Statistics Commentary Series: Commentary #11-Multiple Comparisons and Peeking at Data

Slipped Capital Femoral Epiphysis, Food Deserts, Poverty, and Urban/Rural Residence: Is There a Link?

BACKGROUND

Childhood obesity is increased in food deserts, a community with little to no access to healthy food. As obesity is associated with slipped capital femoral epiphysis (SCFE), it was the purpose of this study to analyze the prevalence of SCFE patients by food desert location and its interaction with rural/urban location.

METHODS

A retrospective review of all consecutive patients with idiopathic SCFE treated at our institution over 11 years was performed. From the patient's address, the US Census Bureau tract in which the patient resided was determined. Using the census tract code, it was ascertained if the patient lived in a food desert and urban or rural location. Standard statistical analyses were performed; a P <0.05 was considered statistically significant.

RESULTS

There were 177 SCFE patients: 79 girls, 98 boys, 106, White, and 69 nonWhite. The average age at diagnosis was 12.1±1.7 years, the average symptom duration 4.1±5.1 months, and the average weight percentile 94±10. Of these 177 patients, 26.5% lived in a food desert, which was higher than the expected 17.5% ( P =0.023). Those living in a food desert were more commonly nonWhite (60% vs. 32%, P =0.0014). There were 25% from rural areas and 75% from urban areas. No rural SCFE patients lived in food deserts whereas 34% of urban patients lived in food deserts. The average poverty rate of the SCFE patient census tracts was 19%, no greater than the expected 15% ( P =0.32). SCFE patients living in rural census tracts had a lower poverty rate ( P <10 -6 ).

CONCLUSIONS

There is a correlation with the prevalence of SCFE patients by residence in a "food desert", but not with rural/urban locale or poverty status in Indiana. Further research will be needed to see if these findings apply to other states within the United States and other parts of the world.

LEVEL OF EVIDENCE

III.

Gender and Geographic Origin as Determinants of Manuscript Publication Outcomes: JBMR® Bibliometric Analysis from 2017 to 2019

The Journal of Bone and Mineral Research (JBMR®), the flagship journal of the American Society for Bone and Mineral Research (ASBMR), enjoys a premiere position in its field and has a global reach. The journal uses a single-blind peer-review process whereby three editors are typically involved in assessing each submission for publication, in addition to external reviewers. Although emphasizing fairness, rigor, and transparency, this process is not immune to the influence of unconscious biases. The gender and geographic diversity of JBMR® authors, editors, and reviewers has increased over the last three decades, but whether such diversity has affected peer-review outcomes is unknown. We analyzed manuscript acceptance rates based on the gender and geographic origin of authors, reviewers, and Associate Editors. The analysis included 1662 original research articles submitted to JBMR® from September 2017 through December 2019. Gender was assigned using probabilities from an online tool and manually validated through internet searches. Predictor variables of manuscript outcome were determined with multivariate logistic regression analysis. The acceptance rate was highest when the first and last authors were of different genders, and lowest when both authors were men. Reviewer gender did not influence the outcome regardless of the genders of the first and last authors. Associate Editors from all geographical regions tended to select reviewers from their same region. The acceptance rate was highest when the Associate Editor was from Europe. Manuscripts with authors from North America and Australia/New Zealand had greater overall odds of acceptance than those from Europe and Asia. Manuscripts reviewed only by Editorial Board (EB) members had a lower acceptance rate than those refereed by non-EB reviewers or a mix of EB and non-EB reviewers. Overall, the geographical origin of authors, reviewers, and editors, as well as reviewers' EB membership may influence manuscript decisions. Yet, the JBMR® peer-review process remains largely free from gender bias. © 2022 American Society for Bone and Mineral Research (ASBMR).

Longitudinal Pathways to Influenza Vaccination Vary With Socio-Structural Disadvantages

BACKGROUND

Although influenza vaccination can prevent influenza-related deaths, uptake remains low, particularly in disadvantaged populations.

PURPOSE

A theoretical model of psychological pathways to vaccination accounting for the direct and moderating role of socio-structural factors was tested. The study sought to understand the joint contributions of psychological (i.e., knowledge, attitudes, and intention) and socio-structural factors (i.e., income, education, and insurance) to influenza vaccination, prospectively.

METHODS

A nationally representative empaneled sample of over 3,000 U.S. adults answered questions about vaccination knowledge, attitudes, and intentions, as well as actual vaccination across five timepoints from September 2018 to May 2019. Socio-structural factors were examined as moderators.

RESULTS

Findings revealed strong positive associations between knowledge and attitudes, attitudes and intentions, as well as intentions and subsequent vaccination. Importantly, health insurance moderated the associations between attitudes and intentions and between intentions and vaccination, such that those without insurance had weaker associations between attitudes and intentions and between intentions and vaccination. In addition, education moderated the path from knowledge to attitude and from intentions to vaccination, such that people with lower educational attainment had weaker associations between knowledge and attitudes and between intentions and vaccination.

CONCLUSIONS

Socio-structural factors act as barriers to the influence of knowledge on attitudes, attitudes on intentions, and intentions on behavior. Future research needs to be mindful of the specific paths disrupted by social disadvantages and examine ways to intervene to decrease those effects.

Validation of a Greek Sentence Repetition Task with Typically Developing Monolingual and Bilingual Children

This study provides a preliminary validation of a Greek Sentence Repetition Task (SRT) with a sample of 110 monolingual and bilingual typically developing (TLD) children and examines the test's ability to distinguish between Greek monolingual children and age-matched Albanian-Greek bilinguals using a Receiver Operating Characteristics (ROC) analysis. This is the first study to report on the psychometric evaluation of a Greek SRT and its discriminatory ability with typical populations. Since most language assessments are standardized with monolinguals and bilingual children tend to underperform on these compared to monolinguals, it is essential to establish the level of bilingual TLD children's ability on the same tests before moving on to diagnose language impairment in bilinguals. Results showed that the Greek SRT had very high validity and reliability scores, with Accuracy measures being more reliable than Grammaticality measures. The school-age monolingual and bilingual TLD children reached different cut-off scores on this task.

Bibliometric Analysis of the English Musculoskeletal Literature over the Last 30 Years

Publication and authorship are important in academia for career advancement, obtaining grants, and improved patient care. There has been a recent interest in bibliometric changes over time, especially regarding the gender gap. The purpose of this study was to explore bibliometric changes in the musculoskeletal literature. Bibliometric variables (number of authors, institutions, countries, pages, references, corresponding author position, author gender, geographic region of origin, and editorial board makeup) were analyzed for 5 basic science and 12 clinically oriented musculoskeletal journals from 1985 through 2016. Statistical analyses comprised bivariate analyses, multifactorial ANOVAs, and logistic regression analyses. A p < 0.005 was considered significant. Nearly, all variables increased over time. Asia had the highest number of authors and corresponding author positions, Australia/New Zealand the highest number of institutions and references, North America the highest number of pages, and Europe the highest number of countries. Those with a female first author had more authors, institutions, countries, references, and pages. Likewise, those with a female corresponding author had more authors, institutions, countries, references, and pages. Single-authored manuscripts decreased over time. The percentage of female first authors rose from 10.8% in 1985-1987 to 23.7% in 2015-2016. There were more female 1^st authors in the basic science journals compared to the clinical journals (33.2% vs. 12.7%). Single-authored manuscripts were more likely to be written by males (5.1 vs. 2.4%) and decreased over time. The many differences by geographic region of origin likely reflect different socio/cultural attitudes regarding academia and research, as well as the gender composition of the disciplines by geographic region. Overall, there has been an increase in the number of female 1^st and corresponding authors, editorial board members, and chief editors, indicating a slow but progressive narrowing of the gender gap.

Bibliometric and authorship trends over a 30 year publication history in two representative US sports medicine journals

Bibliometric studies are important to understand changes and improvement opportunities in academia. This study compared bibliometric trends for two major sports medicine/arthroscopy journals, the American Journal of Sports Medicine® (AJSM®) and Arthroscopy® over the past 30 years. Trends over time and comparisons between both journals were noted for common bibliometric variables (number of authors, references, pages, citations, and corresponding author position) as well as author gender and continental origin. Appropriate statistical analyses were performed. A p < 0.001 was considered statistically significant. One representative year per decade was used. There were 814 manuscripts from AJSM® and 650 from Arthroscopy®. For AJSM® the number of manuscripts steadily increased from 86 in 1986 to 350 in 2016; for Arthroscopy® the number of manuscripts increased from 73 in 1985/1986, to 267 in 2006, but then dropped to 229 in 2016. There were significant increases in all bibliometric variables, except for the number of citations which decreased in Arthroscopy®. There were significant differences in manuscript region of origin by journal (p = 0.000002). Arthroscopy® had a greater percentage of manuscripts from Asia than AJSM® (19.3% vs 11.5%) while AJSM® had a greater percentage from North America (70.3% vs 59.2%); both journals had similar percentages from Europe (18.2% for AJSM® and 21.6% for Arthroscopy®). For AJSM® the average percentage of female first authors was 13.3%, increasing from 4.7% in 1986 to 19.3% in 2016; the average percentage of female corresponding authors was 7.3%. For Arthroscopy®, the average percentage of female first authors was 8.1%, increasing from 2.8% in 1985/1986 to 15.7% in 2016 (p = 0.00007). In conclusion, AJSM® and Arthroscopy® showed an increase in most variables analyzed. Although Arthroscopy® is climbing at a higher rate than AJSM® for female authors, AJSM® has an overall greater percentage of female authors.