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Heckman JD, Swiontkowski M, Katz JN, Losina E, Schoenfeld AJ, Bedard NA, Bono CM, Carey JL, Graham B, Hensinger RN, Gebhardt MC, Mallon WJ, Rossi MJ, Matzkin E, Pinzur MS. Pain management research. Spine J 2020; 20:1165-1166. [PMID: 32713513 DOI: 10.1016/j.spinee.2020.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 04/22/2020] [Accepted: 04/23/2020] [Indexed: 02/03/2023]
Affiliation(s)
| | | | | | - Elena Losina
- Deputy Editor, The Journal of Bone and Joint Surgery
| | | | | | | | - James L Carey
- Associate Editor, American Journal of Sports Medicine
| | | | | | | | | | | | - Elizabeth Matzkin
- Editorial Board, Arthroscopy: The Journal of Arthroscopic and Related Surgery
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Heckman JD, Swiontkowski M, Katz JN, Losina E, Schoenfeld AJ, Bedard NA, Bono CM, Carey JL, Graham B, Hensinger RN, Gebhardt MC, Mallon WJ, Rossi MJ, Matzkin E, Pinzur MS. Pain Management Research. Foot Ankle Int 2020; 41:761-762. [PMID: 32538196 PMCID: PMC7294527 DOI: 10.1177/1071100720925494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Heckman JD, Swiontkowski M, Katz JN, Losina E, Schoenfeld AJ, Bedard NA, Bono CM, Carey JL, Graham B, Hensinger RN, Gebhardt MC, Mallon WJ, Rossi MJ, Matzkin E, Pinzur MS. Pain Management Research. J Bone Joint Surg Am 2020; 102:855. [PMID: 32433323 PMCID: PMC7508273 DOI: 10.2106/jbjs.20.00289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Busse JW, Bhandari M, Einhorn TA, Schemitsch E, Heckman JD, Tornetta P, Leung KS, Heels-Ansdell D, Makosso-Kallyth S, Della Rocca GJ, Jones CB, Guyatt GH. Re-evaluation of low intensity pulsed ultrasound in treatment of tibial fractures (TRUST): randomized clinical trial. BMJ 2016; 355:i5351. [PMID: 27797787 PMCID: PMC5080447 DOI: 10.1136/bmj.i5351] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To determine whether low intensity pulsed ultrasound (LIPUS), compared with sham treatment, accelerates functional recovery and radiographic healing in patients with operatively managed tibial fractures. DESIGN A concealed, randomized, blinded, sham controlled clinical trial with a parallel group design of 501 patients, enrolled between October 2008 and September 2012, and followed for one year. SETTING 43 North American academic trauma centers. PARTICIPANTS Skeletally mature men or women with an open or closed tibial fracture amenable to intramedullary nail fixation. Exclusions comprised pilon fractures, tibial shaft fractures that extended into the joint and required reduction, pathological fractures, bilateral tibial fractures, segmental fractures, spiral fractures >7.5 cm in length, concomitant injuries that were likely to impair function for at least as long as the patient's tibial fracture, and tibial fractures that showed <25% cortical contact and >1 cm gap after surgical fixation. 3105 consecutive patients who underwent intramedullary nailing for tibial fracture were assessed, 599 were eligible and 501 provided informed consent and were enrolled. INTERVENTIONS Patients were allocated centrally to self administer daily LIPUS (n=250) or use a sham device (n=251) until their tibial fracture showed radiographic healing or until one year after intramedullary fixation. MAIN OUTCOME MEASURES Primary registry specified outcome was time to radiographic healing within one year of fixation; secondary outcome was rate of non-union. Additional protocol specified outcomes included short form-36 (SF-36) physical component summary (PCS) scores, return to work, return to household activities, return to ≥80% of function before injury, return to leisure activities, time to full weight bearing, scores on the health utilities index (mark 3), and adverse events related to the device. RESULTS SF-36 PCS data were acquired from 481/501 (96%) patients, for whom we had 2303/2886 (80%) observations, and radiographic healing data were acquired from 482/501 (96%) patients, of whom 82 were censored. Results showed no impact on SF-36 PCS scores between LIPUS and control groups (mean difference 0.55, 95% confidence interval -0.75 to 1.84; P=0.41) or for the interaction between time and treatment (P=0.30); minimal important difference is 3-5 points) or in other functional measures. There was also no difference in time to radiographic healing (hazard ratio 1.07, 95% confidence interval 0.86 to 1.34; P=0.55). There were no differences in safety outcomes between treatment groups. Patient compliance was moderate; 73% of patients administered ≥50% of all recommended treatments. CONCLUSIONS Postoperative use of LIPUS after tibial fracture fixation does not accelerate radiographic healing and fails to improve functional recovery.Study registration ClinicalTrialGov Identifier: NCT00667849.
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Affiliation(s)
- Jason W Busse
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, L8S 4K1, Canada
- Department of Anesthesia, McMaster University, Hamilton, ON L8S 4K1, Canada
- Michael G. DeGroote Institute for Pain Research and Care, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Mohit Bhandari
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, L8S 4K1, Canada
- Department of Surgery, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Thomas A Einhorn
- Department of Orthopedic Surgery, NYU Langone Medical Center, New York, NY 10016, USA
| | - Emil Schemitsch
- Department of Surgery, University of Western Ontario, London, ON N6A 4V2, Canada
| | - James D Heckman
- Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03766, USA
| | - Paul Tornetta
- Department of Orthopedic Surgery, NYU Langone Medical Center, New York, NY 10016, USA
| | - Kwok-Sui Leung
- Department of Orthopedics and Traumatology, Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Diane Heels-Ansdell
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, L8S 4K1, Canada
| | | | | | - Clifford B Jones
- Center for Orthopedic Research and Education, CORE, Banner University, Phoenix, AZ, 85023, USA
| | - Gordon H Guyatt
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, L8S 4K1, Canada
- Department of Medicine, McMaster University, Hamilton, ON L8S 4K1, Canada
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Busse JW, Bhandari M, Einhorn TA, Heckman JD, Leung KS, Schemitsch E, Tornetta P, Walter SD, Guyatt GH. Trial to re-evaluate ultrasound in the treatment of tibial fractures (TRUST): a multicenter randomized pilot study. Trials 2014; 15:206. [PMID: 24898987 PMCID: PMC4060850 DOI: 10.1186/1745-6215-15-206] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 05/21/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The role of low-intensity pulsed ultrasound (LIPUS) in the management of fractures remains controversial. The purpose of this study was to assess the feasibility of a definitive trial to determine the effect of LIPUS on functional and clinical outcomes in tibial fractures managed operatively. METHODS We conducted a multicenter, concealed, blinded randomized trial of 51 skeletally mature adults with operatively managed tibial fractures who were treated with either LIPUS or a sham device. All participating centers were located in Canada and site investigators were orthopedic surgeons specializing in trauma surgery. The goals of our pilot study were to determine recruitment rates in individual centers, investigators' ability to adhere to study protocol and data collection procedures, our ability to achieve close to 100% follow-up rates, and the degree to which patients were compliant with treatment. Patients were followed for one year and a committee (blinded to allocation) adjudicated all outcomes. The committee adjudicators were experienced (10 or more years in practice) orthopedic surgeons with formal research training, specializing in trauma surgery. RESULTS Our overall rate of recruitment was approximately 0.8 patients per center per month and site investigators successfully adhered to the study protocol and procedures. Our rate of follow-up at one year was 84%. Patient compliance, measured by an internal timer in the study devices, revealed that 39 (76%) of the patients were fully compliant and 12 (24%) demonstrated a greater than 50% compliance. Based on patient feedback regarding excessive questionnaire burden, we conducted an analysis using data from another tibial fracture trial that revealed the Short Musculoskeletal Function Assessment (SMFA) dysfunction index offered no important advantages over the SF-36 Physical Component Summary (PCS) score. No device-related adverse events were reported. CONCLUSIONS Our pilot study identified key issues that might have rendered a definitive trial unfeasible. By modifying our protocol to address these challenges we have enhanced the feasibility of a definitive trial to explore the effect of LIPUS on tibial fracture healing. TRIAL REGISTRATION The TRUST definitive trial was registered at ClinicalTrials.gov on 21 April 2008 (identifier: NCT00667849).
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Affiliation(s)
- Jason W Busse
- Department of Anesthesia, McMaster University, HSC-2U1, 1200 Main St. West, Hamilton, ON L8S 4 K1, Canada
- Department of Biostatistics and Clinical Epidemiology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4 K1, Canada
- The Michael G DeGroote Institute for Pain Research and Care, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4 K1, Canada
| | - Mohit Bhandari
- Department of Biostatistics and Clinical Epidemiology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4 K1, Canada
- Department of Surgery, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4 L8, Canada
| | - Thomas A Einhorn
- Department of Orthopedic Surgery, Boston University Medical Center, 725 Albany Street, Shapiro, Suite 4B, Boston, MA 02118, USA
| | - James D Heckman
- Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH 03756, USA
| | - Kwok-Sui Leung
- Department of Orthopedics and Traumatology, the Chinese University of Hong Kong, Professorial Block, Queen Mary Hospital, Pok Fu Lam, Hong Kong, China
| | - Emil Schemitsch
- Division of Orthopedic Surgery, University of Toronto, 149 College Street, Toronto, ON M5T 1P5, Canada
| | - Paul Tornetta
- Department of Orthopedic Surgery, Boston University Medical Center, 725 Albany Street, Shapiro, Suite 4B, Boston, MA 02118, USA
| | - Stephen D Walter
- Department of Biostatistics and Clinical Epidemiology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4 K1, Canada
| | - Gordon H Guyatt
- Department of Biostatistics and Clinical Epidemiology, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4 K1, Canada
- Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, ON L8S 4 K1, Canada
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Heckman JD, Spratt KF. Letter to the editor Re: Wei, Li-Cheng et al. J Orthop Res 30:1572-1576 2012. J Orthop Res 2013; 31:829-30. [PMID: 23362114 DOI: 10.1002/jor.22315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Okike K, Kocher MS, Nwachukwu BU, Mehlman CT, Heckman JD, Bhandari M. The fate of manuscripts rejected by The Journal of Bone and Joint Surgery (American Volume). J Bone Joint Surg Am 2012; 94:e130. [PMID: 22992859 DOI: 10.2106/jbjs.l.00078] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [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: 02/01/2023]
Abstract
BACKGROUND Of the many manuscripts that are submitted to The Journal of Bone and Joint Surgery (American Volume) (JBJS-A) for publication, the majority are not accepted. However, little is known about the outcome of these rejected submissions. To determine the fate of studies rejected by JBJS-A, we conducted a follow-up investigation of all clinical and basic science manuscripts that were submitted to The Journal between January 2004 and June 2005 but were not accepted. METHODS For each rejected manuscript, data were extracted on a wide variety of scientific and nonscientific characteristics, which were plausibly related to subsequent publication. PubMed searches were conducted to determine which manuscripts achieved full publication within five years, and logistic regression was used to identify the factors associated with publication. To further elucidate the factors associated with publication, a survey was administered to the corresponding author of each rejected manuscript. RESULTS At five years following rejection by JBJS-A, 75.8% (696 of 918) of manuscripts had reached full publication. In the multivariate analysis, factors associated with a higher likelihood of subsequent publication included grade of initial review by JBJS-A (p = 0.029), disclosure of a for-profit or nonprofit conflict of interest (p = 0.028 and 0.027, respectively), and a greater number of prior publications in frequently cited orthopaedic journals by the corresponding author (p < 0.0001). Manuscripts were less likely to reach full publication if the corresponding author was from Asia or the Middle East (p = 0.004) or was a woman (p = 0.003). Among survey respondents who indicated that their study had not yet reached full publication, the most commonly cited reason was lack of time (reported by 51.4% of respondents [thirty-eight of seventy-four]). CONCLUSIONS Most manuscripts (75.8%) not accepted by JBJS-A were published elsewhere within five years of rejection. The factors predictive of subsequent publication were primarily investigator-related as opposed to study-related. Given this low threshold for eventual publication, readers are encouraged to use criteria other than inclusion in the PubMed database to identify high-quality papers.
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Affiliation(s)
- Kanu Okike
- Department of Orthopaedic Surgery, Massachusetts General Hospital/Brigham and Women's Hospital, 55 Fruit Street, Boston, MA 02114, USA.
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Heckman JD. Ten years at JBJS: lessons learned. Am J Orthop (Belle Mead NJ) 2011; 40:558-559. [PMID: 22263207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Smith JT, Johnson AH, Heckman JD. Nonoperative treatment of an os peroneum fracture in a high-level athlete: a case report. Clin Orthop Relat Res 2011; 469:1498-501. [PMID: 21328020 PMCID: PMC3069286 DOI: 10.1007/s11999-011-1812-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [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] [Received: 11/01/2010] [Accepted: 02/04/2011] [Indexed: 01/31/2023]
Abstract
BACKGROUND The os peroneum is a sesamoid bone in the peroneus longus tendon. Fractures of the os peroneum are rare. Some authors recommend surgery for active patients. CASE DESCRIPTION A 41-year-old male professional tennis coach sustained a minimally displaced fracture of the os peroneum. He was treated with restricted weightbearing for 2 weeks, followed by physical therapy and gradual return to activities. He returned to tennis 8 weeks after injury. Followup 7 years after the injury showed he had full strength, full motion, and a radiographically healed os peroneum. The American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale score was 100 and Ankle Activity Score and Tegner Activity Level Scale were unchanged from those before injury. LITERATURE REVIEW Fracture of the os peroneum is a rare injury and treatment recommendations are based largely on very small series and case reports. Proposed treatment strategies for fracture of the os peroneum include nonoperative treatment, fixation of the fracture, excision of the bone with direct repair of the tendon, and tenodesis of the peroneus longus to the peroneus brevis. PURPOSES AND CLINICAL RELEVANCE Although some surgeons suggest fracture of the os peroneum should be treated operatively in active patients, this case shows nonoperative treatment allowed pain-free return to activities in a high-level athlete with a minimally-displaced fracture.
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Affiliation(s)
- Jeremy T. Smith
- Harvard Combined Orthopaedic Residency Program, Massachusetts General Hospital, White 535, Boston, MA 02114 USA
| | - Anne H. Johnson
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA
USA
| | - James D. Heckman
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, MA
USA
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Emerson GB, Warme WJ, Wolf FM, Heckman JD, Brand RA, Leopold SS. Testing for the Presence of Positive-Outcome Bias in Peer Review. ACTA ACUST UNITED AC 2010; 170:1934-9. [DOI: 10.1001/archinternmed.2010.406] [Citation(s) in RCA: 168] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Diamond IR, Murray C, Bosse MJ, Heckman JD, Mirza SK, Peabody TD, Saleh KJ, Swiontkowski MF, Wright JG. The American Orthopaedic Association clinical trials curriculum. J Bone Joint Surg Am 2009; 91:1007-11. [PMID: 19339588 DOI: 10.2106/jbjs.h.01864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Ivan R Diamond
- The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada
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Okike K, Kocher MS, Mehlman CT, Heckman JD, Bhandari M. Nonscientific factors associated with acceptance for publication in The Journal of Bone and Joint Surgery (American Volume). J Bone Joint Surg Am 2008; 90:2432-7. [PMID: 18978412 PMCID: PMC2663327 DOI: 10.2106/jbjs.g.01687] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [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: 02/01/2023]
Abstract
BACKGROUND While it is widely accepted that scientific factors may render a study more likely to be accepted for publication, it is less clear whether nonscientific factors may also be associated with publication. The purpose of this study was to identify the nonscientific factors associated with acceptance for publication by The Journal of Bone and Joint Surgery (American Volume). METHODS A total of 1173 manuscripts submitted to The Journal of Bone and Joint Surgery between January 1, 2004, and June 30, 2005, for publication as scientific articles were analyzed as part of a study on publication bias in the editorial decision-making process. Information was collected on nonscientific factors plausibly associated with acceptance for publication, including study location, conflict-of-interest disclosure, sex of the author, primary language, and the number of prior publications by the corresponding author in frequently cited orthopaedic journals. The final disposition term (acceptance or rejection) was recorded, and logistic regression was used to identify factors associated with acceptance for publication. RESULTS Manuscripts from countries other than the United States or Canada were significantly less likely to be accepted (odds ratio, 0.51; 95% confidence interval, 0.28 to 0.92; p = 0.026). Factors positively associated with acceptance for publication were conflict-of-interest disclosure involving a nonprofit entity (odds ratio, 1.92; 95% confidence interval, 1.35 to 2.73; p < 0.001) and ten or more prior publications in frequently cited orthopaedic journals by the corresponding author (odds ratio, 2.01; 95% confidence interval, 1.33 to 3.05; p = 0.001). We did not find a significant association between acceptance and conflict-of-interest disclosure involving a for-profit company, sex of the corresponding author, or primary language. CONCLUSIONS Manuscripts submitted to The Journal of Bone and Joint Surgery were more likely to be accepted if they were from the United States or Canada, reported a conflict of interest related to a nonprofit entity, or were authored by an individual with ten or more prior publications in frequently cited orthopaedic journals.
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Affiliation(s)
- Kanu Okike
- Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114. E-mail address:
| | - Mininder S. Kocher
- Department of Orthopaedic Surgery, Children's Hospital Boston, Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115
| | - Charles T. Mehlman
- Division of Pediatric Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH 45229
| | - James D. Heckman
- The Journal of Bone and Joint Surgery, 20 Pickering Street, Needham, MA 02492
| | - Mohit Bhandari
- Department of Orthopaedic Surgery, Hamilton General Hospital, McMaster University, 7 North, Suite 727, Barton Street East, Hamilton, ON L8L 2X2, Canada
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Heckman JD. Deep venous thrombosis associated with osteomyelitis in children. J Bone Joint Surg Am 2008; 90:1167; author reply 1167-8. [PMID: 18451416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Brand RA, Buckwalter JA, Wright TM, Terry Canale S, Cooney WP, D’Ambrosia R, Frassica FJ, Grana WA, Heckman JD, Hensinger RN, Thompson GH, Andrew Koman L, McCann PD, Poehling GG, Lubowitz JH, Thordarson D, Neviaser RJ. Editorial from journal editors: patient care, professionalism and relations with industry. Clin Orthop Relat Res 2008; 466:517-9. [PMID: 18264839 PMCID: PMC2505209 DOI: 10.1007/s11999-007-0078-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2007] [Accepted: 11/12/2007] [Indexed: 01/31/2023]
Affiliation(s)
- Richard A. Brand
- Clinical Orthopaedics and Related Research, 1600 Spruce Street, Philadelphia, PA 19103 USA
| | | | | | | | - William P. Cooney
- Journal of the American Academy of Orthopaedic Surgeons, Rochester, MN USA
| | | | | | | | - James D. Heckman
- Journal of Bone and Joint Surgery, American Volume, Needham, MA USA
| | | | | | - L. Andrew Koman
- Journal of Surgical Orthopaedic Advances, Winston-Salem, NC USA
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Brand R, Buckwalter JA, Canale ST, Cooney WP, D'Ambrosia R, Grana WA, Heckman JD, Hensinger RN, Koman LA, McCann PD, Poehling GG, Thordarson D. Patient care, professionalism, and relations with industry. J Orthop Res 2008; 26:279-80. [PMID: 18273897 DOI: 10.1002/jor.20613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Okike K, Kocher MS, Mehlman CT, Heckman JD, Bhandari M. Publication bias in orthopaedic research: an analysis of scientific factors associated with publication in the Journal of Bone and Joint Surgery (American Volume). J Bone Joint Surg Am 2008; 90:595-601. [PMID: 18310710 DOI: 10.2106/jbjs.g.00279] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [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: 02/01/2023]
Abstract
BACKGROUND Positive outcomes are common in the orthopaedic literature, and there are many who believe it may be due to the preferential publication of studies with positive findings-a phenomenon known as publication bias. The purpose of this investigation was to determine whether positive findings rendered a manuscript submitted to The Journal of Bone and Joint Surgery (American Volume) more likely to be accepted for publication. METHODS A total of 1181 manuscripts submitted to The Journal of Bone and Joint Surgery between January 1, 2004, and June 30, 2005, for publication as scientific articles were analyzed, with 855 meeting the inclusion criteria. The direction of the study findings (positive, neutral, or negative) was independently graded by three blinded reviewers. The final disposition (acceptance or rejection) was recorded, as was information on the scientific characteristics plausibly related to acceptance or rejection. Logistic regression was used to identify factors associated with acceptance for publication. RESULTS The overall acceptance rate was 21.8% (186 of 855 studies). The study outcome was positive for 72.5% (620) of the manuscripts. The acceptance rate for the 235 manuscripts with nonpositive findings was 23.0% (fifty-four studies) compared with 21.3% (132) of the 620 studies with positive findings (crude odds ratio, 1.10 [95% confidence interval, 0.77 to 1.58]; p = 0.593). After controlling for all covariates, the adjusted odds ratio was 0.92 (95% confidence interval, 0.62 to 1.35; p = 0.652). In the multivariate analysis, the only factor significantly associated with acceptance for publication was level of evidence (p = 0.001). CONCLUSIONS We found no evidence of publication bias in the review of manuscripts for publication by The Journal of Bone and Joint Surgery, as positive and nonpositive studies were accepted at similar rates. The dearth of nonpositive studies in the orthopaedic literature is of concern, and may be due largely to investigator-based factors. Orthopaedic researchers should submit negative and neutral studies for publication, confident that the likelihood of acceptance will not be influenced by the direction of study findings.
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Affiliation(s)
- Kanu Okike
- Department of Orthopaedic Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA.
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Thordarson D, Brand R, Buckwalter JA, Wright TM, Canale ST, Cooney WP, D'Ambrosia R, Frassica FJ, Grana WA, Heckman JD, Hensinger RN, Thompson GH, Koman LA, McCann PD, Neviaser RJ, Poehling GG, Lubowitz JH. Editorial: patient care, professionalism, and relations with industry. Foot Ankle Int 2008; 29:121-3. [PMID: 18315964 DOI: 10.3113/fai.2008.0121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Brand R, Buckwalter JA, Wright TM, Canale ST, Cooney WP, D'Ambrosia R, Frassica FJ, Grana WA, Heckman JD, Hensinger RN, Thompson GH, Koman LA, McCann PD, Neviaser RJ, Poehling GG, Lubowitz JH, Thordarson D. Patient care, professionalism, and relations with industry. Orthopedics 2008; 31:11-2. [PMID: 18269161 DOI: 10.3928/01477447-20080101-05] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Poehling GG, Lubowitz JH, Brand R, Buckwalter JA, Wright TM, Canale ST, Cooney WP, D'Ambrosia R, Frassica FJ, Grana WA, Heckman JD, Hensinger RN, Thompson GH, Koman LA, McCann PD, Thordarson D. Patient care, professionalism, and relations with industry. Arthroscopy 2008; 24:4-6. [PMID: 18182194 DOI: 10.1016/j.arthro.2007.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2007] [Accepted: 11/16/2007] [Indexed: 02/02/2023]
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Brand R, Buckwalter JA, Wright TM, Canale ST, Cooney WP, D'Ambrosia R, Frassica FJ, Grana WA, Heckman JD, Hensinger RN, Thompson GH, Koman LA, McCann PD, Poehling GG, Lubowitz JH, Thordarson D. Patient care, professionalism, and relations with industry. J Surg Orthop Adv 2008; 17:67-68. [PMID: 18549733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Heckman JD, Brand RA. Concern regarding duplicate publications. J Bone Joint Surg Am 2006; 88:2533; author reply 2533-4. [PMID: 17079413 DOI: 10.2106/00004623-200611000-00028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Heckman JD. Editor's note. J Bone Joint Surg Am 2006; 88:446. [PMID: 16452762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Heckman JD. Are validated questionnaires valid? J Bone Joint Surg Am 2006; 88:446. [PMID: 16452761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Heckman JD. A case report, "Bilateral chronic exertional compartment syndrome of the dorsal part of the forearm: the role of magnetic resonance imaging in diagnosis.". J Bone Joint Surg Am 2005; 87:458; author reply 458. [PMID: 15687173 DOI: 10.2106/00004623-200502000-00032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Levine AM, Heckman JD, Hensinger RN. The art and science of reviewing manuscripts for orthopaedic journals: Part I. Defining the review. Instr Course Lect 2004; 53:679-88. [PMID: 15116658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
The peer review process is integral to the functioning of all scientific journals and plays a pivotal role in the publication of new scientific material. Timeliness, freedom from bias, and proper review etiquette are essential for an effective review. Each type of scientific article demands a slightly different reviewing technique. Clinical research articles require that a proper question be asked and that the study methodology allows the question to be answered effectively. All studies dealing with human subjects need to be approved by the Institutional Review Board. Clinical review articles have specific criteria to determine how they should be constructed and when they should be published, whereas basic science research articles should be evaluated for their experimental method as well as the relevance of the conclusions to the data. Finally, case reports have an important place in the scientific literature, but the rationale for publishing any individual case needs to be clearly established.
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Affiliation(s)
- Alan M Levine
- Alvin and Lois Lapidus Cancer Institute, Sinai Hospital of Baltimore, Baltimore, Maryland, USA
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Levine AM, Heckman JD, Hensinger RN. The art and science of reviewing manuscripts for orthopaedic journals: Part II. Optimizing the manuscript: practical hints for improving the quality of reviews. Instr Course Lect 2004; 53:689-97. [PMID: 15116659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Manuscripts submitted to musculoskeletal journals have several key components that need to be critically evaluated. There are specific methods to assess the abstract, illustrations, references, and other major elements of a manuscript under review. If each of these elements is assessed methodically, not only does the quality of the review improve, but it becomes more useful for the journal editor. Additionally, the method in which the review is conveyed has a marked impact on its usefulness. There should be a concise evaluation of the entire work, stating whether a publication should or should not be pursued. For poor manuscripts, several bulleted points that indicate the fatal flaw(s) are sufficient, but for good manuscripts, a systematic itemization of weaknesses will improve the quality of the manuscript. Reviews should not be derogatory and should be prompt and to the point.
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Affiliation(s)
- Alan M Levine
- Alvin and Lois Lapidus Cancer Institute, Sinai Hospital of Baltimore, Baltimore, Maryland, USA
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Poss R, Heckman JD. Letters to the editor: a change in policy. J Bone Joint Surg Am 2004; 86:1. [PMID: 14711937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Brand RA, Heckman JD, Scott J. Changing ethical standards in scientific publication. J Surg Orthop Adv 2004; 13:137-8. [PMID: 15559688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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Abstract
Musculoskeletal medicine is not taught adequately in American medical schools and the predictable consequences are seen. Students cannot show cognitive mastery of the subject and lack confidence in this topic. To address this, the Academic Orthopaedic Society held a symposium on medical school education at its annual meeting in 2001. There, the panelists presented an analysis of the problem and proposed solutions. Specifically, it was noted that because of the autonomy of the various schools and their varied approaches to teaching, it would be unlikely that one monolithic and mandated plan could be effective on a national basis. Rather, successful reform would comprise a coalition-based effort to define learning objectives, to provide teaching materials, and to create forums for sharing resources. Recruitment of national organizations was thought to be essential. Finally, it was felt that although inadequate education is neither new nor necessarily unique among disciplines, the coming year or two, the beginning of the Bone and Joint decade, was seen to be a particularly auspicious time for attempting curricular reform.
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Bhandari M, Einhorn TA, Swiontkowski MF, Heckman JD. Who did what? (Mis)perceptions about authors' contributions to scientific articles based on order of authorship. J Bone Joint Surg Am 2003; 85:1605-9. [PMID: 12925643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Mohit Bhandari
- Department of Clinical Epidemiology and Biostatistics, McMaster University Medical Center, Hamilton, ON, Canada.
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Buckwalter JA, Heckman JD, Petrie DP. An AOA critical issue: aging of the North American population: new challenges for orthopaedics. J Bone Joint Surg Am 2003; 85:748-58. [PMID: 12672854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Joseph A Buckwalter
- Department of othopaedic Surgery, University of Iowa Hospitals, Iowa City 52242, USA.
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Wright JG, Swiontkowski MF, Heckman JD. Introducing levels of evidence to the journal. J Bone Joint Surg Am 2003; 85:1-3. [PMID: 12533564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Zoys GN, McGanity PL, Lanctot DR, Athanasiou KA, Heckman JD. Biomechanical evaluation of fixation of posterior acetabular wall fractures. J South Orthop Assoc 2002; 8:254-60; discussion 260. [PMID: 12132798 DOI: 10.1109/sbec.1998.666622] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Reproducible fractures of the posterior wall of the acetabulum were created in 10 paired hemipelves from fresh human cadavers. Under anterior-to-posterior loading by a Materials Testing System machine, the load to failure of fixation of the acetabular fractures treated with steel pelvic reconstruction plates and steel screws was significantly higher than that of fixation with titanium ribbons and titanium screws. Forces as little as 725 newtons applied directly to the fragment caused fixation failure; even the most secure form of fixation failed when a relatively small force of 2,123 newtons was applied. These results emphasize the importance of appropriate postoperative measures, such as limitation of hip flexion and restricted weightbearing, to minimize the force directed against the posterior wall until the fracture has healed. Secure fixation of fractures of the posterior wall of the acetabulum is critical, since loss of fixation results in instability and joint incongruity, which limit the options for reconstruction.
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Affiliation(s)
- G N Zoys
- Department of Orthopaedics, University of Texas Health Science Center at San Antonio, 78284-7774, USA
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Abstract
Many sources predict an oversupply of orthopaedic surgeons in the United States continuing into the next 30 years. The most attractive solution to this problem is to expand the scope of orthopaedic practice by regaining direct patient access to orthopaedic specialty care, by developing and bringing new technologies and treatments to the marketplace quickly, and by developing alternatives to the typical orthopaedic practice such as expanding nonoperative care, improving the quality of the office practice, and exploring volunteer opportunities.
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Affiliation(s)
- J D Heckman
- Journal of Bone and Joint Surgery, Needham, MA 02492-3157, USA
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Heckman JD, Ingram AJ, Loyd RD, Luck JV, Mayer PW. Nonunion treatment with pulsed electromagnetic fields. Clin Orthop Relat Res 2001:58-66. [PMID: 6975692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Noninvasive, pulsed electromagnetic field treatment, when properly employed, was effective in securing healing of ununited fractures in 64.4% of 149 patients. The effectiveness of this modality can be ascertained after three months of intensive use in more than 85% of patients, thus enabling the clinician to decide to terminate treatment, continue electrostimulation, or abandon it in favor of another treatment modality. The success of treatment is dependent upon certain variables. Anatomic location of the nonunion is important. Higher healing rates were noted in the tibia than in the femur or humerus. In some conditions, combined electrostimulation and bone grafting was more effective than either measure alone. Young patients healed more rapidly than older patients. Electrostimulation is more effective when instituted within two years of the original fracture than when started at longer intervals after the injury. Infection, either quiescent or actively draining, does not seem to affect the overall results. Of greatest importance is patient adherence to the treatment protocol as outlined, with emphasis placed on adequate immobilization of the fracture and absolute nonweight-bearing during treatment. Considering these factors and in light of the very rare frequency of short-term side effects, the use of pulsed electromagnetic fields appears to be a reasonable choice of treatment in the management of ununited fractures.
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