Return of individual research results from genomic research: A systematic review of stakeholder perspectives.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2021
Historique:
received: 19 01 2021
accepted: 02 10 2021
entrez: 8 11 2021
pubmed: 9 11 2021
medline: 25 12 2021
Statut: epublish

Résumé

Despite the plethora of empirical studies conducted to date, debate continues about whether and to what extent results should be returned to participants of genomic research. We aimed to systematically review the empirical literature exploring stakeholders' perspectives on return of individual research results (IRR) from genomic research. We examined preferences for receiving or willingness to return IRR, and experiences with either receiving or returning them. The systematic searches were conducted across five major databases in August 2018 and repeated in April 2020, and included studies reporting findings from primary research regardless of method (quantitative, qualitative, mixed). Articles that related to the clinical setting were excluded. Our search identified 221 articles that met our search criteria. This included 118 quantitative, 69 qualitative and 34 mixed methods studies. These articles included a total number of 118,874 stakeholders with research participants (85,270/72%) and members of the general public (40,967/35%) being the largest groups represented. The articles spanned at least 22 different countries with most (144/65%) being from the USA. Most (76%) discussed clinical research projects, rather than biobanks. More than half (58%) gauged views that were hypothetical. We found overwhelming evidence of high interest in return of IRR from potential and actual genomic research participants. There is also a general willingness to provide such results by researchers and health professionals, although they tend to adopt a more cautious stance. While all results are desired to some degree, those that have the potential to change clinical management are generally prioritized by all stakeholders. Professional stakeholders appear more willing to return results that are reliable and clinically relevant than those that are less reliable and lack clinical relevance. The lack of evidence for significant enduring psychological harm and the clear benefits to some research participants suggest that researchers should be returning actionable IRRs to participants.

Identifiants

pubmed: 34748551
doi: 10.1371/journal.pone.0258646
pii: PONE-D-21-02012
pmc: PMC8575249
doi:

Types de publication

Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0258646

Subventions

Organisme : Wellcome Trust
ID : 206194
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/N01104X/1
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/N01104X/2
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 213422/Z/18/Z
Pays : United Kingdom
Organisme : CIHR
Pays : Canada

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Références

Eur J Hum Genet. 2005 Sep;13(9):1055-62
pubmed: 15957002
Genet Med. 2019 Jul;21(7):1541-1547
pubmed: 30467403
Ir J Med Sci. 2016 Nov;185(4):825-831
pubmed: 26499982
Am J Med Genet A. 2009 Feb;149A(2):188-98
pubmed: 19161150
Genet Med. 2008 Nov;10(11):831-9
pubmed: 19011407
Public Health Genomics. 2020;23(1-2):42-53
pubmed: 32294660
Eur J Hum Genet. 2017 May;25(5):530-537
pubmed: 28272539
Genet Med. 2015 Aug;17(8):644-50
pubmed: 25503499
AJOB Empir Bioeth. 2019 Jan-Mar;10(1):1-22
pubmed: 30596322
Eur J Cancer Care (Engl). 2018 Nov;27(6):e12877
pubmed: 30016002
J Genet Couns. 2015 Oct;24(5):833-41
pubmed: 25592144
Genet Med. 2019 May;21(5):1083-1091
pubmed: 30270361
Genet Med. 2015 May;17(5):374-9
pubmed: 25166427
BMC Med Ethics. 2008 Feb 22;9:4
pubmed: 18294373
Int Psychogeriatr. 2019 Oct;31(10):1499-1507
pubmed: 30894233
Clin Genet. 2013 Jul;84(1):11-8
pubmed: 23590238
J Genet Couns. 2017 Aug;26(4):841-851
pubmed: 28035592
J Med Ethics. 2017 Aug;43(8):535-539
pubmed: 27888232
BMC Med Ethics. 2014 Nov 26;15:81
pubmed: 25425352
Alzheimer Dis Assoc Disord. 2008 Jan-Mar;22(1):94-7
pubmed: 18317253
Am J Med Genet A. 2012 May;158A(5):1029-37
pubmed: 22438108
J Community Genet. 2013 Oct;4(4):435-44
pubmed: 23572417
Clin Genet. 2014 Feb;85(2):120-6
pubmed: 24033230
Genet Med. 2018 Mar;20(3):337-345
pubmed: 28771245
Circ Genom Precis Med. 2019 Dec;12(12):e002632
pubmed: 31756304
Genet Med. 2018 Jul;20(7):760-769
pubmed: 29261173
Genet Med. 2014 Apr;16(4):294-301
pubmed: 24091800
Genet Med. 2012 Apr;14(4):411-6
pubmed: 22382800
Am J Bioeth. 2008 Nov;8(11):36-43
pubmed: 19061108
Ophthalmic Genet. 2007 Sep;28(3):143-9
pubmed: 17896312
Genet Med. 2021 Feb;23(2):298-305
pubmed: 33033403
Public Health Genomics. 2014;17(2):105-14
pubmed: 24642506
J Empir Res Hum Res Ethics. 2010 Sep;5(3):31-41
pubmed: 20831419
Genet Test Mol Biomarkers. 2010 Dec;14(6):821-7
pubmed: 20939736
Am J Hum Genet. 2020 Nov 5;107(5):953-962
pubmed: 33157008
J Empir Res Hum Res Ethics. 2018 Oct;13(4):371-382
pubmed: 29806518
JAMA Neurol. 2015 Dec;72(12):1484-90
pubmed: 26501506
Ann Intern Med. 2016 Feb 2;164(3):155-63
pubmed: 26810768
Transl Behav Med. 2018 Jan 29;8(1):44-53
pubmed: 29385584
Eur J Hum Genet. 2010 Aug;18(8):867-71
pubmed: 20234389
AJOB Empir Bioeth. 2019 Oct-Dec;10(4):265-275
pubmed: 31580791
Public Health Genomics. 2018;21(1-2):18-26
pubmed: 30227419
Eur J Hum Genet. 2016 Jan;24(1):21-9
pubmed: 25920556
Am J Med Genet A. 2017 Oct;173(10):2649-2658
pubmed: 28817238
Health Aff (Millwood). 2019 Mar;38(3):399-407
pubmed: 30830824
Genet Med. 2014 Jun;16(6):442-7
pubmed: 24310310
J Pers Med. 2018 Jun 26;8(3):
pubmed: 29949895
Clin Genet. 2017 Sep;92(3):290-297
pubmed: 28218387
Genet Med. 2019 Feb;21(2):311-318
pubmed: 29904163
Alzheimers Res Ther. 2015 Jul 22;7(1):50
pubmed: 26203303
Eur J Hum Genet. 2012 Mar;20(3):258-62
pubmed: 22126749
Genet Med. 2014 Dec;16(12):932-9
pubmed: 24854226
Mayo Clin Proc. 2015 Oct;90(10):1327-37
pubmed: 26434960
J Community Genet. 2013 Oct;4(4):469-82
pubmed: 23794263
J Community Genet. 2020 Oct;11(4):433-443
pubmed: 32562160
Eur J Hum Genet. 2020 Jul;28(7):874-884
pubmed: 32001839
Genet Med. 2013 Aug;15(8):643-9
pubmed: 23448724
J Hum Genet. 2018 Nov;63(11):1139-1147
pubmed: 30185949
Am J Med Genet C Semin Med Genet. 2008 Feb 15;148C(1):31-9
pubmed: 18189289
Alzheimers Dement (N Y). 2020 Mar 22;6(1):e12002
pubmed: 32211507
Genet Med. 2018 Apr;20(5):545-553
pubmed: 28858330
Genet Med. 2017 Mar;19(3):283-293
pubmed: 27584911
Hum Genomics. 2018 Mar 5;12(1):12
pubmed: 29506557
Eur J Hum Genet. 2011 Nov;19(11):1127-32
pubmed: 21673746
J Hum Genet. 2021 Jul;66(7):671-679
pubmed: 33495570
J Genet Couns. 2021 Jun;30(3):645-655
pubmed: 33319384
Genet Med. 2013 Nov;15(11):888-95
pubmed: 23807616
Genet Med. 2016 Jul;18(7):705-11
pubmed: 26583685
Genet Med. 2012 Dec;14(12):983-9
pubmed: 22935717
Eur J Hum Genet. 2014 Apr;22(4):445-51
pubmed: 23921537
Eur J Hum Genet. 2015 Oct;23(10):1423-6
pubmed: 25604854
Am J Med Genet A. 2013 May;161A(5):1064-72
pubmed: 23610051
J Med Ethics. 2018 Jun;44(6):397-403
pubmed: 29496751
Eur J Hum Genet. 2016 Jan;24(1):14-20
pubmed: 26036856
Public Health Genomics. 2011;14(6):337-45
pubmed: 21487211
Eur J Med Genet. 2020 Nov;63(11):104043
pubmed: 32835846
Genet Med. 2020 Nov;22(11):1821-1829
pubmed: 32669677
J Empir Res Hum Res Ethics. 2015 Apr;10(2):107-20
pubmed: 25742675
Dev World Bioeth. 2018 Dec;18(4):321-330
pubmed: 28513968
Eur J Hum Genet. 2011 Dec;19(12):1213-7
pubmed: 21731059
Clin Genet. 2015 Apr;87(4):311-8
pubmed: 25045831
Genet Med. 2019 Mar;21(3):748-752
pubmed: 29997389
Genet Med. 2005 Jan;7(1):48-53
pubmed: 15654228
J Genet Couns. 2021 Jun;30(3):766-773
pubmed: 33320394
BMC Med Ethics. 2013 Oct 14;14:41
pubmed: 24125465
Genet Med. 2012 Feb;14(2):215-22
pubmed: 22241094
Am J Med Genet A. 2015 Nov;167A(11):2635-46
pubmed: 26198374
Genet Med. 2016 Jun;18(6):577-83
pubmed: 26540156
Genet Test Mol Biomarkers. 2018 Mar;22(3):178-186
pubmed: 29461872
Genet Med. 2019 May;21(5):1100-1110
pubmed: 30287922
J Genet Couns. 2018 Feb;27(1):263-273
pubmed: 28932961
J Empir Res Hum Res Ethics. 2017 Apr;12(2):97-106
pubmed: 28421887
Genet Med. 2019 May;21(5):1092-1099
pubmed: 30237575
J Med Ethics. 2014 Oct;40(10):691-6
pubmed: 24356209
J Med Ethics. 2015 Apr;41(4):322-6
pubmed: 24872596
Genome Med. 2019 Feb 27;11(1):10
pubmed: 30808425
Eur J Hum Genet. 2020 Nov;28(11):1486-1496
pubmed: 32686758
Public Health Genomics. 2016;19(5):269-75
pubmed: 27553645
Am J Med Genet A. 2010 Oct;152A(10):2482-92
pubmed: 20799322
Am J Epidemiol. 2002 Aug 15;156(4):311-8
pubmed: 12181100
N Engl J Med. 2009 Jul 16;361(3):245-54
pubmed: 19605829
Public Health Genomics. 2018;21(3-4):154-163
pubmed: 30999302
Clin Genet. 2015 Oct;88(4):320-6
pubmed: 25492269
J Geriatr Psychiatry Neurol. 2005 Dec;18(4):250-5
pubmed: 16306249
Genet Med. 2018 Mar;20(3):320-328
pubmed: 29261176
Genet Med. 2012 Apr;14(4):451-7
pubmed: 22402755
Eur J Hum Genet. 2013 Mar;21(3):261-5
pubmed: 22892536
J Empir Res Hum Res Ethics. 2011 Dec;6(4):53-67
pubmed: 22228060
Genet Med. 2015 May;17(5):405-24
pubmed: 25741868
Psychiatr Genet. 2015 Jun;25(3):127-30
pubmed: 25748091
J Genet Couns. 2019 Apr;28(2):428-437
pubmed: 30835913
Health Care Women Int. 1992 Jul-Sep;13(3):313-21
pubmed: 1399871
Eur J Hum Genet. 2016 Jan;24(1):30-6
pubmed: 25873015
J Community Genet. 2018 Jul;9(3):201-208
pubmed: 29082482
Am J Med Genet A. 2015 Jul;167(7):1542-50
pubmed: 25900516
Genet Med. 2020 Feb;22(2):345-352
pubmed: 31477844
BMC Med Ethics. 2020 Nov 4;21(1):112
pubmed: 33148222
J Cancer Educ. 2006 Spring;21(1 Suppl):S47-52
pubmed: 17020502
Public Health Genomics. 2021;24(1-2):33-43
pubmed: 33486491
PLoS One. 2016 Apr 15;11(4):e0153597
pubmed: 27082877
Genet Med. 2016 Jan;18(1):82-8
pubmed: 25856669
J Genet Couns. 2018 Jun;27(3):709-722
pubmed: 29168042
BMC Med Ethics. 2019 Nov 14;20(1):81
pubmed: 31727134
J Genet Couns. 2014 Dec;23(6):984-91
pubmed: 24777552
Genet Test Mol Biomarkers. 2017 Mar;21(3):159-165
pubmed: 28177781
J Community Genet. 2018 Jan;9(1):19-26
pubmed: 28656483
J Community Genet. 2012 Oct;3(4):275-83
pubmed: 22454259
J Law Med Ethics. 2015 Fall;43(3):502-13
pubmed: 26479559
Cancer Epidemiol Biomarkers Prev. 2011 Mar;20(3):522-9
pubmed: 21307304
BMC Med Genomics. 2021 Mar 1;14(1):66
pubmed: 33648514
J Genet Couns. 2017 Dec;26(6):1314-1323
pubmed: 28161759
J Genet Couns. 2021 Jun;30(3):755-765
pubmed: 33319432
J Genet Couns. 2021 Feb;30(1):257-267
pubmed: 32951257
Genet Med. 2019 Oct;21(10):2381-2389
pubmed: 30992550
J Genet Couns. 2014 Apr;23(2):179-86
pubmed: 23832708
PLoS One. 2016 Aug 17;11(8):e0160461
pubmed: 27532667
J Law Med Ethics. 2015 Fall;43(3):464-75
pubmed: 26479556
J Med Internet Res. 2018 Jul 12;20(7):e10480
pubmed: 30001997
JCO Precis Oncol. 2018;2:
pubmed: 32095738
Public Health Genomics. 2020;23(1-2):59-68
pubmed: 32289795
Intern Med J. 2015 Dec;45(12):1274-9
pubmed: 26390363
Eur J Hum Genet. 2021 Mar;29(3):471-481
pubmed: 33230308
Public Health Genomics. 2013;16(5):241-50
pubmed: 24029681
Eur J Hum Genet. 2020 Sep;28(9):1178-1186
pubmed: 32424322
J Community Genet. 2021 Jan;12(1):171-184
pubmed: 33219499
Genet Med. 2013 Nov;15(11):882-7
pubmed: 23639901
Eur J Hum Genet. 2018 Aug;26(8):1094-1100
pubmed: 29706632
Am J Hum Genet. 2018 Sep 6;103(3):358-366
pubmed: 30122538
Genome Med. 2019 May 23;11(1):31
pubmed: 31122281
Eur J Hum Genet. 2021 Feb;29(2):231-240
pubmed: 33011736
Nurse Educ Today. 2004 Feb;24(2):105-12
pubmed: 14769454
Clin Genet. 2020 Feb;97(2):312-320
pubmed: 31654527
Genet Med. 2019 Jan;21(1):124-132
pubmed: 29875419
J Empir Res Hum Res Ethics. 2018 Apr;13(2):125-138
pubmed: 29471711
J Med Ethics. 2009 Apr;35(4):251-7
pubmed: 19332583
Per Med. 2016 Jul;13(4):303-314
pubmed: 29749813
J Alzheimers Dis. 2021;79(2):559-572
pubmed: 33337371
Genet Med. 2019 Nov;21(11):2468-2477
pubmed: 30992552
Public Health Genomics. 2020;23(1-2):69-76
pubmed: 32069464
J Law Med Ethics. 2015 Fall;43(3):514-22
pubmed: 26479560
Genet Med. 2021 Jun;23(6):1163-1166
pubmed: 33603197
Clin Genet. 2006 May;69(5):393-8
pubmed: 16650074
Genet Med. 2018 Sep;20(9):1069-1076
pubmed: 29300387
Genet Med. 2016 Dec;18(12):1218-1225
pubmed: 27101135
J Empir Res Hum Res Ethics. 2015 Oct;10(4):414-26
pubmed: 26376753
PLoS One. 2014 Jul 01;9(7):e101111
pubmed: 24983240
Biopreserv Biobank. 2012 Feb;10(1):29-36
pubmed: 24849751
Eur J Hum Genet. 2018 May;26(5):652-659
pubmed: 29440777
J Genet Couns. 2020 Feb;29(1):131-134
pubmed: 31663205
PLoS One. 2016 May 11;11(5):e0154965
pubmed: 27167380
Genet Test Mol Biomarkers. 2012 Jun;16(6):508-13
pubmed: 22352737
Public Health Genomics. 2011;14(6):346-55
pubmed: 21555865
Am J Med Genet A. 2007 Aug 1;143A(15):1733-8
pubmed: 17618487
Biopreserv Biobank. 2020 Oct;18(5):395-402
pubmed: 32706976
BMC Med Ethics. 2021 Jan 28;22(1):7
pubmed: 33509184
Alzheimers Dement. 2008 Nov;4(6):406-13
pubmed: 19012865
Per Med. 2020 Mar;17(2):101-109
pubmed: 32125936
Eur J Med Genet. 2020 Feb;63(2):103642
pubmed: 30904667
J Empir Res Hum Res Ethics. 2011 Sep;6(3):39-46
pubmed: 21931236
Public Health Genomics. 2015;18(5):299-308
pubmed: 26352440
Genet Med. 2013 Jun;15(6):458-65
pubmed: 23448721
J Community Genet. 2021 Jan;12(1):53-65
pubmed: 32761465
BMC Nurs. 2013 Oct 04;12(1):25
pubmed: 24094243
Eur J Hum Genet. 2017 Feb;25(3):280-292
pubmed: 28051073
J Epidemiol. 2008;18(5):217-24
pubmed: 18776708
Am J Med Genet B Neuropsychiatr Genet. 2019 Dec;180(8):589-600
pubmed: 30358063
Genet Med. 2018 Jan;20(1):132-141
pubmed: 28726810
BMC Med Genomics. 2018 May 8;11(1):45
pubmed: 29739461
Cancer Med. 2019 Jan;8(1):227-237
pubmed: 30600607
Genome Med. 2021 Feb 5;13(1):17
pubmed: 33546753
Genet Med. 2014 Aug;16(8):633-40
pubmed: 24434691
J Genet Couns. 2018 Sep;27(5):1220-1227
pubmed: 29497922
J Hum Genet. 2017 Dec;62(12):1037-1048
pubmed: 28794501
Clin Genet. 2018 May;93(5):1022-1029
pubmed: 29383714
Clin Transl Sci. 2021 Mar;14(2):550-557
pubmed: 33108689
Genet Med. 2019 Jun;21(6):1355-1362
pubmed: 30382154
J Pers Med. 2020 Mar 01;10(1):
pubmed: 32121581
PLoS One. 2020 Mar 16;15(3):e0229540
pubmed: 32176704
BMC Med Genomics. 2013 Mar 08;6:8
pubmed: 23497701
J Genet Couns. 2007 Aug;16(4):527-38
pubmed: 17492498
Am J Med Genet A. 2014 Sep;164A(9):2153-60
pubmed: 24845082
Per Med. 2013 Jan;10(1):27-34
pubmed: 24077424
J Empir Res Hum Res Ethics. 2018 Jul;13(3):295-304
pubmed: 29701109
Eur J Hum Genet. 2019 Apr;27(4):535-546
pubmed: 30622328
Public Health Genomics. 2010;13(7-8):431-9
pubmed: 20829581
J Empir Res Hum Res Ethics. 2009 Sep;4(3):99-111
pubmed: 19754239
PLoS One. 2018 Aug 16;13(8):e0202502
pubmed: 30114272
Glob Bioeth. 2019 Mar 24;31(1):184-199
pubmed: 33343192
J Empir Res Hum Res Ethics. 2011 Dec;6(4):30-40
pubmed: 22228058
Eur J Hum Genet. 2010 Dec;18(12):1296-301
pubmed: 20664629
Mayo Clin Proc. 2014 Jun;89(6):738-46
pubmed: 24943692
Genet Med. 2017 Feb;19(2):249-255
pubmed: 27854360
J Med Ethics. 2017 May;43(5):346-349
pubmed: 28039284
Genet Med. 2013 Jul;15(7):558-64
pubmed: 23370450

Auteurs

Danya F Vears (DF)

Melbourne Law School, University of Melbourne, Carlton, Australia.
Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Australia.
Center for Biomedical Ethics and Law, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.
Leuven Institute for Human Genetics and Society, Leuven, Belgium.

Joel T Minion (JT)

Policy, Ethics and Life Sciences (PEALS) Research Centre, Newcastle University, Newcastle, United Kingdom.
Department of Community Health Sciences, O'Brien Institute for Public Health, University of Calgary, Calgary, Canada.

Stephanie J Roberts (SJ)

Policy, Ethics and Life Sciences (PEALS) Research Centre, Newcastle University, Newcastle, United Kingdom.

James Cummings (J)

School of Art, Media and American Studies, University of East Anglia, Norwich, United Kingdom.

Mavis Machirori (M)

Policy, Ethics and Life Sciences (PEALS) Research Centre, Newcastle University, Newcastle, United Kingdom.
Ada Lovelace Institute, London, United Kingdom.

Mwenza Blell (M)

Policy, Ethics and Life Sciences (PEALS) Research Centre, Newcastle University, Newcastle, United Kingdom.

Isabelle Budin-Ljøsne (I)

Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, Oslo, Norway.

Lorraine Cowley (L)

Newcastle upon Tyne NHS Foundation Hospitals Trust, Northern Genetics Service, Centre for Life, Newcastle, United Kingdom.
Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom.

Stephanie O M Dyke (SOM)

McGill Centre for Integrative Neuroscience, Montreal Neurological Institute, Department of Neurology & Neurosurgery, McGill University, Montreal, Canada.

Clara Gaff (C)

Murdoch Children's Research Institute, The Royal Children's Hospital, Parkville, Australia.
Department of Paediatrics, Faculty of Medicine Dentistry & Health Sciences, The University of Melbourne, Parkville, Australia.
Walter and Eliza Hall Institute of Medical Research, Parkville, Australia.

Robert Green (R)

Harvard Medical School, Boston, Massachusetts, United States of America.
Mass General Brigham, Boston, Massachusetts, United States of America.
Broad Institute, Boston, Massachusetts, United States of America.
Ariadne Labs, Boston, Massachusetts, United States of America.

Alison Hall (A)

PHG Foundation, University of Cambridge, Cambridge, United Kingdom.

Amber L Johns (AL)

Cancer Division, Garvan Institute of Medical Research, Sydney, Australia.
International Cancer Genome Consortium, University of Glasgow, Glasgow, United Kingdom.

Bartha M Knoppers (BM)

Centre of Genomics and Policy, McGill University, Montreal, Canada.

Stephanie Mulrine (S)

Northumbria University, Newcastle, United Kingdom.

Christine Patch (C)

Genomics England, Queen Mary University of London, London, United Kingdom.
Society and Ethics Research Group, Connecting Science, Wellcome Genome Campus, Cambridge, United Kingdom.

Eva Winkler (E)

National Center for Tumour Diseases (NCT), Section of Translational Medical Ethics, University of Heidelberg, Heidelberg, Germany.

Madeleine J Murtagh (MJ)

University of Glasgow, Glasgow, United Kingdom.
Newcastle University, Newcastle, United Kingdom.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH