Declarations. Competing interests: PN, SH, JV, HKP, RN, DR, AS, SS, and MD declare no conflicts of interest. AR is a consultant for Medtronic, ERBE, Fujifilm, Apollo Endosurgery, and Olympus. CH is a consultant for Alpha-Sigma, Fujifilm, Medtronic, Erbe, 3DMatrix, Laborie, Norgine, Olympus and Pentax. PS is a consultant for Olympus Corporation, Boston Scientific, Salix Pharmaceuticals, Cipla, Medtronic, Takeda, Samsung Bioepis, CDx, and Exact Sciences. PS has received grant support from Fujifilm, Erbe Medical, and Ironwood Pharmaceuticals. Consent to participate: Not applicable, as this study utilized de-identified aggregate patient data from the TriNetX research network and did not involve direct human participant interaction. Ethical approval: This study utilized de-identified data from the TriNetX research network. TriNetX data are de-identified in accordance with the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule under Section §164.514(a), with the de-identification process formally attested to through expert determination. No identifiable personal health information was accessed or used. As the study involved secondary analysis of de-identified data only, Institutional Review Board review was not sought. The study was conducted in accordance with applicable ethical standards and the principles of the Declaration of Helsinki.
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