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While we continue to believe in the validity and importance of this measure, and the clinical significance of measuring radiation safety, we acknowledge the current challenges that HOPDs face with respect to the measure's implementation that could necessitate a longer implementation timeframe

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Patients with gastrointestinal conditions, absorption disorders, or post-bariatric surgery may not be ideal candidates for oral formulations

This does not mean it would be ineffective for every patient but it does raise questions about expectations

Observed epidemiology diverged in timing from projections: the US experienced a notable summer 2024 wave peaking in August, followed by a smaller winter 2025 peak

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