Aripiprazole in the Maintenance Treatment of Bipolar Disorder: A Critical Review of the Evidence and Its Dissemination into the Scientific Literature
Events
Loading … Spinner

Mendeley | Further Information

{"title"=>"Aripiprazole in the maintenance treatment of bipolar disorder: A critical review of the evidence and its dissemination into the scientific literature", "type"=>"generic", "authors"=>[{"first_name"=>"Alexander C.", "last_name"=>"Tsai", "scopus_author_id"=>"35362700200"}, {"first_name"=>"Nicholas Z.", "last_name"=>"Rosenlicht", "scopus_author_id"=>"6603155202"}, {"first_name"=>"Jon N.", "last_name"=>"Jureidini", "scopus_author_id"=>"56212445800"}, {"first_name"=>"Peter I.", "last_name"=>"Parry", "scopus_author_id"=>"23035985900"}, {"first_name"=>"Glen I.", "last_name"=>"Spielmans", "scopus_author_id"=>"6508110120"}, {"first_name"=>"David", "last_name"=>"Healy", "scopus_author_id"=>"26643139900"}], "year"=>2011, "source"=>"PLoS Medicine", "identifiers"=>{"issn"=>"15491277", "scopus"=>"2-s2.0-79958005192", "pui"=>"361887779", "doi"=>"10.1371/journal.pmed.1000434", "isbn"=>"1549-1676 (Electronic)\\r1549-1277 (Linking)", "sgr"=>"79958005192", "pmid"=>"21559324"}, "id"=>"ff9be8ac-6704-388d-85e7-f6c6304fe69d", "abstract"=>"BACKGROUND: Aripiprazole, a second-generation antipsychotic medication, has been increasingly used in the maintenance treatment of bipolar disorder and received approval from the U.S. Food and Drug Administration for this indication in 2005. Given its widespread use, we sought to critically review the evidence supporting the use of aripiprazole in the maintenance treatment of bipolar disorder and examine how that evidence has been disseminated in the scientific literature. METHODS and FINDINGS: We systematically searched multiple databases to identify double-blind, randomized controlled trials of aripiprazole for the maintenance treatment of bipolar disorder while excluding other types of studies, such as openlabel, acute, and adjunctive studies. We then used a citation search to identify articles that cited these trials and rated the quality of their citations. Our evidence search protocol identified only two publications, both describing the results of a single trial conducted by Keck et al., which met criteria for inclusion in this review. We describe four issues that limit the interpretation of that trial as supporting the use of aripiprazole for bipolar maintenance: (1) insufficient duration to demonstrate maintenance efficacy; (2) limited generalizability due to its enriched sample; (3) possible conflation of iatrogenic adverse effects of abrupt medication discontinuation with beneficial effects of treatment; and (4) a low overall completion rate. Our citation search protocol yielded 80 publications that cited the Keck et al. trial in discussing the use of aripiprazole for bipolar maintenance. Of these, only 24 (30%) mentioned adverse events reported and four (5%) mentioned study limitations. CONCLUSIONS: A single trial by Keck et al. represents the entirety of the literature on the use of aripiprazole for the maintenance treatment of bipolar disorder. Although careful review identifies four critical limitations to the trial’s interpretation and overall utility, the trial has been uncritically cited in the subsequent scientific literature.", "link"=>"http://www.mendeley.com/research/aripiprazole-maintenance-treatment-bipolar-disorder-critical-review-evidence-dissemination-scientifi-6", "reader_count"=>59, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>6, "Librarian"=>2, "Researcher"=>4, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>8, "Student > Postgraduate"=>5, "Other"=>12, "Student > Master"=>9, "Student > Bachelor"=>3, "Lecturer"=>2, "Professor"=>5}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>6, "Librarian"=>2, "Researcher"=>4, "Student > Doctoral Student"=>2, "Student > Ph. D. Student"=>8, "Student > Postgraduate"=>5, "Other"=>12, "Student > Master"=>9, "Student > Bachelor"=>3, "Lecturer"=>2, "Professor"=>5}, "reader_count_by_subject_area"=>{"Unspecified"=>3, "Medicine and Dentistry"=>35, "Agricultural and Biological Sciences"=>3, "Neuroscience"=>2, "Business, Management and Accounting"=>2, "Psychology"=>11, "Social Sciences"=>3}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>35}, "Neuroscience"=>{"Neuroscience"=>2}, "Social Sciences"=>{"Social Sciences"=>3}, "Psychology"=>{"Psychology"=>11}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>2}, "Unspecified"=>{"Unspecified"=>3}}, "reader_count_by_country"=>{"Canada"=>1, "Turkey"=>1, "United States"=>1, "Brazil"=>1, "United Kingdom"=>1, "South Africa"=>1, "Israel"=>1, "Chile"=>1}, "group_count"=>4}

Scopus | Further Information

{"@_fa"=>"true", "link"=>[{"@_fa"=>"true", "@ref"=>"self", "@href"=>"https://api.elsevier.com/content/abstract/scopus_id/79958005192"}, {"@_fa"=>"true", "@ref"=>"author-affiliation", "@href"=>"https://api.elsevier.com/content/abstract/scopus_id/79958005192?field=author,affiliation"}, {"@_fa"=>"true", "@ref"=>"scopus", "@href"=>"https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=79958005192&origin=inward"}, {"@_fa"=>"true", "@ref"=>"scopus-citedby", "@href"=>"https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=79958005192&origin=inward"}], "prism:url"=>"https://api.elsevier.com/content/abstract/scopus_id/79958005192", "dc:identifier"=>"SCOPUS_ID:79958005192", "eid"=>"2-s2.0-79958005192", "dc:title"=>"Aripiprazole in the maintenance treatment of bipolar disorder: A critical review of the evidence and its dissemination into the scientific literature", "dc:creator"=>"Tsai A.", "prism:publicationName"=>"PLoS Medicine", "prism:issn"=>"15491277", "prism:eIssn"=>"15491676", "prism:volume"=>"8", "prism:issueIdentifier"=>"5", "prism:pageRange"=>nil, "prism:coverDate"=>"2011-05-01", "prism:coverDisplayDate"=>"May 2011", "prism:doi"=>"10.1371/journal.pmed.1000434", "citedby-count"=>"25", "affiliation"=>[{"@_fa"=>"true", "affilname"=>"Harvard University", "affiliation-city"=>"Cambridge", "affiliation-country"=>"United States"}], "pubmed-id"=>"21559324", "prism:aggregationType"=>"Journal", "subtype"=>"re", "subtypeDescription"=>"Review", "article-number"=>"e1000434", "source-id"=>"144840", "openaccess"=>"1", "openaccessFlag"=>true}

Facebook

  • {"url"=>"http%3A%2F%2Fjournals.plos.org%2Fplosmedicine%2Farticle%3Fid%3D10.1371%252Fjournal.pmed.1000434", "share_count"=>0, "like_count"=>0, "comment_count"=>0, "click_count"=>0, "total_count"=>0}

Journal Comments | Further Information

Counter

  • {"month"=>"5", "year"=>"2011", "pdf_views"=>"480", "xml_views"=>"39", "html_views"=>"2635"}
  • {"month"=>"6", "year"=>"2011", "pdf_views"=>"116", "xml_views"=>"17", "html_views"=>"1686"}
  • {"month"=>"7", "year"=>"2011", "pdf_views"=>"46", "xml_views"=>"13", "html_views"=>"320"}
  • {"month"=>"8", "year"=>"2011", "pdf_views"=>"44", "xml_views"=>"3", "html_views"=>"227"}
  • {"month"=>"9", "year"=>"2011", "pdf_views"=>"30", "xml_views"=>"2", "html_views"=>"246"}
  • {"month"=>"10", "year"=>"2011", "pdf_views"=>"35", "xml_views"=>"0", "html_views"=>"288"}
  • {"month"=>"11", "year"=>"2011", "pdf_views"=>"39", "xml_views"=>"5", "html_views"=>"308"}
  • {"month"=>"12", "year"=>"2011", "pdf_views"=>"38", "xml_views"=>"1", "html_views"=>"271"}
  • {"month"=>"1", "year"=>"2012", "pdf_views"=>"36", "xml_views"=>"2", "html_views"=>"274"}
  • {"month"=>"2", "year"=>"2012", "pdf_views"=>"47", "xml_views"=>"1", "html_views"=>"370"}
  • {"month"=>"3", "year"=>"2012", "pdf_views"=>"62", "xml_views"=>"2", "html_views"=>"415"}
  • {"month"=>"4", "year"=>"2012", "pdf_views"=>"25", "xml_views"=>"1", "html_views"=>"264"}
  • {"month"=>"5", "year"=>"2012", "pdf_views"=>"42", "xml_views"=>"0", "html_views"=>"238"}
  • {"month"=>"6", "year"=>"2012", "pdf_views"=>"32", "xml_views"=>"1", "html_views"=>"216"}
  • {"month"=>"7", "year"=>"2012", "pdf_views"=>"18", "xml_views"=>"0", "html_views"=>"149"}
  • {"month"=>"8", "year"=>"2012", "pdf_views"=>"21", "xml_views"=>"11", "html_views"=>"203"}
  • {"month"=>"9", "year"=>"2012", "pdf_views"=>"27", "xml_views"=>"0", "html_views"=>"207"}
  • {"month"=>"10", "year"=>"2012", "pdf_views"=>"20", "xml_views"=>"1", "html_views"=>"212"}
  • {"month"=>"11", "year"=>"2012", "pdf_views"=>"31", "xml_views"=>"0", "html_views"=>"259"}
  • {"month"=>"12", "year"=>"2012", "pdf_views"=>"27", "xml_views"=>"1", "html_views"=>"469"}
  • {"month"=>"1", "year"=>"2013", "pdf_views"=>"11", "xml_views"=>"0", "html_views"=>"224"}
  • {"month"=>"2", "year"=>"2013", "pdf_views"=>"18", "xml_views"=>"2", "html_views"=>"203"}
  • {"month"=>"3", "year"=>"2013", "pdf_views"=>"16", "xml_views"=>"0", "html_views"=>"249"}
  • {"month"=>"4", "year"=>"2013", "pdf_views"=>"17", "xml_views"=>"0", "html_views"=>"221"}
  • {"month"=>"5", "year"=>"2013", "pdf_views"=>"22", "xml_views"=>"0", "html_views"=>"191"}
  • {"month"=>"6", "year"=>"2013", "pdf_views"=>"15", "xml_views"=>"4", "html_views"=>"198"}
  • {"month"=>"7", "year"=>"2013", "pdf_views"=>"12", "xml_views"=>"0", "html_views"=>"192"}
  • {"month"=>"8", "year"=>"2013", "pdf_views"=>"10", "xml_views"=>"0", "html_views"=>"164"}
  • {"month"=>"9", "year"=>"2013", "pdf_views"=>"12", "xml_views"=>"8", "html_views"=>"176"}
  • {"month"=>"10", "year"=>"2013", "pdf_views"=>"14", "xml_views"=>"2", "html_views"=>"189"}
  • {"month"=>"11", "year"=>"2013", "pdf_views"=>"17", "xml_views"=>"2", "html_views"=>"176"}
  • {"month"=>"12", "year"=>"2013", "pdf_views"=>"16", "xml_views"=>"0", "html_views"=>"228"}
  • {"month"=>"1", "year"=>"2014", "pdf_views"=>"11", "xml_views"=>"2", "html_views"=>"185"}
  • {"month"=>"2", "year"=>"2014", "pdf_views"=>"16", "xml_views"=>"0", "html_views"=>"246"}
  • {"month"=>"3", "year"=>"2014", "pdf_views"=>"17", "xml_views"=>"2", "html_views"=>"266"}
  • {"month"=>"4", "year"=>"2014", "pdf_views"=>"14", "xml_views"=>"1", "html_views"=>"241"}
  • {"month"=>"5", "year"=>"2014", "pdf_views"=>"13", "xml_views"=>"0", "html_views"=>"156"}
  • {"month"=>"6", "year"=>"2014", "pdf_views"=>"8", "xml_views"=>"0", "html_views"=>"134"}
  • {"month"=>"7", "year"=>"2014", "pdf_views"=>"5", "xml_views"=>"1", "html_views"=>"130"}
  • {"month"=>"8", "year"=>"2014", "pdf_views"=>"12", "xml_views"=>"4", "html_views"=>"195"}
  • {"month"=>"9", "year"=>"2014", "pdf_views"=>"8", "xml_views"=>"0", "html_views"=>"174"}
  • {"month"=>"10", "year"=>"2014", "pdf_views"=>"12", "xml_views"=>"6", "html_views"=>"398"}
  • {"month"=>"11", "year"=>"2014", "pdf_views"=>"13", "xml_views"=>"1", "html_views"=>"264"}
  • {"month"=>"12", "year"=>"2014", "pdf_views"=>"9", "xml_views"=>"2", "html_views"=>"168"}
  • {"month"=>"1", "year"=>"2015", "pdf_views"=>"8", "xml_views"=>"2", "html_views"=>"161"}
  • {"month"=>"2", "year"=>"2015", "pdf_views"=>"8", "xml_views"=>"0", "html_views"=>"100"}
  • {"month"=>"3", "year"=>"2015", "pdf_views"=>"23", "xml_views"=>"0", "html_views"=>"128"}
  • {"month"=>"4", "year"=>"2015", "pdf_views"=>"10", "xml_views"=>"0", "html_views"=>"135"}
  • {"month"=>"5", "year"=>"2015", "pdf_views"=>"12", "xml_views"=>"1", "html_views"=>"152"}
  • {"month"=>"6", "year"=>"2015", "pdf_views"=>"18", "xml_views"=>"0", "html_views"=>"73"}
  • {"month"=>"7", "year"=>"2015", "pdf_views"=>"6", "xml_views"=>"0", "html_views"=>"75"}
  • {"month"=>"8", "year"=>"2015", "pdf_views"=>"3", "xml_views"=>"0", "html_views"=>"107"}
  • {"month"=>"9", "year"=>"2015", "pdf_views"=>"4", "xml_views"=>"1", "html_views"=>"112"}
  • {"month"=>"10", "year"=>"2015", "pdf_views"=>"9", "xml_views"=>"0", "html_views"=>"104"}
  • {"month"=>"11", "year"=>"2015", "pdf_views"=>"10", "xml_views"=>"1", "html_views"=>"108"}
  • {"month"=>"12", "year"=>"2015", "pdf_views"=>"12", "xml_views"=>"0", "html_views"=>"88"}
  • {"month"=>"1", "year"=>"2016", "pdf_views"=>"4", "xml_views"=>"0", "html_views"=>"77"}
  • {"month"=>"2", "year"=>"2016", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"98"}
  • {"month"=>"3", "year"=>"2016", "pdf_views"=>"10", "xml_views"=>"0", "html_views"=>"133"}
  • {"month"=>"4", "year"=>"2016", "pdf_views"=>"11", "xml_views"=>"0", "html_views"=>"95"}
  • {"month"=>"5", "year"=>"2016", "pdf_views"=>"8", "xml_views"=>"0", "html_views"=>"86"}
  • {"month"=>"6", "year"=>"2016", "pdf_views"=>"8", "xml_views"=>"0", "html_views"=>"69"}
  • {"month"=>"7", "year"=>"2016", "pdf_views"=>"6", "xml_views"=>"0", "html_views"=>"58"}
  • {"month"=>"8", "year"=>"2016", "pdf_views"=>"8", "xml_views"=>"0", "html_views"=>"51"}
  • {"month"=>"9", "year"=>"2016", "pdf_views"=>"91", "xml_views"=>"0", "html_views"=>"120"}
  • {"month"=>"10", "year"=>"2016", "pdf_views"=>"154", "xml_views"=>"0", "html_views"=>"84"}
  • {"month"=>"11", "year"=>"2016", "pdf_views"=>"71", "xml_views"=>"0", "html_views"=>"101"}
  • {"month"=>"12", "year"=>"2016", "pdf_views"=>"145", "xml_views"=>"0", "html_views"=>"121"}
  • {"month"=>"1", "year"=>"2017", "pdf_views"=>"52", "xml_views"=>"0", "html_views"=>"143"}
  • {"month"=>"2", "year"=>"2017", "pdf_views"=>"20", "xml_views"=>"3", "html_views"=>"166"}
  • {"month"=>"3", "year"=>"2017", "pdf_views"=>"16", "xml_views"=>"0", "html_views"=>"188"}
  • {"month"=>"4", "year"=>"2017", "pdf_views"=>"20", "xml_views"=>"0", "html_views"=>"263"}
  • {"month"=>"5", "year"=>"2017", "pdf_views"=>"3", "xml_views"=>"1", "html_views"=>"134"}
  • {"month"=>"6", "year"=>"2017", "pdf_views"=>"2", "xml_views"=>"1", "html_views"=>"118"}
  • {"month"=>"7", "year"=>"2017", "pdf_views"=>"7", "xml_views"=>"0", "html_views"=>"115"}
  • {"month"=>"8", "year"=>"2017", "pdf_views"=>"6", "xml_views"=>"1", "html_views"=>"102"}
  • {"month"=>"9", "year"=>"2017", "pdf_views"=>"2", "xml_views"=>"1", "html_views"=>"98"}
  • {"month"=>"10", "year"=>"2017", "pdf_views"=>"7", "xml_views"=>"3", "html_views"=>"196"}
  • {"month"=>"11", "year"=>"2017", "pdf_views"=>"6", "xml_views"=>"0", "html_views"=>"189"}
  • {"month"=>"12", "year"=>"2017", "pdf_views"=>"14", "xml_views"=>"0", "html_views"=>"87"}
  • {"month"=>"1", "year"=>"2018", "pdf_views"=>"15", "xml_views"=>"1", "html_views"=>"79"}
  • {"month"=>"2", "year"=>"2018", "pdf_views"=>"10", "xml_views"=>"0", "html_views"=>"56"}
  • {"month"=>"3", "year"=>"2018", "pdf_views"=>"3", "xml_views"=>"0", "html_views"=>"27"}
  • {"month"=>"4", "year"=>"2018", "pdf_views"=>"6", "xml_views"=>"0", "html_views"=>"43"}
  • {"month"=>"5", "year"=>"2018", "pdf_views"=>"17", "xml_views"=>"0", "html_views"=>"47"}
  • {"month"=>"6", "year"=>"2018", "pdf_views"=>"13", "xml_views"=>"4", "html_views"=>"74"}
  • {"month"=>"7", "year"=>"2018", "pdf_views"=>"10", "xml_views"=>"7", "html_views"=>"70"}
  • {"month"=>"8", "year"=>"2018", "pdf_views"=>"5", "xml_views"=>"4", "html_views"=>"48"}
  • {"month"=>"9", "year"=>"2018", "pdf_views"=>"6", "xml_views"=>"1", "html_views"=>"54"}
  • {"month"=>"10", "year"=>"2018", "pdf_views"=>"11", "xml_views"=>"1", "html_views"=>"55"}
  • {"month"=>"11", "year"=>"2018", "pdf_views"=>"3", "xml_views"=>"0", "html_views"=>"45"}
  • {"month"=>"12", "year"=>"2018", "pdf_views"=>"0", "xml_views"=>"1", "html_views"=>"32"}
  • {"month"=>"1", "year"=>"2019", "pdf_views"=>"3", "xml_views"=>"0", "html_views"=>"21"}
  • {"month"=>"2", "year"=>"2019", "pdf_views"=>"5", "xml_views"=>"0", "html_views"=>"27"}
  • {"month"=>"3", "year"=>"2019", "pdf_views"=>"6", "xml_views"=>"1", "html_views"=>"55"}
  • {"month"=>"4", "year"=>"2019", "pdf_views"=>"6", "xml_views"=>"0", "html_views"=>"40"}
  • {"month"=>"5", "year"=>"2019", "pdf_views"=>"2", "xml_views"=>"0", "html_views"=>"41"}
  • {"month"=>"6", "year"=>"2019", "pdf_views"=>"3", "xml_views"=>"2", "html_views"=>"24"}
  • {"month"=>"7", "year"=>"2019", "pdf_views"=>"3", "xml_views"=>"0", "html_views"=>"28"}
  • {"month"=>"8", "year"=>"2019", "pdf_views"=>"8", "xml_views"=>"1", "html_views"=>"21"}

Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/777379"], "description"=>"<p>These publications were identified using a systematic search of PubMed and\n Scopus, as well as a manual search of the supplemental new drug application\n submitted to the FDA to obtain an additional indication for the use of\n aripiprazole in the maintenance treatment of bipolar disorder.</p>", "links"=>[], "tags"=>["evidence-based healthcare", "evidence-based healthcare/bedside evidence-based medicine", "Mental health", "mental health/mood disorders"], "article_id"=>447744, "categories"=>["Mental Health", "Infectious Diseases", "Medicine"], "users"=>["Alexander C. Tsai", "Nicholas Z. Rosenlicht", "Jon N. Jureidini", "Peter I. Parry", "Glen I. Spielmans", "David Healy"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000434.g001", "stats"=>{"downloads"=>2, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Publications_identified_for_review_/447744", "title"=>"Publications identified for review.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-05-03 02:09:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/777570"], "description"=>"<p>Participants had to complete the 6- to 18-wk stabilization phase before\n they were eligible for randomization. After completion of the 26-wk\n double-blind phase, participants were invited to continue in the 74-wk\n extension phase.</p>", "links"=>[], "tags"=>["evidence-based healthcare", "evidence-based healthcare/bedside evidence-based medicine", "Mental health", "mental health/mood disorders"], "article_id"=>447934, "categories"=>["Mental Health", "Infectious Diseases", "Medicine"], "users"=>["Alexander C. Tsai", "Nicholas Z. Rosenlicht", "Jon N. Jureidini", "Peter I. Parry", "Glen I. Spielmans", "David Healy"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000434.g003", "stats"=>{"downloads"=>2, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Keck_study_participant_flow_/447934", "title"=>"Keck study participant flow.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-05-03 02:12:14"}
  • {"files"=>["https://ndownloader.figshare.com/files/777694"], "description"=>"<p>These publications were identified using Web of Science(R) Science\n Citation Index Expanded. Those that discussed the Keck study in\n relation to the maintenance treatment of bipolar disorder were\n evaluated on three quality indicators, as shown.</p>", "links"=>[], "tags"=>["citing", "keck"], "article_id"=>448066, "categories"=>["Mental Health", "Infectious Diseases", "Medicine"], "users"=>["Alexander C. Tsai", "Nicholas Z. Rosenlicht", "Jon N. Jureidini", "Peter I. Parry", "Glen I. Spielmans", "David Healy"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000434.g004", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Publications_citing_the_Keck_study_/448066", "title"=>"Publications citing the Keck study.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-05-03 02:14:26"}
  • {"files"=>["https://ndownloader.figshare.com/files/390200", "https://ndownloader.figshare.com/files/390227", "https://ndownloader.figshare.com/files/390260"], "description"=>"<div><h3>Background</h3><p>Aripiprazole, a second-generation antipsychotic medication, has been increasingly used in the maintenance treatment of bipolar disorder and received approval from the U.S. Food and Drug Administration for this indication in 2005. Given its widespread use, we sought to critically review the evidence supporting the use of aripiprazole in the maintenance treatment of bipolar disorder and examine how that evidence has been disseminated in the scientific literature.</p> <h3>Methods and Findings</h3><p>We systematically searched multiple databases to identify double-blind, randomized controlled trials of aripiprazole for the maintenance treatment of bipolar disorder while excluding other types of studies, such as open-label, acute, and adjunctive studies. We then used a citation search to identify articles that cited these trials and rated the quality of their citations. Our evidence search protocol identified only two publications, both describing the results of a single trial conducted by Keck et al., which met criteria for inclusion in this review. We describe four issues that limit the interpretation of that trial as supporting the use of aripiprazole for bipolar maintenance: (1) insufficient duration to demonstrate maintenance efficacy; (2) limited generalizability due to its enriched sample; (3) possible conflation of iatrogenic adverse effects of abrupt medication discontinuation with beneficial effects of treatment; and (4) a low overall completion rate. Our citation search protocol yielded 80 publications that cited the Keck et al. trial in discussing the use of aripiprazole for bipolar maintenance. Of these, only 24 (30%) mentioned adverse events reported and four (5%) mentioned study limitations.</p> <h3>Conclusions</h3><p>A single trial by Keck et al. represents the entirety of the literature on the use of aripiprazole for the maintenance treatment of bipolar disorder. Although careful review identifies four critical limitations to the trial's interpretation and overall utility, the trial has been uncritically cited in the subsequent scientific literature.</p> <h3></h3><p> <em>Please see later in the article for the Editors' Summary</em></p> </div>", "links"=>[], "tags"=>["aripiprazole", "bipolar", "dissemination"], "article_id"=>137049, "categories"=>["Mental Health", "Cancer", "Medicine"], "users"=>["Alexander C. Tsai", "Nicholas Z. Rosenlicht", "Jon N. Jureidini", "Peter I. Parry", "Glen I. Spielmans", "David Healy"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1000434.s001", "https://dx.doi.org/10.1371/journal.pmed.1000434.s002", "https://dx.doi.org/10.1371/journal.pmed.1000434.s003"], "stats"=>{"downloads"=>24, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Aripiprazole_in_the_Maintenance_Treatment_of_Bipolar_Disorder_A_Critical_Review_of_the_Evidence_and_Its_Dissemination_into_the_Scientific_Literature/137049", "title"=>"Aripiprazole in the Maintenance Treatment of Bipolar Disorder: A Critical Review of the Evidence and Its Dissemination into the Scientific Literature", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2011-05-03 01:57:29"}
  • {"files"=>["https://ndownloader.figshare.com/files/777798"], "description"=>"a<p>A, reported any quantitative data; B, reported any adverse events; C,\n reported any study limitations.</p><p>BD, bipolar disorder.</p>", "links"=>[], "tags"=>["guidelines", "reviews", "aripiprazole", "of", "bipolar"], "article_id"=>448165, "categories"=>["Mental Health", "Infectious Diseases", "Medicine"], "users"=>["Alexander C. Tsai", "Nicholas Z. Rosenlicht", "Jon N. Jureidini", "Peter I. Parry", "Glen I. Spielmans", "David Healy"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000434.t001", "stats"=>{"downloads"=>1, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Treatment_guidelines_and_reviews_of_aripiprazole_for_the_treatment_of____bipolar_disorder_/448165", "title"=>"Treatment guidelines and reviews of aripiprazole for the treatment of\n bipolar disorder.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2011-05-03 02:16:05"}
  • {"files"=>["https://ndownloader.figshare.com/files/777459"], "description"=>"<p>These clinical trials were identified using a systematic search of\n ClinicalTrials.gov, the Cochrane Central Register of Controlled Trials, the\n World Health Organization (WHO) International Clinical Trials Registry, and\n the Bristol-Myers Squibb Clinical Trials Disclosure Web site, as well as a\n manual search of the supplemental new drug application submitted to the FDA\n to obtain an additional indication for the use of aripiprazole in the\n maintenance treatment of bipolar disorder. The “duplicates” were\n each matched to published studies (see <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1000434#pmed-1000434-g001\" target=\"_blank\">Figure 1</a>).</p>", "links"=>[], "tags"=>["trials"], "article_id"=>447830, "categories"=>["Mental Health", "Infectious Diseases", "Medicine"], "users"=>["Alexander C. Tsai", "Nicholas Z. Rosenlicht", "Jon N. Jureidini", "Peter I. Parry", "Glen I. Spielmans", "David Healy"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1000434.g002", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Clinical_trials_identified_for_review_/447830", "title"=>"Clinical trials identified for review.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2011-05-03 02:10:30"}

PMC Usage Stats | Further Information

  • {"unique-ip"=>"12", "full-text"=>"9", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"7"}
  • {"unique-ip"=>"20", "full-text"=>"20", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"8"}
  • {"unique-ip"=>"26", "full-text"=>"18", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"5", "cited-by"=>"0", "year"=>"2014", "month"=>"9"}
  • {"unique-ip"=>"32", "full-text"=>"25", "pdf"=>"8", "abstract"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"10"}
  • {"unique-ip"=>"17", "full-text"=>"16", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"11"}
  • {"unique-ip"=>"24", "full-text"=>"25", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"12"}
  • {"unique-ip"=>"23", "full-text"=>"20", "pdf"=>"13", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2015", "month"=>"1"}
  • {"unique-ip"=>"40", "full-text"=>"35", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"6", "supp-data"=>"3", "cited-by"=>"1", "year"=>"2015", "month"=>"2"}
  • {"unique-ip"=>"26", "full-text"=>"27", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"3"}
  • {"unique-ip"=>"21", "full-text"=>"23", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"4"}
  • {"unique-ip"=>"31", "full-text"=>"34", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"7", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"5"}
  • {"unique-ip"=>"26", "full-text"=>"24", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"6"}
  • {"unique-ip"=>"21", "full-text"=>"21", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"7"}
  • {"unique-ip"=>"27", "full-text"=>"23", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"8"}
  • {"unique-ip"=>"33", "full-text"=>"29", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"9"}
  • {"unique-ip"=>"19", "full-text"=>"19", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"5", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"10"}
  • {"unique-ip"=>"29", "full-text"=>"25", "pdf"=>"13", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2015", "month"=>"11"}
  • {"unique-ip"=>"24", "full-text"=>"23", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"6", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"12"}
  • {"unique-ip"=>"18", "full-text"=>"18", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"1"}
  • {"unique-ip"=>"29", "full-text"=>"40", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2016", "month"=>"2"}
  • {"unique-ip"=>"24", "full-text"=>"28", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"3"}
  • {"unique-ip"=>"18", "full-text"=>"18", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"4"}
  • {"unique-ip"=>"19", "full-text"=>"22", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"15", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2016", "month"=>"5"}
  • {"unique-ip"=>"13", "full-text"=>"12", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"6"}
  • {"unique-ip"=>"18", "full-text"=>"18", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"7"}
  • {"unique-ip"=>"10", "full-text"=>"9", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"8"}
  • {"unique-ip"=>"27", "full-text"=>"21", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"9"}
  • {"unique-ip"=>"27", "full-text"=>"24", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"10"}
  • {"unique-ip"=>"25", "full-text"=>"26", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"11"}
  • {"unique-ip"=>"21", "full-text"=>"20", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"12"}
  • {"unique-ip"=>"17", "full-text"=>"18", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"1"}
  • {"unique-ip"=>"21", "full-text"=>"24", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"1", "year"=>"2017", "month"=>"2"}
  • {"unique-ip"=>"26", "full-text"=>"34", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"3"}
  • {"unique-ip"=>"29", "full-text"=>"33", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"4"}
  • {"unique-ip"=>"30", "full-text"=>"31", "pdf"=>"12", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"5"}
  • {"unique-ip"=>"32", "full-text"=>"36", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"6"}
  • {"unique-ip"=>"13", "full-text"=>"14", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"7"}
  • {"unique-ip"=>"69", "full-text"=>"69", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"8"}
  • {"unique-ip"=>"43", "full-text"=>"45", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"9"}
  • {"unique-ip"=>"70", "full-text"=>"72", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2017", "month"=>"10"}
  • {"unique-ip"=>"18", "full-text"=>"20", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"11"}
  • {"unique-ip"=>"10", "full-text"=>"8", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"12"}
  • {"unique-ip"=>"13", "full-text"=>"12", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"1"}
  • {"unique-ip"=>"1", "full-text"=>"1", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"2"}
  • {"unique-ip"=>"30", "full-text"=>"34", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"3"}
  • {"unique-ip"=>"24", "full-text"=>"26", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"1"}
  • {"unique-ip"=>"27", "full-text"=>"31", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"4"}
  • {"unique-ip"=>"35", "full-text"=>"39", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"6"}
  • {"unique-ip"=>"23", "full-text"=>"22", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"5"}
  • {"unique-ip"=>"27", "full-text"=>"29", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"7"}
  • {"unique-ip"=>"28", "full-text"=>"36", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"8"}
  • {"unique-ip"=>"23", "full-text"=>"26", "pdf"=>"6", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"9"}
  • {"unique-ip"=>"36", "full-text"=>"44", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"10"}
  • {"unique-ip"=>"15", "full-text"=>"14", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"3", "cited-by"=>"0", "year"=>"2018", "month"=>"11"}
  • {"unique-ip"=>"25", "full-text"=>"25", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"12"}
  • {"unique-ip"=>"18", "full-text"=>"15", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"2"}
  • {"unique-ip"=>"31", "full-text"=>"50", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"3"}
  • {"unique-ip"=>"37", "full-text"=>"41", "pdf"=>"4", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"4"}
  • {"unique-ip"=>"31", "full-text"=>"33", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2019", "month"=>"5"}

Relative Metric

{"start_date"=>"2011-01-01T00:00:00Z", "end_date"=>"2011-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Medicine and health sciences/Clinical medicine", "average_usage"=>[286, 588, 710, 818, 936, 1045, 1150, 1241, 1308, 1382, 1463, 1545, 1602, 1662, 1728, 1807, 1865, 1931, 1998, 2074, 2123, 2191, 2236, 2276, 2342, 2405, 2482, 2536, 2586, 2655, 2710, 2778, 2816, 2895, 2947, 2997, 3047]}, {"subject_area"=>"/Medicine and health sciences/Diagnostic medicine", "average_usage"=>[327, 595, 718, 842, 949, 1065, 1147, 1225, 1316, 1399, 1468, 1541, 1618, 1690, 1756, 1814, 1872, 1924, 1987, 2054, 2118, 2189, 2244, 2300, 2364, 2422, 2480, 2543, 2597, 2665, 2727, 2777, 2821, 2877, 2940, 2996, 3052]}, {"subject_area"=>"/Medicine and health sciences/Immunology", "average_usage"=>[299, 582, 725, 844, 971, 1076, 1167, 1253, 1328, 1403, 1480, 1551, 1620, 1691, 1756, 1821, 1893, 1962, 2032, 2110, 2178, 2236, 2300, 2358, 2419, 2465, 2529, 2587, 2643, 2700, 2756, 2817, 2869, 2932, 2986, 3046, 3101]}, {"subject_area"=>"/Medicine and health sciences/Pharmaceutics", "average_usage"=>[338, 643, 805, 952, 1079, 1194, 1274, 1354, 1463, 1551, 1617, 1697, 1763, 1845, 1913, 1982, 2047, 2122, 2191, 2252, 2312, 2384, 2443, 2530, 2600, 2657, 2714, 2779, 2852, 2900, 2982, 3026, 3090, 3138, 3199, 3253, 3316]}, {"subject_area"=>"/Medicine and health sciences/Pharmacology", "average_usage"=>[337, 604, 750, 875, 1001, 1107, 1205, 1299, 1391, 1468, 1552, 1629, 1709, 1785, 1862, 1935, 2013, 2081, 2140, 2212, 2281, 2352, 2422, 2489, 2564, 2629, 2698, 2752, 2833, 2880, 2925, 2983, 3042, 3111, 3183, 3250, 3311]}, {"subject_area"=>"/Physical sciences/Chemistry", "average_usage"=>[272, 506, 626, 733, 837, 944, 1031, 1116, 1192, 1253, 1324, 1388, 1459, 1528, 1593, 1653, 1718, 1787, 1854, 1916, 1974, 2045, 2111, 2167, 2232, 2297, 2355, 2425, 2489, 2549, 2615, 2675, 2734, 2793, 2851, 2904, 2961]}]}
Loading … Spinner
There are currently no alerts