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Article History

Received: 28 April 2025

Accepted: 6 October 2025

First Online: 29 November 2025

Declarations

:

: This study was approved by the Institutional Review Board (IRB) of Chung Shan Medical University Hospital (Clinical trial number: CS2-22206) and was conducted in accordance with international guidelines and the ethical principles outlined in the Declaration of Helsinki. Ethical approval was obtained in compliance with all applicable regulations and institutional requirements. All data utilized in this study were obtained from the National Health Insurance Research Database (NHIRD), authorized and regulated by the Ministry of Health and Welfare, Taiwan. The NHIRD may be linked with various public databases housed at the Data Science Center, including government surveys, disease registries, health surveys, social welfare reporting systems, and other administrative datasets. These datasets are linked through encrypted personal identification numbers using deterministic record linkage, ensuring both accuracy and confidentiality. To protect patient privacy, all reimbursement claims data were de-identified prior to analysis. The electronic dataset was processed with scrambled patient identifiers, and access was granted solely for academic research purposes under strict data protection protocols.

: Not applicable.

: The authors declare no competing interests.