DVT Surveillance Program in the ICU: Analysis of Cost-Effectiveness
Publication Date
September 30, 2014
Journal
PLOS ONE
Authors
Ajai K. Malhotra, Stephanie R. Goldberg, Laura Mc Lay, Nancy R. Martin, et al
Volume
9
Issue
9
Pages
e106793
DOI
https://dx.plos.org/10.1371/journal.pone.0106793
Publisher URL
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0106793
PubMed
http://www.ncbi.nlm.nih.gov/pubmed/25269021
PubMed Central
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4182316
Europe PMC
http://europepmc.org/abstract/MED/25269021
Web of Science
000343671700017
Scopus
84907482530
Mendeley
http://www.mendeley.com/research/dvt-surveillance-program-icu-analysis-costeffectiveness
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Mendeley | Further Information

{"title"=>"DVT surveillance program in the ICU: Analysis of cost-effectiveness", "type"=>"journal", "authors"=>[{"first_name"=>"Ajai K.", "last_name"=>"Malhotra", "scopus_author_id"=>"7201833493"}, {"first_name"=>"Stephanie R.", "last_name"=>"Goldberg", "scopus_author_id"=>"36722237400"}, {"first_name"=>"Laura", "last_name"=>"McLay", "scopus_author_id"=>"57069988500"}, {"first_name"=>"Nancy R.", "last_name"=>"Martin", "scopus_author_id"=>"22035599700"}, {"first_name"=>"Luke G.", "last_name"=>"Wolfe", "scopus_author_id"=>"7201867125"}, {"first_name"=>"Mark M.", "last_name"=>"Levy", "scopus_author_id"=>"7404616390"}, {"first_name"=>"Vishal", "last_name"=>"Khiatani", "scopus_author_id"=>"57195356973"}, {"first_name"=>"Todd C.", "last_name"=>"Borchers", "scopus_author_id"=>"56373665900"}, {"first_name"=>"Therese M.", "last_name"=>"Duane", "scopus_author_id"=>"6603955528"}, {"first_name"=>"Michel B.", "last_name"=>"Aboutanos", "scopus_author_id"=>"6602403223"}, {"first_name"=>"Rao R.", "last_name"=>"Ivatury", "scopus_author_id"=>"7004887998"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"pui"=>"600086493", "issn"=>"19326203", "isbn"=>"1932-6203", "doi"=>"10.1371/journal.pone.0106793", "scopus"=>"2-s2.0-84907482530", "pmid"=>"25269021", "sgr"=>"84907482530"}, "id"=>"4d268aab-3361-3642-bfdb-576406a80a4f", "abstract"=>"BACKGROUND: Venous Thrombo-embolism (VTE--Deep venous thrombosis (DVT) and/or pulmonary embolism (PE)--in traumatized patients causes significant morbidity and mortality. The current study evaluates the effectiveness of DVT surveillance in reducing PE, and performs a cost-effectiveness analysis.\\n\\nMETHODS: All traumatized patients admitted to the adult ICU underwent twice weekly DVT surveillance by bilateral lower extremity venous Duplex examination (48-month surveillance period--SP). The rates of DVT and PE were recorded and compared to the rates observed in the 36-month pre-surveillance period (PSP). All patients in both periods received mechanical and pharmacologic prophylaxis unless contraindicated. Total costs--diagnostic, therapeutic and surveillance--for both periods were recorded and the incremental cost for each Quality Adjusted Life Year (QALY) gained was calculated.\\n\\nRESULTS: 4234 patients were eligible (PSP--1422 and SP--2812). Rate of DVT in SP (2.8%) was significantly higher than in PSP (1.3%) - p<0.05, and rate of PE in SP (0.7%) was significantly lower than that in PSP (1.5%) - p<0.05. Logistic regression demonstrated that surveillance was an independent predictor of increased DVT detection (OR: 2.53 - CI: 1.462-4.378) and decreased PE incidence (OR: 0.487 - CI: 0.262-0.904). The incremental cost was $509,091/life saved in the base case, translating to $29,102/QALY gained. A sensitivity analysis over four of the parameters used in the model indicated that the incremental cost ranged from $18,661 to $48,821/QALY gained.\\n\\nCONCLUSIONS: Surveillance of traumatized ICU patients increases DVT detection and reduces PE incidence. Costs in terms of QALY gained compares favorably with other interventions accepted by society.", "link"=>"http://www.mendeley.com/research/dvt-surveillance-program-icu-analysis-costeffectiveness", "reader_count"=>23, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Researcher"=>4, "Student > Ph. D. Student"=>1, "Student > Postgraduate"=>3, "Student > Master"=>5, "Other"=>4, "Student > Bachelor"=>4, "Lecturer"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Researcher"=>4, "Student > Ph. D. Student"=>1, "Student > Postgraduate"=>3, "Student > Master"=>5, "Other"=>4, "Student > Bachelor"=>4, "Lecturer"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>3, "Nursing and Health Professions"=>2, "Medicine and Dentistry"=>13, "Pharmacology, Toxicology and Pharmaceutical Science"=>2, "Psychology"=>2, "Social Sciences"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>13}, "Social Sciences"=>{"Social Sciences"=>1}, "Psychology"=>{"Psychology"=>2}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>2}, "Unspecified"=>{"Unspecified"=>3}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>2}}, "group_count"=>2}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1697595"], "description"=>"<p>#p<0.05 – DVT (PSP vs SP); *p<0.05 – PE (PSP vs SP).</p>", "links"=>[], "tags"=>["DVT Surveillance Program", "qaly", "psp", "PE incidence", "ci", "vte", "sp", "calculated.Results 4234 patients", "Quality Adjusted Life Year", "ICU patients increases DVT detection", "DVT surveillance"], "article_id"=>1187717, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Ajai K. Malhotra", "Stephanie R. Goldberg", "Laura McLay", "Nancy R. Martin", "Luke G. Wolfe", "Mark M. Levy", "Vishal Khiatani", "Todd C. Borchers", "Therese M. Duane", "Michel B. Aboutanos", "Rao R. Ivatury"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0106793.g001", "stats"=>{"downloads"=>4, "page_views"=>24, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Figure_showing_the_rates_of_deep_vein_thrombosis_DVT_and_pulmonary_embolism_PE_during_the_pre_surveillance_period_PSP_2001_8211_03_and_the_surveillance_period_SP_2004_8211_07_/1187717", "title"=>"Figure showing the rates of deep vein thrombosis (DVT) and pulmonary embolism (PE) during the pre-surveillance period (PSP: 2001–03) and the surveillance period (SP: 2004–07).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-30 03:24:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/1697596"], "description"=>"<p>The bars represent upper and lower bounds on the incremental cost relative to the base case of $29,102 (dashed line) with respect to the bounds on each parameter value. In this figure, the discount rate ranges from 0% to 5%, the difference in the PE incidence rate between PSP and SP ranges from 0.2% to 1.4%, the PE fatality rate ranges from 5% to 10%, and the health state utility ranges from 0.8 to 1.0.</p>", "links"=>[], "tags"=>["DVT Surveillance Program", "qaly", "psp", "PE incidence", "ci", "vte", "sp", "calculated.Results 4234 patients", "Quality Adjusted Life Year", "ICU patients increases DVT detection", "DVT surveillance"], "article_id"=>1187718, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Ajai K. Malhotra", "Stephanie R. Goldberg", "Laura McLay", "Nancy R. Martin", "Luke G. Wolfe", "Mark M. Levy", "Vishal Khiatani", "Todd C. Borchers", "Therese M. Duane", "Michel B. Aboutanos", "Rao R. Ivatury"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0106793.g002", "stats"=>{"downloads"=>1, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Figure_showing_a_sensitivity_analysis_on_the_incremental_cost_to_obtain_one_additional_QALY_/1187718", "title"=>"Figure showing a sensitivity analysis on the incremental cost to obtain one additional QALY.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-30 03:24:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/1697597"], "description"=>"<p>The bars represent range of cost from the best case scenario (most cost effective) to the worst case scenario (least cost effective) for each intervention. CPR: cardio-pulmonary resuscitation, APC: activated protein C for sepsis, tPA for AMI: tissue plasminogen activator for acute myocardial infarction, CABG: coronary artery bypass grafting, NICU: neonatal intensive care unit. The bracketed number represents the reference the data is derived from.</p>", "links"=>[], "tags"=>["DVT Surveillance Program", "qaly", "psp", "PE incidence", "ci", "vte", "sp", "calculated.Results 4234 patients", "Quality Adjusted Life Year", "ICU patients increases DVT detection", "DVT surveillance"], "article_id"=>1187719, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Ajai K. Malhotra", "Stephanie R. Goldberg", "Laura McLay", "Nancy R. Martin", "Luke G. Wolfe", "Mark M. Levy", "Vishal Khiatani", "Todd C. Borchers", "Therese M. Duane", "Michel B. Aboutanos", "Rao R. Ivatury"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0106793.g003", "stats"=>{"downloads"=>7, "page_views"=>105, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Incremental_dollar_cost_per_quality_adjusted_life_year_QALY_saved_for_selected_interventions_as_compared_to_the_cost_of_deep_venous_thrombosis_surveillance_DVT_Sur_/1187719", "title"=>"Incremental dollar cost per quality adjusted life year (QALY) saved for selected interventions as compared to the cost of deep venous thrombosis surveillance (DVT Sur.).", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-30 03:24:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/1697598"], "description"=>"<p>*p<0.05: PSP vs SP. PSP: pre-surveillance period, SP: surveillance period, ISS: injury severity score, RTS: revised trauma score, AIS: Abbreviated Injury Scale.</p><p>Patient populations in the two periods of study.</p>", "links"=>[], "tags"=>["DVT Surveillance Program", "qaly", "psp", "PE incidence", "ci", "vte", "sp", "calculated.Results 4234 patients", "Quality Adjusted Life Year", "ICU patients increases DVT detection", "DVT surveillance"], "article_id"=>1187720, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Ajai K. Malhotra", "Stephanie R. Goldberg", "Laura McLay", "Nancy R. Martin", "Luke G. Wolfe", "Mark M. Levy", "Vishal Khiatani", "Todd C. Borchers", "Therese M. Duane", "Michel B. Aboutanos", "Rao R. Ivatury"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0106793.t001", "stats"=>{"downloads"=>1, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Patient_populations_in_the_two_periods_of_study_/1187720", "title"=>"Patient populations in the two periods of study.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-09-30 03:24:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/1697599"], "description"=>"<p>Among those developing VTE, details of those developing deep vein thrombosis (DVT), or pulmonary embolism (PE). p<0.05: *No VTE vs VTE, <sup>#</sup>No DVT vs DVT, <sup>∧</sup>No PE vs PE. ISS: injury severity score, RTS: revised trauma score, AIS: abbreviated injury scale, ICULOS: Intensive Care Unit Length of Stay, HLOS: Hospital Length of Stay.</p><p>Details and outcomes of patients developing venous thrombo-embolism (VTE) or not.</p>", "links"=>[], "tags"=>["DVT Surveillance Program", "qaly", "psp", "PE incidence", "ci", "vte", "sp", "calculated.Results 4234 patients", "Quality Adjusted Life Year", "ICU patients increases DVT detection", "DVT surveillance"], "article_id"=>1187721, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Ajai K. Malhotra", "Stephanie R. Goldberg", "Laura McLay", "Nancy R. Martin", "Luke G. Wolfe", "Mark M. Levy", "Vishal Khiatani", "Todd C. Borchers", "Therese M. Duane", "Michel B. Aboutanos", "Rao R. Ivatury"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0106793.t002", "stats"=>{"downloads"=>1, "page_views"=>13, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Details_and_outcomes_of_patients_developing_venous_thrombo_embolism_VTE_or_not_/1187721", "title"=>"Details and outcomes of patients developing venous thrombo-embolism (VTE) or not.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-09-30 03:24:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/1697600"], "description"=>"<p>OR: odds ratio, CI: confidence interval, ISS: injury severity score, AIS: abbreviated injury scale.</p><p>Results of logistic regression showing the independent predictors of Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE).</p>", "links"=>[], "tags"=>["DVT Surveillance Program", "qaly", "psp", "PE incidence", "ci", "vte", "sp", "calculated.Results 4234 patients", "Quality Adjusted Life Year", "ICU patients increases DVT detection", "DVT surveillance"], "article_id"=>1187722, "categories"=>["Biological Sciences", "Science Policy"], "users"=>["Ajai K. Malhotra", "Stephanie R. Goldberg", "Laura McLay", "Nancy R. Martin", "Luke G. Wolfe", "Mark M. Levy", "Vishal Khiatani", "Todd C. Borchers", "Therese M. Duane", "Michel B. Aboutanos", "Rao R. Ivatury"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0106793.t003", "stats"=>{"downloads"=>8, "page_views"=>14, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Results_of_logistic_regression_showing_the_independent_predictors_of_Deep_Vein_Thrombosis_DVT_and_Pulmonary_Embolism_PE_/1187722", "title"=>"Results of logistic regression showing the independent predictors of Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-09-30 03:24:25"}

PMC Usage Stats | Further Information

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  • {"unique-ip"=>"17", "full-text"=>"18", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"5"}
  • {"unique-ip"=>"14", "full-text"=>"13", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"6"}
  • {"unique-ip"=>"22", "full-text"=>"27", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"7"}
  • {"unique-ip"=>"24", "full-text"=>"29", "pdf"=>"14", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"3"}
  • {"unique-ip"=>"20", "full-text"=>"19", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"2"}
  • {"unique-ip"=>"23", "full-text"=>"23", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"8"}
  • {"unique-ip"=>"34", "full-text"=>"45", "pdf"=>"17", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"9"}
  • {"unique-ip"=>"18", "full-text"=>"24", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"10"}
  • {"unique-ip"=>"36", "full-text"=>"38", "pdf"=>"21", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"10"}
  • {"unique-ip"=>"16", "full-text"=>"13", "pdf"=>"11", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"2"}
  • {"unique-ip"=>"25", "full-text"=>"27", "pdf"=>"21", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2014", "month"=>"11"}
  • {"unique-ip"=>"18", "full-text"=>"18", "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"=>"17", "full-text"=>"16", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"1"}
  • {"unique-ip"=>"22", "full-text"=>"18", "pdf"=>"12", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2015", "month"=>"11"}
  • {"unique-ip"=>"17", "full-text"=>"16", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2015", "month"=>"12"}
  • {"unique-ip"=>"27", "full-text"=>"17", "pdf"=>"16", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"1"}
  • {"unique-ip"=>"17", "full-text"=>"20", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"3"}
  • {"unique-ip"=>"17", "full-text"=>"24", "pdf"=>"10", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"4"}
  • {"unique-ip"=>"11", "full-text"=>"12", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"5"}
  • {"unique-ip"=>"16", "full-text"=>"14", "pdf"=>"9", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"6"}
  • {"unique-ip"=>"11", "full-text"=>"12", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"7"}
  • {"unique-ip"=>"13", "full-text"=>"13", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"8"}
  • {"unique-ip"=>"14", "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"=>"9"}
  • {"unique-ip"=>"14", "full-text"=>"14", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"10"}
  • {"unique-ip"=>"21", "full-text"=>"20", "pdf"=>"8", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"11"}
  • {"unique-ip"=>"13", "full-text"=>"15", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2016", "month"=>"12"}
  • {"unique-ip"=>"10", "full-text"=>"8", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"1"}
  • {"unique-ip"=>"13", "full-text"=>"16", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"2"}
  • {"unique-ip"=>"14", "full-text"=>"13", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"3"}
  • {"unique-ip"=>"13", "full-text"=>"12", "pdf"=>"5", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"4"}
  • {"unique-ip"=>"14", "full-text"=>"15", "pdf"=>"6", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"5"}
  • {"unique-ip"=>"11", "full-text"=>"14", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"6"}
  • {"unique-ip"=>"9", "full-text"=>"9", "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"=>"13", "full-text"=>"17", "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"=>"16", "full-text"=>"15", "pdf"=>"7", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"9"}
  • {"unique-ip"=>"10", "full-text"=>"10", "pdf"=>"1", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"10"}
  • {"unique-ip"=>"15", "full-text"=>"17", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"4", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"11"}
  • {"unique-ip"=>"12", "full-text"=>"11", "pdf"=>"2", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2017", "month"=>"12"}
  • {"unique-ip"=>"10", "full-text"=>"11", "pdf"=>"3", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"1"}
  • {"unique-ip"=>"23", "full-text"=>"29", "pdf"=>"4", "abstract"=>"0", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"3"}
  • {"unique-ip"=>"24", "full-text"=>"27", "pdf"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"1"}
  • {"unique-ip"=>"21", "full-text"=>"20", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"4"}
  • {"unique-ip"=>"16", "full-text"=>"14", "pdf"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"5"}
  • {"unique-ip"=>"14", "full-text"=>"11", "pdf"=>"8", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"3", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"6"}
  • {"unique-ip"=>"15", "full-text"=>"14", "pdf"=>"1", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"7"}
  • {"unique-ip"=>"22", "full-text"=>"23", "pdf"=>"11", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"8"}
  • {"unique-ip"=>"17", "full-text"=>"20", "pdf"=>"7", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"10"}
  • {"unique-ip"=>"14", "full-text"=>"15", "pdf"=>"2", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"11"}
  • {"unique-ip"=>"30", "full-text"=>"32", "pdf"=>"8", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"12"}
  • {"unique-ip"=>"11", "full-text"=>"10", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2018", "month"=>"9"}
  • {"unique-ip"=>"22", "full-text"=>"23", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"1", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"2"}
  • {"unique-ip"=>"16", "full-text"=>"20", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"2", "supp-data"=>"0", "cited-by"=>"1", "year"=>"2019", "month"=>"3"}
  • {"unique-ip"=>"16", "full-text"=>"15", "pdf"=>"3", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"4"}
  • {"unique-ip"=>"22", "full-text"=>"30", "pdf"=>"5", "scanned-summary"=>"0", "scanned-page-browse"=>"0", "figure"=>"0", "supp-data"=>"0", "cited-by"=>"0", "year"=>"2019", "month"=>"5"}
  • {"unique-ip"=>"19", "full-text"=>"18", "pdf"=>"14", "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", "average_usage"=>[291]}, {"subject_area"=>"/Medicine and health sciences", "average_usage"=>[285]}, {"subject_area"=>"/Medicine and health sciences/Cardiology", "average_usage"=>[246]}, {"subject_area"=>"/Medicine and health sciences/Diagnostic medicine", "average_usage"=>[257]}, {"subject_area"=>"/Medicine and health sciences/Immunology", "average_usage"=>[289]}, {"subject_area"=>"/Medicine and health sciences/Public and occupational health", "average_usage"=>[327, 510]}, {"subject_area"=>"/Medicine and health sciences/Pulmonology", "average_usage"=>[261, 417]}, {"subject_area"=>"/Medicine and health sciences/Vascular medicine", "average_usage"=>[248]}, {"subject_area"=>"/People and places", "average_usage"=>[302]}, {"subject_area"=>"/People and places/Demography", "average_usage"=>[309]}, {"subject_area"=>"/Social sciences/Economics", "average_usage"=>[340, 521]}]}
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