scholarly journals Quantifying gender disparity in physician authorship among commentary articles in three high-impact medical journals: an observational study

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e034056 ◽  
Author(s):  
Mira Mamtani ◽  
Frances Shofer ◽  
Anita Mudan ◽  
Utsha Khatri ◽  
Rachael Walker ◽  
...  
Keyword(s):  
Observational Study ◽  
Gender Disparity ◽  
Primary Outcome Measure ◽  
High Impact ◽  
Women Physicians ◽  
Secondary Outcome ◽  
Original Research ◽  
Direct Role ◽  
Men And Women ◽  
Gender Concordance

BackgroundScholarship plays a direct role in career advancement, promotion and authoritative recognition, and women physicians remain under-represented as authors of original research articles.ObjectiveWe sought to determine if women physician authors are similarly under-represented in commentary articles within high-impact journals.Design/Setting/ParticipantsIn this observational study, we abstracted and analysed author information (gender and degree) and authorship position from commentary articles published in three high-impact journals between 1 January 2014 and 16 October 2018.Primary outcome measureAuthorship rate of commentary articles over a 5-year period by gender, degree, authorship position and journal.Secondary outcome measuresTo compare the proportion of men and women physician authorship of commentaries relative to the proportion of men and women physician faculty within academic medicine; and to examine the gender concordance among the last and first authors in articles with more than one author.ResultsOf the 2087 articles during the study period, 48% were men physician first authors compared with 17% women physician first authors (p<0.0001). Of the 1477 articles with more than one author, similar distributions were found with regard to last authors: 55% were men physicians compared with only 12% women physicians (p<0.0001). The proportion of women physician first authors increased over time; however, the proportion of women physician last authors remained stagnant. Women coauthored with women in the first and last authorship positions in 9% of articles. In contrast, women coauthored with men in the first and last author positions, respectively, in 55% of articles.ConclusionsWomen physician authors remain under-represented in commentary articles compared with men physician authors in the first and last author positions. Women also coauthored commentaries with other women in far fewer numbers.

scholarly journals Gender disparity between authors in leading medical journals during the COVID-19 pandemic: a cross-sectional review

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e051224
Author(s):  
Vaidehi Misra ◽  
Frozan Safi ◽  
Kathryn A Brewerton ◽  
Wei Wu ◽  
Robin Mason ◽  
...  
Keyword(s):  
Data Extraction ◽  
Gender Disparity ◽  
High Impact ◽  
Original Research ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Medical Journals ◽  
The Usa ◽  
Study Characteristics ◽  
Data Elements

ObjectivesEvaluate gender differences in authorship of COVID-19 articles in high-impact medical journals compared with other topics.DesignCross-sectional review.Data sourcesMedline database.Eligibility criteriaArticles published from 1 January to 31 December 2020 in the seven leading general medical journals by impact factor. Article types included primary research, reviews, editorials and commentaries.Data extractionKey data elements were whether the study topic was related to COVID-19 and names of the principal and the senior authors. A hierarchical approach was used to determine the likely gender of authors. Logistic regression assessed the association of study characteristics, including COVID-19 status, with authors’ likely gender; this was quantified using adjusted ORs (aORs).ResultsWe included 2252 articles, of which 748 (33.2%) were COVID-19-related and 1504 (66.8%) covered other topics. A likely gender was determined for 2138 (94.9%) principal authors and 1890 (83.9%) senior authors. Men were significantly more likely to be both principal (1364 men; 63.8%) and senior (1332 men; 70.5%) authors. COVID-19-related articles were not associated with the odds of men being principal (aOR 0.99; 95% CI 0.81 to 1.21; p=0.89) or senior authors (aOR 0.96; 95% CI 0.78 to 1.19; p=0.71) relative to other topics. Articles with men as senior authors were more likely to have men as principal authors (aOR 1.49; 95% CI 1.21 to 1.83; p<0.001). Men were more likely to author articles reporting original research and those with corresponding authors based outside the USA and Europe.ConclusionsWomen were substantially under-represented as authors among articles in leading medical journals; this was not significantly different for COVID-19-related articles. Study limitations include potential for misclassification bias due to the name-based analysis. Results suggest that barriers to women’s authorship in high-impact journals during COVID-19 are not significantly larger than barriers that preceded the pandemic and that are likely to continue beyond it.PROSPERO registration numberCRD42020186702.

scholarly journals Surveillance arterioveNous fistulAs using ultRasound (SONAR) trial in haemodialysis patients: a study protocol for a multicentre observational study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e031210 ◽  
Author(s):  
James Richards ◽  
Mohammed Hossain ◽  
Dominic Summers ◽  
Matthew Slater ◽  
Matthew Bartlett ◽  
...  
Keyword(s):  
Observational Study ◽  
Venous Catheter ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Patient Acceptability ◽  
Arteriovenous Fistulas ◽  
Ultrasound Study ◽  
Registration Number ◽  
Stage Renal Disease ◽  
End Stage

IntroductionArteriovenous fistulas (AVFs) are considered the best and safest modality for providing haemodialysis in patients with end-stage renal disease. Only 20% of UK centres achieve the recommended 80% target for achieving dialysis of the prevalent dialysis population via permanent access (as opposed to a central venous catheter). This is partly due to the relatively poor maturation rate of newly created fistulas, with as many as 50% of fistulas failing to mature.The Surveillance Of arterioveNous fistulAe using ultRasound study will examine whether a protocolised programme of Doppler ultrasound (US) surveillance can identify, early after creation, potentially correctable problems in those AVFs that subsequently fail to mature.Methods and analysisThis is a multicentre observational study that will assess newly created AVFs by Doppler US performed at 2, 4, 6 and 10 weeks after creation. The primary outcome measure will be primary fistula patency at week 10. Secondary outcome measures include: successful use of the fistula; clinical suitability for dialysis; creation of new fistula or radiological salvage; fistula thrombosis; secondary fistula patency rate and patient acceptability.Ethics and disseminationThe study has been approved by the Cambridgeshire and Hertfordshire Research Ethics Committee and by the Health Research Authority (REC 18/EE/0234). The results generated from this work will be published as open access, within 3 years of trial commencement. We will also present our findings at key national/international renal meetings, as well as support volunteers at renal patient groups to disseminate the trial outcome.Trial registration numberISRCTN36033877

scholarly journals Reduced physical activity and weight gain are associated with an increase of depressive symptoms during the COVID-19 pandemic. A general practitioners’ prospective observational study

2021 ◽  
Vol 10 ◽  
pp. 204800402110477
Author(s):  
Simon Wernhart ◽  
Eberhard Weihe ◽  
Tienush Rassaf
Keyword(s):  
Physical Activity ◽  
Depressive Symptoms ◽  
Weight Gain ◽  
Observational Study ◽  
General Practitioners ◽  
Outcome Measures ◽  
Prospective Observational Study ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Reduced Physical Activity

Objectives We aimed to assess associations between depressive symptoms, lifestyle, and somatic symptoms during the COVID-19 pandemic. Design A prospective, observational study using a self-designed questionnaire. Setting Three general practitioners’ (GP) offices in rural Germany. Participants 271 adult patients without manifest cardiovascular or pulmonary disease with (n = 82) and without (n = 189) hypertension reporting to our GP offices. Main outcome measures The reported increase of depressive symptoms (loneliness, sleeplessness, joylessness, listlessness) prior to the first documented case in Germany on 27.01.2020 (t0) as opposed to patients’ health perception during the Corona pandemic (t1) was the primary outcome measure. The secondary outcome measures were changes in physical activity (PA), dyspnea and angina in the two groups. Results Out of 271 patients (50.8 ± 16.8 years, 55.1% females), 1.5% were tested positive for COVID-19. Overall, listlessness (8.5%, p = 0.001), sleeplessness (5.2%, p = 0.001) and joylessness (4.2%, p = 0.003) were increased. Dyspnea significantly increased (9.2%, p < 0.001) and employment status worsened (6.5%, p < 0.001). There were significant associations between the increase of depressive symptoms, weight increase (p = 0.017), and reduction in physical activity (p = 0.046). However, after adjusting for age, hypertensive patients did not show more depressive symptoms (p = 0.704), dyspnea (p = 0.063) or angina (p = 0.432), nor was there any difference in PA (p = 0.906) compared to healthy individuals. Conclusions We demonstrate an association between the deterioration of depressive symptoms, weight gain, and reduced physical activity during COVID-19, both in hypertensives and healthy controls. Hypertension is no driver of symptom deterioration during the pandemic. The trial was registered in the German Clinical Trials Registry (DRKS00022157).

scholarly journals Gender differences in how scientists present the importance of their research: observational study

BMJ ◽  
2019 ◽  
pp. l6573 ◽  
Author(s):  
Marc J Lerchenmueller ◽  
Olav Sorenson ◽  
Anupam B Jena
Keyword(s):  
Gender Differences ◽  
Observational Study ◽  
Clinical Research ◽  
Gender Gap ◽  
Life Science ◽  
Scientific Journal ◽  
High Impact ◽  
Men And Women ◽  
Research Findings ◽  
Positive Presentation

AbstractObjectivesWomen remain underrepresented on faculties of medicine and the life sciences more broadly. Whether gender differences in self presentation of clinical research exist and may contribute to this gender gap has been challenging to explore empirically. The objective of this study was to analyze whether men and women differ in how positively they frame their research findings and to analyze whether the positive framing of research is associated with higher downstream citations.DesignRetrospective observational study.Data sourcesTitles and abstracts from 101 720 clinical research articles and approximately 6.2 million general life science articles indexed in PubMed and published between 2002 and 2017.Main outcome measuresAnalysis of article titles and abstracts to determine whether men and women differ in how positively they present their research through use of terms such as “novel” or “excellent.” For a set of 25 positive terms, we estimated the relative probability of positive framing as a function of the gender composition of the first and last authors, adjusting for scientific journal, year of publication, journal impact, and scientific field.ResultsArticles in which both the first and last author were women used at least one of the 25 positive terms in 10.9% of titles or abstracts versus 12.2% for articles involving a male first or last author, corresponding to a 12.3% relative difference (95% CI 5.7% to 18.9%). Gender differences in positive presentation were greatest in high impact clinical journals (impact factor >10), in which women were 21.4% less likely to present research positively. Across all clinical journals, positive presentation was associated with 9.4% (6.6% to 12.2%) higher subsequent citations, and in high impact clinical journals 13.0% (9.5% to 16.5%) higher citations. Results were similar when broadened to general life science articles published in journals indexed by PubMed, suggesting that gender differences in positive word use generalize to broader samples.ConclusionsClinical articles involving a male first or last author were more likely to present research findings positively in titles and abstracts compared with articles in which both the first and last author were women, particularly in the highest impact journals. Positive presentation of research findings was associated with higher downstream citations.

scholarly journals Is the Course of Headache Complaints Related to the Course of Orofacial Pain and Disability in Patients Treated for Temporomandibular Pain? An Observational Study

2021 ◽  
Vol 11 (17) ◽  
pp. 7780
Author(s):  
Hedwig A. van der Meer ◽  
Letícia B. Calixtre ◽  
Caroline M. Speksnijder ◽  
Raoul H. H. Engelbert ◽  
Maria W. G. Nijhuis-van der Sanden ◽  
...  
Keyword(s):  
Observational Study ◽  
Usual Care ◽  
Outcome Measures ◽  
Repeated Measures ◽  
Multidisciplinary Treatment ◽  
Pain Scale ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Pain Patients ◽  
Over Time

Migraine, tension-type headache (TTH) and headaches attributed to temporomandibular disorders (TMD) are prevalent in patients with TMD-pain. The objective was to describe the course of headache complaints as compared to the course of TMD complaints in TMD-pain patients with headache during usual care multidisciplinary treatment for TMD. This was a 12-week longitudinal observational study following adults with TMD-pain and headache during a usual-care multidisciplinary TMD-treatment. The Graded Chronic Pain Scale was used for both TMD and headache to measure pain-related disability (primary outcome measure), pain intensity, days with pain and days experiencing disability (secondary outcome measures). Stratified for the headache type, general linear modelling for repeated measures was used to analyze changes over time in the TMD complaints and the headache complaints. TMD-pain patients with migraine (n = 22) showed significant decrease of pain-related disability for both TMD and headache complaints over time. No difference in the effect over time was found between the two complaints. Patients with TMD-pain and TTH (n = 21) or headache attributed to TMD (n = 17) did not improve in disability over time. For the secondary outcome measures, the results were equivocal. In conclusion, TMD-pain patients with migraine, improvement in TMD-related disability was comparable to headache-related disability for TMD-pain patients with TTH or with headache attributed to TMD, no improvements in disability were found.

scholarly journals Discussing suicidality with depressed patients: an observational study in Dutch sentinel general practices

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e027624 ◽  
Author(s):  
Elke Elzinga ◽  
Renske Gilissen ◽  
Gé A Donker ◽  
Aartjan T F Beekman ◽  
Derek P de Beurs
Keyword(s):  
The Netherlands ◽  
Observational Study ◽  
Outcome Measures ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Suicidal Thoughts ◽  
Depressed Patients ◽  
General Practices ◽  
Male Patients ◽  
Suicide Prevention Training

ObjectivesThis paper aims to describe the degree to which general practitioners (GPs) explore suicidal behaviour among depressed patients in the Netherlands.DesignAn observational study of consultations between GPs and depressed patients.Setting39 sentinel GP practices within the Netherlands in 2017.ParticipantsPatients with a registration of depression.Primary and secondary outcome measuresPrimary outcome measure is suicide exploration by the GP. Secondary outcome measures at patient level, assessed by surveying GPs, include prevalence and severity of suicidal thoughts. Secondary outcome measures at GP level include follow-up actions of GP and reasons not to explore suicidality.ResultsA total of 1034 questionnaires were included in the analyses. GPs assessed and explored suicidality in 44% of patients with depression (66% in patients with a new episode of depression). GPs explored suicidal feelings more often in patients with a new episode of depression (OR 4.027, p<0.001, 95% CI 2.924 to 5.588), male patients (OR 1.709, p<0.001, 95% CI 1.256 to 2.330) or younger patients (OR 1.017, p<0.001, 95% CI 1.009 to 1.026). Multilevel analysis showed that 22% of the variation in suicide exploration is due to differences in GP practice. Thirty-eight per cent of the patients who were asked by their GP, reported (severe) suicidal ideation. Most GPs (68%) did not explore suicidal feelings because they thought the patient would not be suicidal.ConclusionGPs explored suicidal thoughts in less than half of all depressed patients and in two-thirds of patients with a new episode of depression. Suicide prevention training is recommended to enhance suicide exploration.

Comparative study of intracranial access in thrombectomy using next generation 0.088 inch guide catheter technology

2021 ◽  
pp. neurintsurg-2021-017341
Author(s):  
Devin V Bageac ◽  
Blake S Gershon ◽  
Jan Vargas ◽  
Maxim Mokin ◽  
Zeguang Ren ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Control Group ◽  
Anterior Circulation ◽  
Guide Catheter ◽  
Catheter Failure ◽  
Catheter Technology ◽  
Intracranial Vasculature

BackgroundMost conventional 0.088 inch guide catheters cannot safely navigate intracranial vasculature. The objective of this study is to evaluate the safety of stroke thrombectomy using a novel 0.088 inch guide catheter designed for intracranial navigation.MethodsThis is a multicenter retrospective study, which included patients over 18 years old who underwent thrombectomy for anterior circulation large vessel occlusions. Technical outcomes for patients treated using the TracStar Large Distal Platform (TracStar LDP) or earlier generation TRX LDP were compared with a matched cohort of patients treated with other commonly used guide catheters. The primary outcome measure was device-related complications. Secondary outcome measures included guide catheter failure and time between groin puncture and clot engagement.ResultsEach study arm included 45 patients. The TracStar group was non-inferior to the control group with regard to device-related complications (6.8% vs 8.9%), and the average time to clot engagement was 8.89 min shorter (14.29 vs 23.18 min; p=0.0017). There were no statistically significant differences with regard to other technical outcomes, including time to recanalization (modified Thrombolysis In Cerebral Infarction (mTICI) ≥2B). The TracStar was successfully advanced into the intracranial internal carotid artery in 33 cases (73.33%); in three cases (6.67%), it was swapped for an alternate catheter. Successful reperfusion (mTICI 2B-3) was achieved in 95.56% of cases. Ninety-day follow-up data were available for 86.67% of patients, among whom 46.15% had an modified Rankin Score of 0–2%, and 10.26% were deceased.ConclusionsTracstar LDP is safe for use during stroke thrombectomy and was associated with decreased time to clot engagement. Intracranial access was regularly achieved.

scholarly journals Use of connected digital products in clinical research following the COVID-19 pandemic: a comprehensive analysis of clinical trials

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047341
Author(s):  
Caroline Marra ◽  
William J Gordon ◽  
Ariel Dora Stern
Keyword(s):  
Clinical Trials ◽  
Clinical Research ◽  
Outcome Measures ◽  
Remote Monitoring ◽  
Search Algorithm ◽  
Primary Outcome Measure ◽  
Secondary Outcome ◽  
Digital Products ◽  
Clinical Trial Registry ◽  
Before And After

ObjectivesIn an effort to mitigate COVID-19 related challenges for clinical research, the US Food and Drug Administration (FDA) issued new guidance for the conduct of ‘virtual’ clinical trials in late March 2020. This study documents trends in the use of connected digital products (CDPs), tools that enable remote patient monitoring and telehealth consultation, in clinical trials both before and after the onset of the pandemic.DesignWe applied a comprehensive text search algorithm to clinical trial registry data to identify trials that use CDPs for remote monitoring or telehealth. We compared CDP use in the months before and after the issuance of FDA guidance facilitating virtual clinical trials.SettingAll trials registered on ClinicalTrials.gov with start dates from May 2019 through February 2021.Outcome measuresThe primary outcome measure was the overall percentage of CDP use in clinical trials started in the 10 months prior to the pandemic onset (May 2019–February 2020) compared with the 10 months following (May 2020–February 2021). Secondary outcome measures included CDP usage by trial type (interventional, observational), funder type (industry, non-industry) and diagnoses (COVID-19 or non-COVID-19 participants).ResultsCDP usage in clinical trials increased by only 1.65 percentage points, from 14.19% (n=23 473) of all trials initiated in the 10 months prior to the pandemic onset to 15.84% (n=26 009) of those started in the 10 months following (p<0.01). The increase occurred primarily in observational studies and non-industry funded trials and was driven entirely by CDP usage in trials for COVID-19.ConclusionsThese findings suggest that in the short-term, new options created by regulatory guidance to stimulate telehealth and remote monitoring were not widely incorporated into clinical research. In the months immediately following the pandemic onset, CDP adoption increased primarily in observational and non-industry funded studies where virtual protocols are likely medically necessary due to the participants’ COVID-19 diagnosis.

scholarly journals Publishing at any cost: a cross-sectional study of the amount that medical researchers spend on open access publishing each year

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e047107
Author(s):  
Mallory K. Ellingson ◽  
Xiaoting Shi ◽  
Joshua J. Skydel ◽  
Kate Nyhan ◽  
Richard Lehman ◽  
...  
Keyword(s):  
Open Access ◽  
Senior Author ◽  
High Impact ◽  
Open Access Publishing ◽  
Original Research ◽  
Potential Cost ◽  
Cross Sectional ◽  
Review Articles ◽  
Open Access Journals ◽  
Medical Researchers

ObjectiveTo estimate the financial costs paid by individual medical researchers from meeting the article processing charges (APCs) levied by open access journals in 2019.DesignCross-sectional analysis.Data sourcesScopus was used to generate two random samples of researchers, the first with a senior author article indexed in the ‘Medicine’ subject area (general researchers) and the second with an article published in the ten highest-impact factor general clinical medicine journals (high-impact researchers) in 2019. For each researcher, Scopus was used to identify all first and senior author original research or review articles published in 2019. Data were obtained from Scopus, institutional profiles, Journal Citation Reports, publisher databases, the Directory of Open Access Journals, and individual journal websites.Main outcome measuresMedian APCs paid by general and high-impact researchers for all first and senior author research and review articles published in 2019.ResultsThere were 241 general and 246 high-impact researchers identified as eligible for our study. In 2019, the general and high-impact researchers published a total of 914 (median 2, IQR 1–5) and 1471 (4, 2–8) first or senior author research or review articles, respectively. 42% (384/914) of the articles from the general researchers and 29% (428/1471) of the articles from the high-impact medical researchers were published in fully open access journals. The median total APCs paid by general researchers in 2019 was US$191 (US$0–US$2500) and the median total paid by high-impact researchers was US$2900 (US$0–US$5465); the maximum paid by a single researcher in total APCs was US$30115 and US$34676, respectively.ConclusionsMedical researchers in 2019 were found to have paid between US$0 and US$34676 in total APCs. As journals with APCs become more common, it is important to continue to evaluate the potential cost to researchers, especially on individuals who may not have the funding or institutional resources to cover these costs.

scholarly journals Pulsed Shortwave Therapy in Cervical Osteoarthritis: an NSAID- Controlled, Randomized Clinical Trial

2021 ◽  
Author(s):  
A. Rachid El Mohammad ◽  
Sree Koneru ◽  
Richard Staelin ◽  
Kenneth McLeod ◽  
Omar Tabbouche ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Outcome Measures ◽  
Neck Disability Index ◽  
Primary Outcome Measure ◽  
Pain Medication ◽  
Secondary Outcome ◽  
Pain Duration ◽  
Cox 2 ◽  
Neck Disability ◽  
Pain At Rest

AbstractAssess treatment superiority of pulsed shortwave therapy (PSWT) against COX-2 NSAID therapy, in reducing disability and pain due to cervical osteoarthritis. Two hundred chronic pain suffers (average pain duration about 2 years) diagnosed with cervical osteoarthritis by radiological imaging were randomized into one of two treatment arms: COX-2 NSAID treatment; etoricoxib 60 mg/day for 4 weeks; or PSWT treatment worn 24 h/day for 4 weeks. The primary outcome measure was the 4-week score on the Neck Disability Index (NDI), a 10-question assessment on a 50-point scale. Secondary outcome measures included pain (at rest and during activity) measured on a visual analog scale (VAS) of 0–100 mm, dose count of rescue pain medication (paracetamol) use, and a treatment satisfaction rating. These 4-week scores were compared across the two arms to assess superiority. After 4 weeks of treatment, subjects in both study arms reported statistically significant (p < 0.0001) reductions in NDI, with final scores of 11.24-NSAID and 9.34-PSWT, VASrest, with final scores of 30.08-NSAID; 22.76-PSWT, and VASactivity, with final scores of 36.40-NSAID; 27.42-PSWT. The absolute reduction from baseline in NDI was significantly greater in the PSWT arm than NSAID arm (3.66 points; 95% CI 2.3 to 5.02; p < 0.0001). Similarly, the reductions from baseline in VASrest and VASactivity were significantly greater in the PSWT arm than NSAID arm (10.89 mm; 95% CI 6.90 to 14.87; p < 0.0001; and 12.05 mm; 95% CI 7.76 to 16.33; p < 0.0001, respectively). The PSWT arm used 50% less rescue pain medication. Eleven adverse effects were reported in the NSAID arm and zero in the PSWT arm. Both NSAID and PSWT treatments resulted in statistically significant improvements in quality of life (NDI) and reduction in pain (VAS) resulting from cervical osteoarthritis. However, the PSWT intervention showed superior improvements in all outcome measures when compared to the NSAID arm with no adverse effects. Clinicaltrials.gov (NCT03542955).

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