahistine as a significant and adequate treatment for patients diagnosed with Menière's disease. Trial registration number: The protocol is registered in PROSPERO. Registration number: CRD42018110127 Accepted 11.10.2018.

Originalsprog Engelsk
Tidsskrift Acta Oto-Laryngologica
Vol/bind 140
Udgave nummer 10
Sider (fra-til) 845-853
Antal sider 9
ISSN 0001-6489
DOI
Status Udgivet - okt. 2020

Using four different clinical tools as predictors for pain after total hip arthroplasty: a prospective cohort study

Geisler, A., Zachodnik, J., Laigaard, J., Kruuse, L. S., Sørensen, C. V., Sandberg, M., Persson, E. I. & Mathiesen, O., 3 mar. 2020, I: BMC Anesthesiology. 20, 1, s. 57

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Validation of the colostomy impact score in patients ostomized for a benign condition

Kristensen, H. Ø., Krogsgaard, M., Christensen, P. & Thomsen, T., 2 aug. 2020, (E-pub ahead of print) I: Colorectal Disease.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

AIM: The colostomy impact (CI) score is a patient-reported outcome measure assessing reduction in health-related quality of life (HRQL) due to a stoma. The score was originally developed and validated in a cohort of rectal cancer survivors with a permanent colostomy. For the CI score to be applied to patients with a colostomy after surgery for a benign condition it must be validated in this patient group. The aim of this study was to assess construct validity and known groups validity of the CI score in patients with a colostomy after surgery for a benign condition.

METHOD: In a cross-sectional survey among ostomates in the Capital Region of Denmark, patients completed the CI score and the SF-36 v2 questionnaires. Construct validity was assessed by Pearson's correlation coefficients and known groups validity was assessed by t-test when dividing patients into groups of minor or major CI.

RESULTS: The CI score showed a moderate negative correlation with the Physical Component Summary (PCS) of -0.41 and a weak negative correlation with the Mental Component Summary (MCS) of -0.39. The strength of the correlation depended on the underlying condition leading to stoma formation. Differences were significant between the minor and major CI groups in mean PSC and MCS with t-values of 5.32 and 3.86, respectively.

CONCLUSION: The CI score is a valid instrument for assessing stoma-related impact on HRQL regardless of the underlying condition leading to stoma formation, and the CI score discriminates meaningfully between groups with known differences in stoma-related reduced HRQL.

Originalsprog Engelsk
Tidsskrift Colorectal Disease
ISSN 1462-8910
DOI
Status E-pub ahead of print - 2 aug. 2020

Bibliografisk note

© 2020 The Association of Coloproctology of Great Britain and Ireland.

Vascular ultrasound for the diagnosis of giant cell arteritis: a reliability and agreement study based on a standardised training programme

Chrysidis, S., Terslev, L., Christensen, R., Fredberg, U., Larsen, K., Lorenzen, T., Døhn, U. M. & Diamantopoulos, A. P., okt. 2020, I: RMD Open. 6, 3, s. e001337 7 s.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

OBJECTIVE: To evaluate the impact of a standardised training programme including equipment adjustment for experienced musculoskeletal ultrasonographers without previous experience in vascular ultrasound (US) on the reliability of US in the diagnosis of giant cell arteritis (GCA).

METHODS: In this prospective, non-interventional observational cohort study, patients suspected of GCA were evaluated by US by one of five rheumatologists with long-standing experience in musculoskeletal US (>8 years), trained using a standardised training programme including equipment adjustment. Images of cranial and large vessels were subsequently evaluated first by the performing ultrasonographer and thereafter by a blinded external expert (gold standard).

RESULTS: In three Danish centres, 112 patients suspected of GCA were included. According to the external expert, vasculitis changes were seen in 66 patients, in 45 of them with only cranial involvement, in 14 with both cranial and large vessel involvement, while in seven patients isolated large vessel vasculitis was found. The reliability was excellent between the local ultrasonographer and the US expert for the overall GCA diagnosis regarding the diagnosis of cranial and for large vessel GCA, with an interobserver agreement of 95-96%, mean kappa values of 0.88-0.92 (95% CI 0.78 to 0.99). Excellent reliability (mean kappa 0.86-1.00) was also found for the US examination of the individual arteries (temporal, facial, common carotid and axillary).

CONCLUSION: The US training programme resulted in excellent agreement between trainees and an expert in patients suspected of GCA and may thus be applicable for implementation of vascular US in clinical practice.

Originalsprog Engelsk
Tidsskrift RMD Open
Vol/bind 6
Udgave nummer 3
Sider (fra-til) e001337
Antal sider 7
ISSN 2056-5933
DOI
Status Udgivet - okt. 2020

Bibliografisk note

COPECARE

Vitamin D and Calcium Milk Fortification in Pregnant Women with Periodontitis: A Feasibility Trial

Rodrigues Amorim Adegboye, A., Dias Santana, D., Cocate, P. G., Benaim, C., Teixeira Dos Santos, P. P., Heitmann, B. L., da Veiga Soares Carvalho, M. C., Schlüssel, M. M., Trindade de Castro, M. B. & Kac, G., 30 okt. 2020, I: International Journal of Environmental Research and Public Health. 17, 21

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This study aims to assess the acceptability, adherence, and retention of a feasibility trial on milk fortification with calcium and vitamin D (Ca+VitD) and periodontal therapy (PT) among low income Brazilian pregnant women with periodontitis (IMPROVE trial). This 2 × 2 factorial feasibility trial used a mixed-methods evaluation. In total, 69 pregnant women were randomly allocated to four groups: 1. fortified sachet with Ca+VitD and milk plus early PT (throughout gestation); 2. placebo and milk plus early PT; 3. fortified sachet with Ca+VitD and milk plus late PT after childbirth; 4. placebo and milk plus late PT. Data were collected via questionnaires, field notes, participant flow logs, treatment diary, and focal group discussions. Quantitative and qualitative data were analysed using appropriate descriptive statistics and content analysis, respectively. Eligibility rate (12%) was below the target of 15%, but participation (76.1%) and recruitment rate (2 women/week) exceeded the targets. Retention rate (78.6%) was slightly below the target (80%). Adherence to the PT was significantly higher in the early treatment groups (98.8%) compared to the late treatment groups (29%). All women accepted the random allocation, and baseline groups were balanced. There was no report of adverse events. This multi-component intervention is acceptable, well-tolerated, and feasible among low-risk pregnant women in Brazil.

Originalsprog Engelsk
Tidsskrift International Journal of Environmental Research and Public Health
Vol/bind 17
Udgave nummer 21
ISSN 1661-7827
DOI
Status Udgivet - 30 okt. 2020

Weekly, seasonal and holiday body weight fluctuation patterns among individuals engaged in a European multi-centre behavioural weight loss maintenance intervention

Turicchi, J., O'Driscoll, R., Horgan, G., Duarte, C., Palmeira, A. L., Larsen, S. C., Heitmann, B. L. & Stubbs, J., apr. 2020, I: PLoS One. 15, 4, s. e0232152 e0232152.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

BACKGROUND: Technological advances in remote monitoring offer new opportunities to quantify body weight patterns in free-living populations. This paper describes body weight fluctuation patterns in response to weekly, holiday (Christmas) and seasonal time periods in a large group of individuals engaged in a weight loss maintenance intervention.

METHODS: Data was collected as part The NoHoW Project which was a pan-European weight loss maintenance trial. Three eligible groups were defined for weekly, holiday and seasonal analyses, resulting in inclusion of 1,421, 1,062 and 1,242 participants, respectively. Relative weight patterns were modelled on a time series following removal of trends and grouped by gender, country, BMI and age.

RESULTS: Within-week fluctuations of 0.35% were observed, characterised by weekend weight gain and weekday reduction which differed between all groups. Over the Christmas period, weight increased by a mean 1.35% and was not fully compensated for in following months, with some differences between countries observed. Seasonal patterns were primarily characterised by the effect of Christmas weight gain and generally not different between groups.

CONCLUSIONS: This evidence may improve current understanding of regular body weight fluctuation patterns and help target future weight management interventions towards periods, and in groups, where weight gain is anticipated.

Originalsprog Engelsk
Artikelnummer e0232152
Tidsskrift PLoS One
Vol/bind 15
Udgave nummer 4
Sider (fra-til) e0232152
ISSN 1932-6203
DOI
Status Udgivet - apr. 2020

What are the prevalence and predictors of psychosocial healthcare among patients with heart disease? A nationwide population-based cohort study

Zinckernagel, L., Ersbøll, A. K., Holmberg, T., Pedersen, S. S., Timm, H. U. & Zwisler, A-D., 10 okt. 2020, I: BMJ Open. 10, 10, s. e037691

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