Thoracic Surgeons' Perception of Frail Behavior in Videos of Standardized Patients
Publication Date
June 03, 2014
Journal
PLOS ONE
Authors
Mark K. Ferguson, Katherine Thompson, Megan Huisingh Scheetz, Jeanne Farnan, et al
Volume
9
Issue
6
Pages
e98654
DOI
https://dx.plos.org/10.1371/journal.pone.0098654
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0098654
PubMed
http://www.ncbi.nlm.nih.gov/pubmed/24892734
PubMed Central
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4043843
Europe PMC
http://europepmc.org/abstract/MED/24892734
Web of Science
000336911400079
Scopus
84902436407
Mendeley
http://www.mendeley.com/research/thoracic-surgeons-perception-frail-behavior-videos-standardized-patients
Events
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Mendeley | Further Information

{"title"=>"Thoracic surgeons' perception of frail behavior in videos of standardized patients", "type"=>"journal", "authors"=>[{"first_name"=>"Mark K.", "last_name"=>"Ferguson", "scopus_author_id"=>"56596117200"}, {"first_name"=>"Katherine", "last_name"=>"Thompson", "scopus_author_id"=>"7402891207"}, {"first_name"=>"Megan", "last_name"=>"Huisingh-Scheetz", "scopus_author_id"=>"55443394600"}, {"first_name"=>"Jeanne", "last_name"=>"Farnan", "scopus_author_id"=>"23567718700"}, {"first_name"=>"Josh A.", "last_name"=>"Hemmerich", "scopus_author_id"=>"15047937500"}, {"first_name"=>"Kris", "last_name"=>"Slawinski", "scopus_author_id"=>"56178958800"}, {"first_name"=>"Julissa", "last_name"=>"Acevedo", "scopus_author_id"=>"56179263000"}, {"first_name"=>"Sang Mee", "last_name"=>"Lee", "scopus_author_id"=>"55295811300"}, {"first_name"=>"Marko", "last_name"=>"Rojnica", "scopus_author_id"=>"56205803200"}, {"first_name"=>"Stephen", "last_name"=>"Small", "scopus_author_id"=>"56178975800"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"pmid"=>"24892734", "doi"=>"10.1371/journal.pone.0098654", "sgr"=>"84902436407", "scopus"=>"2-s2.0-84902436407", "issn"=>"19326203", "pui"=>"373323691"}, "id"=>"6113a62c-e158-334d-b60b-e7d294680ea9", "abstract"=>"BACKGROUND: Frailty is a predictor of poor outcomes following many types of operations. We measured thoracic surgeons' accuracy in assessing patient frailty using videos of standardized patients demonstrating signs of physical frailty. We compared their performance to that of geriatrics specialists. METHODS: We developed an anchored scale for rating degree of frailty. Reference categories were assigned to 31 videos of standardized patients trained to exhibit five levels of activity ranging from \"vigorous\" to \"frail.\" Following an explanation of frailty, thoracic surgeons and geriatrics specialists rated the videos. We evaluated inter-rater agreement and tested differences between ratings and reference categories. The influences of clinical specialty, clinical experience, and self-rated expertise were examined. RESULTS: Inter-rater rank correlation among all participants was high (Kendall's W 0.85) whereas exact agreement (Fleiss' kappa) was only moderate (0.47). Better inter-rater agreement was demonstrated for videos exhibiting extremes of behavior. Exact agreement was better for thoracic surgeons (n = 32) than geriatrics specialists (n = 9; p = 0.045), whereas rank correlation was similar for both groups. More clinical years of experience and self-reported expertise were not associated with better inter-rater agreement. CONCLUSIONS: Videos of standardized patients exhibiting varying degrees of frailty are rated with internal consistency by thoracic surgeons as accurately as geriatrics specialists when referenced to an anchored scale. Ratings were less consistent for moderate degrees of frailty, suggesting that physicians require training to recognize early frailty. Such videos may be useful in assessing and teaching frailty recognition.", "link"=>"http://www.mendeley.com/research/thoracic-surgeons-perception-frail-behavior-videos-standardized-patients", "reader_count"=>12, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>2, "Researcher"=>2, "Student > Ph. D. Student"=>1, "Student > Postgraduate"=>3, "Other"=>1, "Student > Master"=>1, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>2, "Researcher"=>2, "Student > Ph. D. Student"=>1, "Student > Postgraduate"=>3, "Other"=>1, "Student > Master"=>1, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>1, "Medicine and Dentistry"=>9, "Neuroscience"=>1, "Veterinary Science and Veterinary Medicine"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>9}, "Neuroscience"=>{"Neuroscience"=>1}, "Unspecified"=>{"Unspecified"=>1}, "Veterinary Science and Veterinary Medicine"=>{"Veterinary Science and Veterinary Medicine"=>1}}, "group_count"=>0}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1519909"], "description"=>"<p>Exact agreement with references scores by video category according to years of clinical experience.</p>", "links"=>[], "tags"=>["geriatrics", "health care", "Health risk analysis", "Medical humanities", "Medical education", "Surgical and invasive medical procedures", "Thoracic surgery", "references", "scores", "years"], "article_id"=>1045216, "categories"=>["Biological Sciences"], "users"=>["Mark K. Ferguson", "Katherine Thompson", "Megan Huisingh-Scheetz", "Jeanne Farnan", "Josh A. Hemmerich", "Kris Slawinski", "Julissa Acevedo", "Sang Mee Lee", "Marko Rojnica", "Stephen Small"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0098654.g003", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Exact_agreement_with_references_scores_by_video_category_according_to_years_of_clinical_experience_/1045216", "title"=>"Exact agreement with references scores by video category according to years of clinical experience.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-06-03 04:29:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/1519910"], "description"=>"<p>Rating system for frailty videos.</p>", "links"=>[], "tags"=>["geriatrics", "health care", "Health risk analysis", "Medical humanities", "Medical education", "Surgical and invasive medical procedures", "Thoracic surgery", "frailty"], "article_id"=>1045217, "categories"=>["Biological Sciences"], "users"=>["Mark K. Ferguson", "Katherine Thompson", "Megan Huisingh-Scheetz", "Jeanne Farnan", "Josh A. Hemmerich", "Kris Slawinski", "Julissa Acevedo", "Sang Mee Lee", "Marko Rojnica", "Stephen Small"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0098654.t001", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Rating_system_for_frailty_videos_/1045217", "title"=>"Rating system for frailty videos.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-06-03 04:29:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/1519911"], "description"=>"<p>Fleiss' kappa: exact inter-rater agreement; Kendall's W: relative agreement among raters; Kendall's tau: relative agreement with a standard value</p>", "links"=>[], "tags"=>["geriatrics", "health care", "Health risk analysis", "Medical humanities", "Medical education", "Surgical and invasive medical procedures", "Thoracic surgery", "raters"], "article_id"=>1045218, "categories"=>["Biological Sciences"], "users"=>["Mark K. Ferguson", "Katherine Thompson", "Megan Huisingh-Scheetz", "Jeanne Farnan", "Josh A. Hemmerich", "Kris Slawinski", "Julissa Acevedo", "Sang Mee Lee", "Marko Rojnica", "Stephen Small"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0098654.t002", "stats"=>{"downloads"=>2, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Exact_agreement_and_rank_correlation_for_all_raters_and_for_raters_according_to_specialty_/1045218", "title"=>"Exact agreement and rank correlation for all raters and for raters according to specialty.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-06-03 04:29:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/1519912"], "description"=>"<p>Fleiss' kappa: exact inter-rater agreement; Kendall's W: relative agreement among raters; Kendall's tau: relative agreement with a standard value</p>", "links"=>[], "tags"=>["geriatrics", "health care", "Health risk analysis", "Medical humanities", "Medical education", "Surgical and invasive medical procedures", "Thoracic surgery", "years"], "article_id"=>1045219, "categories"=>["Biological Sciences"], "users"=>["Mark K. Ferguson", "Katherine Thompson", "Megan Huisingh-Scheetz", "Jeanne Farnan", "Josh A. Hemmerich", "Kris Slawinski", "Julissa Acevedo", "Sang Mee Lee", "Marko Rojnica", "Stephen Small"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0098654.t003", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Exact_agreement_and_rank_correlation_according_to_expertise_and_years_of_experience_/1045219", "title"=>"Exact agreement and rank correlation according to expertise and years of experience.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-06-03 04:29:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/1519913"], "description"=>"<div><p>Background</p><p>Frailty is a predictor of poor outcomes following many types of operations. We measured thoracic surgeons' accuracy in assessing patient frailty using videos of standarized patients demonstrating signs of physical frailty. We compared their performance to that of geriatrics specialists.</p><p>Methods</p><p>We developed an anchored scale for rating degree of frailty. Reference categories were assigned to 31 videos of standarized patients trained to exhibit five levels of activity ranging from “vigorous” to “frail.” Following an explanation of frailty, thoracic surgeons and geriatrics specialists rated the videos. We evaluated inter-rater agreement and tested differences between ratings and reference categories. The influences of clinical specialty, clinical experience, and self-rated expertise were examined.</p><p>Results</p><p>Inter-rater rank correlation among all participants was high (Kendall's W 0.85) whereas exact agreement (Fleiss' kappa) was only moderate (0.47). Better inter-rater agreement was demonstrated for videos exhibiting extremes of behavior. Exact agreement was better for thoracic surgeons (n = 32) than geriatrics specialists (n = 9; p = 0.045), whereas rank correlation was similar for both groups. More clinical years of experience and self-reported expertise were not associated with better inter-rater agreement.</p><p>Conclusions</p><p>Videos of standarized patients exhibiting varying degrees of frailty are rated with internal consistency by thoracic surgeons as accurately as geriatrics specialists when referenced to an anchored scale. Ratings were less consistent for moderate degrees of frailty, suggesting that physicians require training to recognize early frailty. Such videos may be useful in assessing and teaching frailty recognition.</p></div>", "links"=>[], "tags"=>["geriatrics", "health care", "Health risk analysis", "Medical humanities", "Medical education", "Surgical and invasive medical procedures", "Thoracic surgery", "frail", "videos", "standardized"], "article_id"=>1045220, "categories"=>["Biological Sciences"], "users"=>["Mark K. Ferguson", "Katherine Thompson", "Megan Huisingh-Scheetz", "Jeanne Farnan", "Josh A. Hemmerich", "Kris Slawinski", "Julissa Acevedo", "Sang Mee Lee", "Marko Rojnica", "Stephen Small"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0098654", "stats"=>{"downloads"=>2, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Thoracic_Surgeons_Perception_of_Frail_Behavior_in_Videos_of_Standardized_Patients_/1045220", "title"=>"Thoracic Surgeons' Perception of Frail Behavior in Videos of Standardized Patients", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-06-03 04:29:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/1519907"], "description"=>"<p>Exact agreement with reference scores by video category for all raters and according to specialty.</p>", "links"=>[], "tags"=>["geriatrics", "health care", "Health risk analysis", "Medical humanities", "Medical education", "Surgical and invasive medical procedures", "Thoracic surgery", "scores", "raters"], "article_id"=>1045214, "categories"=>["Biological Sciences"], "users"=>["Mark K. Ferguson", "Katherine Thompson", "Megan Huisingh-Scheetz", "Jeanne Farnan", "Josh A. Hemmerich", "Kris Slawinski", "Julissa Acevedo", "Sang Mee Lee", "Marko Rojnica", "Stephen Small"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0098654.g001", "stats"=>{"downloads"=>0, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Exact_agreement_with_reference_scores_by_video_category_for_all_raters_and_according_to_specialty_/1045214", "title"=>"Exact agreement with reference scores by video category for all raters and according to specialty.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-06-03 04:29:04"}
  • {"files"=>["https://ndownloader.figshare.com/files/1519908"], "description"=>"<p>Exact agreement with reference scores by video category according to self-described expertise in recognizing frailty.</p>", "links"=>[], "tags"=>["geriatrics", "health care", "Health risk analysis", "Medical humanities", "Medical education", "Surgical and invasive medical procedures", "Thoracic surgery", "scores", "self-described", "recognizing"], "article_id"=>1045215, "categories"=>["Biological Sciences"], "users"=>["Mark K. Ferguson", "Katherine Thompson", "Megan Huisingh-Scheetz", "Jeanne Farnan", "Josh A. Hemmerich", "Kris Slawinski", "Julissa Acevedo", "Sang Mee Lee", "Marko Rojnica", "Stephen Small"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0098654.g002", "stats"=>{"downloads"=>0, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Exact_agreement_with_reference_scores_by_video_category_according_to_self_described_expertise_in_recognizing_frailty_/1045215", "title"=>"Exact agreement with reference scores by video category according to self-described expertise in recognizing frailty.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-06-03 04:29:04"}

PMC Usage Stats | Further Information

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  • {"unique-ip"=>"6", "full-text"=>"6", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"4"}
  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"5"}
  • {"unique-ip"=>"7", "full-text"=>"7", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"6"}
  • {"unique-ip"=>"2", "full-text"=>"1", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"7"}
  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"3"}
  • {"unique-ip"=>"3", "full-text"=>"3", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"2"}
  • {"unique-ip"=>"8", "full-text"=>"5", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"8"}
  • {"unique-ip"=>"8", "full-text"=>"6", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"9"}
  • {"unique-ip"=>"5", "full-text"=>"4", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2015", "month"=>"10"}
  • {"unique-ip"=>"18", "full-text"=>"16", "pdf"=>"19", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2014", "month"=>"7"}
  • {"unique-ip"=>"11", "full-text"=>"8", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"8"}
  • {"unique-ip"=>"13", "full-text"=>"12", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"9"}
  • {"unique-ip"=>"16", "full-text"=>"10", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2014", "month"=>"10"}
  • {"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"=>"2016", "month"=>"2"}
  • {"unique-ip"=>"10", "full-text"=>"6", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2014", "month"=>"11"}
  • {"unique-ip"=>"5", "full-text"=>"2", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"12"}
  • {"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"=>"2015", "month"=>"1"}
  • {"unique-ip"=>"10", "full-text"=>"6", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"11"}
  • {"unique-ip"=>"7", "full-text"=>"5", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"12"}
  • {"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"=>"2016", "month"=>"1"}
  • {"unique-ip"=>"2", "full-text"=>"3", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"3"}
  • {"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"=>"2016", "month"=>"4"}
  • {"unique-ip"=>"3", "full-text"=>"2", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"5"}
  • {"unique-ip"=>"4", "full-text"=>"4", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"6"}
  • {"unique-ip"=>"5", "full-text"=>"4", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"7"}
  • {"unique-ip"=>"2", "full-text"=>"1", "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"=>"3", "full-text"=>"3", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"9"}
  • {"unique-ip"=>"2", "full-text"=>"0", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"2", "cited-by"=>"0", "year"=>"2016", "month"=>"10"}
  • {"unique-ip"=>"4", "full-text"=>"6", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"11"}
  • {"unique-ip"=>"5", "full-text"=>"5", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"12"}
  • {"unique-ip"=>"5", "full-text"=>"3", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"1"}
  • {"unique-ip"=>"5", "full-text"=>"4", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"2"}
  • {"unique-ip"=>"3", "full-text"=>"5", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"3"}
  • {"unique-ip"=>"1", "full-text"=>"1", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"4"}
  • {"unique-ip"=>"4", "full-text"=>"3", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"5"}
  • {"unique-ip"=>"1", "full-text"=>"1", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"6"}
  • {"unique-ip"=>"1", "full-text"=>"0", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"7"}
  • {"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"=>"2017", "month"=>"8"}
  • {"unique-ip"=>"4", "full-text"=>"6", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"9"}
  • {"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"=>"2017", "month"=>"10"}
  • {"unique-ip"=>"4", "full-text"=>"3", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"11"}
  • {"unique-ip"=>"1", "full-text"=>"1", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"12"}
  • {"unique-ip"=>"4", "full-text"=>"5", "pdf"=>"0", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"3"}
  • {"unique-ip"=>"2", "full-text"=>"3", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"1"}
  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"4"}
  • {"unique-ip"=>"5", "full-text"=>"4", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"6"}
  • {"unique-ip"=>"7", "full-text"=>"10", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"1", "cited-by"=>"0", "year"=>"2018", "month"=>"7"}
  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"5"}
  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"8"}
  • {"unique-ip"=>"3", "full-text"=>"3", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"10"}
  • {"unique-ip"=>"3", "full-text"=>"3", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"9"}
  • {"unique-ip"=>"5", "full-text"=>"7", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"11"}
  • {"unique-ip"=>"8", "full-text"=>"8", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"12"}
  • {"unique-ip"=>"1", "full-text"=>"2", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"2"}
  • {"unique-ip"=>"4", "full-text"=>"2", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"3"}
  • {"unique-ip"=>"4", "full-text"=>"3", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"4"}
  • {"unique-ip"=>"1", "full-text"=>"1", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"5"}
  • {"unique-ip"=>"2", "full-text"=>"2", "pdf"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"8"}

Relative Metric

{"start_date"=>"2014-01-01T00:00:00Z", "end_date"=>"2014-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Biology and life sciences/Biomechanics", "average_usage"=>[303, 468]}, {"subject_area"=>"/Biology and life sciences/Psychology", "average_usage"=>[307]}, {"subject_area"=>"/Medicine and health sciences/Health care", "average_usage"=>[283, 456]}, {"subject_area"=>"/Medicine and health sciences/Surgical and invasive medical procedures", "average_usage"=>[248, 388]}, {"subject_area"=>"/People and places", "average_usage"=>[302]}, {"subject_area"=>"/People and places/Population groupings", "average_usage"=>[300]}, {"subject_area"=>"/Social sciences", "average_usage"=>[318]}, {"subject_area"=>"/Social sciences/Psychology", "average_usage"=>[314, 476]}]}
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