Changes in the Diagnostic Efficiency of Thyroid Fine-Needle Aspiration Biopsy during the Era of Increased Thyroid Cancer Screening in Korea
The volume of thyroid cancer screening and subsequent thyroid fine-needle aspiration (FNA) have rapidly increased in South Korea. We analyzed the thyroid cancer diagnoses/thyroid FNA ratio according to the annual number of FNA to evaluate changes in the diagnostic efficiency of FNA. This was a natio...
Saved in:
| Published in | Cancer research and treatment Vol. 51; no. 4; pp. 1430 - 1436 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Korea (South)
Korean Cancer Association
01.10.2019
대한암학회 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1598-2998 2005-9256 2005-9256 |
| DOI | 10.4143/crt.2018.534 |
Cover
| Abstract | The volume of thyroid cancer screening and subsequent thyroid fine-needle aspiration (FNA) have rapidly increased in South Korea. We analyzed the thyroid cancer diagnoses/thyroid FNA ratio according to the annual number of FNA to evaluate changes in the diagnostic efficiency of FNA.
This was a nationwide population-based retrospective cohort study. The overall thyroid cancer diagnoses/thyroid FNA ratio and annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratio were indirectly calculated using data obtained from the Korea Central Cancer Registry database and the Korean National Health Insurance Service claims database from 2004 to 2012. Pearson correlation analyses were performed to evaluate the strength of linear associations between variables.
The number of thyroid FNA increased from 28,596 to 177,805 (6.2-fold increase) from 2004 to 2012. The overall thyroid cancer diagnoses/thyroid FNA ratio decreased from 36.5% in 2004 to 25.1% in 2012 and was negatively correlated to the number of FNA (R=‒0.977, p < 0.001). The annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratios (range, 15.3% to 30.7%) were always lower than the overall thyroid cancer diagnoses/thyroid FNA ratio in each year and also worsened according to the increase in the number of FNA (R=‒0.853, p=0.007).
The diagnostic performance of both overall and annual incremental thyroid FNA worsened, whereas the number of thyroid FNA procedures increased. More sophisticated indications for FNA are required to improve its diagnostic efficiency, considering the increased burden of screening-detected thyroid nodules. |
|---|---|
| AbstractList | The volume of thyroid cancer screening and subsequent thyroid fine-needle aspiration (FNA) have rapidly increased in South Korea. We analyzed the thyroid cancer diagnoses/thyroid FNA ratio according to the annual number of FNA to evaluate changes in the diagnostic efficiency of FNA.
This was a nationwide population-based retrospective cohort study. The overall thyroid cancer diagnoses/thyroid FNA ratio and annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratio were indirectly calculated using data obtained from the Korea Central Cancer Registry database and the Korean National Health Insurance Service claims database from 2004 to 2012. Pearson correlation analyses were performed to evaluate the strength of linear associations between variables.
The number of thyroid FNA increased from 28,596 to 177,805 (6.2-fold increase) from 2004 to 2012. The overall thyroid cancer diagnoses/thyroid FNA ratio decreased from 36.5% in 2004 to 25.1% in 2012 and was negatively correlated to the number of FNA (R=‒0.977, p < 0.001). The annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratios (range, 15.3% to 30.7%) were always lower than the overall thyroid cancer diagnoses/thyroid FNA ratio in each year and also worsened according to the increase in the number of FNA (R=‒0.853, p=0.007).
The diagnostic performance of both overall and annual incremental thyroid FNA worsened, whereas the number of thyroid FNA procedures increased. More sophisticated indications for FNA are required to improve its diagnostic efficiency, considering the increased burden of screening-detected thyroid nodules. Purpose The volume of thyroid cancer screening and subsequent thyroid fine-needle aspiration (FNA) have rapidly increased in South Korea. We analyzed the thyroid cancer diagnoses/thyroid FNA ratio according to the annual number of FNA to evaluate changes in the diagnostic efficiency of FNA. Materials and Methods This was a nationwide population-based retrospective cohort study. The overall thyroid cancer diagnoses/thyroid FNA ratio and annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratio were indirectly calculated using data obtained from the Korea Central Cancer Registry database and the Korean National Health Insurance Service claims database from 2004 to 2012. Pearson correlation analyses were performed to evaluate the strength of linear associations between variables. Results The number of thyroid FNA increased from 28,596 to 177,805 (6.2-fold increase) from 2004 to 2012. The overall thyroid cancer diagnoses/thyroid FNA ratio decreased from 36.5% in 2004 to 25.1% in 2012 and was negatively correlated to the number of FNA (R=-0.977, p < 0.001). The annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratios (range, 15.3% to 30.7%) were always lower than the overall thyroid cancer diagnoses/thyroid FNA ratio in each year and also worsened according to the increase in the number of FNA (R=-0.853, p=0.007). Conclusion The diagnostic performance of both overall and annual incremental thyroid FNA worsened, whereas the number of thyroid FNA procedures increased. More sophisticated indications for FNA are required to improve its diagnostic efficiency, considering the increased burden of screening-detected thyroid nodules. KCI Citation Count: 0 The volume of thyroid cancer screening and subsequent thyroid fine-needle aspiration (FNA) have rapidly increased in South Korea. We analyzed the thyroid cancer diagnoses/thyroid FNA ratio according to the annual number of FNA to evaluate changes in the diagnostic efficiency of FNA.PURPOSEThe volume of thyroid cancer screening and subsequent thyroid fine-needle aspiration (FNA) have rapidly increased in South Korea. We analyzed the thyroid cancer diagnoses/thyroid FNA ratio according to the annual number of FNA to evaluate changes in the diagnostic efficiency of FNA.This was a nationwide population-based retrospective cohort study. The overall thyroid cancer diagnoses/thyroid FNA ratio and annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratio were indirectly calculated using data obtained from the Korea Central Cancer Registry database and the Korean National Health Insurance Service claims database from 2004 to 2012. Pearson correlation analyses were performed to evaluate the strength of linear associations between variables.MATERIALS AND METHODSThis was a nationwide population-based retrospective cohort study. The overall thyroid cancer diagnoses/thyroid FNA ratio and annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratio were indirectly calculated using data obtained from the Korea Central Cancer Registry database and the Korean National Health Insurance Service claims database from 2004 to 2012. Pearson correlation analyses were performed to evaluate the strength of linear associations between variables.The number of thyroid FNA increased from 28,596 to 177,805 (6.2-fold increase) from 2004 to 2012. The overall thyroid cancer diagnoses/thyroid FNA ratio decreased from 36.5% in 2004 to 25.1% in 2012 and was negatively correlated to the number of FNA (R=‒0.977, p < 0.001). The annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratios (range, 15.3% to 30.7%) were always lower than the overall thyroid cancer diagnoses/thyroid FNA ratio in each year and also worsened according to the increase in the number of FNA (R=‒0.853, p=0.007).RESULTSThe number of thyroid FNA increased from 28,596 to 177,805 (6.2-fold increase) from 2004 to 2012. The overall thyroid cancer diagnoses/thyroid FNA ratio decreased from 36.5% in 2004 to 25.1% in 2012 and was negatively correlated to the number of FNA (R=‒0.977, p < 0.001). The annual incremental thyroid cancer diagnoses/incremental thyroid FNA ratios (range, 15.3% to 30.7%) were always lower than the overall thyroid cancer diagnoses/thyroid FNA ratio in each year and also worsened according to the increase in the number of FNA (R=‒0.853, p=0.007).The diagnostic performance of both overall and annual incremental thyroid FNA worsened, whereas the number of thyroid FNA procedures increased. More sophisticated indications for FNA are required to improve its diagnostic efficiency, considering the increased burden of screening-detected thyroid nodules.CONCLUSIONThe diagnostic performance of both overall and annual incremental thyroid FNA worsened, whereas the number of thyroid FNA procedures increased. More sophisticated indications for FNA are required to improve its diagnostic efficiency, considering the increased burden of screening-detected thyroid nodules. |
| Author | Song, Sun Ok Lee, Young Ki Park, Kyeong Hye Shin, Dong Yeob Nam, Joo Young Lee, Eun Jig Youk, Taemi Song, Young Duk |
| Author_xml | – sequence: 1 givenname: Young Ki surname: Lee fullname: Lee, Young Ki – sequence: 2 givenname: Kyeong Hye surname: Park fullname: Park, Kyeong Hye – sequence: 3 givenname: Young Duk surname: Song fullname: Song, Young Duk – sequence: 4 givenname: Taemi surname: Youk fullname: Youk, Taemi – sequence: 5 givenname: Joo Young surname: Nam fullname: Nam, Joo Young – sequence: 6 givenname: Sun Ok surname: Song fullname: Song, Sun Ok – sequence: 7 givenname: Dong Yeob surname: Shin fullname: Shin, Dong Yeob – sequence: 8 givenname: Eun Jig surname: Lee fullname: Lee, Eun Jig |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30913873$$D View this record in MEDLINE/PubMed https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART002513446$$DAccess content in National Research Foundation of Korea (NRF) |
| BookMark | eNptkk9vEzEQxS1URNPCjTPyESQ22Os_u74ghZBCRAUShLPleseJ6cYO9gYpn6Ffuk5SIkCcRrJ_897Y8y7QWYgBEHpOyZhTzt7YNIxrQtuxYPwRGtWEiErVQp6hERWqrWql2nN0kfMPQiRnDX2CzhlRlLUNG6G76cqEJWTsAx5WgN97swwxD97imXPeegh2h6PDi9UuRd_hKx-g-gzQ9YAneeOTGXwM-J2Pm7zD3Tb5sDwozZLZ982DTWAydCeFqQkWEv5WziHs6WL9KRboKXrsTJ_h2UO9RN-vZovpx-r6y4f5dHJdWU7boWpcmd4aoRzUShrBWgNW1IQ56W5AStqItubW8q68sWtdw2vBLWm57Rh1jrNL9OqoG5LTt9braPyhLqO-TXrydTHXkhJVfq6wb4_sZnuzhs5CGJLp9Sb5tUm7Q-ffN8Gvis4vLRtVLEkRePkgkOLPLeRBr3220PcmQNxmXVPVCtFIJQv64k-vk8nvbRXg9RGwKeacwJ0QSvQ-DLqEQe_DoEsYCl7_g1s_HNZVJvX9_5vuAa-UuV8 |
| CitedBy_id | crossref_primary_10_17826_cumj_1152618 crossref_primary_10_1002_cam4_3926 crossref_primary_10_1038_s41598_023_36951_2 crossref_primary_10_32322_jhsm_744704 crossref_primary_10_1515_iss_2022_0015 crossref_primary_10_1007_s12020_020_02559_z crossref_primary_10_61751_bmbr_2_2024_85 |
| Cites_doi | 10.1001/jamaoncol.2015.0735 10.1089/thy.2015.0020 10.1186/s12885-017-3104-0 10.4143/crt.2005.37.6.325 10.1056/NEJMp1409841 10.3988/jcn.2016.12.4.434 10.4143/crt.2014.110 10.1016/j.jpeds.2004.10.039 10.1016/S0016-5107(98)70003-3 10.4178/kje.2008.30.2.252 10.1001/archoto.2011.185 10.1007/s00268-011-1291-4 10.1001/jama.2017.0562 10.1016/j.surg.2012.05.038 10.1136/bmj.i5745 10.1002/cncr.29122 10.1089/thy.2015.0116 10.3389/fped.2015.00067 10.1089/thy.2013.0257 10.4143/crt.2016.600 10.3174/ajnr.A3743 10.4093/dmj.2014.38.5.395 10.1210/jc.2011-3048 10.1001/archsurg.140.10.981 10.1002/cncr.30943 10.3348/kjr.2015.16.2.391 10.7326/0003-4819-128-11-199806010-00002 10.1016/j.acra.2014.06.006 10.1001/jama.1980.03300300037023 10.4070/kcj.2012.42.1.10 |
| ContentType | Journal Article |
| Copyright | Copyright © 2019 by the Korean Cancer Association 2019 |
| Copyright_xml | – notice: Copyright © 2019 by the Korean Cancer Association 2019 |
| DBID | AAYXX CITATION CGR CUY CVF ECM EIF NPM 7X8 5PM ACYCR |
| DOI | 10.4143/crt.2018.534 |
| DatabaseName | CrossRef Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic PubMed Central (Full Participant titles) Korean Citation Index |
| DatabaseTitle | CrossRef MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 2005-9256 |
| EndPage | 1436 |
| ExternalDocumentID | oai_kci_go_kr_ARTI_6109299 PMC6790840 30913873 10_4143_crt_2018_534 |
| Genre | Journal Article |
| GeographicLocations | Republic of Korea |
| GeographicLocations_xml | – name: Republic of Korea |
| GrantInformation_xml | – fundername: National Health Insurance Service |
| GroupedDBID | --- 29B 5-W 53G 8JR 9ZL AAYXX ABDBF ACUHS ACYCR ADBBV AENEX ALMA_UNASSIGNED_HOLDINGS AOIJS BAWUL CITATION DIK E3Z EBD EF. F5P HYE OK1 RPM TR2 C1A CGR CUY CVF ECM EIF M~E NPM 7X8 5PM |
| ID | FETCH-LOGICAL-c418t-7f091ca59fe296a538aec5203f6fbe66175824cc4d138d8f74254c084cd31ff43 |
| ISSN | 1598-2998 2005-9256 |
| IngestDate | Sun Mar 09 07:53:29 EDT 2025 Thu Aug 21 18:15:38 EDT 2025 Fri Jul 11 01:50:29 EDT 2025 Thu Jan 02 22:54:10 EST 2025 Tue Jul 01 03:18:49 EDT 2025 Thu Apr 24 23:07:30 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 4 |
| Keywords | Thyroid neoplasms Screening Diagnostic efficiency Fine-needle aspiration |
| Language | English |
| License | This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-c418t-7f091ca59fe296a538aec5203f6fbe66175824cc4d138d8f74254c084cd31ff43 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Young Ki Lee and Kyeong Hye Park contributed equally to this work. |
| OpenAccessLink | https://pubmed.ncbi.nlm.nih.gov/PMC6790840 |
| PMID | 30913873 |
| PQID | 2198557696 |
| PQPubID | 23479 |
| PageCount | 7 |
| ParticipantIDs | nrf_kci_oai_kci_go_kr_ARTI_6109299 pubmedcentral_primary_oai_pubmedcentral_nih_gov_6790840 proquest_miscellaneous_2198557696 pubmed_primary_30913873 crossref_primary_10_4143_crt_2018_534 crossref_citationtrail_10_4143_crt_2018_534 |
| ProviderPackageCode | CITATION AAYXX |
| PublicationCentury | 2000 |
| PublicationDate | 2019-10-01 |
| PublicationDateYYYYMMDD | 2019-10-01 |
| PublicationDate_xml | – month: 10 year: 2019 text: 2019-10-01 day: 01 |
| PublicationDecade | 2010 |
| PublicationPlace | Korea (South) |
| PublicationPlace_xml | – name: Korea (South) |
| PublicationTitle | Cancer research and treatment |
| PublicationTitleAlternate | Cancer Res Treat |
| PublicationYear | 2019 |
| Publisher | Korean Cancer Association 대한암학회 |
| Publisher_xml | – name: Korean Cancer Association – name: 대한암학회 |
| References | ref13 ref12 ref15 ref14 ref31 ref30 ref11 ref10 ref32 ref2 ref1 ref17 ref16 ref19 ref18 ref24 ref23 ref26 Park (ref27) 2003 ref20 ref22 ref21 ref28 Park (ref25) 2003 ref29 ref8 ref7 ref9 ref4 ref3 ref6 ref5 |
| References_xml | – ident: ref1 doi: 10.1001/jamaoncol.2015.0735 – ident: ref7 doi: 10.1089/thy.2015.0020 – ident: ref20 doi: 10.1186/s12885-017-3104-0 – ident: ref16 doi: 10.4143/crt.2005.37.6.325 – ident: ref8 doi: 10.1056/NEJMp1409841 – ident: ref28 doi: 10.3988/jcn.2016.12.4.434 – ident: ref5 doi: 10.4143/crt.2014.110 – ident: ref11 doi: 10.1016/j.jpeds.2004.10.039 – ident: ref13 doi: 10.1016/S0016-5107(98)70003-3 – ident: ref26 doi: 10.4178/kje.2008.30.2.252 – ident: ref30 doi: 10.1001/archoto.2011.185 – ident: ref17 doi: 10.1007/s00268-011-1291-4 – ident: ref23 doi: 10.1001/jama.2017.0562 – ident: ref21 doi: 10.1016/j.surg.2012.05.038 – start-page: 349 volume-title: Assessment of the availability of health insurance data for epidemiologic study of childhood aseptic meningitis year: 2003 ident: ref25 – ident: ref6 doi: 10.1136/bmj.i5745 – ident: ref9 doi: 10.1002/cncr.29122 – ident: ref4 doi: 10.1089/thy.2015.0116 – ident: ref12 doi: 10.3389/fped.2015.00067 – ident: ref2 doi: 10.1089/thy.2013.0257 – ident: ref19 doi: 10.4143/crt.2016.600 – ident: ref3 doi: 10.3174/ajnr.A3743 – ident: ref15 doi: 10.4093/dmj.2014.38.5.395 – ident: ref22 doi: 10.1210/jc.2011-3048 – ident: ref18 doi: 10.1001/archsurg.140.10.981 – ident: ref24 doi: 10.1002/cncr.30943 – ident: ref32 doi: 10.3348/kjr.2015.16.2.391 – ident: ref10 doi: 10.7326/0003-4819-128-11-199806010-00002 – ident: ref31 doi: 10.1016/j.acra.2014.06.006 – start-page: 19 year: 2003 ident: ref27 – ident: ref14 doi: 10.1001/jama.1980.03300300037023 – ident: ref29 doi: 10.4070/kcj.2012.42.1.10 |
| SSID | ssj0064371 |
| Score | 2.1800861 |
| Snippet | The volume of thyroid cancer screening and subsequent thyroid fine-needle aspiration (FNA) have rapidly increased in South Korea. We analyzed the thyroid... Purpose The volume of thyroid cancer screening and subsequent thyroid fine-needle aspiration (FNA) have rapidly increased in South Korea. We analyzed the... |
| SourceID | nrf pubmedcentral proquest pubmed crossref |
| SourceType | Open Website Open Access Repository Aggregation Database Index Database Enrichment Source |
| StartPage | 1430 |
| SubjectTerms | Biopsy, Fine-Needle Cohort Studies Early Detection of Cancer Female Humans Male Original Registries Republic of Korea Retrospective Studies Sensitivity and Specificity Thyroid Gland - pathology Thyroid Neoplasms - diagnosis Thyroid Neoplasms - pathology 의약학 |
| Title | Changes in the Diagnostic Efficiency of Thyroid Fine-Needle Aspiration Biopsy during the Era of Increased Thyroid Cancer Screening in Korea |
| URI | https://www.ncbi.nlm.nih.gov/pubmed/30913873 https://www.proquest.com/docview/2198557696 https://pubmed.ncbi.nlm.nih.gov/PMC6790840 https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART002513446 |
| Volume | 51 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | Cancer Research and Treatment, 2019, 51(4), , pp.1430-1436 |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9swDBbSFhh2GfZe9oI2bKfAnR_y69g0CbKlzQ5LgNwEW5ZXI51dOMkh-wv90yMt2XGKDOh2sQNbpgx9XyjSIilCPqWWCOLEEoaXMNNgYeoaYSgwygKa-5H0zAS_d1xOvfGcfVu4i07nthW1tFnHp-L3wbyS_0EVrgGumCX7D8g2QuEC_AZ84QgIw_FeGKvUgFUdqzhQYXNYgnVYVYao0irBGpxdbcsiS3ojMCmNKcxX1xJwqZbYEf1-VtystnXGIkoalpHKMUGbcgU2aS3hHElSgkbAcB2dDjMpoFHbyNWNdB0hlTrXBLTfiQCqtE1vku2WslTs9mQrcRek8bYh3g8dPKyeGGyWLYWlwr0j-Strf8WwwiYeTiu7qiJqaLu6LPaBa1pbu1aLlaylesHwMw_NCQxuAJCixMhZKzh19cfTvdLb0-98NL-44LPhYnZETmzfxzX_k7P-oD-qJ3Zc4kT_vXktlUeB8r-0pe9ZOEd5mR5yXu7G4LaMmtlj8kh7I_RMUesJ6cj8KXlwqeMtnpFbzTCa5RR4QXcMozuG0SKlmh-0xTC6YxhVDKOKYZUkYBg-1zCskaDIQxuGYdcVw56T-Wg4Ox8bevsOQzArWBt-CraoiNwwlXboRTCzRlK4tumkXhpLsAvBVbWZECyxnCAJUh-mDybMgInEsdKUOS_IcV7k8hWhjpCpa4E6cRIY7TiKnMhithRe7MAABk6X9Ooh50LXtsctVq45-LgIEAeAOALEAaAu-dy0vlE1Xf7S7iOgx5ci41iEHc8_C74sObiaXznuUwC2XJd8qMHloJlxuS3KZbFZcbAFAhfc-dDrkpcK7KY7B8vxBj68uL9Hg6YBdrh_J8-uqurvnh_CGJmv79HvG_Jw9197S47X5Ua-Axt6Hb_X3P4DiY_NOg |
| linkProvider | EBSCOhost |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Changes+in+the+Diagnostic+Efficiency+of+Thyroid+Fine-Needle+Aspiration+Biopsy+during+the+Era+of+Increased+Thyroid+Cancer+Screening+in+Korea&rft.jtitle=Cancer+research+and+treatment&rft.au=Lee%2C+Young+Ki&rft.au=Park%2C+Kyeong+Hye&rft.au=Song%2C+Young+Duk&rft.au=Youk%2C+Taemi&rft.date=2019-10-01&rft.issn=2005-9256&rft.eissn=2005-9256&rft.volume=51&rft.issue=4&rft.spage=1430&rft_id=info:doi/10.4143%2Fcrt.2018.534&rft.externalDBID=NO_FULL_TEXT |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1598-2998&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1598-2998&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1598-2998&client=summon |