{
    "info": {
        "nct_id": "NCT03012984",
        "official_title": "Impact of Dexmedetomidine Supplemented Analgesia on Incidence of Delirium in Elderly Patients After Cancer Surgery: a Multicenter Randomized Controlled Trial",
        "inclusion_criteria": "* Age >= 65 years, < 90 years;\n* Scheduled to undergo surgery for primary solid organ cancer under general anesthesia, with an expected duration of surgery >=2 hours;\n* Planned to use patient-controlled intravenous analgesia after surgery;\n* Provide written informed consent.\nHealthy volunteers allowed\nMust have minimum age of 65 Years\nMust have maximum age of 90 Years",
        "exclusion_criteria": "* Preoperative history of schizophrenia, epilepsy, parkinsonism or myasthenia gravis;\n* Preoperative radio- or chemotherapy;\n* Inability to communicate in the preoperative period because of coma, profound dementia or language barrier;\n* Preoperative obstructive sleep apnea (previously diagnosed as obstructive sleep apnea, or a STOP-Bang score >= 3);\n* Brain trauma or neurosurgery;\n* Preoperative left ventricular ejection fraction < 30%, sick sinus syndrome, severe sinus bradycardia (< 50 beats per minute), or second-degree or above atrioventricular block without pacemaker;\n* Severe hepatic dysfunction (Child-Pugh class C) or severe renal dysfunction (requirement of renal replacement therapy before surgery);\n* ASA classification >= IV.",
        "miscellaneous_criteria": ""
    },
    "inclusion_lines": [
        {
            "identified_line": {
                "line": "* Age >= 65 years, < 90 years;",
                "criterions": [
                    {
                        "exact_snippets": "Age >= 65 years, < 90 years",
                        "criterion": "age",
                        "requirement": {
                            "requirement_type": "N/A",
                            "expected_value": {
                                "comparisons": [
                                    {
                                        "operator": ">=",
                                        "value": 65,
                                        "unit": "years"
                                    },
                                    {
                                        "operator": "<",
                                        "value": 90,
                                        "unit": "years"
                                    }
                                ]
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "Age >= 65 years, < 90 years",
                        "criterion": "age",
                        "requirement": {
                            "requirement_type": "N/A",
                            "expected_value": {
                                "comparisons": [
                                    {
                                        "operator": ">=",
                                        "value": 65,
                                        "unit": "years"
                                    },
                                    {
                                        "operator": "<",
                                        "value": 90,
                                        "unit": "years"
                                    }
                                ]
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Scheduled to undergo surgery for primary solid organ cancer under general anesthesia, with an expected duration of surgery >=2 hours;",
                "criterions": [
                    {
                        "exact_snippets": "Scheduled to undergo surgery for primary solid organ cancer",
                        "criterion": "surgery for primary solid organ cancer",
                        "requirement": {
                            "requirement_type": "scheduled",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "under general anesthesia",
                        "criterion": "general anesthesia",
                        "requirement": {
                            "requirement_type": "scheduled",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "expected duration of surgery >=2 hours",
                        "criterion": "duration of surgery",
                        "requirement": {
                            "requirement_type": "expected duration",
                            "expected_value": {
                                "operator": ">=",
                                "value": 2,
                                "unit": "hours"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "Scheduled to undergo surgery for primary solid organ cancer",
                        "criterion": "surgery for primary solid organ cancer",
                        "requirement": {
                            "requirement_type": "scheduled",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "under general anesthesia",
                        "criterion": "general anesthesia",
                        "requirement": {
                            "requirement_type": "scheduled",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "expected duration of surgery >=2 hours",
                        "criterion": "duration of surgery",
                        "requirement": {
                            "requirement_type": "expected duration",
                            "expected_value": {
                                "operator": ">=",
                                "value": 2,
                                "unit": "hours"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Planned to use patient-controlled intravenous analgesia after surgery;",
                "criterions": [
                    {
                        "exact_snippets": "Planned to use patient-controlled intravenous analgesia after surgery",
                        "criterion": "use of patient-controlled intravenous analgesia",
                        "requirement": {
                            "requirement_type": "planned",
                            "expected_value": true
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "Planned to use patient-controlled intravenous analgesia after surgery",
                        "criterion": "use of patient-controlled intravenous analgesia",
                        "requirement": {
                            "requirement_type": "planned",
                            "expected_value": true
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Provide written informed consent.",
                "criterions": [
                    {
                        "exact_snippets": "written informed consent",
                        "criterion": "informed consent",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "written informed consent",
                        "criterion": "informed consent",
                        "requirement": {
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                            "expected_value": true
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "Healthy volunteers allowed",
                "criterions": [
                    {
                        "exact_snippets": "Healthy volunteers allowed",
                        "criterion": "volunteer health status",
                        "requirement": {
                            "requirement_type": "status",
                            "expected_value": "healthy"
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "Healthy volunteers allowed",
                        "criterion": "volunteer health status",
                        "requirement": {
                            "requirement_type": "status",
                            "expected_value": "healthy"
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "Must have minimum age of 65 Years",
                "criterions": [
                    {
                        "exact_snippets": "minimum age of 65 Years",
                        "criterion": "age",
                        "requirement": {
                            "requirement_type": "minimum",
                            "expected_value": {
                                "operator": ">=",
                                "value": 65,
                                "unit": "Years"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "minimum age of 65 Years",
                        "criterion": "age",
                        "requirement": {
                            "requirement_type": "minimum",
                            "expected_value": {
                                "operator": ">=",
                                "value": 65,
                                "unit": "Years"
                            }
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "Must have maximum age of 90 Years",
                "criterions": [
                    {
                        "exact_snippets": "maximum age of 90 Years",
                        "criterion": "age",
                        "requirement": {
                            "requirement_type": "maximum",
                            "expected_value": {
                                "operator": "<=",
                                "value": 90,
                                "unit": "Years"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "and_criteria": [
                    {
                        "exact_snippets": "maximum age of 90 Years",
                        "criterion": "age",
                        "requirement": {
                            "requirement_type": "maximum",
                            "expected_value": {
                                "operator": "<=",
                                "value": 90,
                                "unit": "Years"
                            }
                        }
                    }
                ]
            }
        }
    ],
    "exclusion_lines": [
        {
            "identified_line": {
                "line": "* Preoperative history of schizophrenia, epilepsy, parkinsonism or myasthenia gravis;",
                "criterions": [
                    {
                        "exact_snippets": "Preoperative history of schizophrenia",
                        "criterion": "schizophrenia",
                        "requirement": {
                            "requirement_type": "history",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "Preoperative history of ... epilepsy",
                        "criterion": "epilepsy",
                        "requirement": {
                            "requirement_type": "history",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "Preoperative history of ... parkinsonism",
                        "criterion": "parkinsonism",
                        "requirement": {
                            "requirement_type": "history",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "Preoperative history of ... myasthenia gravis",
                        "criterion": "myasthenia gravis",
                        "requirement": {
                            "requirement_type": "history",
                            "expected_value": true
                        }
                    }
                ]
            },
            "logical_structure": {
                "or_criteria": [
                    {
                        "exact_snippets": "Preoperative history of schizophrenia",
                        "criterion": "schizophrenia",
                        "requirement": {
                            "requirement_type": "history",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "Preoperative history of ... epilepsy",
                        "criterion": "epilepsy",
                        "requirement": {
                            "requirement_type": "history",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "Preoperative history of ... parkinsonism",
                        "criterion": "parkinsonism",
                        "requirement": {
                            "requirement_type": "history",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "Preoperative history of ... myasthenia gravis",
                        "criterion": "myasthenia gravis",
                        "requirement": {
                            "requirement_type": "history",
                            "expected_value": true
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Inability to communicate in the preoperative period because of coma, profound dementia or language barrier;",
                "criterions": [
                    {
                        "exact_snippets": "Inability to communicate ... because of coma",
                        "criterion": "coma",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "Inability to communicate ... because of ... profound dementia",
                        "criterion": "profound dementia",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "Inability to communicate ... because of ... language barrier",
                        "criterion": "language barrier",
                        "requirement": {
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                            "expected_value": true
                        }
                    }
                ]
            },
            "logical_structure": {
                "or_criteria": [
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "Inability to communicate ... because of coma",
                                "criterion": "coma",
                                "requirement": {
                                    "requirement_type": "presence",
                                    "expected_value": true
                                }
                            }
                        ]
                    },
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "Inability to communicate ... because of ... profound dementia",
                                "criterion": "profound dementia",
                                "requirement": {
                                    "requirement_type": "presence",
                                    "expected_value": true
                                }
                            }
                        ]
                    },
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "Inability to communicate ... because of ... language barrier",
                                "criterion": "language barrier",
                                "requirement": {
                                    "requirement_type": "presence",
                                    "expected_value": true
                                }
                            }
                        ]
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Preoperative obstructive sleep apnea (previously diagnosed as obstructive sleep apnea, or a STOP-Bang score >= 3);",
                "criterions": [
                    {
                        "exact_snippets": "Preoperative obstructive sleep apnea (previously diagnosed as obstructive sleep apnea",
                        "criterion": "obstructive sleep apnea",
                        "requirement": {
                            "requirement_type": "diagnosis",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "STOP-Bang score >= 3",
                        "criterion": "STOP-Bang score",
                        "requirement": {
                            "requirement_type": "score",
                            "expected_value": {
                                "operator": ">=",
                                "value": 3,
                                "unit": "N/A"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
                "or_criteria": [
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "Preoperative obstructive sleep apnea (previously diagnosed as obstructive sleep apnea",
                                "criterion": "obstructive sleep apnea",
                                "requirement": {
                                    "requirement_type": "diagnosis",
                                    "expected_value": true
                                }
                            }
                        ]
                    },
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "STOP-Bang score >= 3",
                                "criterion": "STOP-Bang score",
                                "requirement": {
                                    "requirement_type": "score",
                                    "expected_value": {
                                        "operator": ">=",
                                        "value": 3,
                                        "unit": "N/A"
                                    }
                                }
                            }
                        ]
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Brain trauma or neurosurgery;",
                "criterions": [
                    {
                        "exact_snippets": "Brain trauma",
                        "criterion": "brain trauma",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "neurosurgery",
                        "criterion": "neurosurgery",
                        "requirement": {
                            "requirement_type": "history",
                            "expected_value": true
                        }
                    }
                ]
            },
            "logical_structure": {
                "or_criteria": [
                    {
                        "exact_snippets": "Brain trauma",
                        "criterion": "brain trauma",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "neurosurgery",
                        "criterion": "neurosurgery",
                        "requirement": {
                            "requirement_type": "history",
                            "expected_value": true
                        }
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Preoperative left ventricular ejection fraction < 30%, sick sinus syndrome, severe sinus bradycardia (< 50 beats per minute), or second-degree or above atrioventricular block without pacemaker;",
                "criterions": [
                    {
                        "exact_snippets": "Preoperative left ventricular ejection fraction < 30%",
                        "criterion": "left ventricular ejection fraction",
                        "requirement": {
                            "requirement_type": "value",
                            "expected_value": {
                                "operator": "<",
                                "value": 30,
                                "unit": "%"
                            }
                        }
                    },
                    {
                        "exact_snippets": "sick sinus syndrome",
                        "criterion": "sick sinus syndrome",
                        "requirement": {
                            "requirement_type": "presence",
                            "expected_value": true
                        }
                    },
                    {
                        "exact_snippets": "severe sinus bradycardia (< 50 beats per minute)",
                        "criterion": "sinus bradycardia",
                        "requirement": {
                            "requirement_type": "severity",
                            "expected_value": "severe"
                        }
                    },
                    {
                        "exact_snippets": "severe sinus bradycardia (< 50 beats per minute)",
                        "criterion": "sinus bradycardia",
                        "requirement": {
                            "requirement_type": "heart rate",
                            "expected_value": {
                                "operator": "<",
                                "value": 50,
                                "unit": "beats per minute"
                            }
                        }
                    },
                    {
                        "exact_snippets": "second-degree or above atrioventricular block without pacemaker",
                        "criterion": "atrioventricular block",
                        "requirement": {
                            "requirement_type": "degree",
                            "expected_value": "second-degree or above"
                        }
                    },
                    {
                        "exact_snippets": "second-degree or above atrioventricular block without pacemaker",
                        "criterion": "atrioventricular block",
                        "requirement": {
                            "requirement_type": "pacemaker",
                            "expected_value": false
                        }
                    }
                ]
            },
            "logical_structure": {
                "or_criteria": [
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "Preoperative left ventricular ejection fraction < 30%",
                                "criterion": "left ventricular ejection fraction",
                                "requirement": {
                                    "requirement_type": "value",
                                    "expected_value": {
                                        "operator": "<",
                                        "value": 30,
                                        "unit": "%"
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                                "exact_snippets": "sick sinus syndrome",
                                "criterion": "sick sinus syndrome",
                                "requirement": {
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                                    "expected_value": true
                                }
                            }
                        ]
                    },
                    {
                        "and_criteria": [
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                                "exact_snippets": "severe sinus bradycardia (< 50 beats per minute)",
                                "criterion": "sinus bradycardia",
                                "requirement": {
                                    "requirement_type": "severity",
                                    "expected_value": "severe"
                                }
                            },
                            {
                                "exact_snippets": "severe sinus bradycardia (< 50 beats per minute)",
                                "criterion": "sinus bradycardia",
                                "requirement": {
                                    "requirement_type": "heart rate",
                                    "expected_value": {
                                        "operator": "<",
                                        "value": 50,
                                        "unit": "beats per minute"
                                    }
                                }
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                        ]
                    },
                    {
                        "and_criteria": [
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                                "exact_snippets": "second-degree or above atrioventricular block without pacemaker",
                                "criterion": "atrioventricular block",
                                "requirement": {
                                    "requirement_type": "degree",
                                    "expected_value": "second-degree or above"
                                }
                            },
                            {
                                "exact_snippets": "second-degree or above atrioventricular block without pacemaker",
                                "criterion": "atrioventricular block",
                                "requirement": {
                                    "requirement_type": "pacemaker",
                                    "expected_value": false
                                }
                            }
                        ]
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* Severe hepatic dysfunction (Child-Pugh class C) or severe renal dysfunction (requirement of renal replacement therapy before surgery);",
                "criterions": [
                    {
                        "exact_snippets": "Severe hepatic dysfunction (Child-Pugh class C)",
                        "criterion": "hepatic dysfunction",
                        "requirement": {
                            "requirement_type": "severity",
                            "expected_value": "severe"
                        }
                    },
                    {
                        "exact_snippets": "Severe hepatic dysfunction (Child-Pugh class C)",
                        "criterion": "hepatic dysfunction",
                        "requirement": {
                            "requirement_type": "classification",
                            "expected_value": "Child-Pugh class C"
                        }
                    },
                    {
                        "exact_snippets": "severe renal dysfunction (requirement of renal replacement therapy before surgery)",
                        "criterion": "renal dysfunction",
                        "requirement": {
                            "requirement_type": "severity",
                            "expected_value": "severe"
                        }
                    },
                    {
                        "exact_snippets": "severe renal dysfunction (requirement of renal replacement therapy before surgery)",
                        "criterion": "renal dysfunction",
                        "requirement": {
                            "requirement_type": "treatment requirement",
                            "expected_value": "renal replacement therapy before surgery"
                        }
                    }
                ]
            },
            "logical_structure": {
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                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "Severe hepatic dysfunction (Child-Pugh class C)",
                                "criterion": "hepatic dysfunction",
                                "requirement": {
                                    "requirement_type": "severity",
                                    "expected_value": "severe"
                                }
                            },
                            {
                                "exact_snippets": "Severe hepatic dysfunction (Child-Pugh class C)",
                                "criterion": "hepatic dysfunction",
                                "requirement": {
                                    "requirement_type": "classification",
                                    "expected_value": "Child-Pugh class C"
                                }
                            }
                        ]
                    },
                    {
                        "and_criteria": [
                            {
                                "exact_snippets": "severe renal dysfunction (requirement of renal replacement therapy before surgery)",
                                "criterion": "renal dysfunction",
                                "requirement": {
                                    "requirement_type": "severity",
                                    "expected_value": "severe"
                                }
                            },
                            {
                                "exact_snippets": "severe renal dysfunction (requirement of renal replacement therapy before surgery)",
                                "criterion": "renal dysfunction",
                                "requirement": {
                                    "requirement_type": "treatment requirement",
                                    "expected_value": "renal replacement therapy before surgery"
                                }
                            }
                        ]
                    }
                ]
            }
        },
        {
            "identified_line": {
                "line": "* ASA classification >= IV.",
                "criterions": [
                    {
                        "exact_snippets": "ASA classification >= IV",
                        "criterion": "ASA classification",
                        "requirement": {
                            "requirement_type": "severity",
                            "expected_value": {
                                "operator": ">=",
                                "value": 4,
                                "unit": "N/A"
                            }
                        }
                    }
                ]
            },
            "logical_structure": {
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                    "exact_snippets": "ASA classification >= IV",
                    "criterion": "ASA classification",
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                            "operator": ">=",
                            "value": 4,
                            "unit": "N/A"
                        }
                    }
                }
            }
        }
    ],
    "miscellaneous_lines": [],
    "failed_inclusion": [],
    "failed_exclusion": [
        {
            "identified_line": {
                "line": "* Preoperative radio- or chemotherapy;",
                "criterions": [
                    {
                        "exact_snippets": "Preoperative radio- or chemotherapy",
                        "criterion": "preoperative treatment",
                        "requirement": {
                            "requirement_type": "type",
                            "expected_value": [
                                "radiotherapy",
                                "chemotherapy"
                            ]
                        }
                    }
                ]
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            "logical_structure": {
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                            {
                                "exact_snippets": "Preoperative radio- or chemotherapy",
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                                "requirement": {
                                    "requirement_type": "type",
                                    "expected_value": "radiotherapy"
                                }
                            },
                            {
                                "exact_snippets": "Preoperative radio- or chemotherapy",
                                "criterion": "preoperative treatment",
                                "requirement": {
                                    "requirement_type": "type",
                                    "expected_value": "chemotherapy"
                                }
                            }
                        ]
                    }
                ]
            }
        }
    ],
    "failed_miscellaneous": []
}