A prognostic model for use before elective surgery to estimate the risk of postoperative pulmonary complications (GSU-Pulmonary Score): a development and validation study in three international cohorts

Bal, P; Cheng, Jq; Draman, Mr; Fadzli, An; Ghauth, S; Hung, Wp; Jamaris, S; Koh, Ps; Krishnasamy, S; Lee, Ys; Liew, Yt; Jzk, Lim; Rcs, Lim; Lim, Hc; Sfm, Pauzi; Nah, Sa; Nair, Ak; Dsw, Ng; Yjnw, Yong; Ramayah, K; Roslani, Ac; Saaid, R; Sanmugam, A; See, Mh; Seevalingam, Kk; Sethi, N; Singaravel, S; Snsjh, Zaidi; Tang, Cy; Teoh, Ly; Wong, Kb; Xavier, R; Yahaya, As; Fal, Marson; Delibegovic, S; Pavin, Bal; Cheng Joo Qing,; Draman Mohd Rusdi,; Fadzli Ahmad Nazran,; Sakina, Ghauth; Weipin, Hung; Suniza, Jamaris; Koh Peng Soon,; Sivakumar, Krishnasamy; Lee Yeong Sing,; Liew Yew Toong,; Lim Jeffery, Z. K.; Lim Raymond Chung Siang,; Lim Hiong Chin,; Pauzi Siti Farhan Moh,; Nah Shireen Anne,; Nair Ashvir Krishna,; Ng Doris Sin Wen,; Yong Yuki Julius Ng We,; Kamarajan, Ramayah; Roslani April Camilla,; Rahmah, Saaid; Anand, Sanmugam; See Mee Hoong,; Seevalingam Kanesh Kumaran,; Neha, Sethi; Srihari, Singaravel; Zaidi Syeda Nureena Syed Jafer Hussain,; Tang Chu Yik,; Teoh Li Ying,; Wong Kian Boon,; Ruben, Xavier; Yahaya Ahmad Shuib,; Lima Marson Fernando Augusto,; Samir, Delibegovic; Alessandro, Giardino; Sameh, Emile; Khosravi Mohammad Hossein,; Jose, Calvache; Van Ramshorst Gabrielle,; Cheyaanthan, Haran; Guilherme, Yazbek; Luis, Boccalatte; Tim, Glowka; Lubomir, Martinek; Elodie, Haraux; Danny, Wong; Wong Kitty Hiu Fung,; Eduard-Alexandru, Bonci; Stefano, Magnone; Hesham, Abozied; Irene, Velázquez; Nah Shireen Anne,; Neha, Sethi; Mahmoud, Nassar; James, Glasbey; Suniza, Jamaris; Francesco, Pisanu; Dhufera Hailu Tamiru,; Julio, Mayol; Berik, Dzhumabekov; Chandrashekhar, Mahakalkar; Anupama, Rajanbabu; Fayza, Haider; Julián, Balanta-Melo; Amr, Hamza; Glauco, Baiocchi; Bangash Ali Haider,; Francesco, Nappi; Sivesh, Kamarajah; Stenio, Zequi; Felipe, Coimbra; Ronald, Flumignan; Ramos-De la Medina Antonio,; Mukhtar, Kulimbet; Mohammad, Aloulou; Gianluca, Pellino; David, Watters; Akram, Alkaseek; Milan Peiman, B.; Vivek, Sodhai; Manon, Pigeolet; Sivakumar, Krishnasamy; Daniel, Acquah; Ahmed, Msherghi; Christian, Freyschlag; Asser, Sallam; Danguy Des Déserts Marc,; Herman, Lule; Balqees, Al-Manaseer; Hervé, Lekuya; Joao, Duprat; Ana, Hadzibegovic; Islam, Ibrahim; Ervis, Agastra; Ahmed, Awad; René, Novysedlák; Nuwan, Wickramasinghe; Marcelo, Brandao; David, Borowski; Surya, Dube; Ulysses, Ribeiro; Giuliana, Germinario; Elgun, Samadov; Matthieu, Boisson; Sami, Elwahab; Hani, Marcus; Uros, Bele; Joshua, Ng; Asif, Mehraj; Sumit, Thakar; Tang Chu Yik,; José, Valenzuela; Sameh, Shehata; Ahmad, Ahmad; Alan, Askari; Bourhan, Alrayes; Oumaima, Outani; Mohamed, Fahmy; Mandi Draga Maria,; Emery, Manirambona; Sattar, Alshryda; Federico, Migliorelli; Heloisa, Campos; Manoj, Nagar; Carlos, Rivera; Sofija, Pejkova; Zaza, Demetrashvili; Jasper, Stijns; Mohamed, Mourad; Michel, Adamina; Agathe, seguin-givelet; Mohamed, Abdelkhalek; Sanchez Cuadrado Isabel,; Luiz, Kowalski; Barbara, Seeliger; Peter, Coe; Emily, Shih; Andrea, Rodriguez; Ahmed, Azzam; Lidia, Bravo; Susanne, Wolfer; Natalie, Lott; Sezai, Leventoglu; Russell, Hodgson; Liew Yew Toong,; Ydyrys, Almabayev; Judith, Lindert; Sergio, Lucchini; Mohammad, Aburahmah; Hassan, Mashbari; Joonas, Kauppila; Dennis, Mazingi; Talgat, Nurgozhin; James, Mckelvie; Naser, Kandevani; Ewan, Harrison; Raymund, Horch; Simon, Ng; Leandro, Matos; Alexis, Arnaud; Michael, Kelly; Kacimi Salah Eddine,; Gregor, Stavrou; Mengistu, Maja; Muhammed, Elhadi; Andreas, Demetriades; Marco, Assenza; Luke, Traeger; Kebebe, Bekele; April, Roslani; Albaro, Nieto-Calvache; De Simone Belinda,; Antonio, D'Urso; Mahmoud, Abdelaleem; Mustafa, Al-Yaseen; Ramzee Abdul Aziz Ahmed Faidh,; Carolyn, Nessim; Marta, Domingo; Ahmed Mohamed Moaiad Eldin,; Jose, Baptista-Silva; Samir, Delibegovic; Ionut, Negoi; Navin, Kumar; Alexander, Keppler; Çağrı, Büyükkasap; Ülkü, Köksoy; Markus, Löffler; Peter, Choong; Teoh, Ying; Laurent, Brunaud; Hmkroon,; Jakov, Mihanovic; Julio, Villanueva; Hamed, Akhavizadegan; Kenneth, Mclean; Akhtar Muhammad Shaheer,; Cerovac, Anis; Alvaro, Sousa; Philipp, Höhn; Yoseph, Bezabih; Christian, Umuhoza; Ahmed, Shehta; Annicchiarico, Alfredo; Mahmoud, Macshut; Sofia, Waissbluth; Simon, Laban; Armin, Wiegering; Arda, Isik; Ruth, Benson; Nikolaos, Gouvas; Peng, Koh; Rand, Omari; Ahmad, Bouhuwaish; Ahmed, Hamdan; Ashrarur, Mitul; Faten, Hamad; Marson Ben Arthur,; Veeru, Kasivisvanathan; Chiara, Cremolini; Evripidis, Tokidis; Hetta Helal, F.; Talal, Altuwaijri; Sofia, Waissbluth; George, Weeratunga; Mahmoud, Hafez; Apse Ingus Arnolds,; Paiva Dos Santos Filipe Manuel,; Ling Samuel Ka-Kin,; Francesco, Fleres; Khaled, Demyati; Abd Elwahab Sami,; Tejero-Pintor Francisco, J; Martin, Karamanliev; Ozgen, Isik; Belma, Kocer; Oliver, Warren; Law Jia Hao,; Mario, Rodriguez-Lopez; Riquoir Altamirano Christophe,; Pantelis, Antonakis; Jonker Pascal Klaas Christiaan,; Perez Ferrer Antonio,; Russell, Hodgson; Wong Kitty Hiu Fung,; Joseph, Shalhoub; Barbara, Binda; Zulfu, Bayhan; Sharfuddin, Chowdhury; Caitlin, Brennan; Aldo, Vagge; Nina, Glass; Picardo Antonio, L.; Dona' Maria Gabriella,; Georg, Singer; Di Franco Gregorio,; Katherine, Lehovsky; Jennifer, Plichta; Ramos-De la Medina Antonio,; Ahmed, Tawheed; De Virgilio Armando,; Ehab, Kahka; Alfredo, Annicchiarico; Fabio, Martinelli; Schlager Justin Gabriel,; Luke, Rogers; Yasin, Kara; Tommaso, Violante; Patino-Jaramillo Nasly, G.; Ahmed, Shirazi; Totty Joshua, P; Guldogan Cem Emir,; John, Findlay; Krishna, Narahari; Hadjinicolaou Andreas, V; Ivan, Soto-Darias; Maria, Wittmann; Abdel-Ellah, Al-Shudifat; Jasper, Stijns; Mikhail, Kirov; Paul, Lennon; Saad, Alqasem; Marcello, Migliore; Giorgio, Ercolani; Alessandro, Vitali; Alfie, Kavalakat; Morrison, Jo; Simbad, Costas-Ochoa; Abubakr, Abubakr; Gerardo, Petruzzi; Uzunoglu Faik, G.; Eloy, Espin-Basany; Warwick, Teague; Cioffi Stefano Piero Bernardo,; Kocher Hemant, M; Andrea, Craus-Miguel; Ana, Pucar; Abdulmueti, Alhadi; Ban Vin Shen,; Hammond John Stotesbury,; Nazimi Abd Jabar,; Domenech Fernandez Julio,; Giuseppe, Sena; Maame, Aduse-Poku; Mohit, Singh; Balqis, Shawer; Nikita, Burlov; Peter, Sodde; Emre, Gonullu; Ntalouka Maria, P; Barrag, Alhazmi; Patrick, Coughlin; Ng Calvin, S. H.; Prucher Gian Marco,; Ali, AL-ISAWI; Alberto, Zangrillo; Cagigas Fernandez Carmen,; Michael, Jenkinson; Andreas, Alga; John, Massoud; Adamu, Issaka; Bravo Merodio Laura,; Dale, Vimalachandran; Ruiz Manzanera Juan Jose,; Luigi, Rolli; John, Edwards; Simon, Higgs; Haider Bangash Ali,; Riba Combatti Luisana,; Di Maria Grimaldi Simone,; Segura-Sampedro Juan Jose,; Martin, Rutegard; Francesco, Ferrara; Mahmoud, Elfiky; Arne, Bottcher; Natalia, Motas; Funlayo, Odejinmi; Marson Fernando Augusto Lima,; Philipp, Hohn; Ervis, Agastra; Simon, Lammy; Emmanouil, Giorgakis; Paulo, Santos-Costa; Yousery Askalany Sherine,; Andrea, Barberis; Giulia, Nezi; Tolani Musliu Adetola,; Niall, Davis; Aminder, Singh; Betz Christian Stephan,; Khalil, Tamoos; Nicola, Cillara; Kapil, Sugand; Julio, Mayol; Chean Chung Shen,; Adem, Ozcan; Garcia Florez Luis Joaquin,; Andrea, Bottari; Rahmah, Saaid; Alvarez Torres Eva,; Osama, Alomar; Koksoy Ulku Ceren,; Teeba, Mubaydeen; Oghenekevwe, Okere; Hernandez Pau Joan,; Ildar, Fakhradiyev; Reynolds Ian Sean,; Josephine, Walshaw; Akhilanand, Chaurasia; Jason, Rai; Pedrini Cruz Ricardo,; Gonzalez Suarez Susana,; Enrique, Lopez-Ruiz; Stefano, Olmi; Mohamed, Rabie; Iversen Lene Hjerrild,; Joe, Saavedra; Fra Fernandez Sara,; Efstratia, Baili; Michel, Adamina; Konstantinos, Roditis; Usama, Waqar; Yusra, Shammoon; Ng Anthony Yong Kheng Cordero,; Mohammed, Al-Ghamdi Prof. Dr.; Minaya Bravo Ana Maria,; Pantoja Pachajoa Diana Alejandra,; R Oliveira Priscila,; Natania, Yeshitila; Khaled, Dajani; Alex, Boddy; Loffler Markus, W.; Giovanni, Pirozzolo; Akram, Alkaseek; Goncalves-Nobre Jose Guilherme,; Alfred, Adiamah; Elsie, Bridgman; Mateusz, Zawadka; Ulas Ali Bilal,; De Rosa Raffaele Vincenzo,; Della Gatta Anna Nunzia,; Kroon Hidde, M; Luca, Bruschini; Chiara, Copelli; Christoph, Grimm; Valeria, Fico; Herman, Lule; Almu'Atasim, Khamees; Subhi Malak Taha,; Marko, Todorovic; Justin, Stebbing; Sayedali, Ahmadi; Abad Gurumeta Alfredo,; Valenzuela Jose Ignacio,; Castano-Leon Ana, M; George, Higginbotham; Fadi, Issa; Andrei, Chitul; Seraj Shaikh Sanjid,; Iftikhar Talib Ahmar,; Harmantepe Ahmet Tarik,; Joel, Pitkanen; Giovanni, Landoni; Maggie, Dinome; Ioannis, Tilaveridis; Danguy Des Deserts Marc,; Melika, Akhbari; Mohamed, Elshaer; Evgeniy, Drozdov; Vincenzo, Lizzi; Ismail, Hasirci; Martin Sole Oriol,; Nair Ashvin Krishna,; Barbara, Seeliger; Mohamed, Otify; Ottavio, Scrima; Stavros, Parasyris; Abdulkader, Mohammad; Mihail, Slavchev; Rania, Itani; Dimitra, Akrivou; Ahmed, Abu-Zaid; Maciej, Waledziak; Tayyiba, Wasim; Di Maio Pasquale,; Scanu Antonio Mario,; Susanne, Wolfer; Ramesh, Nataraja; Thomas, Curl-Roper; Karl-Friedrich, Kowalewski; Oliver, Brown; Diego, Sasia; Sonia, Perez-Bertolez; Hiroshi, Yonekura; Abou Chaar Mohamad, K.; Cristina, Tello-Diaz; Adam, Gwozdz; Shiraishi Zapata Carlos,; Andrey, Litvin; Cabanero Sanchez Alberto,; Asensio Diaz Enrique,; Johannes, Fagan; Anazor Fitzgerald Chukwuemeka,; Jason, Fleming; Andriy, Beznosenko; Can, Sahin; Gianluca, Pellino; Matteo, Serenari; Hani, Marcus; Adewale, Adisa; West Silvia, M.; Conde Redondo Consuelo,; Isaie, Ncogoza; Ester, Miralpeix; Paul, Rozenbroek; Ryckie, Wade; Khan Mohammad Burhan,; Michele, Ballabio; Juan, Gilabert-Estelles; Sara, Venturini; Oseihie, Iribhogbe; Mohammed, Abdull; Ramalho De Almeida Filipe,; Pujol Pina Rosa,; Alexandros, Charalabopoulos

doi:10.1016/S2589-7500(24)00065-7

Background: Pulmonary complications are the most common cause of death after surgery. This study aimed to derive and externally validate a novel prognostic model that can be used before elective surgery to estimate the risk of postoperative pulmonary complications and to support resource allocation and prioritisation during pandemic recovery. Methods: Data from an international, prospective cohort study were used to develop a novel prognostic risk model for pulmonary complications after elective surgery in adult patients (aged ≥18 years) across all operation and disease types. The primary outcome measure was postoperative pulmonary complications at 30 days after surgery, which was a composite of pneumonia, acute respiratory distress syndrome, and unexpected mechanical ventilation. Model development with candidate predictor variables was done in the GlobalSurg-CovidSurg Week dataset (global; October, 2020). Two structured machine learning techniques were explored (XGBoost and the least absolute shrinkage and selection operator [LASSO]), and the model with the best performance (GSU-Pulmonary Score) underwent internal validation using bootstrap resampling. The discrimination and calibration of the score were externally validated in two further prospective cohorts: CovidSurg-Cancer (worldwide; February to August, 2020, during the COVID-19 pandemic) and RECON (UK and Australasia; January to October, 2019, before the COVID-19 pandemic). The model was deployed as an online web application. The GlobalSurg-CovidSurg Week and CovidSurg-Cancer studies were registered with ClinicalTrials.gov, NCT04509986 and NCT04384926. Findings: Prognostic models were developed from 13 candidate predictor variables in data from 86 231 patients (1158 hospitals in 114 countries). External validation included 30 492 patients from CovidSurg-Cancer (726 hospitals in 75 countries) and 6789 from RECON (150 hospitals in three countries). The overall rates of pulmonary complications were 2·0% in derivation data, and 3·9% (CovidSurg-Cancer) and 4·7% (RECON) in the validation datasets. Penalised regression using LASSO had similar discrimination to XGBoost (area under the receiver operating curve [AUROC] 0·786, 95% CI 0·774-0·798 vs 0·785, 0·772-0·797), was more explainable, and required fewer covariables. The final GSU-Pulmonary Score included ten predictor variables and showed good discrimination and calibration upon internal validation (AUROC 0·773, 95% CI 0·751-0·795; Brier score 0·020, calibration in the large [CITL] 0·034, slope 0·954). The model performance was acceptable on external validation in CovidSurg-Cancer (AUROC 0·746, 95% CI 0·733-0·760; Brier score 0·036, CITL 0·109, slope 1·056), but with some miscalibration in RECON data (AUROC 0·716, 95% CI 0·689-0·744; Brier score 0·045, CITL 1·040, slope 1·009). Interpretation: This novel prognostic risk score uses simple predictor variables available at the time of a decision for elective surgery that can accurately stratify patients' risk of postoperative pulmonary complications, including during SARS-CoV-2 outbreaks. It could inform surgical consent, resource allocation, and hospital-level prioritisation as elective surgery is upscaled to address global backlogs. Funding: National Institute for Health Research.

A prognostic model for use before elective surgery to estimate the risk of postoperative pulmonary complications (GSU-Pulmonary Score): a development and validation study in three international cohorts / Bal, P; Cheng, Jq; Draman, Mr; Fadzli, An; Ghauth, S; Hung, Wp; Jamaris, S; Koh, Ps; Krishnasamy, S; Lee, Ys; Liew, Yt; Lim, Jzk; Lim, Rcs; Lim, Hc; Pauzi, Sfm; Nah, Sa; Nair, Ak; Ng, Dsw; Yong, Yjnw; Ramayah, K; Roslani, Ac; Saaid, R; Sanmugam, A; See, Mh; Seevalingam, Kk; Sethi, N; Singaravel, S; Zaidi, Snsjh; Tang, Cy; Teoh, Ly; Wong, Kb; Xavier, R; Yahaya, As; Marson, Fal; Delibegovic, S; Bal, Pavin; Cheng Joo, Qing; Draman Mohd, Rusdi; Fadzli Ahmad, Nazran; Ghauth, Sakina; Hung, Weipin; Jamaris, Suniza; Koh Peng, Soon; Krishnasamy, Sivakumar; Lee Yeong, Sing; Liew Yew, Toong; Lim Jeffery, Z. K.; Lim Raymond Chung, Siang; Lim Hiong, Chin; Pauzi Siti Farhan, Moh; Nah Shireen, Anne; Nair Ashvir, Krishna; Ng Doris Sin, Wen; Yong Yuki Julius Ng, We; Ramayah, Kamarajan; Roslani April, Camilla; Saaid, Rahmah; Sanmugam, Anand; See Mee, Hoong; Seevalingam Kanesh, Kumaran; Sethi, Neha; Singaravel, Srihari; Zaidi Syeda Nureena Syed Jafer, Hussain; Tang Chu, Yik; Teoh Li, Ying; Wong Kian, Boon; Xavier, Ruben; Yahaya Ahmad, Shuib; Lima Marson Fernando, Augusto; Delibegovic, Samir; Giardino, Alessandro; Emile, Sameh; Khosravi Mohammad, Hossein; Calvache, Jose; Van Ramshorst, Gabrielle; Haran, Cheyaanthan; Yazbek, Guilherme; Boccalatte, Luis; Glowka, Tim; Martinek, Lubomir; Haraux, Elodie; Wong, Danny; Wong Kitty Hiu, Fung; Bonci, Eduard-Alexandru; Magnone, Stefano; Abozied, Hesham; Velázquez, Irene; Nah Shireen, Anne; Sethi, Neha; Nassar, Mahmoud; Glasbey, James; Jamaris, Suniza; Pisanu, Francesco; Dhufera Hailu, Tamiru; Mayol, Julio; Dzhumabekov, Berik; Mahakalkar, Chandrashekhar; Rajanbabu, Anupama; Haider, Fayza; Balanta-Melo, Julián; Hamza, Amr; Baiocchi, Glauco; Bangash Ali, Haider; Nappi, Francesco; Kamarajah, Sivesh; Zequi, Stenio; Coimbra, Felipe; Flumignan, Ronald; Ramos-De la Medina, Antonio; Kulimbet, Mukhtar; Aloulou, Mohammad; Pellino, Gianluca; Watters, David; Alkaseek, Akram; B., Milan Peiman; Sodhai, Vivek; Pigeolet, Manon; Krishnasamy, Sivakumar; Acquah, Daniel; Msherghi, Ahmed; Freyschlag, Christian; Sallam, Asser; Danguy Des Déserts, Marc; Lule, Herman; Al-Manaseer, Balqees; Lekuya, Hervé; Duprat, Joao; Hadzibegovic, Ana; Ibrahim, Islam; Agastra, Ervis; Awad, Ahmed; Novysedlák, René; Wickramasinghe, Nuwan; Brandao, Marcelo; Borowski, David; Dube, Surya; Ribeiro, Ulysses; Germinario, Giuliana; Samadov, Elgun; Boisson, Matthieu; Elwahab, Sami; Marcus, Hani; Bele, Uros; Ng, Joshua; Mehraj, Asif; Thakar, Sumit; Tang Chu, Yik; Valenzuela, José; Shehata, Sameh; Ahmad, Ahmad; Askari, Alan; Alrayes, Bourhan; Outani, Oumaima; Fahmy, Mohamed; Mandi Draga, Maria; Manirambona, Emery; Alshryda, Sattar; Migliorelli, Federico; Campos, Heloisa; Nagar, Manoj; Rivera, Carlos; Pejkova, Sofija; Demetrashvili, Zaza; Stijns, Jasper; Mourad, Mohamed; Adamina, Michel; seguin-givelet, Agathe; Abdelkhalek, Mohamed; Sanchez Cuadrado, Isabel; Kowalski, Luiz; Seeliger, Barbara; Coe, Peter; Shih, Emily; Rodriguez, Andrea; Azzam, Ahmed; Bravo, Lidia; Wolfer, Susanne; Lott, Natalie; Leventoglu, Sezai; Hodgson, Russell; Liew Yew, Toong; Almabayev, Ydyrys; Lindert, Judith; Lucchini, Sergio; Aburahmah, Mohammad; Mashbari, Hassan; Kauppila, Joonas; Mazingi, Dennis; Nurgozhin, Talgat; Mckelvie, James; Kandevani, Naser; Harrison, Ewan; Horch, Raymund; Ng, Simon; Matos, Leandro; Arnaud, Alexis; Kelly, Michael; Kacimi Salah, Eddine; Stavrou, Gregor; Maja, Mengistu; Elhadi, Muhammed; Demetriades, Andreas; Assenza, Marco; Traeger, Luke; Bekele, Kebebe; Roslani, April; Nieto-Calvache, Albaro; De Simone, Belinda; D'Urso, Antonio; Abdelaleem, Mahmoud; Al-Yaseen, Mustafa; Ramzee Abdul Aziz Ahmed, Faidh; Nessim, Carolyn; Domingo, Marta; Ahmed Mohamed Moaiad, Eldin; Baptista-Silva, Jose; Delibegovic, Samir; Negoi, Ionut; Kumar, Navin; Keppler, Alexander; Büyükkasap, Çağrı; Köksoy, Ülkü; Löffler, Markus; Choong, Peter; Ying, Teoh; Brunaud, Laurent; Hmkroon, ; Mihanovic, Jakov; Villanueva, Julio; Akhavizadegan, Hamed; Mclean, Kenneth; Akhtar Muhammad, Shaheer; Anis, Cerovac; Sousa, Alvaro; Höhn, Philipp; Bezabih, Yoseph; Umuhoza, Christian; Shehta, Ahmed; Annicchiarico, Alfredo; Macshut, Mahmoud; Waissbluth, Sofia; Laban, Simon; Wiegering, Armin; Isik, Arda; Benson, Ruth; Gouvas, Nikolaos; Koh, Peng; Omari, Rand; Bouhuwaish, Ahmad; Hamdan, Ahmed; Mitul, Ashrarur; Hamad, Faten; Marson Ben, Arthur; Kasivisvanathan, Veeru; Cremolini, Chiara; Tokidis, Evripidis; Hetta Helal, F.; Altuwaijri, Talal; Waissbluth, Sofia; Weeratunga, George; Hafez, Mahmoud; Apse Ingus, Arnolds; Paiva Dos Santos Filipe, Manuel; Ling Samuel, Ka-Kin; Fleres, Francesco; Demyati, Khaled; Abd Elwahab, Sami; Tejero-Pintor Francisco, J; Karamanliev, Martin; Isik, Ozgen; Kocer, Belma; Warren, Oliver; Law Jia, Hao; Rodriguez-Lopez, Mario; Riquoir Altamirano, Christophe; Antonakis, Pantelis; Jonker Pascal Klaas, Christiaan; Perez Ferrer, Antonio; Hodgson, Russell; Wong Kitty Hiu, Fung; Shalhoub, Joseph; Binda, Barbara; Bayhan, Zulfu; Chowdhury, Sharfuddin; Brennan, Caitlin; Vagge, Aldo; Glass, Nina; Picardo Antonio, L.; Dona' Maria, Gabriella; Singer, Georg; Di Franco, Gregorio; Lehovsky, Katherine; Plichta, Jennifer; Ramos-De la Medina, Antonio; Tawheed, Ahmed; De Virgilio, Armando; Kahka, Ehab; Annicchiarico, Alfredo; Martinelli, Fabio; Schlager Justin, Gabriel; Rogers, Luke; Kara, Yasin; Violante, Tommaso; Patino-Jaramillo Nasly, G.; Shirazi, Ahmed; Totty Joshua, P; Guldogan Cem, Emir; Findlay, John; Narahari, Krishna; Hadjinicolaou Andreas, V; Soto-Darias, Ivan; Wittmann, Maria; Al-Shudifat, Abdel-Ellah; Stijns, Jasper; Kirov, Mikhail; Lennon, Paul; Alqasem, Saad; Migliore, Marcello; Ercolani, Giorgio; Vitali, Alessandro; Kavalakat, Alfie; Morrison, Jo; Costas-Ochoa, Simbad; Abubakr, Abubakr; Petruzzi, Gerardo; Uzunoglu Faik, G.; Espin-Basany, Eloy; Teague, Warwick; Cioffi Stefano Piero, Bernardo; Kocher Hemant, M; Craus-Miguel, Andrea; Pucar, Ana; Alhadi, Abdulmueti; Ban Vin, Shen; Hammond John, Stotesbury; Nazimi Abd, Jabar; Domenech Fernandez, Julio; Sena, Giuseppe; Aduse-Poku, Maame; Singh, Mohit; Shawer, Balqis; Burlov, Nikita; Sodde, Peter; Gonullu, Emre; Ntalouka Maria, P; Alhazmi, Barrag; Coughlin, Patrick; Ng Calvin, S. 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DIGITAL HEALTH. - ISSN 2589-7500. - 6:7(2024). [10.1016/S2589-7500(24)00065-7]