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Article History

Received: 21 October 2025

Accepted: 3 February 2026

First Online: 14 February 2026

Declarations

:

: The study was approved by the Clalit Health Services Data Committee (Main Management) (Approval Number: 819, dated 06/07/2021) and by the institutional research committees of Clalit Health Services and Assuta Ashdod Public Hospital. Both institutional research committees confirmed that, as this study is based on retrospective, de-identified data, an additional submission to the ethics committee was not required. Subsequently, the study was also approved by the Helsinki Committee of Clalit Health Services (Approval Number: 0349-22-SOR) and the Helsinki Committee of Assuta Ashdod Public Hospital (Approval Number: AAA-0190-21). All approvals are valid until 22/01/2026. As this study involved retrospective analysis of existing, de-identified data, the Helsinki Committees of Clalit Health Services and Assuta Ashdod Public Hospital both granted a full exemption from informed consent, in accordance with institutional and national regulations governing secondary use of anonymized health data.

: Not applicable (The requirement for patient consent was waived by the approving institutional review boards and Helsinki Committees due to the retrospective nature of the study, which was conducted using anonymized data).

: The authors declare no competing interests.