Clinical Implications

LNG-IUS avoided surgery and could be inserted in an outpatient setting by a wider range of healthcare providers. Nepal-specific intervals may reduce false-negative classification of early insulin resistance and metabolic dysfunction. Addressing diagnostic delays, screening, AYA-tailored treatments and testing, psychosocial research, and survivorship research is presented as an opportunity to improve outcomes and care. A strong salivary-plasma correlation could enable routine non-invasive circadian monitoring on surgical wards. Validated salivary melatonin could help identify patients at high risk for postoperative delirium. LNG-IUS may maintain or increase its cost-effectiveness advantage over longer follow-up because therapeutic effects improved over time in earlier analyses of the same cohort. Circadian data could guide personalized chronotherapeutic interventions to resynchronize disrupted rhythms. None of the 58 summary questions were judged to be fully answered by existing evidence. The single-centre Shanghai setting and Chinese pricing structures limit the transferability of absolute cost estimates to other health systems. The article calls for longitudinal research to estab…