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Janssen SJ, Langerhuizen DWG, Kerkhoffs GMMJ, Ring D. Payments by Industry to Residency Program Directors in the United States: A Cross-Sectional Study. Acad Med 2022; 97:278-285. [PMID: 34010861 DOI: 10.1097/acm.0000000000004166] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE To assess the proportion, nature, and extent of financial payments from industry to residency program directors in the United States. METHOD This cross-sectional study used open-source data from Doximity and the Centers for Medicare and Medicaid (CMS) open payments database. Profiles of 4,686 residency program directors from 28 different specialties were identified using Doximity and matched to records in the CMS database. All payments received per residency program director over the years 2014 to 2018 were extracted, including amount in U.S. dollars, payment year, and nature of payment (research versus general payments). Total payments (research plus general payments) received over the 5 years were added up per residency program director. Only personal payments were included. RESULTS Overall, 74% (3,465/4,686) of all residency program directors received 1 or more personal payments, totaling $77,058,139, with a median of $216 (interquartile range, $0-$2,150) and a mean of $16,444 (standard deviation, $183,061) per residency program director over the 5 years. Ninety-five percent of total payment value were general payments, and 5% were personal research payments. About 11% (536/4,686) of residency program directors received more than $10,000, while 3% (133/4,686) received more than $100,000 in the study years. There was a substantial difference in the proportion (P < .001), nature (P < .001), and amount (P < .001) of payments of residency program directors between specialties. Almost all residency program directors of interventional radiology (96% [74/77]), vascular surgery (96% [53/55]), and orthopedic surgery (92% [184/201]) received payments, while only one-third to one-half of those in preventive medicine (29% [18/62]), pediatrics (43% [90/211]), and pathology (51% [73/143]) received payments. CONCLUSIONS Industry payments to residency program directors are common, although large variation exists between specialties. The majority of direct payments to residency program directors are for non-research-related activities.
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Affiliation(s)
- Stein J Janssen
- S.J. Janssen is a resident, Department of Orthopaedic Surgery, Amsterdam Movement Sciences (AMS), Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - David W G Langerhuizen
- D.W.G. Langerhuizen is a PhD candidate, Department of Orthopaedic Surgery, Amsterdam Movement Sciences (AMS), Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - Gino M M J Kerkhoffs
- G.M.M.J. Kerkhoffs is professor of orthopaedic surgery, Department of Orthopaedic Surgery, Amsterdam Movement Sciences (AMS), Amsterdam University Medical Centre, Amsterdam, the Netherlands
| | - David Ring
- D. Ring is professor of orthopaedic surgery and psychiatry, Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, Texas
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Walinga AB, Stornebrink T, Langerhuizen DWG, Struijs PAA, Kerkhoffs GMMJ, Janssen SJ. What are the best diagnostic tests for diagnosing bacterial arthritis of a native joint? : a systematic review of 27 studies. Bone Joint J 2021; 103-B:1745-1753. [PMID: 34847715 DOI: 10.1302/0301-620x.103b12.bjj-2021-0114.r1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIMS This study aimed to answer two questions: what are the best diagnostic methods for diagnosing bacterial arthritis of a native joint?; and what are the most commonly used definitions for bacterial arthritis of a native joint? METHODS We performed a search of PubMed, Embase, and Cochrane libraries for relevant studies published between January 1980 and April 2020. Of 3,209 identified studies, we included 27 after full screening. Sensitivity, specificity, area under the curve, and Youden index of diagnostic tests were extracted from included studies. We grouped test characteristics per diagnostic modality. We extracted the definitions used to establish a definitive diagnosis of bacterial arthritis of a native joint per study. RESULTS Overall, 28 unique diagnostic tests for diagnosing bacterial arthritis of a native joint were identified. The following five tests were deemed most useful: serum ESR (sensitivity: 34% to 100%, specificity: 23% to 93%), serum CRP (sensitivity: 58% to 100%, specificity: 0% to 96%), serum procalcitonin (sensitivity: 0% to 100%, specificity: 68% to 100%), the proportion of synovial polymorphonuclear cells (sensitivity: 42% to 100%, specificity: 54% to 94%), and the gram stain of synovial fluid (sensitivity: 27% to 81%, specificity: 99% to 100%). CONCLUSION Diagnostic methods with relatively high sensitivities, such as serum CRP, ESR, and synovial polymorphonuclear cells, are useful for screening. Diagnostic methods with a relatively high specificity, such as serum procalcitonin and synovial fluid gram stain, are useful for establishing a diagnosis of bacterial arthritis. This review helps to interpret the value of various diagnostic tests for diagnosing bacterial arthritis of a native joint in clinical practice. Cite this article: Bone Joint J 2021;103-B(12):1745-1753.
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Affiliation(s)
- Alex B Walinga
- Department of Orthopedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Academic Center for Evidence-based Sports medicine, Amsterdam, the Netherlands.,Amsterdam Collaboration for Health and Safety in Sports, International Olympic Committee Research Center Amsterdam UMC, Amsterdam, the Netherlands
| | - Tobias Stornebrink
- Department of Orthopedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Academic Center for Evidence-based Sports medicine, Amsterdam, the Netherlands.,Amsterdam Collaboration for Health and Safety in Sports, International Olympic Committee Research Center Amsterdam UMC, Amsterdam, the Netherlands
| | - David W G Langerhuizen
- Department of Orthopedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Academic Center for Evidence-based Sports medicine, Amsterdam, the Netherlands.,Amsterdam Collaboration for Health and Safety in Sports, International Olympic Committee Research Center Amsterdam UMC, Amsterdam, the Netherlands
| | - Peter A A Struijs
- Department of Orthopedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Academic Center for Evidence-based Sports medicine, Amsterdam, the Netherlands.,Amsterdam Collaboration for Health and Safety in Sports, International Olympic Committee Research Center Amsterdam UMC, Amsterdam, the Netherlands
| | - Gino M M J Kerkhoffs
- Department of Orthopedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Academic Center for Evidence-based Sports medicine, Amsterdam, the Netherlands.,Amsterdam Collaboration for Health and Safety in Sports, International Olympic Committee Research Center Amsterdam UMC, Amsterdam, the Netherlands
| | - Stein J Janssen
- Department of Orthopedic Surgery, Amsterdam Movement Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,Academic Center for Evidence-based Sports medicine, Amsterdam, the Netherlands.,Amsterdam Collaboration for Health and Safety in Sports, International Olympic Committee Research Center Amsterdam UMC, Amsterdam, the Netherlands
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Steffens ANV, Langerhuizen DWG, Doornberg JN, Ring D, Janssen SJ. Emotional tones in scientific writing: comparison of commercially funded studies and non-commercially funded orthopedic studies. Acta Orthop 2021; 92:240-243. [PMID: 33263445 PMCID: PMC8158288 DOI: 10.1080/17453674.2020.1853341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Background and purpose - There is ongoing debate as to whether commercial funding influences reporting of medical studies. We asked: Is there a difference in reported tones between abstracts, introductions, and discussions of orthopedic journal studies that were commercially funded and those that were not commercially funded?Methods - We conducted a systematic PubMed search to identify commercially funded studies published in 20 orthopedic journals between January 1, 2000 and December 1, 2019. We identified commercial funding of studies by including in our search the names of 10 medical device companies with the largest revenue in 2019. Commercial funding was designated when either the study or 1 or more of the authors received funding from a medical device company directly related to the content of the study. We matched 138 commercially funded articles 1 to 1 with 138 non-commercially funded articles with the same study design, published in the same journal, within a time range of 5 years. The IBM Watson Tone Analyzer was used to determine emotional tones (anger, fear, joy, and sadness) and language style (analytical, confident, and tentative).Results - For abstract and introduction sections, we found no differences in reported tones between commercially funded and non-commercially funded studies. Fear tones (non-commercially funded studies 5.1%, commercially funded studies 0.7%, p = 0.04), and analytical tones (non-commercially funded studies 95%, commercially funded studies 88%, p = 0.03) were more common in discussions of studies that were not commercially funded.Interpretation - Commercially funded studies have comparable tones to non-commercially funded studies in the abstract and introduction. In contrast, the discussion of non-commercially funded studies demonstrated more fear and analytical tones, suggesting them to be more tentative, accepting of uncertainty, and dispassionate. As text analysis tools become more sophisticated and mainstream, it might help to discern commercial bias in scientific reports.
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Affiliation(s)
- Anath N V Steffens
- Department of Orthopaedic Surgery, Amsterdam, Amsterdam Movement Sciences (AMS), Amsterdam University Medical Centre, The Netherlands;
| | - David W G Langerhuizen
- Department of Orthopaedic Surgery, Amsterdam, Amsterdam Movement Sciences (AMS), Amsterdam University Medical Centre, The Netherlands; ,Correspondence:
| | - Job N Doornberg
- Department of Orthopaedic & Trauma Surgery, Flinders University, Adelaide, Australia, Flinders Medical Centre;
| | - David Ring
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Stein J Janssen
- Department of Orthopaedic Surgery, Amsterdam, Amsterdam Movement Sciences (AMS), Amsterdam University Medical Centre, The Netherlands;
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Langerhuizen DWG, Bergsma M, Selles CA, Jaarsma RL, Goslings JC, Schep NWL, Doornberg JN. Diagnosis of dorsal screw penetration after volar plating of a distal radial fracture. Bone Joint J 2020; 102-B:874-880. [DOI: 10.1302/0301-620x.102b7.bjj-2019-1489.r1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aims The aim of this study was to investigate whether intraoperative 3D fluoroscopic imaging outperforms dorsal tangential views in the detection of dorsal cortex screw penetration after volar plating of an intra-articular distal radial fracture, as identified on postoperative CT imaging. Methods A total of 165 prospectively enrolled patients who underwent volar plating for an intra-articular distal radial fracture were retrospectively evaluated to study three intraoperative imaging protocols: 1) standard 2D fluoroscopic imaging with anteroposterior (AP) and elevated lateral images (n = 55); 2) 2D fluoroscopic imaging with AP, lateral, and dorsal tangential views images (n = 50); and 3) 3D fluoroscopy (n = 60). Multiplanar reconstructions of postoperative CT scans served as the reference standard. Results In order to detect dorsal screw penetration, the sensitivity of dorsal tangential views was 39% with a negative predictive value (NPV) of 91% and an accuracy of 91%; compared with a sensitivity of 25% for 3D fluoroscopy with a NPV of 93% and an accuracy of 93%. On the postoperative CT scans, we found penetrating screws in: 1) 40% of patients in the 2D fluoroscopy group; 2) in 32% of those in the 2D fluoroscopy group with AP, lateral, and dorsal tangential views; and 3) in 25% of patients in the 3D fluoroscopy group. In all three groups, the second compartment was prone to penetration, while the postoperative incidence decreased when more advanced imaging was used. There were no penetrating screws in the third compartment (extensor pollicis longus groove) in the 3D fluoroscopy groups, and one in the dorsal tangential views group. Conclusion Advanced intraoperative imaging helps to identify screws which have penetrated the dorsal compartments of the wrist. However, based on diagnostic performance characteristics, one cannot conclude that 3D fluoroscopy outperforms dorsal tangential views when used for this purpose. Dorsal tangential views are sufficiently accurate to detect dorsal screw penetration, and arguably more efficacious than 3D fluoroscopy. Cite this article: Bone Joint J 2020;102-B(7):874–880.
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Affiliation(s)
- David W. G. Langerhuizen
- Department of Orthopaedic Surgery, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Minke Bergsma
- Department of Orthopaedic Surgery, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Caroline A. Selles
- Department of Surgery, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Ruurd L. Jaarsma
- Department of Orthopaedic & Trauma Surgery, Flinders Medical Centre, Adelaide, Australia
| | - J. Carel Goslings
- Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - Niels W. L. Schep
- Department of Surgery, Maasstad ziekenhuis, Rotterdam, The Netherlands
| | - Job N. Doornberg
- Department of Orthopaedic & Trauma Surgery, Flinders Medical Centre, Adelaide, Australia
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Janssen SJ, Langerhuizen DWG, Schwab JH, Bramer JAM. Outcome after reconstruction of proximal femoral tumors: A systematic review. J Surg Oncol 2018; 119:120-129. [DOI: 10.1002/jso.25297] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 10/25/2018] [Indexed: 11/11/2022]
Affiliation(s)
- Stein J. Janssen
- Department of Orthopaedic SurgeryAmphia HospitalBreda The Netherlands
| | - David W. G. Langerhuizen
- Department of Orthopaedic SurgeryAcademic Medical Center, University of AmsterdamAmsterdam The Netherlands
| | - Joseph H. Schwab
- Department of Orthopaedic SurgeryOrthopaedic Oncology Service, Massachusetts General Hospital, Harvard Medical SchoolBoston Massachusetts
| | - Jos A. M. Bramer
- Department of Orthopaedic SurgeryAcademic Medical Center, University of AmsterdamAmsterdam The Netherlands
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