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Systematic Review and Meta-Analysis of Multitargeted Tyrosine Kinase Inhibitors in Patients With Intractable Metastatic Colorectal Cancer
Background: The treatment options for intractable metastatic colorectal cancer include regorafenib, trifluridine/tipiracil, and fruquintinib. In this study, we aimed to conduct a network meta-analysis for comparing the efficacy of these agents. Methods: We searched the PubMed, EMBASE, Cochrane Centr...
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| Published in: | Technology in cancer research & treatment 2020, Vol.19, p.1533033820943241-1533033820943241 |
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| creator | Gao, Zhenzhen Cao, Chenxi Bao, Yi Fan, Yaohua Chen, Gang Fu, Peng |
| description | Background:
The treatment options for intractable metastatic colorectal cancer include regorafenib, trifluridine/tipiracil, and fruquintinib. In this study, we aimed to conduct a network meta-analysis for comparing the efficacy of these agents.
Methods:
We searched the PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials databases for relevant literature, up to February 2020. The data were collected from randomized controlled trials on regorafenib, trifluridine/tipiracil, or fruquintinib, administered to patients with metastatic colorectal cancer who failed on treatment with oxaliplatin, irinotecan, or fluoropyrimidine. The primary end points, namely, the overall survival and progression-free survival, were analyzed for subsequent network analysis using the Review Manager and Aggregate Data Drug Information System software for performing direct and indirect comparisons.
Results:
A total of 7 trials were analyzed in this study. Trifluridine/tipiracil and regorafenib proved to be superior to the placebo, with respect to the overall survival (odds ratio: 0.38, 95% confidence interval: 0.27-0.52 for trifluridine/tipiracil; odds ratio: 0.47, 95% confidence interval: 0.26-0.84 for regorafenib) and progression-free survival (odds ratio: 0.18, 95% confidence interval: 0.05-0.67 for trifluridine/tipiracil; odds ratio: 0.06, 95% confidence interval: 0.04-0.09 for regorafenib). Regorafenib (80 mg) was superior to the placebo in terms of the overall survival and progression-free survival and inferior to trifluridine/tipiracil and fruquintinib. Network analysis revealed that the efficacy of trifluridine/tipiracil and fruquintinib was fundamentally similar, and both the agents were superior to regorafenib.
Conclusion:
Regorafenib (80 mg) was superior to the placebo, but inferior to 160 mg regorafenib, trifluridine/tipiracil, and fruquintinib. This study further revealed that the efficiency of trifluridine/tipiracil and fruquintinib is identical, but their toxicity profiles are different. |
| doi_str_mv | 10.1177/1533033820943241 |
| format | article |
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The treatment options for intractable metastatic colorectal cancer include regorafenib, trifluridine/tipiracil, and fruquintinib. In this study, we aimed to conduct a network meta-analysis for comparing the efficacy of these agents.
Methods:
We searched the PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials databases for relevant literature, up to February 2020. The data were collected from randomized controlled trials on regorafenib, trifluridine/tipiracil, or fruquintinib, administered to patients with metastatic colorectal cancer who failed on treatment with oxaliplatin, irinotecan, or fluoropyrimidine. The primary end points, namely, the overall survival and progression-free survival, were analyzed for subsequent network analysis using the Review Manager and Aggregate Data Drug Information System software for performing direct and indirect comparisons.
Results:
A total of 7 trials were analyzed in this study. Trifluridine/tipiracil and regorafenib proved to be superior to the placebo, with respect to the overall survival (odds ratio: 0.38, 95% confidence interval: 0.27-0.52 for trifluridine/tipiracil; odds ratio: 0.47, 95% confidence interval: 0.26-0.84 for regorafenib) and progression-free survival (odds ratio: 0.18, 95% confidence interval: 0.05-0.67 for trifluridine/tipiracil; odds ratio: 0.06, 95% confidence interval: 0.04-0.09 for regorafenib). Regorafenib (80 mg) was superior to the placebo in terms of the overall survival and progression-free survival and inferior to trifluridine/tipiracil and fruquintinib. Network analysis revealed that the efficacy of trifluridine/tipiracil and fruquintinib was fundamentally similar, and both the agents were superior to regorafenib.
Conclusion:
Regorafenib (80 mg) was superior to the placebo, but inferior to 160 mg regorafenib, trifluridine/tipiracil, and fruquintinib. This study further revealed that the efficiency of trifluridine/tipiracil and fruquintinib is identical, but their toxicity profiles are different.</description><identifier>ISSN: 1533-0346</identifier><identifier>EISSN: 1533-0338</identifier><identifier>DOI: 10.1177/1533033820943241</identifier><identifier>PMID: 32914703</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Cancer ; Clinical trials ; Colorectal cancer ; Colorectal carcinoma ; Confidence intervals ; Irinotecan ; Meta-Analysis ; Metastases ; Metastasis ; Oxaliplatin ; Patients ; Placebos ; Survival ; Targeted cancer therapy ; Toxicity ; Tyrosine kinase inhibitors</subject><ispartof>Technology in cancer research & treatment, 2020, Vol.19, p.1533033820943241-1533033820943241</ispartof><rights>The Author(s) 2020</rights><rights>The Author(s) 2020. This work is licensed under the Creative Commons Attribution – Non-Commercial License https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2020 2020 SAGE Publications</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c528t-8a0cc06bc985ab43b64422eacf88c213b03f129505fe9b69f9129ca13f3256a53</citedby><cites>FETCH-LOGICAL-c528t-8a0cc06bc985ab43b64422eacf88c213b03f129505fe9b69f9129ca13f3256a53</cites><orcidid>0000-0002-9518-7634 ; 0000-0003-2982-6300</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488883/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2569998874?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,4024,21966,25753,27853,27923,27924,27925,37012,37013,44590,44945,45333,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32914703$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gao, Zhenzhen</creatorcontrib><creatorcontrib>Cao, Chenxi</creatorcontrib><creatorcontrib>Bao, Yi</creatorcontrib><creatorcontrib>Fan, Yaohua</creatorcontrib><creatorcontrib>Chen, Gang</creatorcontrib><creatorcontrib>Fu, Peng</creatorcontrib><title>Systematic Review and Meta-Analysis of Multitargeted Tyrosine Kinase Inhibitors in Patients With Intractable Metastatic Colorectal Cancer</title><title>Technology in cancer research & treatment</title><addtitle>Technol Cancer Res Treat</addtitle><description>Background:
The treatment options for intractable metastatic colorectal cancer include regorafenib, trifluridine/tipiracil, and fruquintinib. In this study, we aimed to conduct a network meta-analysis for comparing the efficacy of these agents.
Methods:
We searched the PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials databases for relevant literature, up to February 2020. The data were collected from randomized controlled trials on regorafenib, trifluridine/tipiracil, or fruquintinib, administered to patients with metastatic colorectal cancer who failed on treatment with oxaliplatin, irinotecan, or fluoropyrimidine. The primary end points, namely, the overall survival and progression-free survival, were analyzed for subsequent network analysis using the Review Manager and Aggregate Data Drug Information System software for performing direct and indirect comparisons.
Results:
A total of 7 trials were analyzed in this study. Trifluridine/tipiracil and regorafenib proved to be superior to the placebo, with respect to the overall survival (odds ratio: 0.38, 95% confidence interval: 0.27-0.52 for trifluridine/tipiracil; odds ratio: 0.47, 95% confidence interval: 0.26-0.84 for regorafenib) and progression-free survival (odds ratio: 0.18, 95% confidence interval: 0.05-0.67 for trifluridine/tipiracil; odds ratio: 0.06, 95% confidence interval: 0.04-0.09 for regorafenib). Regorafenib (80 mg) was superior to the placebo in terms of the overall survival and progression-free survival and inferior to trifluridine/tipiracil and fruquintinib. Network analysis revealed that the efficacy of trifluridine/tipiracil and fruquintinib was fundamentally similar, and both the agents were superior to regorafenib.
Conclusion:
Regorafenib (80 mg) was superior to the placebo, but inferior to 160 mg regorafenib, trifluridine/tipiracil, and fruquintinib. This study further revealed that the efficiency of trifluridine/tipiracil and fruquintinib is identical, but their toxicity profiles are different.</description><subject>Cancer</subject><subject>Clinical trials</subject><subject>Colorectal cancer</subject><subject>Colorectal carcinoma</subject><subject>Confidence intervals</subject><subject>Irinotecan</subject><subject>Meta-Analysis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Oxaliplatin</subject><subject>Patients</subject><subject>Placebos</subject><subject>Survival</subject><subject>Targeted cancer therapy</subject><subject>Toxicity</subject><subject>Tyrosine kinase inhibitors</subject><issn>1533-0346</issn><issn>1533-0338</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>PIMPY</sourceid><sourceid>DOA</sourceid><recordid>eNp1kk1vEzEQhi0EoiVw54QsceGy4K_12hekKuIjohUIijhaXu9s4mizbm1vUX4C_xonKYFWwhfbM-88M6MZhJ5T8prSpnlDa84J54oRLTgT9AE63Zmqne3h8S3kCXqS0poQJiWnj9EJZ5qKhvBT9OvbNmXY2Owd_go3Hn5iO3b4ArKtzkY7bJNPOPT4YhqyzzYuIUOHL7cxJD8C_uRHmwAvxpVvfQ4xYT_iL4UGY074h8-r4svRumzbAfbYlPfJ5mEIEYp9wHM7OohP0aPeDgme3d4z9P39u8v5x-r884fF_Oy8cjVTuVKWOEdk67SqbSt4K4VgDKzrlXKM8pbwnjJdk7oH3Urd6_JzlvKes1rams_Q4sDtgl2bq-g3Nm5NsN7sDSEujY2lwgFMLXlHWtYxLTsBROpGcMmUEi1o6YQurLcH1tXUbqBzsOt1uAO96xn9yizDjWmEKocXwKtbQAzXE6RsNj45GAY7QpiSYUJQSaQss5qhl_ek6zDFMqKiqqXWWqlS3gyRg8qVCaUI_bEYSsxuZ8z9nSkhL_5t4hjwZ0mKoDoIkl3C36z_Bf4G-qvKKQ</recordid><startdate>2020</startdate><enddate>2020</enddate><creator>Gao, Zhenzhen</creator><creator>Cao, Chenxi</creator><creator>Bao, Yi</creator><creator>Fan, Yaohua</creator><creator>Chen, Gang</creator><creator>Fu, Peng</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><general>SAGE Publishing</general><scope>AFRWT</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0002-9518-7634</orcidid><orcidid>https://orcid.org/0000-0003-2982-6300</orcidid></search><sort><creationdate>2020</creationdate><title>Systematic Review and Meta-Analysis of Multitargeted Tyrosine Kinase Inhibitors in Patients With Intractable Metastatic Colorectal Cancer</title><author>Gao, Zhenzhen ; Cao, Chenxi ; Bao, Yi ; Fan, Yaohua ; Chen, Gang ; Fu, Peng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c528t-8a0cc06bc985ab43b64422eacf88c213b03f129505fe9b69f9129ca13f3256a53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Cancer</topic><topic>Clinical trials</topic><topic>Colorectal cancer</topic><topic>Colorectal carcinoma</topic><topic>Confidence intervals</topic><topic>Irinotecan</topic><topic>Meta-Analysis</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Oxaliplatin</topic><topic>Patients</topic><topic>Placebos</topic><topic>Survival</topic><topic>Targeted cancer therapy</topic><topic>Toxicity</topic><topic>Tyrosine kinase inhibitors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gao, Zhenzhen</creatorcontrib><creatorcontrib>Cao, Chenxi</creatorcontrib><creatorcontrib>Bao, Yi</creatorcontrib><creatorcontrib>Fan, Yaohua</creatorcontrib><creatorcontrib>Chen, Gang</creatorcontrib><creatorcontrib>Fu, Peng</creatorcontrib><collection>SAGE Open Access Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Technology in cancer research & treatment</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gao, Zhenzhen</au><au>Cao, Chenxi</au><au>Bao, Yi</au><au>Fan, Yaohua</au><au>Chen, Gang</au><au>Fu, Peng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Systematic Review and Meta-Analysis of Multitargeted Tyrosine Kinase Inhibitors in Patients With Intractable Metastatic Colorectal Cancer</atitle><jtitle>Technology in cancer research & treatment</jtitle><addtitle>Technol Cancer Res Treat</addtitle><date>2020</date><risdate>2020</risdate><volume>19</volume><spage>1533033820943241</spage><epage>1533033820943241</epage><pages>1533033820943241-1533033820943241</pages><issn>1533-0346</issn><eissn>1533-0338</eissn><abstract>Background:
The treatment options for intractable metastatic colorectal cancer include regorafenib, trifluridine/tipiracil, and fruquintinib. In this study, we aimed to conduct a network meta-analysis for comparing the efficacy of these agents.
Methods:
We searched the PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials databases for relevant literature, up to February 2020. The data were collected from randomized controlled trials on regorafenib, trifluridine/tipiracil, or fruquintinib, administered to patients with metastatic colorectal cancer who failed on treatment with oxaliplatin, irinotecan, or fluoropyrimidine. The primary end points, namely, the overall survival and progression-free survival, were analyzed for subsequent network analysis using the Review Manager and Aggregate Data Drug Information System software for performing direct and indirect comparisons.
Results:
A total of 7 trials were analyzed in this study. Trifluridine/tipiracil and regorafenib proved to be superior to the placebo, with respect to the overall survival (odds ratio: 0.38, 95% confidence interval: 0.27-0.52 for trifluridine/tipiracil; odds ratio: 0.47, 95% confidence interval: 0.26-0.84 for regorafenib) and progression-free survival (odds ratio: 0.18, 95% confidence interval: 0.05-0.67 for trifluridine/tipiracil; odds ratio: 0.06, 95% confidence interval: 0.04-0.09 for regorafenib). Regorafenib (80 mg) was superior to the placebo in terms of the overall survival and progression-free survival and inferior to trifluridine/tipiracil and fruquintinib. Network analysis revealed that the efficacy of trifluridine/tipiracil and fruquintinib was fundamentally similar, and both the agents were superior to regorafenib.
Conclusion:
Regorafenib (80 mg) was superior to the placebo, but inferior to 160 mg regorafenib, trifluridine/tipiracil, and fruquintinib. This study further revealed that the efficiency of trifluridine/tipiracil and fruquintinib is identical, but their toxicity profiles are different.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>32914703</pmid><doi>10.1177/1533033820943241</doi><orcidid>https://orcid.org/0000-0002-9518-7634</orcidid><orcidid>https://orcid.org/0000-0003-2982-6300</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Cancer Clinical trials Colorectal cancer Colorectal carcinoma Confidence intervals Irinotecan Meta-Analysis Metastases Metastasis Oxaliplatin Patients Placebos Survival Targeted cancer therapy Toxicity Tyrosine kinase inhibitors |
| title | Systematic Review and Meta-Analysis of Multitargeted Tyrosine Kinase Inhibitors in Patients With Intractable Metastatic Colorectal Cancer |
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