JAMA Netw Open:纳入多因素的AI辅助决策工具有助于为晚期膝骨关节炎患者制定更好的治疗方案

2021-02-22 Nebula MedSci原创

全膝关节置换手术方案该怎么制定?

骨关节炎(OA)的患病率有所增加,现已成为主要的公共健康问题和医疗保健支出的驱动因素之一。膝骨关节炎的治疗选择包括调整活动、减轻体重、物理疗法、口服止痛药、关节注射和关节置换手术。多种治疗方案的存在凸显了骨关节炎管理的偏好敏感性和共享决策制定(SDM)的机会。

辅助决策有助于为晚期膝骨关节炎(OA)患者选择合适的全膝关节置换术(TKR)。然而,很少有决策辅助工具将患者教育水平、偏好评估和人工智能(AI)结合起来,使用患者报告的结果测量数据来生成个性化的预后估计,以增强SDM。

这是一项美国学术整形外科实践中进行的随机临床试验,在晚期膝骨关节炎患者中评估AI支持的囊括了患者教育水平、偏好评估和个性化预后的患者辅助决策对治疗决策质量、患者经历、功能性预后和过程水平结果的影响,并与仅考虑患者教育水平进行比较。

研究流程

该试验纳入了129名在2019年3月-2020年1月期间表现为OA相关性膝关节疼痛的成年患者。患者被随机分为两组,一组接受包括患者教育水平、偏好评估和个性化结果评估在内的决策辅助(干预组),另一组在常规护理的同时只考虑患者的教育水平(对照组)。主要结果是决策质量,使用膝骨性关节炎决策质量仪(K-DQI)进行测量。次要结果是协作决策制定、患者对会诊的满意度、膝关节损伤和骨关节炎预后评分关节置换(KOOS JR)评分、会诊时间、TKR率和治疗一致性。

主要和次要结果

干预组 69例(46例[67%]女性)和对照组 60例(37例[62%]女性)患者被纳入分析。干预组表现出更好的决策质量(K-DQI平均差异 20.0%;SE 3.02;95%CI 14.2%-26.1%;P<0.001)、协作决策制定(CollaboRATE:8/69[12%] vs 28/60[47%];P<0.001)、满意度(数字评定量表:9/65[14%] vs 19/58[33%];P=0.01),干预并可改善患者4~6个月时的功能预后(平均[SE]KOOS JR,比干预组高 4.9[2.24]分;95%CI 0.8-9.0;P=0.02)。

干预对会诊时间(平均[SE]差:2.23[2.18]分钟;P=0.31)、TKR率(23% vs 12%;P=0.11)或治疗一致性(84% vs 73%;P=0.19)没有显著影响。

在这项随机临床试验中,AI-辅助决策工具显著改善了考虑进行全膝关节置换的膝骨关节炎患者的决策质量、SDM水平、满意度和身体限制性,但对会诊时间、TKR率或治疗一致性没有显著影响。总之,使用个性化的、数据驱动的方法进行决策辅助可以增强膝OA管理中的SDM。

原始出处:

Jayakumar Prakash,Moore Meredith G,Furlough Kenneth A et al. Comparison of an Artificial Intelligence-Enabled Patient Decision Aid vs Educational Material on Decision Quality, Shared Decision-Making, Patient Experience, and Functional Outcomes in Adults With Knee Osteoarthritis: A Randomized Clinical Trial. JAMA Netw Open, 2021, 4: e2037107.

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    2021-12-01 lisa438
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    2021-12-05 canlab
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    2021-11-18 feather89
  4. [GetPortalCommentsPageByObjectIdResponse(id=2026690, encodeId=16ed20266907e, content=<a href='/topic/show?id=e0b110159578' target=_blank style='color:#2F92EE;'>#骨关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101595, encryptionId=e0b110159578, topicName=骨关节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373b263, createdName=lisa438, createdTime=Wed Dec 01 10:04:53 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1734321, encodeId=1fde1e343212b, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ea033781210, createdName=canlab, createdTime=Sun Dec 05 03:04:53 CST 2021, time=2021-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728836, encodeId=e2711e28836c7, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Thu Nov 18 03:04:53 CST 2021, time=2021-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1747048, encodeId=59bb1e4704845, content=<a href='/topic/show?id=495385896b5' target=_blank style='color:#2F92EE;'>#膝骨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85896, encryptionId=495385896b5, topicName=膝骨)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=zhangpaul93, createdTime=Sat Feb 27 00:04:53 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905155, encodeId=55591905155d2, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sun Aug 01 10:04:53 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266261, encodeId=eb811266261d3, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1269256, encodeId=2bff1269256ae, content=<a href='/topic/show?id=59088589e97' target=_blank style='color:#2F92EE;'>#膝骨关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85897, encryptionId=59088589e97, topicName=膝骨关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f5e185, createdName=zlawrance, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541874, encodeId=d16515418e481, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036470, encodeId=db1f10364e051, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Feb 22 21:04:53 CST 2021, time=2021-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=926437, encodeId=dc1992643ebe, content=很不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9af75462079, createdName=雀巢, createdTime=Mon Feb 22 18:51:03 CST 2021, time=2021-02-22, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2026690, encodeId=16ed20266907e, content=<a href='/topic/show?id=e0b110159578' target=_blank style='color:#2F92EE;'>#骨关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101595, encryptionId=e0b110159578, topicName=骨关节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373b263, createdName=lisa438, createdTime=Wed Dec 01 10:04:53 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1734321, encodeId=1fde1e343212b, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ea033781210, createdName=canlab, createdTime=Sun Dec 05 03:04:53 CST 2021, time=2021-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728836, encodeId=e2711e28836c7, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Thu Nov 18 03:04:53 CST 2021, time=2021-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1747048, encodeId=59bb1e4704845, content=<a href='/topic/show?id=495385896b5' target=_blank style='color:#2F92EE;'>#膝骨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85896, encryptionId=495385896b5, topicName=膝骨)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=zhangpaul93, createdTime=Sat Feb 27 00:04:53 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905155, encodeId=55591905155d2, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sun Aug 01 10:04:53 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266261, encodeId=eb811266261d3, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1269256, encodeId=2bff1269256ae, content=<a href='/topic/show?id=59088589e97' target=_blank style='color:#2F92EE;'>#膝骨关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85897, encryptionId=59088589e97, topicName=膝骨关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f5e185, createdName=zlawrance, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541874, encodeId=d16515418e481, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036470, encodeId=db1f10364e051, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Feb 22 21:04:53 CST 2021, time=2021-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=926437, encodeId=dc1992643ebe, content=很不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9af75462079, createdName=雀巢, createdTime=Mon Feb 22 18:51:03 CST 2021, time=2021-02-22, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=2026690, encodeId=16ed20266907e, content=<a href='/topic/show?id=e0b110159578' target=_blank style='color:#2F92EE;'>#骨关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101595, encryptionId=e0b110159578, topicName=骨关节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373b263, createdName=lisa438, createdTime=Wed Dec 01 10:04:53 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1734321, encodeId=1fde1e343212b, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ea033781210, createdName=canlab, createdTime=Sun Dec 05 03:04:53 CST 2021, time=2021-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728836, encodeId=e2711e28836c7, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Thu Nov 18 03:04:53 CST 2021, time=2021-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1747048, encodeId=59bb1e4704845, content=<a href='/topic/show?id=495385896b5' target=_blank style='color:#2F92EE;'>#膝骨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85896, encryptionId=495385896b5, topicName=膝骨)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=zhangpaul93, createdTime=Sat Feb 27 00:04:53 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905155, encodeId=55591905155d2, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sun Aug 01 10:04:53 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266261, encodeId=eb811266261d3, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1269256, encodeId=2bff1269256ae, content=<a href='/topic/show?id=59088589e97' target=_blank style='color:#2F92EE;'>#膝骨关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85897, encryptionId=59088589e97, topicName=膝骨关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f5e185, createdName=zlawrance, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541874, encodeId=d16515418e481, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036470, encodeId=db1f10364e051, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Feb 22 21:04:53 CST 2021, time=2021-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=926437, encodeId=dc1992643ebe, content=很不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9af75462079, createdName=雀巢, createdTime=Mon Feb 22 18:51:03 CST 2021, time=2021-02-22, status=1, ipAttribution=)]
    2021-02-24 lmm397
  7. [GetPortalCommentsPageByObjectIdResponse(id=2026690, encodeId=16ed20266907e, content=<a href='/topic/show?id=e0b110159578' target=_blank style='color:#2F92EE;'>#骨关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101595, encryptionId=e0b110159578, topicName=骨关节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373b263, createdName=lisa438, createdTime=Wed Dec 01 10:04:53 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1734321, encodeId=1fde1e343212b, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ea033781210, createdName=canlab, createdTime=Sun Dec 05 03:04:53 CST 2021, time=2021-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728836, encodeId=e2711e28836c7, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Thu Nov 18 03:04:53 CST 2021, time=2021-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1747048, encodeId=59bb1e4704845, content=<a href='/topic/show?id=495385896b5' target=_blank style='color:#2F92EE;'>#膝骨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85896, encryptionId=495385896b5, topicName=膝骨)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=zhangpaul93, createdTime=Sat Feb 27 00:04:53 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905155, encodeId=55591905155d2, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sun Aug 01 10:04:53 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266261, encodeId=eb811266261d3, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1269256, encodeId=2bff1269256ae, content=<a href='/topic/show?id=59088589e97' target=_blank style='color:#2F92EE;'>#膝骨关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85897, encryptionId=59088589e97, topicName=膝骨关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f5e185, createdName=zlawrance, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541874, encodeId=d16515418e481, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036470, encodeId=db1f10364e051, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Feb 22 21:04:53 CST 2021, time=2021-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=926437, encodeId=dc1992643ebe, content=很不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9af75462079, createdName=雀巢, createdTime=Mon Feb 22 18:51:03 CST 2021, time=2021-02-22, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=2026690, encodeId=16ed20266907e, content=<a href='/topic/show?id=e0b110159578' target=_blank style='color:#2F92EE;'>#骨关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101595, encryptionId=e0b110159578, topicName=骨关节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373b263, createdName=lisa438, createdTime=Wed Dec 01 10:04:53 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1734321, encodeId=1fde1e343212b, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, 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topicList=[TopicDto(id=85896, encryptionId=495385896b5, topicName=膝骨)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=zhangpaul93, createdTime=Sat Feb 27 00:04:53 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905155, encodeId=55591905155d2, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sun Aug 01 10:04:53 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266261, encodeId=eb811266261d3, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1269256, encodeId=2bff1269256ae, content=<a href='/topic/show?id=59088589e97' target=_blank style='color:#2F92EE;'>#膝骨关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85897, encryptionId=59088589e97, topicName=膝骨关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f5e185, createdName=zlawrance, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1541874, encodeId=d16515418e481, content=<a href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036470, encodeId=db1f10364e051, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Feb 22 21:04:53 CST 2021, time=2021-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=926437, encodeId=dc1992643ebe, content=很不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9af75462079, createdName=雀巢, createdTime=Mon Feb 22 18:51:03 CST 2021, time=2021-02-22, status=1, ipAttribution=)]
  9. [GetPortalCommentsPageByObjectIdResponse(id=2026690, encodeId=16ed20266907e, content=<a href='/topic/show?id=e0b110159578' target=_blank style='color:#2F92EE;'>#骨关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101595, encryptionId=e0b110159578, topicName=骨关节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373b263, createdName=lisa438, createdTime=Wed Dec 01 10:04:53 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1734321, encodeId=1fde1e343212b, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, 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href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036470, encodeId=db1f10364e051, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Feb 22 21:04:53 CST 2021, time=2021-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=926437, encodeId=dc1992643ebe, content=很不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9af75462079, createdName=雀巢, createdTime=Mon Feb 22 18:51:03 CST 2021, time=2021-02-22, status=1, ipAttribution=)]
    2021-02-22 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=2026690, encodeId=16ed20266907e, content=<a href='/topic/show?id=e0b110159578' target=_blank style='color:#2F92EE;'>#骨关节#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=101595, encryptionId=e0b110159578, topicName=骨关节)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373b263, createdName=lisa438, createdTime=Wed Dec 01 10:04:53 CST 2021, time=2021-12-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1734321, encodeId=1fde1e343212b, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ea033781210, createdName=canlab, createdTime=Sun Dec 05 03:04:53 CST 2021, time=2021-12-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1728836, encodeId=e2711e28836c7, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Thu Nov 18 03:04:53 CST 2021, time=2021-11-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1747048, encodeId=59bb1e4704845, content=<a href='/topic/show?id=495385896b5' target=_blank style='color:#2F92EE;'>#膝骨#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85896, encryptionId=495385896b5, topicName=膝骨)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a9de34, createdName=zhangpaul93, createdTime=Sat Feb 27 00:04:53 CST 2021, time=2021-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1905155, encodeId=55591905155d2, content=<a href='/topic/show?id=21f66464823' target=_blank style='color:#2F92EE;'>#治疗方案#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64648, encryptionId=21f66464823, topicName=治疗方案)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=5ee4187, createdName=zhangjiqing, createdTime=Sun Aug 01 10:04:53 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1266261, encodeId=eb811266261d3, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, 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href='/topic/show?id=e8ca3108823' target=_blank style='color:#2F92EE;'>#决策#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31088, encryptionId=e8ca3108823, topicName=决策)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e76e13331157, createdName=ms2999106592497887, createdTime=Wed Feb 24 09:04:53 CST 2021, time=2021-02-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036470, encodeId=db1f10364e051, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Mon Feb 22 21:04:53 CST 2021, time=2021-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=926437, encodeId=dc1992643ebe, content=很不错, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9af75462079, createdName=雀巢, createdTime=Mon Feb 22 18:51:03 CST 2021, time=2021-02-22, status=1, ipAttribution=)]
    2021-02-22 雀巢

    很不错

    0

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