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What is a DOI? | Finding and Using Digital Object Identifiers

Published on December 19, 2018 by Courtney Gahan . Revised on February 24, 2023 by Raimo Streefkerk.

A DOI (Digital Object Identifier) is a unique and never-changing string assigned to online (journal) articles , books , and other works. DOIs make it easier to retrieve works, which is why citation styles, like APA and MLA Style , recommend including them in citations.

You may find DOIs formatted in various ways:

  • doi:10.1080/02626667.2018.1560449
  • https://doi.org/10.1111/hex.12487
  • https://dx.doi.org/10.1080/02626667.2018.1560449
  • https://doi.org/10.1016/j.jpsychires.2017.11.014

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Table of contents

How to find a doi, apa style guidelines for using dois, mla style guidelines for using dois, chicago style guidelines for using dois, frequently asked questions about dois.

The DOI will usually be clearly visible when you open a journal article on a database.

Examples of where to find DOIs

  • Taylor and Francis Online
  • SAGE journals

Taylor and Francis Online DOI

Note: JSTOR uses a different format, but their “stable URL” functions in the same way as a DOI.

What to do when you cannot find the DOI

If you cannot find the DOI for a journal article, you can also check Crossref . Simply paste the relevant information into the “Search Metadata” box to find the DOI. If the DOI does not exist here, the article most likely does not have one; in this case, use a URL instead.

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APA Style guidelines state that DOIs should be included whenever they’re available. In practice, almost all journal articles and most academic books have a DOI assigned to them.

You can find the DOI on the first page of the article or copyright page of a book. Omit the DOI from the APA citation if you cannot find it.

Formatting DOIs in APA Style

DOIs are included at the end of the APA reference entry . In the 6th edition of the APA publication manual, DOIs can be preceded by the label “doi:” or formatted as URLs. In the 7th edition , DOIs should be formatted as URLs with ‘https://doi.org/’ preceding the DOI.

  • APA 6th edition: doi: 10.1177/0269881118806297 or https://doi.org/ 10.1177/0269881118806297
  • APA 7th edition: https://doi.org/ 10.1177/0269881118806297

APA citation examples with DOI

  • Fardouly, J., & Vartanian, L. R. (2016). Social media and body image concerns: Current research and future directions. Current Opinion in Psychology , 9 , 1–5. https://doi.org/10.1016/j.copsyc.2015.09.005
  • Sustersic, M., Gauchet, A., Foote, A., & Bosson, J.-L. (2016). How best to use and evaluate Patient Information Leaflets given during a consultation: a systematic review of literature reviews. Health Expectations , 20 (4), 531–542. https://doi.org/10.1111/hex.12487

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MLA recommends using the format doi:10.1177/0269881118806297.

Generate accurate MLA citations with Scribbr

In Chicago style , the format https://doi.org/10.1177/0269881118806297 is preferred.

A DOI is a unique identifier for a digital document. DOIs are important in academic citation because they are more permanent than URLs, ensuring that your reader can reliably locate the source.

Journal articles and ebooks can often be found on multiple different websites and databases. The URL of the page where an article is hosted can be changed or removed over time, but a DOI is linked to the specific document and never changes.

The DOI is usually clearly visible when you open a journal article on an academic database. It is often listed near the publication date, and includes “doi.org” or “DOI:”. If the database has a “cite this article” button, this should also produce a citation with the DOI included.

If you can’t find the DOI, you can search on Crossref using information like the author, the article title, and the journal name.

Include the DOI at the very end of the APA reference entry . If you’re using the 6th edition APA guidelines, the DOI is preceded by the label “doi:”. In the 7th edition , the DOI is preceded by ‘https://doi.org/’.

  • 6th edition: doi: 10.1177/0894439316660340
  • 7th edition: https://doi.org/ 10.1177/0894439316660340

APA citation example (7th edition)

Hawi, N. S., & Samaha, M. (2016). The relations among social media addiction, self-esteem, and life satisfaction in university students. Social Science Computer Review , 35 (5), 576–586. https://doi.org/10.1177/0894439316660340

In an APA journal citation , if a DOI (digital object identifier) is available for an article, always include it.

If an article has no DOI, and you accessed it through a database or in print, just omit the DOI.

If an article has no DOI, and you accessed it through a website other than a database (for example, the journal’s own website), include a URL linking to the article.

In MLA style citations , format a DOI as a link, including “https://doi.org/” at the start and then the unique numerical code of the article.

DOIs are used mainly when citing journal articles in MLA .

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If you want to cite this source, you can copy and paste the citation or click the “Cite this Scribbr article” button to automatically add the citation to our free Citation Generator.

Gahan, C. (2023, February 24). What is a DOI? | Finding and Using Digital Object Identifiers. Scribbr. Retrieved April 2, 2024, from https://www.scribbr.com/citing-sources/what-is-a-doi/

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How to Cite the DOI of a Journal Article

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DOI (digital object identifier) is an identification code for a journal article or other published works. The code was developed and introduced in 2000 by the International DOI Foundation (IDF) and is assigned by the publisher . A DOI is generated by a registration agency ( Crossref ) that contains an alphanumeric string beginning with “10” and a prefix of four or more numbers. The prefix is followed by a slash (/) and a suffix. The suffix is assigned by the publisher.

DOIs create unique uniform resource locators (URLs) that begin with https://doi.org/ . For example, the DOI https://doi.org/10.1086/679716 will take you to the article titled  “Scott’s Editing: History, Polyphony, Authority” by Robert Mayer, published in the May 2015 issue of Modern Philology. DOIs are used as electronic links to an article’s location and helps identify an article’s subject matter. They should always be used in your printed or electronic articles or in any other published materials. DOIs are usually placed on the first page of a journal article.

Crossref recently changed the DOI format to make it more web-friendly and secure. There is only a slight difference between the old and new formats, but be sure to check the new format and incorporate it into your references.

Citations and References

Citation and reference are two different things. A citation is a note within the text in parentheses and a reference is the full expansion of that note (all the information necessary to find the referenced material). You can cite passages or quotations and provide a citation for that within the text.

An example of in-text citation would be (Johnson 2017) in parentheses, or it could be just a numeral in brackets or superscript. A reference list would then list all the citations in alphabetical or numeric order, depending on the author guidelines.

Note that some style guides prefer to use the word “bibliography” instead of “references.” Be aware that these two words actually mean the same thing.

The following is a list of some style guides and how they prefer to list DOIs in their references.

American Psychological Association

The American Psychological Association ( APA ) style guide is used mainly in the social sciences. APA uses the “author-date” style for in-text citations (e.g., Johnson, 2017). Note the comma after the name and before the date.

When referencing the citations in the reference list, APA style is to include the DOI for all electronic media. The typical reference in APA style would use the following format:

Author, A. A., & Author, B. B. (Date of publication). Title of article. Title of Journal, volume number, page range. doi:0000000/000000000000 or http://dx.doi.org/10.0000/0000 .

An example of a reference in APA style is as follows: (boldface type added for emphasis but not included in the reference):

Morey, C. C., Cong, Y., Zheng, Y., Price, M., & Morey, R. D. (2015). The color-sharing bonus: Roles of perceptual organization and attentive processes in visual working memory. Archives of Scientific Psychology , 3, 18–29. https://doi.org/10.1037/arc0000014 .

Note the DOI is placed at the end of the reference.

American Medical Association

The American Medical Association ( AMA ) style is a guide used by medical researchers and those who are part of the medical and scientific publishing industry. The DOI included at the end of a reference in AMA style is similar to that in APA style, except that AMA does not require the preceding “https://” notation. An example of AMA reference style is as follows:

Coppinger T, Jeanes YM, Hardwick J, Reeves S. Body mass, frequency of eating and breakfast consumption in 9-13- year-olds. J Hum Nutr Diet . 2012; 25(1): 43-49. doi: 10.1111/j.1365-277X.2011.01184.x

Modern Language Association

The Modern Language Association ( MLA ) style is most commonly used in the liberal arts and humanities fields of study. MLA style is a bit different from APA or AMA in that its in-text citations include a page number (e.g., Johnson 15) instead of a date after the author name. If the author name is used within the text itself, only the page number is noted in the citation.

Although MLA does not require that a DOI or URL be used in a reference, it is a good idea to do so, especially when the journal or your professor prefers it. An example reference in MLA style is as follows:

Alonso, Alvaro, and Julio A. Camargo. “Toxicity of Nitrite to Three Species of Freshwater Invertebrates.” Environmental Toxicology , vol. 21, no. 1, 3 Feb. 2006, pp. 90-94. Wiley Online Library , doi: 10.1002/tox.20155.

Note that in MLA style, the full names of the authors are listed, not just the last name and initials. The names are arranged by the first author’s last name first and subsequent authors’ first then last names. The title of the work is in quotation marks.

Many older published papers might not have a DOI. If your article has no DOI , you can use the words “retrieved from” in your reference with a link to the journal’s homepage on the Internet. Do not use the web page that hosted the specific article. An example of an APA reference in which there is no DOI is as follows:

Author, A. A., & Author, B. B. (Date of publication). Title of article. Title of Journal, volume number. Retrieved from http://www.journalhomepage.com/full/url/.

As always, be sure to check author guidelines of your target journal for specific rules on citations and references.

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The DOI System provides a framework for persistent identification, managing intellectual content, managing metadata, linking customers with content suppliers, facilitating electronic commerce, and enabling automated management of media. DOI names can be used for any form of management of any data, whether commercial or non-commercial.

What does that mean?

A digital object identifier (DOI) is a unique alphanumeric string that identifies content and provide a persistent link to its location on the Internet. The publisher assigns a DOI when the article is published and made available electronically.

All DOI numbers begin with a 10 and contain a prefix and a suffix separated by a slash. The prefix is a unique number of four or more digits assigned to organizations; the suffix is assigned by the publisher and was designed to be flexible with publisher identification standards.

Not all articles or journals use DOIs; if you can't find a DOI you can use the persistant url in your citation instead.

Here are some examples of DOIs:

10.1093/ajae/aaq063

10.1371/journal.pgen.1001111

A DOI is a permanent ID that, when appended to http://dx.doi.org/ in the address bar of an Internet browser, will lead to the source.

For example, http://dx.doi.org/10.1093/ajae/aaq063 will take you directly to the information page for the article "An Analysis of the Pricing of Traits in the U.S. Corn Seed Market."

If an article has not been assigned a DOI, many citation styles require that you create a permanent link so that other users can find and view the article.  For information on creating a permalink, visit o ur FAQ page for help .

What is a permanent link?

The URL (Uniform Resource Locator or Web address) appears in a Web browser's address box, when an online article is viewed, is usually intended to be temporary and often does not function a few days or weeks later. Links designated as "permanent", "persistent" or "stable" are designed specifically to remain active and useable over time.

The location of the DOI can depend on many things. Here are some places to look for the DOI:

  • First page of the electronic journal article
  • Near the copyright notice
  • Database landing page for an article
  • Hidden behind a button
  • In the citation generated by the database
  • Online using the free DOI lookup on www.crossref.org

Not every electronic journal article has a DOI. If no DOI is available and you retrieved the journal article online, you should include the persistent URL.

Article From an Online Periodical with DOI Assigned:

Author, A. A., & Author, B. B. (Date of publication). Title of article. Title of Journal, volume number, page range .           doi:0000000/000000000000

Brownlie, D. (2007). Toward effective poster presentations: An annotated bibliography. European Journal of Marketing, 41 (11/12),           1245-1283. doi:10.1108/03090560710821161

Article From an Online Periodical with No DOI Assigned:

Online scholarly journal articles without a DOI require the URL of the journal home page. Remember that one goal of citations is to provide your readers with enough information to find the article; providing the journal home page aids readers in this process.

Author, A. A., & Author, B. B. (Date of publication). Title of article. Title of Journal, volume number . Retrieved from           http://www.journalhomepage.com/full/url/

Kenneth, I. A. (2000). A Buddhist response to the nature of human rights. Journal of Buddhist Ethics, 8 . Retrieved from           http://www.cac.psu.edu/jbe/twocont.html

Online periodicals are cited exactly as their print counterparts with the addition of a DOI or URL at the end of the citation.  Include a DOI (Digital Object Identifier) if the journal lists one. If no DOI is available, list a URL. Include an access date only if one is required by your publisher or discipline.

Author, A. A., and Author, B. B. "Title of article." Title of Journal , volume number, issue number (Date of publication): page numbers,           doi: 0000000/000000000000 (access date if necessary).

Peltonen, Kirsi, Noora Ellonen, Helmer B. Larsen, and Karin Helweg-Larsen. “Parental Violence and Adolescent Mental Health.” European           Child & Adolescent Psychiatry 19, no. 11 (2010): 813-822. doi: 10.1007/s00787-010-0130-8.

Author, A. A., and Author, B. B. "Title of Article." Title of Journal , volume number, issue number (Date of publication): page numbers.           http://www.journalhomepage.com/full/url/ (access date if necessary).

Hlatky, Mark A., Derek Boothroyd, Eric Vittinghoff, Penny Sharp, and Mary A. Whooley. "Quality-of-Life and Depressive Symptoms in           Postmenopausal Women after Receiving Hormone Therapy: Results from the Heart and Estrogen/Progestin Replacement Study           (HERS) Trial." Journal of the American Medical Association 287, no. 5 (February 6, 2002), http://jama.ama-assn.org/issues/           v287n5/rfull/joc10108.html#aainfo (accessed January 7, 2004).

Source: Purdue Online Writing Lab , Chicago Style Citation Quick Guide , Turabian Quick Guide

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URLs vs. DOIs

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While citation styles can vary greatly in their particulars, most major styles (including APA, MLA, and Chicago) require writers to include either a URL or a DOI in citations for digital content whenever possible. You do not normally need to include both.

This resource explains the difference between URLs and DOIs and briefly describes how to incorporate either form of information into your citations.

What are DOIs?

When sources are published electronically, they are assigned DOIs—a unique series of letters and numbers set by the International DOI Foundation. The IDF, founded in 1998, handles creator requests for DOIs and standardizes each DOI they assign. Every DOI begins with the number 10, and can generally be found on the first page of the digital article. DOIs also associate their publications with metadata, or relevant information related to each source (such as author, location, and date information). Because DOIs are assigned when a source is published electronically, some older sources will not have DOIs. If you are citing a print source and want to know if it has been assigned a DOI, use CrossRef.org’s DOI lookup on the website’s home page.

DOIs differ from URLs in that they are static. In other words, once they are assigned, they will not change, which makes it very easy to locate at any future time (even after it has been moved). Here is an example DOI for Ryan LaMothe’s article “Pebbles in the Shoe: Acts of Compassion as Subversion in a Market Society,” published in the journal Pastoral Psychology:

DOI: 10.1007/s11089-018-0833-1

This image shows the title page of the Ryan LaMothe article “Pebbles in the Shoe: Acts of Compassion as Subversion in a Market Society.”

The title page of a scholarly article hosted online. Note the DOI at the top of the page.

When should I use a URL?

In the event that a source does not have a DOI assigned, or if the citation style you are using specifically calls for URLs over DOIs, cite the source’s URL. This is its ordinary web address, which typically appears in the navigation bar at the top of your web browser.

Here is an example of a URL for the Purdue OWL homepage:

https://owl.purdue.edu/owl/purdue_owl.html

This image shows a screenshot of a Safari browser window cropped so that it is centered on the Purdue OWL homepage URL, visible in the address field.

A screenshot of a web browser's navigation bar. Note that the Purdue OWL homepage URL is visible in the address field.

URLs can change if the website is edited or updated, or the source is moved. Because of this, many online databases (such as library websites and scholarly article repositories) assign sources with stable URLs (sometimes called “permalinks”) unique to the database’s own website for this purpose. Like DOIs, these will not change and will link directly to the source on that specific webpage.

Note that some citation styles provide specific directions for how to format source URLs. For example, MLA only requires the www. portion of the URL, so leave off the https://.

Quick Guide

The following chart breaks down the use of DOIs and URLs in four major citation styles and provides links to OWL pages that describe DOI and/or URL formatting rules for citations in those styles. Note that some of the styles have very similar guidelines.

For more in-depth information on formatting DOIs and URLs in your citations, be sure to consult the style guide for whatever style you are using, as each has different ordering and formatting preferences.

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Apa: using a doi in your reference list.

You have probably had difficulty at some time locating information about electronic resources:  they can change or even disappear, and that makes citing them in your reference list challenging.  Various publishers have started using what is called a DOI number that offers readers a persistent link to the source on the Internet.  Below is a guide on how to cite with a DOI number.

What Is a DOI?

A Digital Object Identifier (DOI) is a string of numbers and letters that uniquely identify a source.  They can be found in a library entry; here is an example:

DOI:  10.1111/j.1467-873X.2008.00424.x

How Do You Use a DOI in a Reference List?

You use a DOI number instead of the URL.  You do not need to list the database you used to find the source either.  Here is an example:

Prabhu, V., Sutton, C., & Sauser, W.  (2008).  Creativity and certain personality             personality traits:  Understanding the mediating effect of intrinsic

          motivation.  Creativity Research Journal, 20 (1), 53-66.  doi:

          10.1080/10400410701841955.

(Note:  The APA manual uses lower case in the reference list but all caps in the explanations.)

How a Reader Uses a DOI Number

Your professor can check your reference by clicking the DOI when on the CSU library webpages.

Use the URL if There Is No DOI Number

When there is no DOI number, use the URL.  Here is an example:

Bunce, A.  (1995, September 9).  Beowulf in the boardroom:  Executives ponder

          poetry.  Christian Science Monitor .  Retrieved from

          http://www.lexisnexis.com/us/lnacademic/auth/checkbrowser.do?ipcounter=1&cookieState=0&rand=0.1250821016424858&  bhcp=1

APA Electronic Reference Style Guide

The Library has a copy and so does the Writing Center.  You can download a copy for $11.95 from: http://books.apa.org/books.cfm?id=4210509 The Purdue Online Writing Center web site also has a fantastic APA electronic references section that includes DOIs: http://owl.english.purdue.edu/owl/resource/560/01/ .    

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APA Style, 7th edition - Citing Sources

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The APA 7th edition requires publication data for electronic sources. The DOI is the preferred electronic retrieval format because it provides a persistent link to a document’s location on the Internet. If no DOI is available, a URL can be included.

DOI is an abbreviation for digital object identifier. This is simply an ID number assigned to an ‘object’ such as a journal article (or a book).  It allows the ‘object’ to be found across any physical location such as a database.  Publishers assign it to online articles so that an article may be easily identified and found within the many possible databases in which they may reside.

There are several ways to find the DOI:

  • Look for the DOI on the PDF of the article.
  • Look for the DOI on the detailed record for the article in the EBSCO database.
  • Search for the DOI in crossref.org
  • Use Google Scholar to find the DOI.
  • Locate the DOI using PubMed.
  • How to Find the DOI - detailed instructions
  • CrossRef: Free DOI Lookup CrossRef is the organization that creates and assigns DOIs.
  • APA DOI's and URLs

As of March, 2017 the recommended format for the DOI within an APA reference is like this example:   https://doi.org/10.1037/arc0000014

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how to cite paper with doi

Article with a DOI

If an article has a DOI, you must include it in your reference.

For information on DOIs see here .

Author, A. (Date). Title of article in sentence case: Subtitle in sentence case.  Title of Publication in I talic Title Case , volume number (issue number), page range of article. DOI

Grady, J. (2019). Emotions in storybooks: A comparison of storybooks that represent ethnic and racial groups in the United States.  Psychology of Popular Media Culture ,   8 (3), 207–217.   https://doi.org/10.1037/ppm0000185

Reference list entry

Grady, J. (2019). Emotions in storybooks: A comparison of storybooks that represent ethnic and racial groups in the United States. Psychology of Popular Media Culture, 8 (3), 207-217. https://doi.org/10.1037/ppm0000185   

In-text citation

Page/paragraph numbers are optional for paraphrased information.

Narrative Grady (2019) argues that ... (p. 209). Parenthetical ... (Grady, 2019, p. 209).

Journal with an article number or an eLocator

If an online journal article has an article number or an eLocator, you must include it in your reference.

What does it look like?

An eLocator will be a set of numbers with an 'e' in front of it: e0205568

An article number will often be labelled as 'Article number' after the volume information, or will be a single, long number instead of a page range.

The following is how you reference each:

An elocator is a form of article number, so must have the word Article in front of it.

Author, A. (Date). Title of journal article in sentence case: Subtitle in sentence case.  Title of Journal in                     Italic Title Case , volume number (issue number) ,   Article eLocator,  page range of article if applicable. URL/DOI

Jerrentrup, A., Mueller, T., Glowalla, U., Herder, M., Henrichs, N., Neubauer, A., & Schaefer, J. R . (2018). Teaching medicine with the help of “Dr. House".   PLoS ONE,   13 (3),   Article e0193972.    https://doi.org/10.1371/journal.pone.0193972

Article number

Author, A. (Date). Title of journal article in sentence case: Subtitle in sentence case.  Title of Journal in                     Italic Title Case , volume number (issue number) ,   Article number,  page range of article if applicable. URL/DOI

Kim, S. R. (2022). Viral infection and airway epithelial immunity in asthma .  International Journal of Molecular Sciences ,   23 (17),   Article 9914.   https://doi.org/10.3390/ijms23179914

Missing information in a journal article

If a journal article does not have information, like:

  • a volume number
  • an issue number
  • a page range

then simply exclude these from the reference.

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Reference management. Clean and simple.

What is a DOI?

how to cite paper with doi

Using DOIs in APA and other styles

How to find the doi, doi examples and format, why is it important to use dois, frequently asked questions about dois, related articles.

DOI stands for "digital object identifier." Also known as a permalink, a DOI is an article's permanent online location. DOIs are used for a variety of academic and non-academic sources that are located online.

APA and other styles now require DOIs to be included in references, if they are available:

Warren, R., Price, J., Graham, E., Forstenhaeusler, N., & VanDerWal, J. (2018). The projected effect on insects, vertebrates, and plants of limiting global warming to 1.5°C rather than 2°C. Science (New York, N.Y.) , 360 (6390), 791–795. https://doi.org/10.1126/science.aar3646

The DOI is included at the very end of the reference. If an online work has both a DOI and a URL, include only the DOI. However, if the source only has a URL, then include the URL at the end of the reference.

If the DOI is too long, APA allows the use of DOI shorteners like shortDOI® , a service created by the International DOI Foundation to create shortDOIs.

Tip: Instead of manually adding citations with DOIs to your documents, which is error-prone and strenuous, consider using a reference manager like Paperpile to format and organize your citations. Paperpile allows you to save and organize your citations for later use and cite them in thousands of citation styles directly in Google Docs, Microsoft Word, or LaTeX, including the DOI:

For journal articles, the DOI can typically be found at the top of the page, along with the title, author's name, and other publication information. PDFs of journal articles downloaded from an academic database often include the DOI on the cover page and/or at the bottom of each page.

➡️ Learn how to find a DOI in our “ How to find a DOI ” guide.

There are three different ways of writing a DOI:

  • http:/dx.doi.org
  • doi: xxxx or DOI: xxxx
  • https://doi.org/xxxx

The most recent and preferred format is the last one ( https://doi.org/xxxx ), but any type is valid as long as it includes the right alphanumeric identifier. A correct DOI would look something like this: https://doi.org/10.1080/10509585.2015.1092083 .

It’s important to use DOIs when available because they add credibility to the source. If a citation includes a DOI, it means that the source is unique and real.

Ultimately, if the source has a DOI, use it! Do not use the URL of the source if a DOI is available. URLs might change over time, while DOIs do not.

No, URLs and DOIs are not interchangeable. A DOI is an unchanging, unique alphanumeric identifier that labels digital material and pinpoints its location online, whereas a URL is a digital locator that can change over time.

The preferred format for a DOI is https://doi.org/xxxx , without a period at the end. A correct DOI would look something like this: https://doi.org/10.1080/10509585.2015.1092083 .

DOIs are typically found near the top of an article page, along with the author and publication information. They can also be found on PDFs of online journal articles, at the bottom of each page, or on a cover page.

DOIs were invented for a reason. Digital object identifiers allow readers to locate specific material online. They also add credibility to your sources.

Whenever the source has a DOI, use it! Do not use the URL of the source if a DOI is available. However, if the material does not feature a DOI, add the URL to your citation instead.

how to cite paper with doi

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What is a DOI and how do I use them in citations?

A DOI, or Digital Object Identifier, is a string of numbers, letters and symbols used to uniquely identify an article or document, and to provide it with a permanent web address (URL).

A DOI will help your reader easily locate a document from your citation. Think of it like a Social Security number for the article you're citing — it will always refer to that article, and only that one. While a web address (URL) might change, the DOI will never change.

Where can I find a DOI?

  • In most scholarly journal articles, the DOI will be printed with the article itself, usually on the first page somewhere: below the title or in the header or footer.
  • If the DOI isn't included in the article, look it up on the website  CrossRef.org  (use the "Search Metadata" option) to check for an assigned DOI.

How can I use a DOI to find the article it refers to?

  • If your DOI starts with http:// or https:// , simply paste it into your web browser. This will usually lead you to a journal publisher's page for the article.
  • You can turn any DOI starting with 10 into a URL by adding http://doi.org/ before the DOI. For example, 10.3352/jeehp.2013.10.3 becomes  https://doi.org/10.3352/jeehp.2013.10.3
  • If you're off campus when you do this, you'll need to use this URL prefix in front of the DOI to gain access to UIC's full text journal subscriptions: https://proxy.cc.uic.edu/login?url=https://doi.org/ . For example:  https://proxy.cc.uic.edu/login?url=http://doi.org/10.3352/jeehp.2013.10.3

Psst! It's not a bad i dea to check the DOIs in your references list this way to make sure they lead to the correct articles!

How do I cite a journal article with a DOI in...

Apa format.

  • Author, A. A., & Author, B. B. (Date of publication). Title of article. Title of Journal, volume number, page range. https://doi.org/10.0000/0000
  • Author, A. A., & Author, B. B. (Date of publication). Title of article. Title of Journal, volume number, page range.
  • If your article includes both a DOI and a URL, include only the DOI.
  • See these and other examples in the Purdue OWL: APA Formatting and Style Guide .

AMA/JAMA format?

  • 1. Author AA, Author BB. Title of article. Name of Jrnl. Year;vol(issue):inclusive pages. doi:10.0000000/000000000000

MLA format?

  • Author LastName, FirstName, and FirstName LastName. "Article Title." Journal Name , vol. #, no. #, date, pp. ##-##. Name of Database , doi: 10.0000/000000000.
  • It's a good idea to check with your instructor whether they want you to include the date you accessed the article, although this is not required by MLA.
  • by: Allan Berry
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How to find an article's DOI to include in a citation

A DOI (Digital Object Identifier) is a unique identifier that identifies digital objects. The object may change physical locations, but the DOI assigned to that object will never change. Journal publishers often assign DOIs to electronic copies of individual articles in their journals. Because the DOI insures findability for the e-journal article, many citation styles (APA, MLA, Chicago Manual of Style, Turabian, etc.) require the use of a DOI in a citation for e-journal content. Below are some methods that can be used to obtain DOIs:

  • Go to http://www.crossref.org/ and follow the instructions provided there to search for a DOI using the article title and author's last name. If this method doesn't yield a DOI, don't assume that a DOI doesn't exist. Follow up with the next two options.  
  • If a journal publisher uses DOIs, they will usually print the DOI somewhere on the first page of the article. Open the full-text source and look for the DOI on the article's first page, usually in the header or footer.  
  • Some online resources, such as EBSCO databases, will supply DOIs in their citation formatter. View the full citation to see if a DOI is included.

DOI Pro Tip:

  • Some articles won't have a DOI. The International DOI Foundation was created in 1998 but not all publishers immediately started assigning DOIs. The publisher Elsevier, for example, appears to have started using DOIs on all of their journal articles around 2003. So unless a publisher has retrospectively assigned DOIs to articles, articles published prior to 1998 are less likely to have DOIs. So, if you have tried all the suggestions above, but you still cannot find the DOI, it may be that your article does not have one.

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Basic rules for all AMA citations

Anonymous works:

If there is no named author, follow the citation style for the item, and omit the author name field.  If the item is really authored by a person going by the name Anonymous, use the word "Anonymous" as if it were a complete name of the author, and then use the appropriate style.

Author names in all references:

For materials with 1-6 authors or editors, list all author or editor names.

For materials with 7 or more authors or editors, list the first three, then abbreviate with et al. 

Capitalization of titles in reference list:

For journal article titles and book chapters: capitalize the first letter of the first word, proper names, names of trials or study groups, and abbreviations. For titles of books and government documents, capitalize the first letter of each major word, but not articles, prepositions of less than 3 letters, conjunctions, or infinitives.

(note: No guidance is provided regarding capitalization for titles of conference materials, titles of journals, or other titles used in AMA citations.)

Titles of journals :

Use PubMed journal abbreviations. You can find these by using the citing tool within PubMed, or search the NLM Catalog for journal titles to locate the preferred abbreviation. If no abbreviation is found in PubMed or the NLM Catalog, consult section 13.10 of the AMA Manual of Style for standard abbreviations for individual words used in a title.

Non-scholarly or non-peer-reviewed materials appearing in journals (editorials, letters to the editor, comments, interviews, etc.):

Unlike prior editions of AMA style, the 11th edition has removed the suggestion to indicate special types of materials within journals. Cite all materials published in journals using the article style.

Use of Artificial Intelligence (A.I.):

"Nonhuman artificial intelligence, language models, machine learning, or similar technologies cannot be listed as authors because these technologies do not qualify for authorship." (quotation from AMA Manual, section 5.1.12). According to a strict reading of the Manual, AI programs should never appear in a reference list as an author or creator of content. Instead, AMA suggest that writers place an acknowledgement into the acknowledgement section of the manuscript or describe how AI was used in the Methods section of the manuscript. The primary goal of the AMA Manual of Style is to share the official JAMA (Journal of the American Medical Association) guidance for formatting manuscripts for JAMA, so this is helpful in this context. However, it is difficult to put into place in coursework, where assignments typically do not include either an acknowledgements or Methods section. When writing for a class, review  the syllabus or  speak with the faculty member to determine if you are allowed to use AI tools, then use the guidance on this page to appropriately describe use of AI in your written assignments.

How to cite information when there is no guidance on this website:

This website attempts to summarize over 500 pages of content from the AMA Manual and cannot cover all. Read the AMA Manual of Style, section 3, to find guidance for citing many other types of publications. If there is no guidance in the Manual on your specific type of publication-- which there may be, the Manual does not include everything-- adapt an existing AMA citation style.

General format: Author AA, Author BB, Author CC. Title of article. Abbreviated Title of Journal. Year of publication;volume(issue):complete page numbers or e-locator. DOI (if not provided, omit and replace with an accessed date and a URL)

Note that there is no period at the end of the DOI or URL in online journal article citations.

Print journal article:

Towfighi A, Markovic D, Ovbiagele B. Utility of Framingham coronary disease risk score for predicting cardiac risk after stroke.  Stroke. 2012;43(11):2942-2947.

Journal article viewed online with DOI available:

Towfighi A, Markovic D, Ovbiagele B. Utility of Framingham coronary disease risk score for predicting cardiac risk after stroke. Stroke . 2012;43(11):2942-2947. doi: 10.1161/STROKEAHA.112.668319

Journal article viewed online, but the journal does not use DOI:

Ng L, Karunasinghe N, Benjamin CS, Ferguson LR. Beyond PSA: are new prostate cancer biomarkers of potential value to New Zealand doctors? N Z Med J. 2012;125(1353). Accessed April 15, 2020. https://www.nzma.org.nz/journal-articles/beyond-psa-are-new-prostate-cancer-biomarkers-of-potential-value-to-new-zealand-doctors/

Artificial Intelligence (A.I.)

"Nonhuman artificial intelligence, language models, machine learning, or similar technologies cannot be listed as authors because these technologies do not qualify for authorship." (quotation from AMA Manual, section 5.1.12). No AI programs should ever appear in the numbered reference list. AMA suggests that writers place an acknowledgement into the acknowledgement section of the manuscript or describe how AI was used in the Methods section of the manuscript. This advice is difficult to put into place in coursework, where assignments typically do not include either an acknowledgements or Methods section. When writing for a class, review  the syllabus or  speak with the faculty member to determine if you are allowed to use AI tools, then use this guide to get ideas for how to acknowledge the source.

"Section 5.2.1.1 Acknowledgment of Use of Artificial Intelligence and Language Models in Writing and Editing

Authors should report the use of artificial intelligence, language models, machine learning, or similar technologies to create content or assist with writing or editing of manuscripts in the Acknowledgment section or the Methods section if this is part of formal research design or methods. This should include a description of the content that was created or edited and the name of the language model or tool, version and extension numbers, and manufacturer. (Note: this does not include basic tools for checking grammar, spelling, references, etc.)."

Strict interpretation of this for publication in a journal:

In 1-5 sentences, describe what you used AI to do in the manuscript, with enough information to explain the actual model used. Place this in the Methods section if the AI content was important to the methods. Otherwise, place in the Acknowledgements section. The AMA Manual does not provide any examples. Here are two examples created by a USC librarian that attempt to fulfill the AMA rules:

"On August 3, 2023, I used AI to summarize five research papers, to help me determine which idea was least studied and focus my topics for this essay. I used ChatGPT, model 3.5, made by OpenAI, hosted at https://chat.openai.com/."

"I used Bard, release 2023.07.13, made by Google and hosted at https://bard.google.com/, to edit my manuscript. I uploaded my original writing and asked Bard to reduce the word count and make the language more formal. I also used Bard to determine which of the data points I had collected would be the most useful for including as figures, and used its advice to create figure 1 and table 2."

Potential ways to acknowledge use of AI tools in a written document for a course:

There is no guidance on this from the AMA Manual. As typical with this style, when no guidance exists, try to follow the basic rules of the style while respecting the underlying goal of any citation system: to acknowledge the use of other's ideas, thoughts, and opinions. While AI might not be a person, it’s still not you, so its ideas and work needs to be acknowledged. Based  on this, here are some options that might work:

- While your assignment may not require you to include a formal Methods section, you could decide to include one anyway. You could describe all the methods used to create this assignment: searching for literature, using modeling software, collaboratively editing with a colleague, etc., alongside how you used AI, and which model you used.

- Add a few sentences about your use of AI and the model (as recommended by AMA) into another section of the assignment. If you used AI to generate ideas, perhaps this acknowledge would fit into the introduction. If you used AI to edit the paper, this might be acknowledged in the conclusion. 

- AMA style requires a numbered reference list. You could add an unnumbered bullet point to the start or end of your reference list that acknowledges the use(s) of AI in your assignment and provides the model number as instructed by AMA.

Books and chapters

General format: Author AA, Author BB, Author CC. Title of book . Edition number (if beyond first). Publisher name; year of publication. To indicate online access, add the word Accessed and the date you accessed the item, then the URL.

While some books and book chapters may have assigned DOIs, book citations do not include DOIs, only URLs and accessed dates. If a book has editors instead of or in addition to authors, their names are indicated with "eds." after the author field names.

Print book:

Wasserman K, Hansen JE, Sue DY, et al . Principles of Exercise Testing and Interpretation: Including Pathophysiology and Clinical Applications . 5th ed. Wolters Kluwer Health/Lippincott William and Wilkins; 2012. 

Entire edited print book:

Alldredge BK, Corelli RL, Ernst ME, et al., eds. Koda-Kimble and Young’s Applied Therapeutics: The Clinical Use of Drugs. 10th ed. Lippincott Williams and Wilkins; 2013.

Chapter within an edited book in print:

Relling MV, Giacomini KM. Pharmacogenomics. In: Brunton LL, Chabner BA, Knollmann BC, eds. Goodman and Gilman’s The Pharmacological Basis of Therapeutics . 12th ed.  McGraw-Hill; 2011: 145-168.

Book viewed online:

Suchmacher M, Geller M. Practical Biostatistics. Elsevier; 2012. Accessed November 5, 2012. https://www.sciencedirect.com/science/book/9780124157941

Edited book viewed online :

Brunton LL, Blumenthal DK, Murri N, Hilal-Danden R, Knollmann BC, eds. Goodman and Gilman’s The Pharmacological Basis of Therapeutics . 12th ed. McGraw-Hill; 2011. Accessed November 4, 2012. https://www.accesspharmacy.com/resourceToc.aspx?resourceID=28

Chapter within an edited book viewed online:

Relling MV, Giacomini KM. Chapter 7. Pharmacogenomics. In : Brunton LL, Blumenthal DK, Murri N, Hilal-Danden R, Knollmann BC, eds. Goodman and Gilman’s The Pharmacological Basis of Therapeutics . 12th ed. McGraw-Hill; 2011. Accessed October 4, 2012. https://www.accesspharmacy.com/content.aspx?aID=16659580

Conference presentations

If materials presented at a conference are published elsewhere as a book, issue of a journal, or other medium, AMA instructs you to cite them using that reference style. Only use this style for materials not formally published as part of another publication.

General format: Author AA, Author BB, Author CC. Title of poster.  Poster presented at: Name of conference; Month, Day Year; City, State abbreviation.

Pasternak B. Carvedilol vs metoprolol succinate and risk of mortality in patients with heart failure: national cohort study. Paper presented at: European Society of Cardiology Congress; August 31, 2014; Barcelona, Spain. Morales M, Zhou X. Health practices of immigrant women: indigenous knowledge in an urban environment. Paper presented at: 78th Association for Information Science and Technology Annual Meeting; November 6-10, 2015; St Louis, MO. Accessed March 15, 2016. https://dl.acm.org/doi/10.5555/2857070.2857108

  • If the conference is held outside the US, replace "City, State" with City, Country.
  • The manual instructs you to use this to cite any type of presentation occurring at a conference, using any special name the conference chose to use. To cite a poster, a presentation, a keynote address, a panel, a lecture, etc., replace the word 'paper' in the phrase  "Paper presented at."
  • Add the Accessed date and the DOI (preferred) or the accessed date and URL (if DOI not available) for materials you viewed online.

Government or agency reports

3.13.2 Special Materials: Government or Agency Reports provides this format for citing reports issued by a department or agency of a government.

(1) name of author (if given); (2) title of bulletin in italics; (3) name of issuing bureau, agency, department, or other governmental division; (4) date of publication; (5) page numbers (if specified); (6) publication number (if any); (7) series number (if given); (8) online accessed date (if applicable); and (9) web address (if applicable).

3.15.5 Electronic References:Government/Organization Reports provides this guidance for citing Government/Organization reports: "These reports are treated much like electronic journal and book references: use journal style for articles and book style for monographs."

  • There is no guidance provided in the Manual for how to differentiate between "reports issued by a department or agency of a government" or a "government/organization report," and so there is no way to determine which of these is "more correct." Be consistent in your choices for citation in your document and within content: if you cite two articles from MMWR, use the same style for each.
  • While some online-issued government reports include DOIs, AMA style requires the accessed date and URL.
  • The example in the Manual for Government or Agency Reports includes semicolons between each field; the worked examples in the Manual show semicolons, colons, periods, and commas between fields, and there is no explanation for how or why to use each diacritical mark.. In creating examples, the diacritical marks used in the Manual were used as guides.

MMRW is a journal that publishes reports from the US CDC. Based on the rules of AMA Style, you could choose to cite reports from MMWR as a Government Report or a Journal Article. Here is the same report in both styles:

Selik RM, Mokotoff ED, Branson B, Owen SM, Whitmore S, Hall HI. Revised Surveillance Case Definition for HIV Infection- United States, 2014 . Centers for Disease Control and Prevention. 2014;1-11: Morbidity and Mortality Weekly Report. Accessed January 5, 2019. https://www.cdc.gov/mmwr/pdf/rr/rr6303.pdf

Selik RM, Mokotoff ED, Branson B, Owen SM, Whitmore S, Hall HI. Revised Surveillance Case Definition for HIV Infection- United States, 2014. MMWR. 2014;63(3):1-11. Accessed January 5, 2019. https://www.cdc.gov/mmwr/pdf/rr/rr6303.pdf

The Government Accountability Office is a federal office charged with assessing the function of federal government. They publish reports in the form of monographs. Based on the rules of AMA Style, you could choose to cite reports from this office as a Government Report or Monograph style:

Covid-19:Federal Efforts Could be Strengthened by Timely and Concerted Actions . United States Government Accountability Office. September 21, 2020. GAO-20-701. Accessed January 5, 2021. https://www.gao.gov/assets/710/709934.pdf

United States Government Accountability Office. Covid-19:Federal Efforts Could be Strengthened by Timely and Concerted Actions. Government Publication Office; 2020. Accessed January 5, 2021. https://www.gao.gov/assets/710/709934.pdf

In citing data from a website, include the following elements, if available, in the order shown:

■ Authors’ surnames and initials, if given, or name of the group who made the site

■ Title of the specific item cited. If none is given, use the name of the organization responsible for the site.

■ Name of the website

■ [Date published]

■ Updated [date]

■ Accessed [date]

■ URL (verify that the link still works as close as possible to publication)

There is no guidance in the Manual on how to separate elements (using periods, commas, semicolons, etc.); the example above is directly copied from the Manual. The examples below use the diacritical marks as shown in one example in the Manual, separating each field with a period.

Warfarin. Drug Information Online: Drugs.com. September 1, 2012. Updated January 23, 2020. Accessed April 15, 2020. https://www.drugs.com/cons/warfarin.html

DrugBank Online. Acetaminophen. DrugBank Online. June 13, 2005. Updated January 5, 2021. Accessed January 5, 2021. https://go.drugbank.com/drugs/DB00316

Additional citation types

Package insert s and prescribing information

Name of drug. Type of material. Company Name; year of publication. To indicate online access, add the accessed date and URL.

Lamasil. Package insert. Sandoz Pharmaceutics Corporation; 1993.

Lovenox. Prescribing information. s anofi - aventis U.S. LLC. Accessed April 15, 2020. https://products.sanofi.us/Lovenox/Lovenox.pdf

Drug Monographs . AMA style does not provide rules for citing drug monographs. These are suggested by the Norris Library and were created by adapting the book and website styles, as these contain similar pieces of information.

Print drug monographs

Author AA. Title of monograph being cited . Editor AA, ed. Title of book . Edition (if beyond first). Publisher name; year of publication.

Online drug monographs

Title of monograph. Title of book of monographs . Title of compendia where book is found (only include if different than book title). Pub lished date. Updated date. Accessed date. URL

Lisinopril. McEvoy GK, ed. AHFS Drug I nformation 2014 . American Society of Health - System Pharmacists, Inc.; 2014.

Lisinopril. AHFS DI (Adult and Pediatric) . Lexicomp. Updated March 11, 2016. Accessed May 11, 2016. https://online.lexi.com/lco/action/doc/retrieve/docid /complete_ashp /414040

Inventor names, inventor; assignee company, assignee. Title of patent. Patent issued agency and number. Date patent was grant ed.

Abram AZ, Fuchsuber L, inventors; Stiefel Research Australia, assignee. Foamable suspension gel. US Patent 8,158,109. April 17, 2012.

Note: this example is for a patent that was granted by the US Patent Office. To cite a patent issued by a different patent office, use this same style but replace the words "US Patent" with the issuing body: WIPO Patent.   You may instead need to cite a patent application. Use the same style, but replace the words "US Patent" with "US Patent Application."

Personal communications:

AMA Style states that personal communications such as phone calls, emails, conversations, etc. are not included in the reference list. However, you should cite these materials parenthetically within the text. Provide the name and highest academic degree of the author, type of communication, and date sent. If this would compromise patient anonymity, replace the name with a title and remove the day of communication.

Individuals on this new experimental drug should not take aspirin. (Sara P. Norris, M.D., email communication, November 3, 2012.)

For all five patients I have seen with this rare disorder, I have prescribed Interferon. (Physician at LAC + USC Healthcare Network, phone call, October 2012).

Common questions about AMA

What is a DOI?:

A DOI is a Digital Object Identifier. It is a series of letters and numbers that identifies a specific online item. Depending on the publisher, DOIs may be registered through international clearinghouses and function as web links or may not. AMA style allows you to choose to display DOIs in references in two ways, with or without the https://.  doi:10.1001/jama.2017.13737 and  https://doi.org/10.1001/jama.2017.13737 are both acceptable, and used interchangeably throughout the Manual when a DOI is included in a reference. When you discuss a DOI in writing, capital letters are used to denote that this is an abbreviation. When using a DOI in a citation, AMA Style requires all lowercase: doi.

Including words/phrases like "Paper presented at", "Date Accessed," "Date Updated," etc. in the citations: AMA Style sometimes requires the use of these "helper phrases" in the reference; in other cases, they are used in examples to show you where to place the information and will be deleted in your final completed citation. AMA Style is not particularly consistent nor logical in its choices to include or exclude "helper phrases" in citations. Examine both the example citation format and the worked examples citing a specific item to determine what to include.

Use Online or Print style?

AMA Style requires you to cite the version of an item you read. An article might be available online and in a print journal. If you read the online copy, cite it using the online citation format. If you read the print item, use the print format.

The URL is incredibly long-- do I need to include the whole thing? AMA Style's main preference is for you to include the entire and functional URL. However, if a URL is very long and breaks across lines, you may remove portions of the lengthy URL as long as the reader would reasonably be able to access the item from the short URL and information from the citation itself.

Here is an example of when and how to edit URLs:

is a citation to a drug monograph appearing in the book AHFS DI (Adult and Pediatric) available on the online database Lexicomp. The URL provided by Lexicomp for this monograph is actually much longer (it is https://online-lexi-com.libproxy1.usc.edu/lco/action/doc/retrieve/docid/complete_ashp/414040?cesid=aNQswQkZlPy&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dlisinopril%26t%3Dname%26va%3Dlisinopril). If you paste the short URL provided in this citation into your browser, you will arrive at the table of contents of the book AHFS DI (Adult and Pediatric) and can then look for the monograph described in this citation (Lisinopril).

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What is a DOI?

A DOI , or Digital Object Identifier, is a string of numbers, letters and symbols used to permanently identify an article or document and link to it on the web. For example: DOI: 10.1016/j.jenvman.2021.112050 . They are a source locator for online content.

They give each electronic, or digital, item (book, article) a unique, persistent identifier .

A DOI will assist the reader of your work to easily locate a document from your citation. It will always refer to that article, and only that one. While a web address (URL) might change, the DOI will never change.

Some referencing styles such as APA, Harvard ,Chicago, Vancouver and MLA recommend their use in citations.

The DOI is a shorter (as opposed to a URL) more convenient link to use in citations.

DOI's can be added in to EndNote and used in your bibliographies.

Note: Not all articles or resources have a DOI.

DOI's can be formatted in a number of different ways for example:  

doi:10.1080/02626667.2018.1560449 https://doi.org/10.1111/hex.12487 https://dx.doi.org/10.1080/02626667.2018.1560449 https://doi.org/10.1016/j.jpsychires.2017.11.014

Where is the DOI located?

In most recently published articles, the DOI will be printed with the article itself , usually on the first page somewhere, or in the header or footer. In the example below its in the footer. If the DOI isn’t on the article, look it up on the website CrossRef.org (use the “Search Metadata” option). You'll also find DOI's on Pubmed .

how to cite paper with doi

Digital Object Identifiers: A quick guide

What if my document doesn't have a DOI? Using persistent links

If your article doesn't have a DOI you can use the  permalink or persistant link option – this creates a tiny url which can be used in the reference without having long links.

how to cite paper with doi

Persistent Links will not expire as long as the content is available within the database. If the content is removed from the database, the Persistent Link will no longer be active.

A persistent link, a lso known as a durable link, stable link, or permalink , is a URL that connects directly to a specific full-text article in a library database or electronic journal subscription.

Many databases have an option for creating a persistent link. For example Library Search (see image above), ProQuest (Sociological Abstracts, E-book Central, ERIC), EBSCO (PsyInfo, Business Source Complete) and JSTOR Databases.

Persistent URLs (Document URLs)are designed so that your bookmarks and links don't break when a website gets updated. If you want to bookmark a study page or link to it from your website, you should bookmark/link the persistent URL.

How to find a DOI and What to do if there is no DOI

How do I cite a Journal Article with a DOI in it?

Referencing with DOI's and URL's using APA Style  DOIs and URLs (apa.org)  

MLA Formatting & Style Guide  MLA Formatting and Style Guide // Purdue Writing Lab   shows examples of referencing DOI's 

APA format? In APA format, include the DOI for all works that have one. It goes at the end of your reference–no period at the end.

Author, A. A., & Author, B. B. (Date of publication). Title of article. Title of Journal, volume number, page range. https://doi.org/10.0000/0000

If your article has no DOI whatsoever, which may happen with older articles, simply omit this from the citation.

Author, A. A., & Author, B. B. (Date of publication). Title of article. Title of Journal, volume number, page range.

See these and other examples in the Purdue OWL: APA Formatting and Style Guide.

AMA/JAMA format? When using a DOI in an AMA citation, do not include an “Accessed” date or a URL. Put the DOI at the end of your citation, prefaced with “doi:”

1. Author AA, Author BB. Title of article. Name of Jrnl. Year;vol(issue):inclusive pages. doi:10.0000000/000000000000

MLA format? As of the most recent (8th) edition, MLA encourages students to include the DOI at the end of the citation for an online scholarly journal article. If no DOI exists, use the URL.

Author LastName, FirstName, and FirstName LastName. “Article Title.” Journal Name, vol. #, no. #, date, pp. ##-##. Name of Database, doi: 10.0000/000000000.

It’s a good idea to check with your instructor whether they want you to include the date you accessed the article, although this is not required by MLA.

Examples sourced  What is a DOI and how do I use them in citations? (uic.edu)   and  MLA Formatting and Style Guide // Purdue Writing Lab  

DOI or URL? APA Style Guidelines

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APA 6th Edition Citation Style

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Journal Article with DOI

Document Example:

Proper Bibliographic Reference Format:

  • Bibliographic references are double-spaced and indented half an inch after the first line.
  • When a DOI is used, no further retrieval information is needed to identify or locate the content. Do not include the database name.
  • It is no longer necessary to include the date of retrieval unless the source material may change over time (e.g., Wikis).

Spitz, D., & Hunter, S. (2005). Contested codes: The social construction of Napster. Information Society, 21 (3), 169-180. doi:10.1080/01972240490951890

In-Text Citations:

Citations are placed in the context of discussion using the authors' last names and date of publication.

(Spitz & Hunter, 2005)

Alternatively, you can integrate the citation into the sentence by means of narrative.

Spitz and Hunter (2005) examine why certain assumptions about Napster have gained greater currency while others have not.

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DOI citation generator

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What is a DOI citation generator and how can it help you?

Getting citations and reference lists correctly done can be very confusing and time-consuming.

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If you need to know more about DOI citations check out our How do I cite in DOI style? section.

Why, when, and what do I have to cite?

Why The broad scientific knowledge we have today is the accomplishment of many researchers over time. To put your own contribution in context , it is important to cite the work of the researchers who influenced you. Cited sources can provide key background information, support or dispute your thesis, or offer important definitions and data. Citing also shows that you have personally read the work.

When In addition to crediting the ideas of others that you used to build your own argument, you need to provide documentation for all facts and figures that are not common knowledge. Common knowledge is knowledge that is known by everyone, or nearly everyone, and can basically concern any subject. An example for common knowledge would be "There are seven days in a week".

What The number of sources you cite in your work depends on the intent of the paper. In most cases, you will need to cite one or two of the most representative sources for each key point. However, if you are working on a review article, the aim is to present to the readers everything that has been written on a topic, so you will need to include a more exhaustive list of citations.

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How do I cite with a DOI?

How you cite with a DOI depends on the citation style you use. APA, MLA and all big citation styles include a DOI. BibGuru makes citing with a DOI as easy as it gets. Simply copy and paste the DOI into the Article search field and BibGuru will find your source and give you the correct citation with your DOI in the style you prefer.

DOI stands for digital object identifier and is a string of numbers, letters and symbols used to uniquely identify an article and document and link it to the web. A DOI of an object will never change, which makes it a permanent identification.

How you cite a DOI depends on the citation style you use. Many citation styles, including APA or MLA ask you to include the DOI at the end of your citation in the bibliography. You don't need to worry how to cite a DOI with the BibGuru DOI citation generator in any style - we will do it in the correct way for you.

If you cite in the APA style, include the DOI for all works that have one. If you find an article on the "open web" (such as finding it on Google), and it doesn't have a DOI, you need the full URL of the article.

DOI and ISBN (International Standard Book Number) are two different identification numbers and are totally unrelated.

A DOI is used to permanently identify an electronic article or book and link it to the web. Beware that not all electronic materials will have a DOI. As it is a fairly new concept, books and articles published prior to 2000 are less likely to have a DOI.

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Computer Science > Computation and Language

Title: jamba: a hybrid transformer-mamba language model.

Abstract: We present Jamba, a new base large language model based on a novel hybrid Transformer-Mamba mixture-of-experts (MoE) architecture. Specifically, Jamba interleaves blocks of Transformer and Mamba layers, enjoying the benefits of both model families. MoE is added in some of these layers to increase model capacity while keeping active parameter usage manageable. This flexible architecture allows resource- and objective-specific configurations. In the particular configuration we have implemented, we end up with a powerful model that fits in a single 80GB GPU. Built at large scale, Jamba provides high throughput and small memory footprint compared to vanilla Transformers, and at the same time state-of-the-art performance on standard language model benchmarks and long-context evaluations. Remarkably, the model presents strong results for up to 256K tokens context length. We study various architectural decisions, such as how to combine Transformer and Mamba layers, and how to mix experts, and show that some of them are crucial in large scale modeling. We also describe several interesting properties of these architectures which the training and evaluation of Jamba have revealed, and plan to release checkpoints from various ablation runs, to encourage further exploration of this novel architecture. We make the weights of our implementation of Jamba publicly available under a permissive license.

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Introduction, conclusions, supplementary data, declarations, data availability, ethical approval, pre-registered clinical trial number.

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Transcatheter or surgical aortic valve implantation: 10-year outcomes of the NOTION trial

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Hans Gustav Hørsted Thyregod and Troels Højsgaard Jørgensen shared first authorship.

Daniel Andreas Steinbrüchel Retired researcher.

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Hans Gustav Hørsted Thyregod, Troels Højsgaard Jørgensen, Nikolaj Ihlemann, Daniel Andreas Steinbrüchel, Henrik Nissen, Bo Juel Kjeldsen, Petur Petursson, Ole De Backer, Peter Skov Olsen, Lars Søndergaard, Transcatheter or surgical aortic valve implantation: 10-year outcomes of the NOTION trial, European Heart Journal , Volume 45, Issue 13, 1 April 2024, Pages 1116–1124, https://doi.org/10.1093/eurheartj/ehae043

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Transcatheter aortic valve implantation (TAVI) has become a viable treatment option for patients with severe aortic valve stenosis across a broad range of surgical risk. The Nordic Aortic Valve Intervention (NOTION) trial was the first to randomize patients at lower surgical risk to TAVI or surgical aortic valve replacement (SAVR). The aim of the present study was to report clinical and bioprosthesis outcomes after 10 years.

The NOTION trial randomized 280 patients to TAVI with the self-expanding CoreValve (Medtronic Inc.) bioprosthesis ( n = 145) or SAVR with a bioprosthesis ( n = 135). The primary composite outcome was the risk of all-cause mortality, stroke, or myocardial infarction. Bioprosthetic valve dysfunction (BVD) was classified as structural valve deterioration (SVD), non-structural valve dysfunction (NSVD), clinical valve thrombosis, or endocarditis according to Valve Academic Research Consortium-3 criteria. Severe SVD was defined as (i) a transprosthetic gradient of 30 mmHg or more and an increase in transprosthetic gradient of 20 mmHg or more or (ii) severe new intraprosthetic regurgitation. Bioprosthetic valve failure (BVF) was defined as the composite rate of death from a valve-related cause or an unexplained death following the diagnosis of BVD, aortic valve re-intervention, or severe SVD.

Baseline characteristics were similar between TAVI and SAVR: age 79.2 ± 4.9 years and 79.0 ± 4.7 years ( P = .7), male 52.6% and 53.8% ( P = .8), and Society of Thoracic Surgeons score < 4% of 83.4% and 80.0% ( P = .5), respectively. After 10 years, the risk of the composite outcome all-cause mortality, stroke, or myocardial infarction was 65.5% after TAVI and 65.5% after SAVR [hazard ratio (HR) 1.0; 95% confidence interval (CI) 0.7–1.3; P = .9], with no difference for each individual outcome. Severe SVD had occurred in 1.5% and 10.0% (HR 0.2; 95% CI 0.04–0.7; P = .02) after TAVI and SAVR, respectively. The cumulative incidence for severe NSVD was 20.5% and 43.0% ( P < .001) and for endocarditis 7.2% and 7.4% ( P = 1.0) after TAVI and SAVR, respectively. No patients had clinical valve thrombosis. Bioprosthetic valve failure occurred in 9.7% of TAVI and 13.8% of SAVR patients (HR 0.7; 95% CI 0.4–1.5; P = .4).

In patients with severe AS and lower surgical risk randomized to TAVI or SAVR, the risk of major clinical outcomes was not different 10 years after treatment. The risk of severe bioprosthesis SVD was lower after TAVR compared with SAVR, while the risk of BVF was similar.

Clinical and bioprosthesis 10-year outcomes after transcatheter or surgical aortic valve implantation. TAVI, transcatheter aortic valve implantation; SAVR, surgical aortic valve replacement. Hazard ratio (HR); 95% confidence interval (CI); the P-value was based on Cox regression.

Clinical and bioprosthesis 10-year outcomes after transcatheter or surgical aortic valve implantation. TAVI, transcatheter aortic valve implantation; SAVR, surgical aortic valve replacement. Hazard ratio (HR); 95% confidence interval (CI); the P -value was based on Cox regression.

See the editorial comment for this article ‘Transcatheter vs. surgical treatment of aortic stenosis: long-awaited long-term data, yet a long road to go’, by S. Bleiziffer, https://doi.org10.1093/eurheartj/ehad873 .

Transcatheter aortic valve implantation (TAVI) has revolutionized the treatment of patients with acquired severe aortic valve stenosis (AS). Randomized clinical trials have documented the benefits of TAVI compared with medical therapy in patients who are ineligible for surgery, as well as to surgery in patients who are at high or intermediate surgical risk up to 5 years. 1 , 2 , 3 , 4 , 5 , 6 In recent European guidelines, TAVI is recommended instead of surgery for high-risk and suitable moderate-risk patients and in patients older than 75 years. 7 Surgery is still recommended for younger and low-risk patients, mainly because the durability of transcatheter heart valves (THV) is unknown. The general recommendation for the use of surgical bioprosthetic aortic valves as opposed to mechanical valves is age older than 65 years, but as TAVI offers a less invasive treatment, an increasing number of younger patients are now treated with THV. In the United States, about half of the patients younger than 65 years treated for isolated AS undergoes TAVI. 8 Due to the longer life expectancy of these patients, evidence on long-term durability of THV vs. surgical bioprostheses is needed.

The Nordic Aortic Valve Intervention Trial (NOTION) enrolled patients with severe AS from 2009 to 2013 and was the first to randomize primarily patients at lower surgical risk to TAVI or surgical aortic valve replacement (SAVR). 9 The trial has documented no significant difference in mortality, stroke, or myocardial infarction (MI) up to 8 years after intervention. 10 Furthermore, no significant difference has been found for structural deterioration of or re-intervention on the bioprostheses used. Two other larger trials including low-risk patients, the PARTNER 3 and Evolut Low Risk trial, have documented outcomes after 5 and 4 years, with no significant difference between TAVI and SAVR for all-cause mortality or disabling stroke. 11 , 12 The aim of this secondary analysis was to document clinical and prosthesis outcomes after 10 years in the NOTION trial.

The details of the trial design have previously been published. 13 In short, the trial was investigator-initiated, multicentre, non-blinded, and randomized patients to TAVI or SAVR. Follow-up was yearly and life-long. All patients provided informed written consent. The regional ethical review board approved the protocol at each site, and the trial was conducted according to the principles of the Declaration of Helsinki. All data were collected and stored by the investigators and were externally monitored. Only outcomes within the first post-procedural year were adjudicated by an independent clinical events committee. Outcomes thereafter were adjudicated by the investigators at each centre. Patients suspected of a stroke were evaluated by a neurologist including clinical examination and potentially brain imaging studies. The trial was registered with ClinicalTrials.gov , NCT01057173.

All patients aged 70 years or older with symptomatic severe AS were considered for inclusion. No specific surgical risk profile was required if patients were anatomically suitable for both procedures as determined by an echocardiogram and in some cases a computed tomography scan. Major exclusion criteria were the need for acute treatment, other significant cardiovascular diseases, and/or other major organ failures (see Thyregod et al. 13 for more details).

Patients who were randomized to TAVI received a self-expanding first- or second-generation CoreValve bioprosthesis (Medtronic Inc., Minneapolis, MN, USA) using a transfemoral access in almost all cases. Surgical patients had a full sternotomy and standard implantation of a porcine or bovine stented bioprosthesis without the use of annular enlargement techniques. The specific type of bioprosthesis was left at the discretion of the surgeon.

Outcome definitions

The primary outcome was a composite of all-cause death, stroke, or MI after 1 year. Here, we report the composite outcome and all its components after 10 years. Other relevant clinical outcomes reported include transient ischaemic attack, new-onset atrial fibrillation, permanent pacemaker implantation, and endocarditis. Echocardiographic outcomes were the effective orifice area (EOA) of the bioprosthesis and the mean transprosthetic gradient, the degree of central regurgitation, and paravalvular leakage (PVL). Outcomes were defined according to the Valve Academic Research Consortium (VARC)-2 criteria. 14

Bioprosthesis durability was classified according to the VARC-3 criteria. 15 The criteria distinguish between bioprosthetic valve failure (BVF) and bioprosthetic valve dysfunction (BVD). Bioprosthetic valve failure was defined as one of the following three: (i) valve-related death (death caused by BVD or sudden unexplained death following the diagnosis of BVD), (ii) severe haemodynamic structural valve deterioration (SVD), or (iii) prosthesis re-intervention following diagnosis of BVD. Bioprosthetic valve dysfunction was categorized into four groups: (i) SVD (moderate SVD: mean transprosthetic gradient ≥ 20 mmHg and increase ≥ 10 mmHg from 3 months or new ≥ moderate intraprosthetic regurgitation; severe SVD: mean transprosthetic gradient ≥ 30 mmHg and increase ≥ 20 mmHg from 3 months echo or new severe intraprosthetic regurgitation), (ii) non-structural valve deterioration (NSVD) defined as moderate/severe PVL or prosthesis–patient mismatch (PPM) at 3 months [moderate PPM: if body mass index (BMI) < 30 kg/m 2 then indexed 0.65 cm 2 /m 2 < indexed EOA ≤ 0.85 cm 2 /m 2 and if BMI ≥ 30 kg/m 2 then 0.55 cm 2 /m 2 < indexed EOA ≤ 0.7 cm 2 /m 2 ; severe PPM: if BMI < 30 kg/m 2 then indexed EOA ≤ 0.65 cm 2 /m 2 and if BMI ≥ 30 kg/m 2 then indexed EOA ≤ 0.55 cm 2 /m 2 ], (iii) clinical bioprosthetic valve thrombosis, or (iv) endocarditis according to the modified Duke criteria. Prosthesis–patient mismatch was evaluated at the echocardiography performed 3 months post-procedure, whereas SVD was defined as an increase in transprosthetic gradient or intraprosthetic regurgitation over time. The original complete VARC-3 definition of SVD includes a concomitant decrease in EOA and/or a decrease in Doppler velocity index. We used the modified ‘haemodynamic’ definition, as we did not systematically calculate velocity indices.

Clinical outcomes of all-cause mortality, stroke, or MI were reported for the intention-to-treat population. Echocardiographic data and other data on bioprosthesis durability were reported for the as-implanted population. A time-to-event analysis using Kaplan–Meier estimates was used for survival analyses of all-cause mortality. The log-rank test was used for outcome comparisons between treatment groups. When death was a competing risk, the cumulative incidence was analysed using the Aalen–Johansen method, and groups were compared using Gray’s test provided in tables. For echocardiographic outcomes, patients were censored after date of re-intervention if performed. The association between exposure and mortality rates was analysed with Cox regression and reported as hazard ratio (HR) with 95% confidence interval (CI), and the P -value in figures was based on cause-specific HR. The association between exposure (TAVI vs. SAVR) and SVD, BVF, and stroke rates was analysed with Cox regression with death (and aortic valve re-intervention in the case of SVD and BVF) considered as competing risk and reported as HR with 95% CI and P -value in figures. Furthermore, a multivariate Cox regression including exposure, left ventricular ejection fraction (LVEF) at 3 months post-procedure (≥50% vs. <50%), gender (male vs. female), age (≥ 80 vs. <80 years), presence/absence of pacemaker at 1 month, and/or PVL at 3 months post-procedure analysed the association with all-cause mortality. The association of exposure and atrial fibrillation as a time-dependent variable with the risk of stroke (death considered competing risk) was analysed with Cox regression. All categorical variables were presented as counts and percentages and compared with the χ 2 or Fisher’s exact test. Continuous variables were presented as mean with standard deviation and compared using Student’s t -test or median with interquartile range and compared using the Wilcoxon signed-rank test. The null hypothesis was rejected for P -values < .05. All statistical analyses were performed with SAS Enterprise Guide 8.3 (SAS Institute, Cary, NC, USA).

For the intention-to-treat population, 280 patients were enrolled (145 TAVI and 135 SAVR). There was no significant difference between any baseline characteristic in the two treatment groups for both populations (see Supplementary data online , Tables S1 and S2 ). The mean age was 79.1 ± 4.8 years, 47% were female, and mean Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM) score was 3.0 ± 1.7%, indicating a low-risk cohort. Four patients died before receiving a procedure, 3 TAVI patients crossed over to SAVR after attempted TAVI, and 3 SAVR patients never received a bioprosthesis, leaving 274 patients (139 TAVI and 135 SAVR) for the as-implanted population (see Supplementary data online , Figure S1 ). After 10 years, 98.9% of patients could be followed up (2 TAVI and 1 SAVR patients were lost) and of these 101 (36.1%) patients were alive. Echocardiographic data were available for 82 (81.2%) patients reaching 10 years. Missing 10-year echo data for 12 of 52 (23.1%) TAVI and 7 of 49 (14.2%) SAVR patients. For procedural details, see Supplementary data online , Tables S1 , S2 , and S4 .

Clinical outcomes

After 10 years in the intention-to-treat population, there was no difference for all-cause mortality between the two treatment groups (TAVI 62.7% and SAVR 64.0%, HR 1.0; 95% CI 0.7–1.3, P = .8) ( Figure 1 ). An analysis for all-cause mortality in three age groups can be found the Supplementary data online , Figure S2 . For the initial primary composite outcome of all-cause mortality, stroke, or MI, no difference could be found for this composite outcome (TAVI 65.5% and SAVR 65.5%, HR 1.0; 95% CI 0.7–1.3, P = .9). Furthermore, for each component in the composite outcome, no difference could be found ( Table 1 ). About half of MIs occurred immediately after the procedure and were rarely confirmed by angiographic studies. More SAVR patients had experienced new-onset atrial fibrillation (TAVI 52.0% and SAVR 74.1%, P < .01) at any time during follow-up. At 10 years, 13.0% of TAVI and 20.5% of SAVR patients ( P = .4) had atrial fibrillation on their ECG. For anticoagulation therapy, see Supplementary data online , Table S3 . More TAVI patients without a pacemaker at baseline had received a new permanent pacemaker (TAVI 44.7% and SAVR 14.0%, P < .01) ( Table 1 ), with the majority of implants occurring during the first year after the procedure. 9 Similar results were found in the as-implanted population. In the multivariate Cox regression analysis, only age older than 80 years was significantly associated with increased all-cause mortality after 10 years (see Supplementary data online , Table S5 ). Permanent pacemaker implantation during the first 30 days after the index procedure or moderate/severe PVL was not associated with all-cause mortality. Type of procedure or presence of atrial fibrillation was not associated with the risk of stroke (see Supplementary data online , Table S6 ). The distribution of New York Heart Association (NYHA) functional class for those alive at 10 years was similar between groups (NYHA classes I and II, TAVI 83.7% and SAVR 80.6%, P = .93) (see Supplementary data online , Figure S3 ).

NOTION—clinical outcomes up to 10 years of follow-up: all-cause mortality and all-cause mortality, stroke, or myocardial infarction (MI). TAVI, transcatheter aortic valve implantation; SAVR, surgical aortic valve replacement; MI, myocardial infarction. Hazard ratio (HR); 95% confidence interval (CI); P-value was based on Cox regression

NOTION—clinical outcomes up to 10 years of follow-up: all-cause mortality and all-cause mortality, stroke, or myocardial infarction (MI). TAVI, transcatheter aortic valve implantation; SAVR, surgical aortic valve replacement; MI, myocardial infarction. Hazard ratio (HR); 95% confidence interval (CI); P -value was based on Cox regression

Adverse outcomes

All analyses are cumulative incidence compared with Gray’s test, except the absolute risk of all-cause mortality compared with log-rank test. Risk estimates are %.

TAVI, transcatheter aortic valve implantation; SAVR, surgical aortic valve replacement.

a Include both disabling and non-disabling strokes.

Echocardiographic outcomes

The initial improvement in EOA and corresponding decrease in mean transprosthetic gradient seen after both procedures remained significant within groups, but over time, EOA decreased and the gradient increased for both groups ( Figure 2 ). At all time-points, the increase in area and decrease in gradient was more pronounced for TAVI compared with SAVR. Transcatheter aortic valve implantation patients had more moderate or severe PVL or bioprosthesis regurgitation after 10 years (risk of moderate/severe PVL at any time during follow-up, TAVI 25.4% and SAVR 2.5%, P < .01). For TAVI patients, there was no association between moderate or severe PVL at 3 months after the procedure and all-cause mortality after 10 years (rate of all-cause mortality for moderate/severe PVL 62.0% and no/mild PVL 55.0%, P = .84) (see Supplementary data online , Table S5 ). No difference in LVEF after 10 years could be found between the two groups (TAVI 50.7% and SAVR 52.8%, P = .11).

NOTION—aortic valve haemodynamics up to 10 years of follow-up: transprosthetic gradient and effective orifice area (EOA). EOA, effective orifice area; TAVI, transcatheter aortic valve implantation; SAVR, surgical aortic valve replacement. *P < .05 for inter-group comparison

NOTION—aortic valve haemodynamics up to 10 years of follow-up: transprosthetic gradient and effective orifice area (EOA). EOA, effective orifice area; TAVI, transcatheter aortic valve implantation; SAVR, surgical aortic valve replacement. * P < .05 for inter-group comparison

Bioprosthesis durability

In the as-implanted population after 10 years, the risk of moderate or severe SVD was similar after TAVI compared with SAVR (TAVI 15.4% and SAVR 20.8%, HR 0.7; 95% CI 0.4–1.3, P = .3) ( Figure 3 ), while the risk of severe SVD was lower for TAVI (TAVI 1.5% and SAVR 10.0%, HR 0.2; 95% CI 0.04–0.7, P = .02). The proportion of patients with mild or more PVL at 10 years was larger for TAVI than SAVR (TAVI 18.0% and SAVR 5.2%, P < .05), while the proportion with mild or moderate intraprosthetic regurgitation was similar between groups (TAVI 5.8% and SAVR 2.2%, P = .5) (see Supplementary data online , Figures S4–S6 ). Severe BVD occurred less frequent in the TAVI group compared with SAVR (TAVI 20.5% and SAVR 43.0%, P < .01) ( Figure 4 ). This was mainly driven by a high risk of severe NSVD, e.g. severe PPM, for SAVR patients (TAVI 10.2% and SAVR 31.9%, P < .01). No patient had clinical valve thrombosis, and the rate of infective endocarditis was low and similar for both groups (TAVI 7.2% and SAVR 7.4, P = 1.0). The risk of BVD over time within each group was similar. Overall, there was no difference in BVF between groups (TAVI 9.7% and SAVR 13.8%, HR, 0.7; 95% CI: 0.4–1.5, P = .4), and in particular, the rate of prosthesis re-intervention was low and similar for the two types of bioprostheses (TAVI 4.3% and SAVR 2.2%, P = .3). Reasons for re-intervention were restenosis (five TAVI and two SAVR) and central regurgitation (1 TAVI and 1 SAVR), and TAVI was done for all re-interventions. For cumulative incidences of SVD, BVD, and BVF defined according to VARC-3 but excluding Doppler velocity index, see Supplementary data online , Figures S7 and S8 .

Structural valve deterioration (SVD)—haemodynamic VARC-3 definition: ≥moderate SVD and severe SVD. SVD, structural valve deterioration; AR, aortic valve regurgitation; TAVI, transcatheter aortic valve implantation; SAVR, surgical aortic valve replacement; VARC-3, Valve Academic Research Consortium third definition. Table and curve are cumulative incidences after 10 years of follow-up compared with Gray’s test. Hazard ratio (HR); 95% confidence interval (CI); P-value was based on Cox regression

Structural valve deterioration (SVD)—haemodynamic VARC-3 definition: ≥moderate SVD and severe SVD. SVD, structural valve deterioration; AR, aortic valve regurgitation; TAVI, transcatheter aortic valve implantation; SAVR, surgical aortic valve replacement; VARC-3, Valve Academic Research Consortium third definition. Table and curve are cumulative incidences after 10 years of follow-up compared with Gray’s test. Hazard ratio (HR); 95% confidence interval (CI); P -value was based on Cox regression

Bioprosthetic valve dysfunction (BVD) and failure (BVF)—haemodynamic VARC-3 definition: severe BVD and BVF. BVD, bioprosthetic valve dysfunction; BVF, bioprosthetic valve failure; TAVI, transcatheter aortic valve implantation; SAVR, surgical aortic valve replacement. VARC-3, Valve Academic Research Consortium third definition. Table and curve are cumulative incidences after 10 years of follow-up compared with Gray’s test. Hazard ratio (HR); 95% confidence interval (CI); P-value was based on Cox regression

Bioprosthetic valve dysfunction (BVD) and failure (BVF)—haemodynamic VARC-3 definition: severe BVD and BVF. BVD, bioprosthetic valve dysfunction; BVF, bioprosthetic valve failure; TAVI, transcatheter aortic valve implantation; SAVR, surgical aortic valve replacement. VARC-3, Valve Academic Research Consortium third definition. Table and curve are cumulative incidences after 10 years of follow-up compared with Gray’s test. Hazard ratio (HR); 95% confidence interval (CI); P -value was based on Cox regression

The NOTION trial completed enrolment in 2013 and included patients at lower surgical risk. This allows for the first comparison of clinical outcomes and durability after TAVI or SAVR with 10-year follow-up. We found no significant difference for all-cause mortality, stroke, or MI. As seen in our previous trial reports, new-onset atrial fibrillation occurred more often after SAVR in the immediate post-operative period. More TAVI patients had conduction abnormalities immediately after the procedure requiring a permanent pacemaker. The rates of bioprosthesis endocarditis and re-intervention were very low and similar between the two groups. The bioprosthetic EOA was larger after TAVI, but more patients had PVL compared with SAVR patients. The risk of SVD and BVF was not different for the two types of bioprostheses ( Structured Graphical Abstract ).

Most trials and observational studies comparing TAVI with SAVR beyond 5 years have included old and moderate- and high-risk patients resulting in high overall mortality rates, caused by both non- and cardiovascular causes, and therefore small study populations at risk. All-cause mortality rates after 5 years were similar between TAVI and SAVR (55.3%–67.8% for TAVI and 55.4%–62.4% for SAVR) in high- and intermediate-risk patients (30%–46% for TAVI and 28.7%–42.1% for SAVR). 2 , 3 , 5 , 6 , In the NOTION trial, all consecutive patients were considered for enrolment and no specific risk profile was defined. This resulted in the enrolment of old, mean age 79 years, but lower-risk patients, with more than 80% of patients having a STS-PROM score < 4% and limited comorbidities. Frailty was not systematically assessed. A recent observational study in low-risk patients found an all-cause mortality rate of 7.1% and 12.4% 5 and 8 years after isolated SAVR, respectively. 16 These rates were 28.9% and 52.6% in our trial. 10 , 17 After 10 years, more than 60% of patients had died, suggesting a higher risk profile than the one measured by the STS-PROM score, while the type of intervention and bioprosthesis did not seem to affect the outcome. The two other trials in younger low-risk patients currently only have intermediate-term follow-up with all-cause mortality rates of 10.0% for TAVI and 8.2% for SAVR after 5 years in the PARTNER 3 trial 11 and 9.0% for TAVI and 12.1% for SAVR after 4 years in the Evolut Low Risk trial, 12 with no significant difference in either trial. Mean age in these larger trials were 73 and 74 years, respectively, and up to 26% of surgical patients underwent concomitant cardiac procedures including coronary artery bypass grafting. Similar rates of disabling stroke (5.8% and 2.9% for TAVI; 6.4% and 3.8% for SAVR) and cardiac re-hospitalizations were reported, but more SAVR patients had new-onset atrial fibrillation and serious bleeding. For TAVI patients in the Evolut Low Risk trial, using a self-expanding THV, the rate of pacemaker implantation was higher compared with SAVR patients. We also found less new-onset atrial fibrillation but more pacemaker implantation after TAVR compared with SAVR but at higher rates.

Procedural factors such as conduction abnormalities and all degrees of PVL and PPM have all been associated with an increased risk of death in both trials and observational studies. 3 , 4 , 18 , 19 , 20 , 21 , 22 We have not been able to demonstrate any of these associations in the NOTION trial, although our rates of these complications were higher compared with more contemporary trials. 9 , 23 The limited sample size could be an explanation for this finding.

Bioprosthesis haemodynamics and durability

After both interventions, the EOA increased significantly and significantly more after TAVI compared with SAVR. Consequently, the transprosthetic gradient was lower after TAVI. This did not result in differences in LVEF or left ventricular mass regression as reported previously. 24 These more favourable haemodynamic parameters after TAVI have been demonstrated in all trials. On the other hand, significantly more TAVI patients had PVL. The rate of mild or more PVL after TAVI was higher in the NOTION trial (53% after 5 years) 17 compared with more recent trials using newer delivery systems and THV designs (15.3% and 20.8% after 4 and 5 years, respectively). 11 , 12 More than 98% of TAVI patients had a THV sized 26–31 mm, while 98% of SAVR patients received a size 19–25 mm stented bioprosthesis from various manufacturers. Consequently, more SAVR patients had PPM and high transprosthetic gradients. This explains the higher rates of NSVD, as PPM (e.g. the prosthetic opening area indexed to body size 3 months after the procedure) is part of the NSVD definition. We did not observe any other NSVD such as cusp entrapment by pannus, dilatation of the aortic root, prosthesis erosion, or embolization. The rate of severe SVD was higher after SAVR (e.g. a significant change in prosthetic cusp structure leading to an increase in transprosthetic gradient). No patients had severe intraprosthetic regurgitation. The ‘haemodynamic’ VARC-3 definition of SVD used in the current report included only the transprosthetic gradient and has been shown to be more predictive of adverse clinical outcomes than the complete VARC-3 definition. 25 Both the calculated EOA and Doppler velocity index, included in the complete definition, are more affected by observer variability and error. 26 We found no difference in severe SVD if EOA was included in the definition. A too small prosthesis causing a high transprosthetic gradient and persistent left ventricular hypertrophy has been associated with an accelerated risk of SVD, heart failure, and decreased survival. 20 , 21 , 22 Other clinical predictors of SVD have been reported to be a younger age, smoking, higher BMI, dyslipidaemia, diabetes mellitus, and renal insufficiency. Furthermore, the specific type of bioprosthesis used for TAVR, e.g. self-expanding or balloon-expanding, and SAVR, e.g. pericardial or porcine and externally or internally mounted cusps, will also influence the rate of SVD and should be considered when comparing trial results. 27 We used five different surgical bioprostheses (both bovine pericardial and porcine and with internally or externally mounted cusps on the stent) making comparisons with other study cohorts difficult. In the PARTNER 2A trial, the rate of SVD after 5 years was higher after TAVR using the SAPIEN-XT balloon-expanding THV compared with SAVR using a pericardial bioprosthesis in 80% of patients (1.61 ± 0.24% vs. 0.63 ± 0.16%, P ≤ .01), while the SVD rate for the SAPIEN 3 THV was not different. 11 , 28 For the self-expanding THV, the cumulative incidence of SVD using the ‘haemodynamic’ VARC-3 criteria was lower after TAVR compared with SAVR after 5 years (2.20% vs. 4.38%; HR, 0.46; 95% CI, 0.27–0.78; P = .004). 25 The rates of BVF, in particular bioprosthesis re-intervention, and endocarditis were similar between groups. Causes of re-intervention were primarily stenosis of the prosthesis, and re-intervention with TAVI was used for all cases. The rates of endocarditis and causative bacteria were similar to findings from other series. 29 In the PARTNER 3 trial using a balloon-expanding THV, clinically significant bioprosthesis thrombosis occurred more often in TAVI patients. 11 We did not find any clinically significant bioprosthesis thrombosis or late coronary obstruction in our trial. There was no systematic screening for subclinical leaflet thrombosis or thickening with high-resolution cardiac computed tomography scans. 30 As described above, we have not experienced any signs of earlier failure nor improved durability for THV compared with surgical bioprostheses after 10 years. This emphasizes the concept of lifetime management when considering treatment of young and/or lower-risk AS patients with few comorbidities, higher risk of a bicuspid aortic valve, and longer life expectancy. 31 Conduction abnormalities and even mild PVL could negatively impact survival making the evaluation of native aortic valve anatomy and size, the choice of THV, and its positioning even more important. Bioprosthesis re-intervention will probably be required, but the optimal type of re-intervention is not known at this time. Furthermore, coronary access is compromised in some patients after TAVI and even more after redo TAVI, 32 , 33 and for patients younger than 65 years of age, observational studies have demonstrated a survival benefit of surgical mechanical prostheses compared with biological prostheses. 34 Despite of the lack of evidence for the use of TAVI in younger and/or lower-risk patients, its use has substantially increased in both the USA and Europe. 8 , 35

Trial limitations

The NOTION trial was designed with a primary outcome after the first year; consequently, all other analyses are considered exploratory. More SAVR patients had withdrawn from the trial, and this could have introduced attrition bias. All outcome assessments were done unblinded. Both echocardiograms and strokes were site reported. All patients with concomitant significant cardiac diseases, primarily coronary artery disease, and bicuspid aortic valves were excluded, and results cannot be extrapolated to these patients. We only used transthoracic echocardiography for trial screening and THV sizing. Current guidelines recommend concurrent computed tomography scans to improve THV sizing and positioning. 7 , 36 We only used one type of an early generation delivery system and self-expanding THV. Currently available multiple different types of THVs have different designs and delivery systems with proven lower rates of PVL, conduction abnormalities, and vascular complications. 37 , 38 For SAVR, no annular enlargement techniques were used to increase bioprosthesis sizes. Surgical bioprostheses with externally mounted leaflets on the stent and now known decreased durability were used, 39 , 40 and only 10% of SAVR patients received a pericardial bioprosthesis which has demonstrated improved durability compared with porcine bioprostheses. 41

The NOTION trial randomized lower-risk patients with severe AS to TAVI vs. SAVR. After 10 years, no significant differences were found between the two groups regarding all-cause mortality, stroke, or MI. More TAVR patients had permanent pacemaker implantation. Surgical aortic valve replacement patients had new-onset atrial fibrillation more often. Transcatheter aortic valve implantation patients had larger EOA and lower transprosthetic gradients but more PVL. The rate of severe SVD was higher after SAVR but was not significantly different for BVF. Rates of re-intervention were very low and not different between groups. More long-term follow-up data from trials are required to recommend one type of intervention over the other in lower-risk AS patients.

Supplementary data are available at European Heart Journal online.

Disclosure of Interest

T.H.J. has received a research grant from Edwards Lifesciences. O.D.B. has received research grants and consultant fees from Medtronic, outside the submitted work, Abbott, and Boston Scientific. L.S. has been Chief Medical Officer and Divisional VP for Medical Affairs at Abbott Structural Heart since June 2023 and has received consultant fees and/or research grants from Abbott, Boston Scientific, and Medtronic outside the submitted work. B.J.K. has received consultant fees from Edwards Lifesciences. All other authors have reported, that they have no relationships relevant to the contents of this paper to disclose.

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, therefore supporting data are not available.

This work was supported by the Danish Heart Foundation (grant numbers: 09-10-AR76-A2733-25400, 12-04-R90-A3879-22733, and 13-04-R94-A4473-22762) and Medtronic. Medtronic did not participate in the design or conduct of the trial and was not involved in the preparation of this manuscript.

All patients provided informed written consent. The regional ethical review board approved the protocol at each site, and the trial was conducted according to the principles of the Declaration of Helsinki.

The trial was registered with ClinicalTrials.gov , NCT01057173.

Kapadia   SR , Leon   MB , Makkar   RR , Tuzcu   EM , Svensson   LG , Kodali   S , et al.    5-year outcomes of transcatheter aortic valve replacement compared with standard treatment for patients with inoperable aortic stenosis (PARTNER 1): a randomised controlled trial . Lancet Lond Engl   2015 ; 385 : 2485 – 91 . https://doi.org/10.1016/S0140-6736(15)60290-2

Google Scholar

Arnold   SV , Petrossian   G , Reardon   MJ , Kleiman   NS , Yakubov   SJ , Wang   K , et al.    Five-year clinical and quality of life outcomes from the CoreValve US Pivotal Extreme Risk Trial . Circ Cardiovasc Interv   2021 ; 14 : e010258 . https://doi.org/10.1161/CIRCINTERVENTIONS.120.010258

Mack   MJ , Leon   MB , Smith   CR , Miller   DC , Moses   JW , Tuzcu   EM , et al.    5-year outcomes of transcatheter aortic valve replacement or surgical aortic valve replacement for high surgical risk patients with aortic stenosis (PARTNER 1): a randomised controlled trial . Lancet Lond Engl   2015 ; 385 : 2477 – 84 . https://doi.org/10.1016/S0140-6736(15)60308-7

Gleason   TG , Reardon   MJ , Popma   JJ , Deeb   GM , Yakubov   SJ , Lee   JS , et al.    5-year outcomes of self-expanding transcatheter versus surgical aortic valve replacement in high-risk patients . J Am Coll Cardiol   2018 ; 72 : 2687 – 96 . https://doi.org/10.1016/j.jacc.2018.08.2146

Makkar   RR , Thourani   VH , Mack   MJ , Kodali   SK , Kapadia   S , Webb   JG , et al.    Five-year outcomes of transcatheter or surgical aortic-valve replacement . N Engl J Med   2020 ; 382 : 799 – 809 . https://doi.org/10.1056/NEJMoa1910555

Van Mieghem   NM , Deeb   GM , Søndergaard   L , Grube   E , Windecker   S , Gada   H , et al.    Self-expanding transcatheter vs surgical aortic valve replacement in intermediate-risk patients: 5-year outcomes of the SURTAVI randomized clinical trial . JAMA Cardiol   2022 ; 7 : 1000 – 8 . https://doi.org/10.1001/jamacardio.2022.2695

Vahanian   A , Beyersdorf   F , Praz   F , Milojevic   M , Baldus   S , Bauersachs   J , et al.    2021 ESC/EACTS guidelines for the management of valvular heart disease . Eur Heart J   2022 ; 43 : 561 – 632 . https://doi.org/10.1093/eurheartj/ehab395

Sharma   T , Krishnan   AM , Lahoud   R , Polomsky   M , Dauerman   HL . National trends in TAVR and SAVR for patients with severe isolated aortic stenosis . J Am Coll Cardiol   2022 ; 80 : 2054 – 6 . https://doi.org/10.1016/j.jacc.2022.08.787

Thyregod   HGH , Steinbrüchel   DA , Ihlemann   N , Nissen   H , Kjeldsen   BJ , Petursson   P , et al.    Transcatheter versus surgical aortic valve replacement in patients with severe aortic valve stenosis: 1-year results from the all-comers NOTION randomized clinical trial . J Am Coll Cardiol   2015 ; 65 : 2184 – 94 . https://doi.org/10.1016/j.jacc.2015.03.014

Jørgensen   TH , Thyregod   HGH , Ihlemann   N , Nissen   H , Petursson   P , Kjeldsen   BJ , et al.    Eight-year outcomes for patients with aortic valve stenosis at low surgical risk randomized to transcatheter vs. surgical aortic valve replacement . Eur Heart J   2021 ; 42 : 2912 – 9 . https://doi.org/10.1093/eurheartj/ehab375

Mack   MJ , Leon   MB , Thourani   VH , Pibarot   P , Hahn   RT , Genereux   P , et al.    Transcatheter aortic-valve replacement in low-risk patients at five years . N Engl J Med   2023 ; 389 : 1949 – 60 . https://doi.org/10.1056/NEJMoa2307447

Forrest   JK , Deeb   GM , Yakubov   SJ , Gada   H , Mumtaz   MA , Ramlawi   B , et al.    4-year outcomes of patients with aortic stenosis in the Evolut Low Risk Trial . J Am Coll Cardiol   2023 ; 82 : 2163 – 5 . https://doi.org/10.1016/j.jacc.2023.09.813

Thyregod   HG , Søndergaard   L , Ihlemann   N , Franzen   O , Andersen   LW , Hansen   PB , et al.    The Nordic aortic valve intervention (NOTION) trial comparing transcatheter versus surgical valve implantation: study protocol for a randomised controlled trial . Trials   2013 ; 14 : 11 . https://doi.org/10.1186/1745-6215-14-11

Kappetein   AP , Head   SJ , Généreux   P , Piazza   N , van Mieghem   NM , Blackstone   EH , et al.    Updated standardized endpoint definitions for transcatheter aortic valve implantation: the Valve Academic Research Consortium-2 consensus document (VARC-2) . Eur J Cardio-Thorac Surg   2012 ; 42 : S45 – 60 . https://doi.org/10.1093/ejcts/ezs533

VARC-3 WRITING COMMITTEE ; Généreux   P , Piazza   N , Alu   MC , Nazif   T , Hahn   RT , et al.    Valve Academic Research Consortium 3: updated endpoint definitions for aortic valve clinical research . Eur Heart J   2021 ; 42 : 1825 – 57 . https://doi.org/10.1093/eurheartj/ehaa799

Thourani   VH , Habib   R , Szeto   WY , Sabik   JF , Romano   JC , MacGillivray   TE , et al.    Survival following surgical aortic valve replacement in low-risk patients: a contemporary trial benchmark . Ann Thorac Surg   2024 ; 117 : 106 – 12 . https://doi.org/10.1016/j.athoracsur.2023.10.006

Thyregod   HGH , Ihlemann   N , Jørgensen   TH , Nissen   H , Kjeldsen   BJ , Petursson   P , et al.    Five-year clinical and echocardiographic outcomes from the NOTION randomized clinical trial in patients at lower surgical risk . Circulation   2019 ; 139 : 2714 – 23 . https://doi.org/10.1161/CIRCULATIONAHA.118.036606

Jørgensen   TH , De Backer   O , Gerds   TA , Bieliauskas   G , Svendsen   JH , Søndergaard   L . Mortality and heart failure hospitalization in patients with conduction abnormalities after transcatheter aortic valve replacement . JACC Cardiovasc Interv   2019 ; 12 : 52 – 61 . https://doi.org/10.1016/j.jcin.2018.10.053

Gilard   M , Eltchaninoff   H , Donzeau-Gouge   P , Chevreul   K , Fajadet   J , Leprince   P , et al.    Late outcomes of transcatheter aortic valve replacement in high-risk patients: the FRANCE-2 registry . J Am Coll Cardiol   2016 ; 68 : 1637 – 47 . https://doi.org/10.1016/j.jacc.2016.07.747

Rodriguez-Gabella   T , Voisine   P , Puri   R , Pibarot   P , Rodés-Cabau   J . Aortic bioprosthetic valve durability: incidence, mechanisms, predictors, and management of surgical and transcatheter valve degeneration . J Am Coll Cardiol   2017 ; 70 : 1013 – 28 . https://doi.org/10.1016/j.jacc.2017.07.715

Head   SJ , Mokhles   MM , Osnabrugge   RLJ , Pibarot   P , Mack   MJ , Takkenberg   JJM , et al.    The impact of prosthesis–patient mismatch on long-term survival after aortic valve replacement: a systematic review and meta-analysis of 34 observational studies comprising 27 186 patients with 133 141 patient-years . Eur Heart J   2012 ; 33 : 1518 – 29 . https://doi.org/10.1093/eurheartj/ehs003

Ochi   A , Cheng   K , Zhao   B , Hardikar   AA , Negishi   K . Patient risk factors for bioprosthetic aortic valve degeneration: a systematic review and meta-analysis . Heart Lung Circ   2020 ; 29 : 668 – 78 . https://doi.org/10.1016/j.hlc.2019.09.013

Thyregod   HGH , Steinbrüchel   DA , Ihlemann   N , Ngo   TA , Nissen   H , Kjeldsen   BJ , et al.    No clinical effect of prosthesis-patient mismatch after transcatheter versus surgical aortic valve replacement in intermediate- and low-risk patients with severe aortic valve stenosis at mid-term follow-up: an analysis from the NOTION trial . Eur J Cardiothorac Surg   2016 ; 50 : 721 – 8 . https://doi.org/10.1093/ejcts/ezw095

Ngo   A , Hassager   C , Thyregod   HGH , Søndergaard   L , Olsen   PS , Steinbrüchel   D , et al.    Differences in left ventricular remodelling in patients with aortic stenosis treated with transcatheter aortic valve replacement with corevalve prostheses compared to surgery with porcine or bovine biological prostheses . Eur Heart J Cardiovasc Imaging   2018 ; 19 : 39 – 46 . https://doi.org/10.1093/ehjci/jew321

O’Hair   D , Yakubov   SJ , Grubb   KJ , Oh   JK , Ito   S , Deeb   GM , et al.    Structural valve deterioration after self-expanding transcatheter or surgical aortic valve implantation in patients at intermediate or high risk . JAMA Cardiol   2023 ; 8 : 111 – 9 . https://doi.org/10.1001/jamacardio.2022.4627

Roslan   AB , Naser   JA , Nkomo   VT , Padang   R , Lin   G , Pislaru   C , et al.    Performance of echocardiographic algorithms for assessment of high aortic bioprosthetic valve gradients . J Am Soc Echocardiogr   2022 ; 35 : 682 – 91 . e2. https://doi.org/10.1016/j.echo.2022.01.019

Ueyama   H , Kuno   T , Takagi   H , Kobayashi   A , Misumida   N , Pinto   DS , et al.    Meta-analysis comparing valve durability among different transcatheter and surgical aortic valve bioprosthesis . Am J Cardiol   2021 ; 158 : 104 – 11 . https://doi.org/10.1016/j.amjcard.2021.07.046

Pibarot   P , Ternacle   J , Jaber   WA , Salaun   E , Dahou   A , Asch   FM , et al.    Structural deterioration of transcatheter versus surgical aortic valve bioprostheses in the PARTNER-2 trial . J Am Coll Cardiol   2020 ; 76 : 1830 – 43 . https://doi.org/10.1016/j.jacc.2020.08.049

Strange   JE , Østergaard   L , Køber   L , Bundgaard   H , Iversen   K , Voldstedlund   M , et al.    Patient characteristics, microbiology, and mortality of infective endocarditis after transcatheter aortic valve implantation . Clin Infect Dis   2023 ; 77 : 1617 – 25 . https://doi.org/10.1093/cid/ciad431

Makkar   RR , Fontana   G , Jilaihawi   H , Chakravarty   T , Kofoed   KF , De Backer   O , et al.    Possible subclinical leaflet thrombosis in bioprosthetic aortic valves . N Engl J Med   2015 ; 373 : 2015 – 24 . https://doi.org/10.1056/NEJMoa1509233

Yerasi   C , Rogers   T , Forrestal   BJ , Case   BC , Khan   JM , Ben-Dor   I , et al.    Transcatheter versus surgical aortic valve replacement in young, low-risk patients with severe aortic stenosis . JACC Cardiovasc Interv   2021 ; 14 : 1169 – 80 . https://doi.org/10.1016/j.jcin.2021.03.058

Barbanti   M , Costa   G , Picci   A , Criscione   E , Reddavid   C , Valvo   R , et al.    Coronary cannulation after transcatheter aortic valve replacement: the RE-ACCESS study . JACC Cardiovasc Interv   2020 ; 13 : 2542 – 55 . https://doi.org/10.1016/j.jcin.2020.07.006

Buzzatti   N , Romano   V , De Backer   O , Soendergaard   L , Rosseel   L , Maurovich-Horvat   P , et al.    Coronary access after repeated transcatheter aortic valve implantation: a glimpse into the future . JACC Cardiovasc Imaging   2020 ; 13 : 508 – 15 . https://doi.org/10.1016/j.jcmg.2019.06.025

Park   SJ , Ok   YJ , Kim   HJ , Kim   YJ , Kim   S , Ahn   JM , et al.    Evaluating reference ages for selecting prosthesis types for heart valve replacement in Korea . JAMA Netw Open   2023 ; 6 : e2314671 . https://doi.org/10.1001/jamanetworkopen.2023.14671

Mauri   V , Abdel-Wahab   M , Bleiziffer   S , Veulemans   V , Sedaghat   A , Adam   M , et al.    Temporal trends of TAVI treatment characteristics in high volume centers in Germany 2013–2020 . Clin Res Cardiol   2022 ; 111 : 881 – 8 . https://doi.org/10.1007/s00392-021-01963-3

Writing Committee Members ; Otto   CM , Nishimura   RA , Bonow   RO , Carabello   BA , Erwin   JP , et al.    2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines . J Am Coll Cardiol   2021 ; 77 : e25 – 197 . https://doi.org/10.1016/j.jacc.2020.11.018

Leon   MB , Mack   MJ , Hahn   RT , Thourani   VH , Makkar   R , Kodali   SK , et al.    Outcomes 2 years after transcatheter aortic valve replacement in patients at low surgical risk . J Am Coll Cardiol   2021 ; 77 : 1149 – 61 . https://doi.org/10.1016/j.jacc.2020.12.052

Forrest   JK , Deeb   GM , Yakubov   SJ , Gada   H , Mumtaz   MA , Ramlawi   B , et al.    3-year outcomes after transcatheter or surgical aortic valve replacement in low-risk patients with aortic stenosis . J Am Coll Cardiol   2023 ; 81 : 1663 – 74 . https://doi.org/10.1016/j.jacc.2023.02.017

Kalra   A , Rehman   H , Ramchandani   M , Barker   CM , Lawrie   GM , Reul   RM , et al.    Early trifecta valve failure: report of a cluster of cases from a tertiary care referral center . J Thorac Cardiovasc Surg   2017 ; 154 : 1235 – 40 . https://doi.org/10.1016/j.jtcvs.2017.05.044

Sénage   T , Le Tourneau   T , Foucher   Y , Pattier   S , Cueff   C , Michel   M , et al.    Early structural valve deterioration of Mitroflow aortic bioprosthesis: mode, incidence, and impact on outcome in a large cohort of patients . Circulation   2014 ; 130 : 2012 – 20 . https://doi.org/10.1161/CIRCULATIONAHA.114.010400

Grunkemeier   GL , Furnary   AP , Wu   Y , Wang   L , Starr   A . Durability of pericardial versus porcine bioprosthetic heart valves . J Thorac Cardiovasc Surg   2012 ; 144 : 1381 – 6 . https://doi.org/10.1016/j.jtcvs.2012.08.060

Author notes

  • aortic valve
  • aortic valve stenosis
  • myocardial infarction
  • endocarditis
  • cerebrovascular accident
  • aortic valve replacement
  • bioprosthesis
  • operative risk
  • surgical procedures, operative
  • treatment outcome
  • transcatheter aortic-valve implantation
  • notion trial

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  • Transcatheter vs. surgical treatment of aortc stenosis: long awaited long-term data, yet a long way to go

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COMMENTS

  1. What is a DOI?

    Revised on February 24, 2023 by Raimo Streefkerk. A DOI (Digital Object Identifier) is a unique and never-changing string assigned to online (journal) articles, books, and other works. DOIs make it easier to retrieve works, which is why citation styles, like APA and MLA Style, recommend including them in citations.

  2. How to Cite the DOI of a Journal Article

    Note the comma after the name and before the date. When referencing the citations in the reference list, APA style is to include the DOI for all electronic media. The typical reference in APA style would use the following format: Author, A. A., & Author, B. B. (Date of publication). Title of article.

  3. Citation Help and Style Guide

    A digital object identifier (DOI) is a unique alphanumeric string that identifies content and provide a persistent link to its location on the Internet. The publisher assigns a DOI when the article is published and made available electronically. All DOI numbers begin with a 10 and contain a prefix and a suffix separated by a slash. The prefix ...

  4. DOIs and URLs

    A DOI is a unique alphanumeric string that identifies content and provides a persistent link to its location on the internet. DOIs can be found in database records and the reference lists of published works. A URL specifies the location of digital information on the internet and can be found in the address bar of your internet browser.

  5. DOIs vs. URLs

    Place the DOI or URL at the end of the citation, formatting the rest of the citation as normal for an equivalent non-digital source. A DOI should be preceded by a "doi:" label (note the lowercase). Access dates are not required for formally published electronic sources (like journal articles). They can be useful for informally published ...

  6. APA: Using a DOI in Your Reference List

    You use a DOI number instead of the URL. You do not need to list the database you used to find the source either. Here is an example: Prabhu, V., Sutton, C., & Sauser, W. (2008). Creativity and certain personality. motivation. Creativity Research Journal, 20 (1), 53-66. doi: 10.1080/10400410701841955. (Note: The APA manual uses lower case in ...

  7. All about the DOI

    DOI is an abbreviation for digital object identifier. This is simply an ID number assigned to an 'object' such as a journal article (or a book). It allows the 'object' to be found across any physical location such as a database. Publishers assign it to online articles so that an article may be easily identified and found within the many ...

  8. LibGuides: APA 7th Edition Referencing Guide1: Article with DOI

    An eLocator will be a set of numbers with an 'e' in front of it: e0205568. An article number will often be labelled as 'Article number' after the volume information, or will be a single, long number instead of a page range. The following is how you reference each: Elocator. An elocator is a form of article number, so must have the word Article ...

  9. What is a DOI [with examples]

    Definition. DOI stands for "digital object identifier." Also known as a permalink, a DOI is an article's permanent online location. DOIs are used for a variety of academic and non-academic sources that are located online. Organize your papers in one place.

  10. PDF Reference Guide

    Does the book have a DOI? Include a DOI if available. Do not include a URL or database information for works from academic research databases. Include a URL for ebooks from other websites. Do not put a period after the DOI or URL. Does the book have an edition or volume number? If so, include

  11. Journal article references

    Narrative citation: Grady et al. (2019) If a journal article has a DOI, include the DOI in the reference. Always include the issue number for a journal article. If the journal article does not have a DOI and is from an academic research database, end the reference after the page range (for an explanation of why, see the database information ...

  12. What is a DOI and how do I use them in citations?

    A DOI, or Digital Object Identifier, is a string of numbers, letters and symbols used to uniquely identify an article or document, and to provide it with a permanent web address (URL). A DOI will help your reader easily locate a document from your citation. Think of it like a Social Security number for the article you're citing — it will ...

  13. How to find an article's DOI

    If this method doesn't yield a DOI, don't assume that a DOI doesn't exist. Follow up with the next two options. If a journal publisher uses DOIs, they will usually print the DOI somewhere on the first page of the article. Open the full-text source and look for the DOI on the article's first page, usually in the header or footer.

  14. Reference List

    When using a DOI in a citation, AMA Style requires all lowercase: doi. Including words/phrases like "Paper presented at", "Date Accessed," "Date Updated," etc. in the citations: AMA Style sometimes requires the use of these "helper phrases" in the reference; in other cases, they are used in examples to show you where to place the information ...

  15. DOI's: what they are and how to cite them!

    A DOI, or Digital Object Identifier, is a string of numbers, letters and symbols used to permanently identify an article or document and link to it on the web. For example: DOI: 10.1016/j.jenvman.2021.112050.They are a source locator for online content. They give each electronic, or digital, item (book, article) a unique, persistent identifier.. A DOI will assist the reader of your work to ...

  16. Article, Journal (with DOI)

    When a DOI is used, no further retrieval information is needed to identify or locate the content. Do not include the database name. It is no longer necessary to include the date of retrieval unless the source material may change over time (e.g., Wikis). Spitz, D., & Hunter, S. (2005). Contested codes: The social construction of Napster.

  17. Free DOI citation generator [2024 Update]

    Here are 5 reasons why you are going to love the BibGuru DOI citation maker: 🚀 Fast. 😌 No flood of distracting ads. 👌 Simple and intuitive interface. 🎓 DOI, APA, MLA, Chicago and thousands of other citation styles. 🥇 Most accurate citation data. With BibGuru we have made a citation tool that truly helps students to focus on the ...

  18. DOI Citation Formatter

    DOI Citation Formatter Paste your DOI: For example 10.1145/2783446.2783605. Select Formatting Style: Begin typing (e.g. Chicago or IEEE.) or use the drop down menu. Select Language and Country: Begin typing (e.g. en-GB for English, Great Britain) or use the drop down menu.

  19. How do I handle inaccessible DOIs when citing papers?

    In case such a DOI is broken, the publisher or a DOI authority could be notified. Usually, the new publisher can fix it. Some papers might be revoked after publication. In this case a DOI authority should be contacted so that the DOI does not link to a URL which e.g. does not exist anymore.

  20. How does Citation Statement Search work?

    Using Citation Statement search allows you to search for how anything was mentioned in the scholarly literature from datasets, methods, protocols, assets, and research products to specific results, claims, and arguments. For example, if you are interested in a particular fact you might search "Rate of chromosome missegregation in HeLa Cells ...

  21. Editor's Note: "Leadership Characteristics Through The Lens of

    SUBMIT PAPER. SAGE Open. Impact Factor: 2.0 / 5-Year Impact Factor: 2. ... old concepts: the limits of 'culture', Ethnic and Racial Studies, 24:4, 619-641, DOI: 10.1080/01419870120049815. Anthias, F. (2002). Where do I belong?: Narrating collective identity and translocational positionality. ... you can download article citation data to the ...

  22. Disparities in Overdose Deaths: Looking Back at Larochelle and

    article citation Nora D. Volkow MD , Beth Han PhD, MD, MPH , and Redonna K. Chandler PhD All authors are with the National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD. "Disparities in Overdose Deaths: Looking Back at Larochelle and Colleagues' 2021 Paper", American Journal of Public Health , no. (): pp. e1-e3.

  23. [2403.20329] ReALM: Reference Resolution As Language Modeling

    ReALM: Reference Resolution As Language Modeling. Reference resolution is an important problem, one that is essential to understand and successfully handle context of different kinds. This context includes both previous turns and context that pertains to non-conversational entities, such as entities on the user's screen or those running in the ...

  24. [2403.19977] Is Winter Coming?

    We critically examine the often-made observation that "quantum winter [or some other winter] is coming", and the related admonition to prepare for this or that winter, inevitably bound to arrive. What we find based on even the most superficial look at the available evidence is that such statements not only are overblown hype, but are also factually wrong: Winter is here, and the real question ...

  25. [2403.19887] Jamba: A Hybrid Transformer-Mamba Language Model

    We present Jamba, a new base large language model based on a novel hybrid Transformer-Mamba mixture-of-experts (MoE) architecture. Specifically, Jamba interleaves blocks of Transformer and Mamba layers, enjoying the benefits of both model families. MoE is added in some of these layers to increase model capacity while keeping active parameter ...

  26. Transcatheter or surgical aortic valve implantation: 10-year outcomes

    Hans Gustav Hørsted Thyregod, Troels Højsgaard Jørgensen, Nikolaj Ihlemann, Daniel Andreas Steinbrüchel, Henrik Nissen, Bo Juel Kjeldsen, Petur Petursson, Ole De Backer, Peter Skov Olsen, Lars Søndergaard, Transcatheter or surgical aortic valve implantation: 10-year outcomes of the NOTION trial, European Heart Journal, Volume 45, Issue 13 ...

  27. Optimal Batch Size and Process Setting in Light-Emitting Diode (LED

    This paper studies the challenges involved in production planning in coproduction systems, specifically the production of semiconductor chips for light-emitting diodes (LEDs). The production output in this industry is characterized by a stochastic distribution over the targeted production metric; thus the whole range of production is not ...