Academic Productivity of Spine Surgeons at United States Neurological Surgery and Orthopedic Surgery Training Programs

Factors Associated with Future Academic Faculty Appointment After Spine Surgery Fellowship Training

BACKGROUND CONTEXT

Understanding optimal training environments for future academic leaders is a topic of increasing interest in spine surgery.

PURPOSE

This study determined the association between surgeon factors and future academic faculty appointment after spine surgery fellowship training.

STUDY DESIGN/SETTING

This was a retrospective observational study of spine surgery fellows in the United States (2016-2017 to 2022-2023).

PATIENT SAMPLE

N/A OUTCOME MEASURES: The primary outcome of interest was future academic faculty appointment, which was assigned if the spine surgeon was employed at a teaching hospital. Demographic, bibliometric, and training characteristics of spine surgery fellows were obtained.

METHODS

Bivariate analyses were performed to determine the association between surgeon factors and future academic faculty appointment.

RESULTS

There were 654 spine surgery fellows and 243 were appointed to academic faculty positions (37.2%). There was no difference in the rate of future academic faculty appointment between male and female spine surgeons (36.7% vs 45.7%, P=0.368). Allopathic graduates were more likely to obtain academic faculty positions than osteopathic graduates (40.6% vs 12.5%, P<0.001). Compared to spine surgeons in private practice, spine surgeons in academic practice had more peer-reviewed publications during medical school (1 ± 3 vs 0 ± 2, P<0.001) and orthopaedic surgery residency training (5 ± 13 vs 3 ± 5, P<0.001). Several characteristics of spine surgery fellowship programs were associated with future academic faculty appointment including geographic region (P=0.013), Accreditation Council for Graduate Medical Education (ACGME) accreditation status (P<0.001), and a greater volume of annual fellows (P=0.003).

CONCLUSIONS

Several factors were associated with future academic faculty appointment in spine surgery including higher scholarly output during medical school and orthopaedic residency. These data may ultimately help trainees and fellowship selection committees in spine surgery align on desired academic career objectives.

Social Media Influence and Gender Are Correlated with Industry Payments to Orthopaedic Sports Surgeons

Social media, specifically Twitter, has become an increasingly used tool in academic orthopaedic surgery to help surgeons connect with patients and peers. This study seeks to understand correlations among social medial influence, academic influence, and gender among academic orthopaedic sport surgeons. A list of all orthopaedic sports surgeons serving as faculty of sports fellowships in the United States was compiled, along with publicly available demographic information. Their Hirsh indices (h-indices) were obtained using the Scopus database. The Physician Payments Sunshine Act Web site was used to determine their industry payments from 2014 through 2020. The number of Twitter followers was used as a measure of social media influence. Multivariable linear regression models were employed to explore the associations between these parameters and industry payments. Of the 633 surgeons, 33% had a Twitter account. Surgeons with > 1,000 followers (7.3%) were awarded 186% more in nonresearch funding (p = 0.01) and had a higher probability of receiving industry research funding compared with those with no followers (p = 0.03). Sports surgeons had an average h-index of 16, with 44% having ≤ 20 publications and 21% having ≥ 100 publications. Surgeons with ≥ 100 publications were awarded 453% more in nonresearch funding (p = 0.001) and had a 32% higher probability of receiving industry research funding (p < 0.001) when compared with their colleagues with ≤ 20 publications. Female sports surgeons accounted for only 7.9% of surgeons included in the study, and were awarded 65% less in industry nonresearch funding compared with their male colleagues (p = 0.004) when controlling for other factors. Both number of publications and a high level of Twitter activity (> 1,000 followers) had the strongest associations with the quantity of industry nonresearch funding and the highest probability of industry research funding. Female sports surgeons received significantly less industry nonresearch funding compared with their male colleagues. Future studies further exploring gender disparities in industry funding for orthopaedic surgeons may be warranted. LEVEL OF EVIDENCE:  Prognostic, Level III.

Differences in productivity and collaboration patterns on spine-related research between neurosurgeons and orthopedic spine surgeons: Bibliometric analysis

BACKGROUND

Spinal surgeries are commonly performed by neurosurgeons and orthopedic spine surgeons, with many spine-related articles published by them. However, there has been limited research that directly compares their research achievements. This article conducted a comparative analysis of spine-related research achievements between neurosurgeons and orthopedic spine surgeons. This study examines differences in productivity and impact on spine-related research between them using these measures, particularly with a novel clustering algorithm.

METHODS

We gathered 2148 articles written by neurosurgeons and orthopedic spine surgeons from the Web of Science core collections, covering the period from 2013 to 2022. To analyze author collaborations, we employed the follower-leader clustering algorithm (FLCA) and conducted cluster analysis. A 3-part analysis was carried out: cluster analysis of author collaborations; mean citation analysis; and a category, journal, authorship, L-index (CJAL) score based on article category, journal impact factors, authorships, and L-indices. We then utilized R to create visual displays of our findings, including circle bar charts, heatmaps with dendrograms, 4-quadrant radar plots, and forest plots. The mean citations and CJAL scores were compared between neurosurgeons and orthopedic spine surgeons.

RESULTS

When considering first and corresponding authors, orthopedics authors wrote a greater proportion of the articles in the article collections, accounting for 75% (1600 out of 2148). The CJAL score based on the top 10 units each also favored orthopedic spine surgeons, with 71% (3626 out of 6139) of the total score attributed to them. Using the FLCA, we observed that orthopedic spine surgeons tended to have more collaborations across countries. Additionally, while citation per article favored orthopedic spine surgeons with standard mean difference (= -0.66) and 95%CI: -0.76, -0.56, the mean CJAL score in difference (= 0.34) favored neurosurgeons with 95%CI: 0.24 0.44.

CONCLUSION

Orthopedic spine surgeons have a higher number of publications, citations, and CJAL scores in spine research than those in neurosurgeons. Orthopedic spine surgeons tend to have more collaborations and coauthored papers in the field. The study highlights the differences in research productivity and collaboration patterns between the 2 authors in spine research and sheds light on potential contributing factors. The study recommends the use of FLCA for future bibliographical studies.

Geographic Distribution in Training and Practice of Academic Neurological and Orthopedic Spine Surgeons in the United States

STUDY DESIGN

Cross-sectional study.

OBJECTIVE

This study aimed to stratify the geographic distribution of academic spine surgeons in the United States, analyzing how this distribution highlights differences in academic, demographic, professional metrics, and gaps in access to spine care.

METHODS

Spine surgeons were identified using American Association of Neurological Surgeons and American Academy of Orthopedic Surgeons databases, categorizing into geographic regions of training and practice. Departmental websites, National Institutes of Health (NIH) RePort Expenditures and Results, Google Patent, and NIH icite databases were queried for demographic and professional metrics.

RESULTS

Academic spine surgeons (347 neurological; 314 orthopedic) are predominantly male (95%) and few have patents (23%) or NIH funding (4%). Regionally, the Northeast has the highest proportion per capita (3.28 surgeons per million), but California is the state with the highest proportion (13%). The Northeast has the greatest regional retention post-residency at 74%, followed by the Midwest (59%). The West and South are more associated with additional degrees. Neurosurgery-trained surgeons hold more additional degrees (17%) than orthopedic surgeons (8%), whereas more orthopedic surgeons hold leadership positions (34%) than neurosurgeons (20%).

CONCLUSIONS

Academic spine surgeons are found at the highest proportion in the Northeast and California; the Northeast has the greatest regional retention. Spine neurosurgeons have more additional degrees, whereas spine orthopedic surgeons have more leadership positions. These results are relevant to training programs looking to correct geographic disparities, surgeons in search of training programs, or students in pursuit of spine surgery.

Academic benchmark of highly influential ophthalmologists listed in the ophthalmology power list

OBJECTIVE

To review the academic benchmark of highly influential ophthalmologists listed in the ophthalmology '2020 Power List'.

METHODS

In this cross-sectional study, the academic profiles, achievements, and bibliometric profiles of all ophthalmologists listed in the 'Power List of 2020', regarded as the most influential figures in ophthalmology today, were analysed.

RESULTS

Ninety-five ophthalmologists were studied, after excluding 10 non-ophthalmologist figures that are also listed. Their mean age is 63 ± 11.7 years, with a strong male predominance (84.2%, n = 80 males, P < 0.001). All have a medical doctorate degree, and 31% (n = 29) have a Philosophy Doctor (PhD) degree. Fifty-three percent (n = 51) are graduates of medical schools in the United States (US). However, non-US ophthalmologists have a higher percentage of PhD degrees (41%, 18/44) vs. US ophthalmologists (22%, 11/51, P = 0.069), and also a longer duration of post-residency training (5.8 ± 3.1 vs. 1.8 ± 0.9 years, P < 0.001). The most common subspecialty was cataract and anterior segment surgery (42%, n = 40). The mean and standard deviation of the total number of papers published by ophthalmologists were 307.4 ± 226.3, with a mean citation record of 11,835.7 ± 13,330.5, and a mean h-index of 46.9 ± 27.9.

CONCLUSIONS

The ophthalmologists listed on the 'Power List of 2020' are leaders with high accomplishments and an established interest in research evidenced by a high record of publications and an exceptional bibliometric profile. The list contains more US figures with a gender disparity, demonstrating a greater difficulty for international ophthalmologists, especially women, in achieving this high level of recognition.

Predictors of Academic Productivity Among Spine Surgeons

INTRODUCTION

The relationship between research productivity in training and future productivity as an attending spine surgeon is not well-established in the literature nor has the effect of geographic location of training institutions on future academic success been investigated. The aim of our study was to (1) summarize characteristics of academically productive spine surgeons, (2) assess predictors of long-term academic productivity, and (3) establish the effect of geographic location on long-term academic productivity.

METHODS

A query was conducted of the 2021 to 2022 North American Spine Society Spine Fellowship Directory of all orthopaedic and neurosurgical spine fellowship selection committee members for each institution participating in the spine fellowship match. The attending publication rate and h-index were determined. A multivariate linear regression model was developed. P value was set to <0.05.

RESULTS

We identified 310 orthopaedic and neurosurgical spine surgeons, representing 76 fellowship programs. Multivariate linear regression analysis identified that the publications during residency (P < 0.001) and during fellowship (P < 0.001) were significant predictors of an increased publication rate as an attending surgeon. By contrast, the preresidency publication rate (P = 0.729) was not significantly predictive of the attending publication rate. Multivariate analysis of h-index found that residency publication rate had a positive correlation (P = 0.031) compared with preresidency (P = 0.579) or fellowship (P = 0.257) rates. Attendings who had attended residency in the Northeast and currently practicing in the Northeast had a higher publication rate (P < 0.001 and P = 0.004, respectively).

DISCUSSION

A higher number of publications in residency and fellowship were markedly predictive of an increased publication rate as an attending spine surgeon. By contrast, preresidency publications may not be indicative of future academic productivity as an attending. Location may also contribute to attending publication rate and favor those who undergo residency training and ultimately practice in the Northeast.

Evaluation of the National Institutes of Health–supported relative citation ratio among American orthopedic spine surgery faculty: A new bibliometric measure of scientific influence

•

Analyze new NIH-Supported bibliometric tool, the relative citation ratio (RCR).

•

Evaluate research productivity among fellowship trained Orthopedic Spine Surgeons.

•

Conduct demographic analysis of research productivity among fellowship trained Orthopedic Spine Surgeons.

Background

Publication metrics have been traditionally used to compare research productivity amongst academic faculty. However, traditional bibliometrics lack field-normalization and are often biased towards time-dependent publication factors. The National Institutes of Health (NIH) has developed a new, field-normalized, article-level metric, known as the “relative citation ratio” (RCR), that can be used to make accurate self, departmental, and cross-specialty comparisons of research productivity. This study evaluates the use of the RCR amongst academic orthopedic spine surgery faculty and analyzes physician factors associated with RCR values.

Methods

A retrospective data analysis was performed using the iCite database for all fellowship trained orthopedic spine surgery (OSS) faculty associated with Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopedic surgery residency program. Mean RCR, weighted RCR, and total publication count were compared by sex, career duration, academic rank, and presence of additional degrees. A value of 1.0 is the NIH-funded field-normalized standard. Student t-tests were used for two-group analyses whereas the analysis of variance tests (ANOVA) was used for between-group comparisons of three or more subgroups. Statistical significance was achieved at P < 0.05.

Results

A total of 502 academic OSS faculty members from 159 institutions were included in the analysis. Overall, OSS faculty were highly productive, with a median RCR of 1.62 (IQR 1.38-2.32) and a median weighted RCR of 68.98 (IQR 21.06-212.70). Advancing academic rank was associated with weighted RCR, career longevity was associated with mean RCR score, and male sex was associated with having increased mean and weighted RCR scores. All subgroups analyzed had an RCR value above 1.0.

Conclusions

Academic orthopedic spine surgery faculty produce impactful research as evidenced by the high median RCR relative to the standard value set by the NIH of 1.0. Our data can be used to evaluate research productivity in the orthopedic spine community.

What are the academic and demographic characteristics of orthopaedic spine surgery division chiefs?

Background

To our knowledge no analysis of academic orthopedics division chiefs (DC) exists in the current orthopedic literature. Serving as a Division Chief may be a career milestone or an opportunity to lead and transition to additional leadership roles. Our objective is to answer the following questions (1) Are there academic characteristics common to Spine divisions chiefs? (2) Are there demographic characteristics common to Spine division chiefs? (3) Do most Spine division chiefs train at certain fellowships?

Methods

Allopathic residency program websites were used to locate DC and Division Co-Chiefs (DCC). Academic characteristics evaluated included: H-index, academic rank, number of degrees, additional leadership titles, the availability of fellowship training and service as past/current society president and participation in travelling fellowships. Demographic characteristics including gender and race were collected. Years since completions of fellowship and which fellowship program the DC/DCC trained at were collected.

Results

102 DC/DCC were identified and had an average H-index of 22.1. The majority (48%) had an academic rank of Professor, 29% Associate Professor, 16% Assistant Professor and 8% rank could not be identified. 45% had additional leadership positions within their department and 18% had additional graduate degrees. Two institutions had designations of co-chiefs. The majority (57%) offered spine fellowships at their institution. The majority of DC were males (99%) and White (72.5%). On average the DC/DCC were 19.5 years past their fellowship completion. 19% participated in at least one travelling fellowship and 14% served as a president of a Spine or Orthopaedic Society.

Conclusions

Spine surgery division chiefs are 99% male, with a rank of Professor and trained at select fellowship programs. Nearly half of spine surgery division chiefs held concurrent administrative roles in the department and 14% have served as President of a spine or Orthopaedic society. There is room to Improve on the gender and ethnic/racial diveristy of spine surgery division chief leadership.

Subspecialty Selection Impacts Research Productivity and Faculty Rank of Academic Orthopaedic Surgeons

BACKGROUND

Faculty promotion and research productivity are important for the overall career trajectory of academic orthopaedic surgeons. The purpose of this study was to investigate the role that subspecialty and demographic factors play in research productivity and academic advancement among orthopaedic surgeons.

METHODS

We conducted a retrospective cross-sectional analysis of academic rank among orthopaedic surgeons in 2018. We identified academic orthopaedic programs in the United States from the Fellowship and Residency Electronic Interactive Database (FREIDA) and collected publicly available data for surgeons, including fellowship training, gender, faculty rank, geographic region, and years since residency, from institutional websites. Research productivity was defined with the Hirsch index (h-index) from Scopus, and the m-index was calculated from the surgeon's h-index and the date of the first publication. Multivariate regression analyses were performed to determine the variables that are associated with associate professorship, full professorship, and the h-index.

RESULTS

In this study, we identified and included 2,879 academic orthopaedic surgeons. Completion of a fellowship in foot and ankle (odds ratio [95% confidence interval]: 2.45 [1.17 to 5.15]), sports medicine (2.15 [1.12 to 4.15]), trauma (2.83 [1.42 to 5.66]), hand and upper extremity (2.20 [1.13 to 4.28]), musculoskeletal oncology (3.28 [1.49 to 7.21]), or upper-extremity reconstruction (3.20 [1.31 to 7.81]) was associated with associate professorship. Completion of a trauma fellowship was associated with full professorship (2.93 [1.27 to 6.77]). Completion of a fellowship in adult reconstruction (difference in least-squares means [95% confidence interval]: 5.01 [1.22 to 8.81]), sports medicine (4.52 [1.00 to 8.04]), spine (5.40 [1.63 to 9.18]), or upper-extremity reconstruction (10.64 [6.15 to 15.12]) or the completion of multiple fellowships (5.12 [1.27 to 8.94]) were independently associated with a higher h-index. Women had significantly lower h-indices than men at the assistant (median [interquartile range]: 3 [1 to 6] versus 4 [2 to 8]) and full professor (17 [12 to 26] versus 22 [13 to 34]) levels. There were no differences in the m-index between men and women at any academic rank.

CONCLUSIONS

Orthopaedic subspecialty selection is independently associated with research productivity and academic rank. The differences in research productivity may be important to consider when evaluating orthopaedic surgeons for promotion. While female surgeons had lower h-indices than their male counterparts, this difference was not seen when using the m-index.

Academic, Leadership, and Demographic Characteristics of Orthopaedic Sports Medicine Division Chiefs in the United States

Introduction:

Division chiefs (DCs) play an integral role within the department, making critical decisions and helping shape the future of both the division and the department. This study aimed to investigate the demographic characteristics and scholarly work of DCs in academic orthopaedic sports medicine division in the United States.

Methods:

Orthopaedic residency programs at academic centers were identified using the Association of American Medical Colleges' Electronic Residency Application Service. DCs were identified using the program's respective websites where data points such as sex, race/ethnicity, fellowship training institution, time since graduating fellowship, academic rank, number of degrees, and additional leadership titles were collected. Scopus database was used to determine h-indices.

Results:

From the 191 programs identified, 100 had a DC for the sports medicine subspecialty division, and 66 programs offered a sports medicine fellowship. Most DCs (96%) were men. The racial/ethnic demographics of the DCs were mostly White (86%), followed by Asian (11%), African American (1%), Hispanic/Latino (1%), and mixed ethnicity (1%). On average, the DCs were 19.6 years past their fellowship completion. The average h-index was 21.2. Many (48%) had an academic rank of professor, 28% associate professor, and 12% assistant professor. Four held additional graduate degrees. The fellowship programs that trained the most DCs were Hospital for Special Surgery (11), Kerlan Jobe Orthopaedic Clinic (8), University of Pittsburgh (7), American Sports Medicine Institution (5), Cleveland Clinic (5), Cincinnati Sports Medicine (4), Massachusetts General Hospital (4), and Steadman Hawkins Clinic (4).

Discussion:

DCs in academic orthopaedic surgery plays a crucial role in the department and is a topic that is understudied. A lack of diversity exists among DCs in academic Sports Medicine in orthopaedics. The position is held predominately by White men with a rank of either full or associate professor and extensive leadership experience. More efforts are needed to increase the diversity of sports medicine leadership within academic orthopaedic programs in the United States.

Bibliometric Evaluation of U.S. Neurosurgery Subspecialties and Academic Rank Using RCR Index

INTRODUCTION

Academic productivity, a key feature of academic neurosurgery, has been linked to academic rank, subspecialty, and institutional rank. Relative Citation Ratio (RCR) has emerged as a new metric of scholarly output that can make field-normalized comparisons between researchers, a feature unavailable in prior metrics such as h-index. Here we evaluate the influence of academic rank and neurosurgical subspecialties on RCR scores.

METHODS

We identified 1640 academic neurosurgeons from 115 ACGME-accredited programs in the United States, along with their neurosurgical specialty and demographic information, using publicly available data. Mean RCR (m-RCR) and weighted RCR (w-RCR) for each neurosurgeon were queried from the iCite database, which included publications from 2002-2020. m-RCR and w-RCR scores were compared across subspecialties and academic rank using multivariable regression while controlling for demographic factors.

RESULTS

Multivariable analysis indicated that academic neurosurgeons in general neurosurgery (P = 0.039) and pediatric neurosurgery (P = 0.003) had lower m-RCR scores than their peers in other subspecialties. w-RCR did not differ significantly among subspecialties. Higher academic rank was associated with increased m-RCR (P < 0.05) and w-RCR scores (P < 0.0001).

CONCLUSIONS

Professors have a higher m-RCR score relative to assistant professors, while general and pediatric neurosurgery were linked to lower m-RCR values. Although neurosurgical subspecialty choice did not influence w-RCR, a higher w-RCR score corresponded to a higher academic rank. Overall, the RCR metric can be utilized for field-normalized comparisons of faculty who differ in academic rank and subspecialty.

Evaluation of Sports Medicine Fellowships in the United States Based on Academic Productivity

Institutional academic productivity remains an influential factor in an applicant's selection of fellowship training. This study aimed to determine the quality and quantity of research in the United States orthopaedic sports medicine fellowship programs and identify those with highest productivity.

Analysis of Factors That Influence Academic Productivity Among Neurological and Orthopedic Spine Surgeons

BACKGROUND

Academic productivity plays a growing role in professional advancement in academic medicine. This study aimed to assess academic productivity among spine surgeons by investigating differences in h indices between neurological and orthopedic spine surgeons.

METHODS

The American Association of Neurological Surgeons (AANS) Neurosurgical Residency Training Program Directory provided names of U.S. and Canadian academic neurological surgeons. The National Institutes of Health (NIH) Research Portfolio Online Reporting Tools database was consulted for NIH funding statuses of the surgeons. Scopus yielded the h indices. Orthopedic spine surgeons were identified at the same institutions as the neurological spine surgeons, and NIH funding statuses and h indices were identified from the same databases. Differences between the disciplines and across the categories of NIH funding receipt, having a Ph.D., and academic rank were analyzed.

RESULTS

Inclusion criteria were met by 215 neurological spine surgeons and 513 orthopedic spine surgeons. Neurological spine surgeons had a mean h index of 21.16, and orthopedic spine surgeons had a mean h index of 14.08 (P < 0.0001). Neurological surgeons with NIH funding had higher (P < 0.0001) h indices (34.15) than surgeons without funding (19.29). Likewise, orthopedic surgeons with NIH funding had higher (P < 0.001) h indices (42.83) than surgeons without funding (13.39). Analysis of variance showed that department chairmen and professors had higher h indices than associate or assistant professors among neurological (P < 0.01) and orthopedic (P < 0.001) surgeons.

CONCLUSIONS

These results demonstrate the importance of the h index in measuring academic productivity among neurological and orthopedic spine surgeons.

Differences in management of isolated spinal fractures between neurosurgery and orthopaedics: a 6-year retrospective study

INTRODUCTION

The acute management of spinal fractures is traditionally split between neurosurgeons and orthopaedic surgeons and the specialities have varying approaches to management. This study investigates differences between neurosurgeons and spinal orthopaedic surgeons in the management of spinal fractures at a single trauma centre in the United Kingdom.

METHODS

A retrospective study at a single trauma centre of patients identified using the Trauma Audit and Research Network (TARN). Case notes and radiological investigations were reviewed for demographics, fracture classification, clinical management and outcomes. Polytrauma cases and patients managed by non-neurosurgical/orthopaedic specialties were excluded.

RESULTS

A total of 465 patients were included in this study (neurosurgery n = 266, orthopaedics n = 199). There were no significant differences between groups for age, gender, Charlson co-morbidity score or distribution of fractures using the AO spine classification. Patients admitted and managed under the orthopaedic surgeons were more likely to undergo a surgical procedure when compared to those admitted under the neurosurgeons (n = 71; 35.7% vs n = 71; 26.8%, p = 0.042, OR 1.56 95%CI 1.056 to 2.31). The median overall length of stay was 8 days and there was no significant difference between teams; however, the neurosurgical cohort were more likely to be admitted to an intensive care unit (24.3% vs 16.2%, p = 0.04).

CONCLUSION

This study is the first in the United Kingdom to compare neurosurgical and orthopaedic teams in their management of spinal fractures. It demonstrates that differences may exist both in operating rates and outcomes.

Does the h-index and self-citation affect external funding of orthopedic surgery research? An analysis of fellowship directors and their subspecialties

Purpose

Determine the impact of self-citation on external funding for orthopedic fellowship directors.

Methods

The San Francisco Match's website identified directors encompassing 8 subspecialties. The Scopus database identified the number of publications, citations, and h-index for each director. H-index was assessed with/without self-citation.

Results

Mean publications, citations, self-citation rate, and h-index for the 446 directors were 71.2, 1816, 3.86%, and 18.3, respectively. Excluding self-citations reduces mean h-index to 18.0; and h-index changed by ≤ 1 integer in 95% of directors.

Conclusions

Self-citation has minimal impact among fellowship directors and should not be adjusted for when considering external funding.

Shining Sunlight on Industry Payments in Oral and Maxillofacial Surgery: The Sunshine Act

PURPOSE

To characterize industry payments to oral and maxillofacial surgeons (OMSs) and to determine the accuracy of the Centers for Medicare and Medicaid Services (CMS) Open Payments Databases.

MATERIALS AND METHODS

This was a cross-sectional study of the CMS General and Research Payments Databases in 2016 for clinicians categorized as OMSs. General payments include consulting fees, honoraria, gifts, entertainment, food and beverage, travel and education, and others. Research payments include payments associated with research. Variables collected included number of OMSs who received payments, type of and number of payments, total amount paid, geographic distribution, and proportion of funding allotted to research. The accuracy of payee categorization was determined by verifying a random selection of 5% of those categorized as "OMS" in the database with publicly available data. To assess impact on research productivity, the h-index of research payment recipients was calculated.

RESULTS

A total of 6,720 OMSs received industry compensation in 2016. Accuracy was 88% in the General Payments Database and 50% in the Research Payments Database. OMSs received 28,456 general payments totaling $5,971,800.79. The average number of payments and the average amount per payment were 4.27 and $1,597.60, respectively. The CMS reported total research payments of $23,592.17. The 4 verified OMSs received a total of $18,500 in research payments and had an average h-index of 3.25 (range, 0 to 8). The most common payments made were for food and beverage (80.2%), travel and lodging (5.83%), education (3.91%), compensation for services other than consulting (3.1%), and gifts (3.03%). Research accounted for 0.07% of all payments.

CONCLUSION

Although industry payments to OMSs were common, research funding was negligible. Most industry value transfers were related to food and beverage or travel and lodging. Clinicians were accurately classified in the CMS General Payments Database but not in the Research Payments Database.