Association Between Accelerometer-Assessed Physical Activity and Severity of COVID-19 in UK Biobank
PhD Alex V Rowlands, PhD Paddy C Dempsey, PhD Clare Gillies, MPhil David E Kloecker, PhD Cameron Razieh, PhD Yogini Chudasama, PhD Nazrul Islam, PhD Francesco Zaccardi, PhD Claire Lawson, PhD Tom Norris, MD Melanie J Davies, PhD Kamlesh Khunti, PhD Tom Yates
Mayo Clinic Proceedings: Innovations, Quality & Outcomes, doi:10.1016/j.mayocpiqo.2021.08.011
Objective: To quantify the association between accelerometer-assessed physical activity and coronavirus disease 2019 (COVID-19) outcomes.
Research and InnovationeDepartment of Health and Social Care COVID-19 Rapid Response Rolling Call (MR/ V020536/1) and Health Data Research UK (HDRUK2020.138). The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. Potential Competing Interests: K.K. is a member of the UK Scientific Advisory Group for Emergencies (SAGE), Chair of the SAGE subgroup on ethnicity and COVID-19, and member of Independent SAGE. All other authors declare that they have no competing interests.
References
Anderson, Heesterbeek, Klinkenberg, Hollingsworth, How will country-based mitigation . How will country-based mitigation measures influence the course of the COVID-19 epidemic?, Lancet
Armstrong, Rudkin, Allen, Dynamic linkage of COVID-19 test results between Public Health England's Second Generation Surveillance System and UK Biobank, Microb Genom
Arvidsson, Fridolfsson, Börjesson, Measurement of physical activity in clinical practice using accelerometers, J Intern Med
Batty, Gale, Kivimäki, Deary, Bell, Comparison of risk factor associations in UK Biobank against representative, general population-based studies with conventional response rates: prospective cohort study and individual participant meta-analysis, BMJ
Brawner, Ehman, Bole, Inverse relationship of maximal exercise capacity to hospitalization secondary to coronavirus disease 2019, Mayo Clin Proc
Bull, Al-Ansari, Biddle, World Health Organization 2020 guidelines on physical activity and sedentary behaviour, Br J Sports Med
Chastin, Abaraogu, Bourgois, Effects of regular physical activity on the immune system, vaccination and risk of community-acquired infectious disease in the general population: systematic review and meta-analysis, Sports Med
Doherty, Jackson, Hammerla, Large scale population assessment of physical activity using wrist worn accelerometers: the UK Biobank Study, PLoS One
Gao, Piernas, Astbury, Associations between body-mass index and COVID-19 severity in 6.9 million people in England: a prospective, community-based, cohort study. Lan, cet Diabetes Endocrinol
Griffith, Morrus, Tudball, Collider bias undermines our understanding of COVID-19 disease risk and severity, Nat Comm
Hildebrand, Van Hees, Hansen, Ekelund, Age group comparability of raw accelerometer output from wrist-and hipworn monitors, Med Sci Sports Exerc
Lavie, Sanchis-Gomar, Arena, Fit is it in COVID-19, future pandemics, and overall healthy living, Mayo Clin Proc
Mathur, Rentsch, Morton, Ethnic differences in SARS-CoV-2 infection and COVID-19erelated hospitalisation, intensive care unit admission, and death in 17 million adults in England: an observational cohort study using the OpenSAFELY platform, Lancet
Migueles, Rowlands, Huber, Sabia, Van Hees et al., GGIR: a research community-driven open-source R-package for generating physical activity and sleep outcomes from multi-day raw accelerometer data, J Measure Phys Behav
Mutambudzi, Niedwiedz, Macdonald, Occupation and risk of severe COVID-19: prospective cohort study of 120, 075 UK Biobank participants, Occup Environ Med
Razieh, Zaccardi, Islam, Ethnic minorities and COVID-19: examining whether excess risk is mediated through deprivation, Eur J Public Health
Rowlands, Edwardson, Davies, Khunti, Harrington et al., Beyond cut points: accelerometer metrics that capture the physical activity profile, Med Sci Sports Exerc
Rowlands, Edwardson, Dawkins, Maylor, Metcalf et al., Physical activity for bone health: how much and/or how hard?, Med Sci Sports Exerc
Rowlands, Gillies, Chudasama, Association of working shifts, inside and outside of healthcare, with severe COVID-19: an observational study, BMC Public Health
Rowlands, Kloecker, Chudasama, Association of balance and timing of physical activity and rest with risk of COVID-19 in UK Biobank, Mayo Clin Proc
Rowlands, Yates, Edwardson, Activity intensity, volume and norms: utility and interpretation of accelerometer metrics, Med Sci Sports Exerc
Sallis, Adlakha, Oyeyemi, An international physical activity and public health research agenda to inform coronavirus disease-2019 policies and practices, J Sport Health Sci
Sallis, Young, Tartof, Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients, Br J Sports Med
Smith, Gardner, Fisher, Hamer, Patterns and correlates of physical activity behaviour over 10 years in older adults: prospective analyses from the English Longitudinal Study of Ageing, BMJ Open
Strain, Wijendaele, Dempsey, Wearable-devicemeasured physical activity and future health risk, Nat Med
Sudlow, Gallacher, Allen, UK Biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age, PLoS Med
Vepa, Bae, Ahmed, Pareek, Khunti, COVID-19 and ethnicity: a novel pathophysiological role for inflammation, Diabetes Metab Syndr
Warburton, Nicol, Bredin, Health benefits of physical activity: the evidence, CMAJ
Yang, Zheng, Gou, Prevalence of comorbidities and its effects in patients infected with SARS-CoV-2: a systematic review and meta-analysis, Int J Infect Dis
Yates, Razieh, Zaccardi, Davies, Khunti, Obesity and risk of COVID-19: analysis of UK Biobank, Prim Care Diabetes
Yates, Razieh, Zaccardi, Obesity, walking pace and risk of severe COVID-19: analysis of UK Biobank, Int J Obes (Lond)
{ 'indexed': {'date-parts': [[2022, 4, 1]], 'date-time': '2022-04-01T15:50:57Z', 'timestamp': 1648828257796},
'reference-count': 31,
'publisher': 'Elsevier BV',
'issue': '6',
'license': [ { 'start': { 'date-parts': [[2021, 12, 1]],
'date-time': '2021-12-01T00:00:00Z',
'timestamp': 1638316800000},
'content-version': 'tdm',
'delay-in-days': 0,
'URL': 'https://www.elsevier.com/tdm/userlicense/1.0/'},
{ 'start': { 'date-parts': [[2021, 8, 14]],
'date-time': '2021-08-14T00:00:00Z',
'timestamp': 1628899200000},
'content-version': 'vor',
'delay-in-days': 0,
'URL': 'http://creativecommons.org/licenses/by/4.0/'}],
'funder': [ { 'DOI': '10.13039/501100000271',
'name': 'UKRI Science and Technology Facilities Council',
'doi-asserted-by': 'publisher'}],
'content-domain': {'domain': [], 'crossmark-restriction': False},
'published-print': {'date-parts': [[2021, 12]]},
'DOI': '10.1016/j.mayocpiqo.2021.08.011',
'type': 'journal-article',
'created': {'date-parts': [[2021, 8, 20]], 'date-time': '2021-08-20T05:36:03Z', 'timestamp': 1629437763000},
'page': '997-1007',
'source': 'Crossref',
'is-referenced-by-count': 3,
'title': 'Association Between Accelerometer-Assessed Physical Activity and Severity of COVID-19 in UK '
'Biobank',
'prefix': '10.1016',
'volume': '5',
'author': [ { 'ORCID': 'http://orcid.org/0000-0002-1463-697X',
'authenticated-orcid': False,
'given': 'Alex V.',
'family': 'Rowlands',
'sequence': 'first',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-1714-6087',
'authenticated-orcid': False,
'given': 'Paddy C.',
'family': 'Dempsey',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-8417-9700',
'authenticated-orcid': False,
'given': 'Clare',
'family': 'Gillies',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-8910-2091',
'authenticated-orcid': False,
'given': 'David E.',
'family': 'Kloecker',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0003-3597-2945',
'authenticated-orcid': False,
'given': 'Cameron',
'family': 'Razieh',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-6777-0064',
'authenticated-orcid': False,
'given': 'Yogini',
'family': 'Chudasama',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0003-3982-4325',
'authenticated-orcid': False,
'given': 'Nazrul',
'family': 'Islam',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-2636-6487',
'authenticated-orcid': False,
'given': 'Francesco',
'family': 'Zaccardi',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0003-0127-5236',
'authenticated-orcid': False,
'given': 'Claire',
'family': 'Lawson',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-9140-0776',
'authenticated-orcid': False,
'given': 'Tom',
'family': 'Norris',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-9987-9371',
'authenticated-orcid': False,
'given': 'Melanie J.',
'family': 'Davies',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0003-2343-7099',
'authenticated-orcid': False,
'given': 'Kamlesh',
'family': 'Khunti',
'sequence': 'additional',
'affiliation': []},
{ 'ORCID': 'http://orcid.org/0000-0002-5724-5178',
'authenticated-orcid': False,
'given': 'Tom',
'family': 'Yates',
'sequence': 'additional',
'affiliation': []}],
'member': '78',
'reference': [ { 'issue': '3',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib2',
'doi-asserted-by': 'crossref',
'first-page': '630',
'DOI': '10.1093/eurpub/ckab041',
'article-title': 'Ethnic minorities and COVID-19: examining whether excess risk is '
'mediated through deprivation',
'volume': '31',
'author': 'Razieh',
'year': '2021',
'journal-title': 'Eur J Public Health'},
{ 'issue': '10228',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib3',
'doi-asserted-by': 'crossref',
'first-page': '931',
'DOI': '10.1016/S0140-6736(20)30567-5',
'article-title': 'How will country-based mitigation . How will country-based mitigation '
'measures influence the course of the COVID-19 epidemic?',
'volume': '395',
'author': 'Anderson',
'year': '2020',
'journal-title': 'Lancet'},
{ 'issue': '10286',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib4',
'doi-asserted-by': 'crossref',
'first-page': '1711',
'DOI': '10.1016/S0140-6736(21)00634-6',
'volume': '397',
'author': 'Mathur',
'year': '2021',
'journal-title': 'Lancet'},
{ 'issue': '5',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib5',
'doi-asserted-by': 'crossref',
'first-page': '566',
'DOI': '10.1016/j.pcd.2020.05.011',
'article-title': 'Obesity and risk of COVID-19: analysis of UK Biobank',
'volume': '14',
'author': 'Yates',
'year': '2020',
'journal-title': 'Prim Care Diabetes'},
{ 'issue': '5',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib6',
'doi-asserted-by': 'crossref',
'first-page': '115',
'DOI': '10.1038/s41366-021-00771-z',
'article-title': 'Obesity, walking pace and risk of severe COVID-19: analysis of UK '
'Biobank',
'volume': '45',
'author': 'Yates',
'year': '2021',
'journal-title': 'Int J Obes (Lond)'},
{ 'issue': '8',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib7',
'doi-asserted-by': 'crossref',
'first-page': '1673',
'DOI': '10.1007/s40279-021-01466-1',
'article-title': 'Effects of regular physical activity on the immune system, vaccination '
'and risk of community-acquired infectious disease in the general '
'population: systematic review and meta-analysis',
'volume': '51',
'author': 'Chastin',
'year': '2021',
'journal-title': 'Sports Med'},
{ 'issue': '4',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib8',
'first-page': '328',
'article-title': 'An international physical activity and public health research agenda to '
'inform coronavirus disease-2019 policies and practices',
'volume': '9',
'author': 'Sallis',
'year': '2020',
'journal-title': 'J\xa0Sport Health Sci'},
{ 'issue': '5',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib9',
'doi-asserted-by': 'crossref',
'first-page': '1043',
'DOI': '10.1016/j.dsx.2020.06.056',
'article-title': 'COVID-19 and ethnicity: a novel pathophysiological role for '
'inflammation',
'volume': '14',
'author': 'Vepa',
'year': '2020',
'journal-title': 'Diabetes Metab Syndr'},
{ 'issue': '6',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib10',
'doi-asserted-by': 'crossref',
'first-page': '801',
'DOI': '10.1503/cmaj.051351',
'article-title': 'Health benefits of physical activity: the evidence',
'volume': '174',
'author': 'Warburton',
'year': '2006',
'journal-title': 'CMAJ'},
{ 'key': '10.1016/j.mayocpiqo.2021.08.011_bib11',
'doi-asserted-by': 'crossref',
'first-page': '91',
'DOI': '10.1016/j.ijid.2020.03.017',
'article-title': 'Prevalence of comorbidities and its effects in patients infected with '
'SARS-CoV-2: a systematic review and meta-analysis',
'volume': '94',
'author': 'Yang',
'year': '2020',
'journal-title': 'Int J Infect Dis'},
{ 'issue': '1',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib12',
'doi-asserted-by': 'crossref',
'first-page': '156',
'DOI': '10.1016/j.mayocp.2020.10.032',
'article-title': 'Association of balance and timing of physical activity and rest with '
'risk of COVID-19 in UK Biobank',
'volume': '96',
'author': 'Rowlands',
'year': '2020',
'journal-title': 'Mayo Clin Proc'},
{ 'key': '10.1016/j.mayocpiqo.2021.08.011_bib13',
'doi-asserted-by': 'crossref',
'article-title': 'Physical inactivity is associated with a higher risk for severe '
'COVID-19 outcomes: a study in 48 440 adult patients',
'author': 'Sallis',
'year': '2021',
'journal-title': 'Br J Sports Med',
'DOI': '10.1136/bjsports-2021-104080'},
{ 'issue': '2',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib14',
'first-page': '137',
'article-title': 'Measurement of physical activity in clinical practice using '
'accelerometers',
'volume': '286',
'author': 'Arvidsson',
'year': '2019',
'journal-title': 'J\xa0Intern Med'},
{ 'issue': '11',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib15',
'doi-asserted-by': 'crossref',
'first-page': '2410',
'DOI': '10.1249/MSS.0000000000002047',
'article-title': 'Activity intensity, volume and norms: utility and interpretation of '
'accelerometer metrics',
'volume': '51',
'author': 'Rowlands',
'year': '2019',
'journal-title': 'Med Sci Sports Exerc'},
{ 'issue': '9',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib16',
'doi-asserted-by': 'crossref',
'first-page': '1385',
'DOI': '10.1038/s41591-020-1012-3',
'article-title': 'Wearable-device-measured physical activity and future health risk',
'volume': '26',
'author': 'Strain',
'year': '2020',
'journal-title': 'Nat Med'},
{ 'issue': '2',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib17',
'doi-asserted-by': 'crossref',
'first-page': 'e0169649',
'DOI': '10.1371/journal.pone.0169649',
'article-title': 'Large scale population assessment of physical activity using wrist worn '
'accelerometers: the UK Biobank Study',
'volume': '12',
'author': 'Doherty',
'year': '2017',
'journal-title': 'PLoS One'},
{ 'issue': '3',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib18',
'doi-asserted-by': 'crossref',
'first-page': 'e1001779',
'DOI': '10.1371/journal.pmed.1001779',
'article-title': 'UK Biobank: an open access resource for identifying the causes of a '
'wide range of complex diseases of middle and old age',
'volume': '12',
'author': 'Sudlow',
'year': '2015',
'journal-title': 'PLoS Med'},
{ 'issue': '7',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib19',
'first-page': 'mgen000397',
'article-title': 'Dynamic linkage of COVID-19 test results between Public Health '
'England’s Second Generation Surveillance System and UK Biobank',
'volume': '6',
'author': 'Armstrong',
'year': '2020',
'journal-title': 'Microb Genom'},
{ 'issue': '3',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib20',
'doi-asserted-by': 'crossref',
'first-page': '188',
'DOI': '10.1123/jmpb.2018-0063',
'article-title': 'GGIR: a research community-driven open-source R-package for generating '
'physical activity and sleep outcomes from multi-day raw accelerometer '
'data',
'volume': '2',
'author': 'Migueles',
'year': '2019',
'journal-title': 'J\xa0Measure Phys Behav'},
{ 'issue': '6',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib21',
'doi-asserted-by': 'crossref',
'first-page': '1323',
'DOI': '10.1249/MSS.0000000000001561',
'article-title': 'Beyond cut points: accelerometer metrics that capture the physical '
'activity profile',
'volume': '50',
'author': 'Rowlands',
'year': '2018',
'journal-title': 'Med Sci Sports Exerc'},
{ 'issue': '9',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib22',
'doi-asserted-by': 'crossref',
'first-page': '1816',
'DOI': '10.1249/MSS.0000000000000289',
'article-title': 'Age group comparability of raw accelerometer output from wrist- and '
'hip-worn monitors',
'volume': '46',
'author': 'Hildebrand',
'year': '2014',
'journal-title': 'Med Sci Sports Exerc'},
{ 'issue': '11',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib23',
'doi-asserted-by': 'crossref',
'first-page': '2331',
'DOI': '10.1249/MSS.0000000000002380',
'article-title': 'Physical activity for bone health: how much and/or how hard?',
'volume': '52',
'author': 'Rowlands',
'year': '2020',
'journal-title': 'Med Sci Sports Exerc'},
{ 'issue': '6',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib24',
'doi-asserted-by': 'crossref',
'first-page': '350',
'DOI': '10.1016/S2213-8587(21)00089-9',
'article-title': 'Associations between body-mass index and COVID-19 severity in 6.9 '
'million people in England: a prospective, community-based, cohort study',
'volume': '9',
'author': 'Gao',
'year': '2021',
'journal-title': 'Lancet Diabetes Endocrinol'},
{ 'issue': '1',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib25',
'doi-asserted-by': 'crossref',
'first-page': '773',
'DOI': '10.1186/s12889-021-10839-0',
'article-title': 'Association of working shifts, inside and outside of healthcare, with '
'severe COVID-19: an observational study',
'volume': '21',
'author': 'Rowlands',
'year': '2021',
'journal-title': 'BMC Public Health'},
{ 'issue': '24',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib26',
'doi-asserted-by': 'crossref',
'first-page': '1451',
'DOI': '10.1136/bjsports-2020-102955',
'article-title': 'World Health Organization 2020 guidelines on physical activity and '
'sedentary behaviour',
'volume': '54',
'author': 'Bull',
'year': '2020',
'journal-title': 'Br J Sports Med'},
{ 'issue': '1',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib27',
'doi-asserted-by': 'crossref',
'first-page': '32',
'DOI': '10.1016/j.mayocp.2020.10.003',
'article-title': 'Inverse relationship of maximal exercise capacity to hospitalization '
'secondary to coronavirus disease 2019',
'volume': '96',
'author': 'Brawner',
'year': '2021',
'journal-title': 'Mayo Clin Proc'},
{ 'issue': '1',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib28',
'doi-asserted-by': 'crossref',
'first-page': '7',
'DOI': '10.1016/j.mayocp.2020.11.013',
'article-title': 'Fit is it in COVID-19, future pandemics, and overall healthy living',
'volume': '96',
'author': 'Lavie',
'year': '2021',
'journal-title': 'Mayo Clin Proc'},
{ 'issue': '1',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib29',
'doi-asserted-by': 'crossref',
'first-page': '5749',
'DOI': '10.1038/s41467-020-19478-2',
'article-title': 'Collider bias undermines our understanding of COVID-19 disease risk and '
'severity',
'volume': '11',
'author': 'Griffith',
'year': '2020',
'journal-title': 'Nat Comm'},
{ 'key': '10.1016/j.mayocpiqo.2021.08.011_bib30',
'article-title': 'Occupation and risk of severe COVID-19: prospective cohort study of '
'120,075 UK Biobank participants',
'author': 'Mutambudzi',
'year': '2020',
'journal-title': 'Occup Environ Med'},
{ 'issue': '4',
'key': '10.1016/j.mayocpiqo.2021.08.011_bib31',
'doi-asserted-by': 'crossref',
'first-page': 'e007423',
'DOI': '10.1136/bmjopen-2014-007423',
'article-title': 'Patterns and correlates of physical activity behaviour over 10 years in '
'older adults: prospective analyses from the English Longitudinal Study '
'of Ageing',
'volume': '5',
'author': 'Smith',
'year': '2015',
'journal-title': 'BMJ Open'},
{ 'key': '10.1016/j.mayocpiqo.2021.08.011_bib32',
'doi-asserted-by': 'crossref',
'first-page': 'm131',
'DOI': '10.1136/bmj.m131',
'article-title': 'Comparison of risk factor associations in UK Biobank against '
'representative, general population-based studies with conventional '
'response rates: prospective cohort study and individual participant '
'meta-analysis',
'volume': '368',
'author': 'Batty',
'year': '2020',
'journal-title': 'BMJ'}],
'container-title': 'Mayo Clinic Proceedings: Innovations, Quality & Outcomes',
'original-title': [],
'language': 'en',
'link': [ { 'URL': 'https://api.elsevier.com/content/article/PII:S2542454821001302?httpAccept=text/xml',
'content-type': 'text/xml',
'content-version': 'vor',
'intended-application': 'text-mining'},
{ 'URL': 'https://api.elsevier.com/content/article/PII:S2542454821001302?httpAccept=text/plain',
'content-type': 'text/plain',
'content-version': 'vor',
'intended-application': 'text-mining'}],
'deposited': { 'date-parts': [[2021, 12, 26]],
'date-time': '2021-12-26T04:06:39Z',
'timestamp': 1640491599000},
'score': 1,
'resource': {'primary': {'URL': 'https://linkinghub.elsevier.com/retrieve/pii/S2542454821001302'}},
'subtitle': [],
'short-title': [],
'issued': {'date-parts': [[2021, 12]]},
'references-count': 31,
'journal-issue': {'issue': '6', 'published-print': {'date-parts': [[2021, 12]]}},
'alternative-id': ['S2542454821001302'],
'URL': 'http://dx.doi.org/10.1016/j.mayocpiqo.2021.08.011',
'relation': {},
'ISSN': ['2542-4548'],
'subject': ['General Medicine'],
'container-title-short': 'Mayo Clinic Proceedings: Innovations, Quality & Outcomes',
'published': {'date-parts': [[2021, 12]]}}