341:
appointments process after the first round of interviews was "within the range of reasonable responses", and that the Review Group was "entitled to reach the decision it did given the circumstances facing it at the time". Although he ruled against invalidating the interviews that had already taken place, Mr
Justice Goldring added that this judgement did not imply that junior doctors were not entitled to feel aggrieved, as "the premature introduction of MTAS has had disastrous consequences". Remedy UK have said they will not appeal the verdict, in order to avoid further uncertainty for junior doctors.
179:
membership of the Royal
College of Physicians (MRCP) or had taken part in research in their chosen speciality. It was a common misconception amongst more senior colleagues that SHOs would essentially be reapplying for their old jobs. Given the centralised nature of the selection process, this was not the case. Tabulation of the number of jobs at each level revealed that there were far fewer posts in the upper ranks of training than there were doctors already at that stage, which left many doctors partially trained and without a career under the new system.
246:
interview for their first choice if this was in
England, with Wales and Scotland deciding to interview all applicants for all posts. Applicants for English programmes were able to make any of their four initial choices into their new first choice if they wished, in order to maximise the number of interviews they would have. This extra round of interviews was called Round 1B. Estimates are that there were 30,000 extra interviews requiring at least 15,000 consultant hours of interview time.
64:(SHO). They could apply for as many posts as they wished, and would be selected by their future employers based on their CV / application form and interview. They could devise their own training programme or apply to be part of a training rotation – usually entailing changing jobs every six months, but staying within the same speciality and hospital. Whilst training, an SHO would be encouraged to take professional exams to enable them to become a member of one of the
115:"Free-text boxes encouraged plagiarism and commercial websites sold responses. Plagiarism was common but the promised plagiarism software did not function initially. Even when it did, plagiarism detection was relatively unhelpful as it could identify similar responses but could not identify whether the applicant composed or copied the text and thus could not be used to exclude applicants. In addition, the word limit was felt to be too restrictive by many.
90:
UoAs), or to two specialties in two UoAs, or four specialties in one UoA. There were twelve geographical areas: one each for
Scotland, Wales and Northern Ireland; one covering the whole of London, Kent, Surrey and Sussex; and eight others. The completed application forms were used for selection for interviews. Candidates who were not eligible (for example, not having practised medicine for a number of years, or not being registered with the UK
208:, whereby each of a single candidate's responses were marked by a different set of markers. Unfortunately, candidates were not informed that this would occur, and many had assumed the entire form would have been marked by the same markers. Consequently, candidates that cross referenced their answers across the form (e.g., by writing "as detailed in my answer above") failed to score marks compared to candidates who did not do this.
120:
is our professional duty as shortlisters to make sure that the appointment process is carried out correctly and that all candidates are considered equally and fairly. There have been a series of serious procedural errors during the processThere has been a general recognition that round 1 of MTAS has been unfair and ineffective."
40:, and allocating them to jobs in the UK. Its implementation was heavily criticised both in the press and within the medical profession, and its operation was marked by the resignation of key staff and serious security breaches. The system affected junior doctors, and so every qualified doctor in the UK who had not yet attained
250:
junior doctor in substantive employment on 31 July, and taking part in Round 2 will be guaranteed employment until the end of Round 2 in
October, "Please note that all applicants who applied to MTAS who are in substantive NHS employment on 31 July will continue to have employment while they progress through Round 2".
296:
welcomed the government's acknowledgement of the problem but stated that "an apology isn't enough". Patricia Hewitt's apology was repeated to parliament on 16 April 2007, however she stated that, "the problems that have arisen relate in the main to the implementation process and not to the underlying
245:
The allegations of widespread execution problems led to a review and a rolling program of sweeping changes, leaving the junior doctors in the system unsure of where they stood for long periods. The review stated that everyone should be entitled to keep any previous interviews in hand and also have an
132:
As with other areas of the scheme, the interview process attracted several criticisms at independent review as they were "felt by many to be too formulaic and politically correct rather than sufficiently probing to demonstrate differences in competencies and abilities", they were frequently too short
128:
The interviews were again designed to be unbiased, in that, once selected for interview, the application form would be ignored, and CVs would not be allowed at interview. Instead, defined questions with explicit marking schemes gave scores to the candidate's answers by looking for certain phrases and
76:
grade led to SHOs being labelled as a "lost tribe". During the MTAS crisis, however, "The Lost Tribe" was used to refer to doctors who were not able to proceed using the new computer system and as a result were left with no career at all, and so in a worse situation that the original "Lost Tribe" the
153:
Unfortunately in practice the centralised system failed, with MTAS withdrawn after the matching process, and the workload for consultants was hugely increased, as evidenced in several of the resignation letters prompted by the procedure: "The
Consultants involved in shortlisting have all worked long
119:
Shortlisting was widely regarded as uneven and unfair, with the Tooke Report noting: "Some excellent candidates not shortlisted. Many very poor candidates were shortlisted." A number of local schools withdrew from the process in protest, with the North
Central London School of Anaesthesia noting "It
89:
grades, along with those who already had up to several years of experience working at the old SHO (next grade up) level, were invited to submit an electronic application form on the MTAS website. Applications could be made to one speciality in four geographic areas (called 'Units of
Application' or
280:
On 30 March 2007 Professor Alan
Crockard resigned as National Director of Modernising Medical Careers. In his resignation letter he stated that he has "responsibility but less and less authority" and that "the overriding message coming back from the profession is that it has lost confidence in the
276:
The BMA later rejoined the review and have since lent their support to the proposed changes ("Round 1B"). However, following an outcry by members and a controversial letter to The Times newspaper, Mr James
Johnson, Chairman of the BMA resigned on 20 May 2007, citing his reasons for leaving as the
136:
After the first round of interviews, there was a plan for a second round of applications. Candidates who were unsuccessful in both rounds would have no further opportunity to gain access to a training job in the UK for the year ahead, as MMC meant it was impossible to recruit junior doctors after
236:
The security of the system failed, with personal details including phone numbers, home addresses and sexual orientation of junior doctors publicly available for several hours to anyone with the right URL. The following day it was reported that applicants had been able to see each other's files by
182:
Since geographical units of application were so large, candidates had to be prepared to work in a huge area of the country, or to compromise on their speciality since they were warned that making fewer than four choices would place them at a disadvantage. This was extremely hard for those who had
178:
It was decided to make a 'clean break' with the old system of Senior House Officer training by making all SHOs currently in training apply through the system. These doctors were between six months and six years into their training in a particular speciality. Many had higher qualifications such as
249:
The initial offers from Rounds 1 & 1B were made by 10 June 2007. Round 2 started on 22 June and was organised locally as the MTAS system was offline. Round 2 continued until 31 October 2007, three months after the process should have been completed. The guidance from MMC indicated that any
222:
Not all forms were marked by consultants. Many deaneries asked non-medical staff to help them meet their deadlines. It is unclear whether these non-medical staff were appropriately trained to mark the papers, and whether applicants were disadvantaged or advantaged if their forms were marked by
102:
The application form consisted of shortlisting questions with space for 150-word answers. One of the changes promoted by the new system was that little (25%) importance was given to past experience, achievements, or examinations passed in the specialties, while the majority of the weighting for
226:
Exceptional candidates received no interviews. A large proportion of candidates who had already passed professional exams, had PhDs or research experience in the relevant speciality and many with considerable clinical experience were not shortlisted for interviews. This was largely due to the
140:
Application forms were released in February 2007, with two weeks to complete and submit. The first round of interviews were due to be carried out in February, March, and April 2007 with applicants finding out whether they were successful in May. The second round was to take place after this,
340:
from 16 to 17 May 2007, where the BMA sided with the government despite an overwhelming majority of their own membership opposing MTAS. On Wednesday 23 May 2007 Mr Justice Goldring ruled against Remedy UK, stating that "although far from ideal", the Review Group's decision on amending the
103:
selection was based on the 150-word answers in the electronic application form (75% weighting). This was in sharp contrast to the previous CV-led process where past experience, achievements and examinations passed in the specialties were used to shortlist candidates for interview.
133:("In many cases the time allocated to interviews was the minimum of 30 minutes which some interviewers felt was insufficient"), and they failed to reward those with high academic achievements, who "were particularly disadvantaged by a non-CV based process."
211:
The online application system frequently became overloaded which meant that potential applicants were unable to log into the site, complete or submit their forms. The application deadline was extended by 48 hours to enable candidates to submit their
304:
report stated that applicants had been able to see each other's files by changing two digits in the personalised web address given to each individual. At that point the Department of Health announced that this was a temporary suspension.
149:
In theory, the new application system centralised the application process, reducing the workload for consultants in shortlisting candidates for interview, and the workload of candidates applying multiple times for different posts.
218:
The "double-blind" system for marking failed. Each form should have been marked independently by two consultants to ensure mistakes by one marker are covered by the second marker. Unfortunately, some forms were only marked by one
106:
The questions on which the majority of the score was based were heavily criticised both at the time by the medical professionals obliged to answer them and subsequently in the independent review of MMC led by Professor
186:
Because interview and selection took place centrally, rather than at the employing institution or hospital, specialist institutions had no input into the particular skills and attributes needed to work in particular
129:
keywords. Again, the emphasis here was on removing possible bias due to a candidate's past achievements and experience, and focusing only on the performance at the standardised interview.
269:(the largest trade union body representing doctors) pulled out of the review panel after their announcement that each doctor would only be given one interview. Organisations like the
154:
hours, often at weekends or during half term holidays, and have done their utmost to cooperateMost of us had 48 hours in which to carry out shortlisting of up to 650 applications.".
1205:
253:
There was, however, a general feeling amongst those involved in the system that it was beyond repair and further efforts to do so constituted an example of '
171:
The MTAS system was based on five academic papers all produced by Fiona Patterson. The papers were based on a very small sample size and made clear that the
791:
297:
principles of Modernising Medical Careers." Later that month Ms Hewitt was accused by the opposition of failing to express genuine regret over the fiasco.
312:
after the suspension of the MTAS website due to security breaches that she described as "utterly deplorable". On 3 May, Hewitt appeared on BBC
968:
807:
833:
876:
411:
1173:
738:
563:
Beard J, Strachan A, Davies H, et al. (2005). "Developing an education and assessment framework for the Foundation Programme".
946:
292:
apologised to junior doctors over the crisis, saying that the application scheme had caused "needless anxiety and distress". The
175:
between successful completion of the MTAS form and having the competencies required to be a successful doctor was 0.35, or poor.
57:
194:, leading to a moral dilemma for those disagreeing with the system but obliged to apply in order to have a chance of a job.
473:
293:
266:
191:
53:
29:
901:
94:) were rejected at the 'longlisting' stage, with the 'shortlisting' stage designed to pick out the best applicants.
412:"Aspiring to Excellence: findings and recommendations of the independent inquiry into Modernising Medical Careers"
934:
314:
270:
788:
309:
86:
33:
864:
608:"A new selection system to recruit general practice registrars: preliminary findings from a validation study"
237:
changing two digits in the personalised web address given to each individual, and the system was suspended.
91:
65:
337:
254:
205:
41:
1064:
Brown M, Boon N, Brooks N, et al. (2007). "Medical training in the UK: sleepwalking to disaster".
697:
516:"Selecting doctors for postgraduate training in paediatrics using a competency based assessment centre"
336:, who demanded that the appointments process should be scrapped altogether. The case was heard in the
1151:
366:
73:
69:
61:
37:
811:
215:
Some forms were "lost" in the online system, and parts of other forms were not visible to markers.
56:(MMC), junior doctors who had completed their initial training after medical school (formerly the
1089:
1016:
588:
450:
840:
657:"A competency model for general practice: implications for selection, training, and development"
329:
said that after the first round of recruitment, the system would only fulfil a monitoring role.
1081:
678:
637:
580:
545:
496:
1073:
668:
627:
619:
572:
535:
527:
488:
880:
795:
418:
326:
289:
1177:
673:
656:
540:
515:
474:""Trust me...": psychological and behavioral predictors of perceived physician empathy"
301:
1077:
715:
632:
607:
391:
Dillner L. Senior house officers: the lost tribes. BMJ 1993;307:1549–51. (11 December)
1199:
576:
319:
1093:
592:
85:
Under MTAS, junior doctors who had completed the PRHO grade, and more recently the
1129:
1107:
1038:
990:
913:
285:
172:
492:
1012:
108:
623:
227:
weighting of questionnaire responses over academic and clinical achievements.
767:
531:
333:
1085:
682:
641:
584:
549:
500:
332:
A judicial review of MTAS was successfully called for by pressure group
865:
James Johnson and Carol Black, The Times – Letters Section, 17 May 2007
839:. The Association of Surgeons in Training. 5 March 2007. Archived from
655:
Patterson F, Ferguson E, Lane P, Farrell K, Martlew J, Wells A (2000).
325:
On 15 May 2007 MTAS was shelved by ministers due to security breaches.
834:"Failures of the Medical Training Application Service (MTAS) system"
28:) was an on-line application system set up under the auspices of
72:. The lack of formal structure between the PRHO grade and the
1013:"Patricia Hewitt attacked by junior doctor on Question Time"
370:
472:
Silvester J, Patterson F, Koczwara A, Ferguson E (2007).
68:. Once this was achieved, they could apply for jobs as a
716:"Hewitt apologises for junior doctor recruitment crisis"
300:
The MTAS website was suspended on 26 April 2007 after a
190:
An application via MTAS was seen as an endorsement for
808:"BMA junior doctors leave talks on recruitment system"
514:
Randall R, Davies H, Patterson F, Farrell K (2006).
308:
Ms Hewitt made another apology on 1 May 2007 in the
273:
stated that they had lost confidence in the system.
969:"Exclusive: junior doctors' details exposed online"
606:Patterson F, Ferguson E, Norfolk T, Lane P (2005).
762:
760:
167:Theoretical concerns behind the process include:
935:MMC360 transcript from parliament, 16 April 2007
1174:"BMA – Parliamentary questions on MTAS and MMC"
739:"Security lapse in junior doctor jobs website"
405:
403:
401:
399:
397:
8:
318:where she faced hostile questioning from a
789:Letter to Applicants from MMC, 8 June 2007
453:. The Central London School of Anaesthesia
451:"Resignation from MTAS Appointments Panel"
445:
443:
441:
439:
60:or PRHO grade) could apply for posts as a
672:
631:
539:
288:'s Today programme, the Health Secretary
284:On 3 April 2007, during an interview on
1206:Medical education in the United Kingdom
410:Professor John Tooke (8 January 2008).
358:
349:The estimated cost of MTAS was £6.3m.
32:in 2007 and used for the selection of
1019:from the original on 15 December 2021
947:"Hewitt blasted over training fiasco"
877:"James Johnson Resignation Statement"
7:
241:Attempts to repair interview process
18:Medical Training Application Service
1108:"'Scrap' junior doctors job system"
1039:"Doctor application system ditched"
991:"Hewitt attacked over jobs website"
914:"Hewitt apology for training chaos"
768:"Doctors' job website is suspended"
48:Overview of the system prior to MMC
1152:"Improving Doctors' Working Lives"
77:system had been intended to help.
14:
1130:"Junior doctors lose court fight"
137:the single specified start date.
577:10.1111/j.1365-2929.2005.02236.x
810:. 23 March 2007. Archived from
718:. E-Health Insider Primary Care
737:Fleming, Nic (27 April 2007).
58:Pre-registration house officer
1:
1078:10.1016/S0140-6736(07)60754-5
281:current recruitment system".
141:finishing in late June 2007.
52:Prior to the introduction of
145:Theoretical benefits of MTAS
698:"Doctors who face the dole"
696:Sarah Hall (6 March 2007).
294:British Medical Association
267:British Medical Association
192:Modernising Medical Careers
54:Modernising Medical Careers
30:Modernising Medical Careers
1222:
493:10.1037/0021-9010.92.2.519
770:. BBC News. 26 April 2007
271:Royal College of Surgeons
183:family or financial ties.
34:Foundation House Officers
916:. BBC News. 3 April 2007
624:10.1136/bmj.330.7493.711
277:contents of the letter.
111:. The report commented:
87:Foundation House Officer
81:MTAS application process
1132:. BBC News. 23 May 2007
1110:. BBC News. 16 May 2007
1015:. YouTube. 3 May 2007.
532:10.1136/adc.2005.076653
199:Implementation problems
92:General Medical Council
993:. BBC News. 1 May 2007
117:
66:medical royal colleges
255:irrational escalation
113:
98:Scoring of applicants
1180:on 10 September 2007
814:on 26 September 2007
794:12 June 2007 at the
353:Notes and references
322:over MTAS failures.
163:Theoretical problems
74:specialist registrar
70:specialist registrar
62:Senior House Officer
38:Specialty Registrars
743:The Daily Telegraph
1172:Winterton, Rosie.
902:Resignation Letter
223:non-medical staff.
206:horizontal marking
158:Problems with MTAS
846:on 6 October 2007
232:Security concerns
1213:
1190:
1189:
1187:
1185:
1176:. Archived from
1169:
1163:
1162:
1160:
1158:
1148:
1142:
1141:
1139:
1137:
1126:
1120:
1119:
1117:
1115:
1104:
1098:
1097:
1072:(9574): 1673–5.
1061:
1055:
1054:
1052:
1050:
1035:
1029:
1028:
1026:
1024:
1009:
1003:
1002:
1000:
998:
987:
981:
980:
978:
976:
971:. Channel 4 News
965:
959:
958:
956:
954:
949:. Channel 4 News
943:
937:
932:
926:
925:
923:
921:
910:
904:
899:
893:
892:
890:
888:
879:. Archived from
873:
867:
862:
856:
855:
853:
851:
845:
838:
830:
824:
823:
821:
819:
804:
798:
786:
780:
779:
777:
775:
764:
755:
754:
752:
750:
734:
728:
727:
725:
723:
712:
706:
705:
693:
687:
686:
676:
652:
646:
645:
635:
603:
597:
596:
560:
554:
553:
543:
520:Arch. Dis. Child
511:
505:
504:
478:
469:
463:
462:
460:
458:
447:
434:
433:
431:
429:
423:
417:. Archived from
416:
407:
392:
389:
383:
382:
380:
378:
369:. Archived from
363:
310:House of Commons
204:The system used
1221:
1220:
1216:
1215:
1214:
1212:
1211:
1210:
1196:
1195:
1194:
1193:
1183:
1181:
1171:
1170:
1166:
1156:
1154:
1150:
1149:
1145:
1135:
1133:
1128:
1127:
1123:
1113:
1111:
1106:
1105:
1101:
1063:
1062:
1058:
1048:
1046:
1037:
1036:
1032:
1022:
1020:
1011:
1010:
1006:
996:
994:
989:
988:
984:
974:
972:
967:
966:
962:
952:
950:
945:
944:
940:
933:
929:
919:
917:
912:
911:
907:
900:
896:
886:
884:
875:
874:
870:
863:
859:
849:
847:
843:
836:
832:
831:
827:
817:
815:
806:
805:
801:
796:Wayback Machine
787:
783:
773:
771:
766:
765:
758:
748:
746:
736:
735:
731:
721:
719:
714:
713:
709:
695:
694:
690:
667:(452): 188–93.
654:
653:
649:
618:(7493): 711–4.
605:
604:
600:
562:
561:
557:
513:
512:
508:
476:
471:
470:
466:
456:
454:
449:
448:
437:
427:
425:
424:on 6 March 2009
421:
414:
409:
408:
395:
390:
386:
376:
374:
373:on 6 April 2007
365:
364:
360:
355:
347:
327:Patricia Hewitt
290:Patricia Hewitt
263:
243:
234:
201:
165:
160:
147:
126:
100:
83:
50:
12:
11:
5:
1219:
1217:
1209:
1208:
1198:
1197:
1192:
1191:
1164:
1143:
1121:
1099:
1056:
1030:
1004:
982:
960:
938:
927:
905:
894:
883:on 24 May 2007
868:
857:
825:
799:
781:
756:
729:
707:
688:
661:Br J Gen Pract
647:
598:
555:
506:
481:J Appl Psychol
464:
435:
393:
384:
357:
356:
354:
351:
346:
343:
302:Channel 4 News
262:
259:
242:
239:
233:
230:
229:
228:
224:
220:
216:
213:
209:
200:
197:
196:
195:
188:
184:
180:
176:
164:
161:
159:
156:
146:
143:
125:
122:
99:
96:
82:
79:
49:
46:
13:
10:
9:
6:
4:
3:
2:
1218:
1207:
1204:
1203:
1201:
1179:
1175:
1168:
1165:
1153:
1147:
1144:
1131:
1125:
1122:
1109:
1103:
1100:
1095:
1091:
1087:
1083:
1079:
1075:
1071:
1067:
1060:
1057:
1045:. 15 May 2007
1044:
1040:
1034:
1031:
1018:
1014:
1008:
1005:
992:
986:
983:
970:
964:
961:
948:
942:
939:
936:
931:
928:
915:
909:
906:
903:
898:
895:
882:
878:
872:
869:
866:
861:
858:
842:
835:
829:
826:
813:
809:
803:
800:
797:
793:
790:
785:
782:
769:
763:
761:
757:
744:
740:
733:
730:
717:
711:
708:
703:
699:
692:
689:
684:
680:
675:
670:
666:
662:
658:
651:
648:
643:
639:
634:
629:
625:
621:
617:
613:
609:
602:
599:
594:
590:
586:
582:
578:
574:
571:(8): 841–51.
570:
566:
559:
556:
551:
547:
542:
537:
533:
529:
525:
521:
517:
510:
507:
502:
498:
494:
490:
487:(2): 519–27.
486:
482:
475:
468:
465:
452:
446:
444:
442:
440:
436:
420:
413:
406:
404:
402:
400:
398:
394:
388:
385:
372:
368:
362:
359:
352:
350:
344:
342:
339:
335:
330:
328:
323:
321:
320:junior doctor
317:
316:
315:Question Time
311:
306:
303:
298:
295:
291:
287:
282:
278:
274:
272:
268:
261:Repercussions
260:
258:
256:
251:
247:
240:
238:
231:
225:
221:
217:
214:
210:
207:
203:
202:
198:
193:
189:
185:
181:
177:
174:
170:
169:
168:
162:
157:
155:
151:
144:
142:
138:
134:
130:
123:
121:
116:
112:
110:
104:
97:
95:
93:
88:
80:
78:
75:
71:
67:
63:
59:
55:
47:
45:
43:
39:
35:
31:
27:
24:, pronounced
23:
19:
1182:. Retrieved
1178:the original
1167:
1155:. Retrieved
1146:
1134:. Retrieved
1124:
1112:. Retrieved
1102:
1069:
1065:
1059:
1047:. Retrieved
1042:
1033:
1021:. Retrieved
1007:
995:. Retrieved
985:
973:. Retrieved
963:
951:. Retrieved
941:
930:
918:. Retrieved
908:
897:
885:. Retrieved
881:the original
871:
860:
848:. Retrieved
841:the original
828:
816:. Retrieved
812:the original
802:
784:
772:. Retrieved
747:. Retrieved
742:
732:
720:. Retrieved
710:
702:The Guardian
701:
691:
664:
660:
650:
615:
611:
601:
568:
564:
558:
526:(5): 444–8.
523:
519:
509:
484:
480:
467:
455:. Retrieved
426:. Retrieved
419:the original
387:
375:. Retrieved
371:the original
361:
348:
331:
324:
313:
307:
299:
283:
279:
275:
264:
252:
248:
244:
235:
166:
152:
148:
139:
135:
131:
127:
118:
114:
105:
101:
84:
51:
25:
21:
17:
15:
286:BBC Radio 4
219:consultant.
173:correlation
338:High Court
124:Interviews
109:John Tooke
42:Consultant
704:. London.
334:Remedy UK
1200:Category
1157:31 March
1136:31 March
1114:31 March
1094:28231442
1086:17512840
1049:31 March
1043:BBC News
1023:31 March
1017:Archived
997:31 March
975:31 March
953:31 March
920:31 March
850:31 March
818:31 March
792:Archived
774:31 March
745:. London
722:31 March
683:10750226
642:15790641
593:10083757
585:16048627
565:Med Educ
550:16632675
501:17371096
377:26 March
44:status.
1184:17 June
749:8 March
674:1313648
541:2082751
428:16 June
26:em-tass
1092:
1084:
1066:Lancet
887:20 May
681:
671:
640:
633:555635
630:
591:
583:
548:
538:
499:
457:28 May
367:"MTAS"
187:posts.
1090:S2CID
844:(PDF)
837:(PDF)
589:S2CID
477:(PDF)
422:(PDF)
415:(PDF)
212:forms
1186:2008
1159:2008
1138:2008
1116:2008
1082:PMID
1051:2008
1025:2008
999:2008
977:2008
955:2008
922:2008
889:2007
852:2008
820:2008
776:2008
751:2022
724:2008
679:PMID
638:PMID
581:PMID
546:PMID
497:PMID
459:2010
430:2008
379:2007
345:Cost
265:The
36:and
22:MTAS
16:The
1074:doi
1070:369
669:PMC
628:PMC
620:doi
616:330
612:BMJ
573:doi
536:PMC
528:doi
489:doi
257:'.
1202::
1088:.
1080:.
1068:.
1041:.
759:^
741:.
700:.
677:.
665:50
663:.
659:.
636:.
626:.
614:.
610:.
587:.
579:.
569:39
567:.
544:.
534:.
524:91
522:.
518:.
495:.
485:92
483:.
479:.
438:^
396:^
1188:.
1161:.
1140:.
1118:.
1096:.
1076::
1053:.
1027:.
1001:.
979:.
957:.
924:.
891:.
854:.
822:.
778:.
753:.
726:.
685:.
644:.
622::
595:.
575::
552:.
530::
503:.
491::
461:.
432:.
381:.
20:(
Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.