To estimate financial payments from industry to US journal editors.
Retrospective observational study.
52 influential (high impact factor for their specialty) US medical journals from 26 ...specialties and US Open Payments database, 2014.
713 editors at the associate level and above identified from each journal's online masthead.
All general payments (eg, personal income) and research related payments from pharmaceutical and medical device manufacturers to eligible physicians in 2014. Percentages of editors receiving payments and the magnitude of such payments were compared across journals and by specialty. Journal websites were also reviewed to determine if conflict of interest policies for editors were readily accessible.
Of 713 eligible editors, 361 (50.6%) received some (>$0) general payments in 2014, and 139 (19.5%) received research payments. The median general payment was $11 (£8; €9) (interquartile range $0-2923) and the median research payment was $0 ($0-0). The mean general payment was $28 136 (SD $415 045), and the mean research payment was $37 963 (SD $175 239). The highest median general payments were received by journal editors from endocrinology ($7207, $0-85 816), cardiology ($2664, $0-12 912), gastroenterology ($696, $0-20 002), rheumatology ($515, $0-14 280), and urology ($480, $90-669). For high impact general medicine journals, median payments were $0 ($0-14). A review of the 52 journal websites revealed that editor conflict of interest policies were readily accessible (ie, within five minutes) for 17/52 (32.7%) of journals.
Industry payments to journal editors are common and often large, particularly for certain subspecialties. Journals should consider the potential impact of such payments on public trust in published research.
Identifying characteristics of disciplined surgeons is important for public safety. A database of all physicians disciplined by a Canadian provincial medical regulatory authority (College of ...Physicians and Surgeons) between 2000 and 2017 was constructed, and comparisons between surgeons and other physicians were undertaken. Of 1100 disciplined physicians, 174 (15.8 %) were surgeons. Obstetrics and gynecology was the specialty with the most disciplined surgeons (57 of 174 32.8%), followed by general surgery (48 of 174 27.6%). The overall disciplinary rate for surgeons was higher than for other physicians (12.59, 95 % confidence interval CI 10.69-14.83 v. 9.85, 95 % CI 8.88-10.94 cases per 10 000 physician-years, p = 0.013). Even after adjusting for surgeon age, sex, international medical graduation and years in practice, surgeons remained more likely than other physicians to be disciplined for standard of care issues (55.6%, 95% CI 46.6-64.2 v. 38.7%, 95% CI 32.6-45.2, p < 0.001).
The implementation of Course‐Based Undergraduate Research Experiences (CUREs) has made it possible to expose large undergraduate populations to research experiences. For these research experiences to ...be authentic, they should reflect the increasing collaborative nature of research. While some CUREs have expanded with multiple schools across the nation, it is still unclear how a structured extramural collaboration between students and faculty from an outside institution affects student outcomes. In this study, we established three cohorts of students: 1) no‐CURE 2) single institution CURE (CURE) and 3) external collaborative CURE (ec‐CURE) and assessed academic and attitudinal outcomes. The ec‐CURE differs from a regular CURE in that students work with faculty member from an external institution to refine their hypothesis and discuss their data. The sharing of ideas, data and materials with an external faculty allowed students to experience a level of collaboration not typically found in an undergraduate setting. Students in the ec‐CURE had the greatest gains in experimental design, self‐reported course benefits, scientific skills and STEM importance. Importantly this study occurred in a diverse community of STEM disciplinary faculty from 2‐ and 4‐year institutions illustrating that exposing students to structured external collaboration is both feasible and beneficial to student learning.
Postpartum depression (PPD) affects up to 19% of women, negatively impacting maternal and infant health. Reductions in plasma oxytocin levels have been associated with PPD and heritability studies ...have established a genetic contribution. Epigenetic regulation of the oxytocin receptor gene (OXTR) has been demonstrated and we hypothesized that individual epigenetic variability at OXTR may impact the development of PPD and that such variability may be central to predicting risk. This case-control study is nested within the Avon Longitudinal Study of Parents and Children and included 269 cases with PPD and 276 controls matched on age group, parity, and presence or absence of depressive symptoms in pregnancy as assessed by the Edinburgh Postnatal Depression Scale. OXTR DNA methylation (CpG site -934) and genotype (rs53576 and rs2254298) were assayed from DNA extracted from blood collected during pregnancy. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association of elevated symptoms of PPD with genotype, methylation, and their interaction adjusted for psychosocial factors (n = 500). There was evidence of an interaction between rs53576 and methylation in the OXTR gene amongst women who did not have depression prenatally but developed PPD (p interaction = 0.026, adjusted for covariates, n = 257). Those women with GG genotype showed 2.63 greater odds of PPD for every 10% increase in methylation level (95% CI: 1.37, 5.03), whereas methylation was unrelated to PPD amongst "A" carriers (OR = 1.00, 95% CI: 0.58, 1.73). There was no such interaction among women with PPD and prenatal depression. These data indicate that epigenetic variation that decreases expression of OXTR in a susceptible genotype may play a contributory role in the etiology of PPD.
This study evaluated the proportion and characteristics of international medical graduates (IMGs) who have been disciplined by professional regulatory colleges in Canada in comparison with ...disciplined North American medical graduates (NAMGs).
The authors compiled a database of the nature of professional misconduct and penalties incurred by disciplined physicians from January 2000 to May 2015 using public records. They compared discipline data for IMGs versus those for NAMGs, and calculated risk ratios (RRs) and 95% confidence intervals (CIs) for select outcomes.
There were 794 physicians disciplined; 922 disciplinary cases during the 15-year study period. IMGs composed an average of 23.4% (standard deviation = 1.1%) of the total physician population and represented one-third of disciplined physicians and discipline cases. The overall disciplinary rate for all Canadian physicians was 8.52 cases per 10,000 physician years (95% CI 7.77, 9.31). This rate per group was higher for IMGs than for NAMGs (12.91 95% CI (11.50, 14.43) vs. 8.16 95% CI (7.53, 8.82) cases per 10,000 physician years, P < .01, and RR 1.58 (95% CI 1.38, 1.82). IMGs were disciplined at significantly higher rates than NAMGs if they were trained in South Africa (RR 1.73 95% CI (1.14, 2.51), P < .01), Egypt (RR 3.59 95% CI (2.18, 5.52), P < .01), or India (RR 1.66 95% CI (1.01, 2.55), P = .03).
IMGs are disciplined at a higher rate than NAMGs. Future initiatives should be focused to delineate the exact cause of this observation.
Physician misconduct is of serious concern to patient safety and quality of care. Currently, there are limited data on disciplinary proceedings involving internal medicine (IM) physicians.The aim of ...this study was to investigate the number and nature of disciplinary cases among IM physicians compared with those of other disciplined physicians.Our retrospective study reviewed information from all provincial Colleges of Physicians and Surgeons (CPS) and compiled a database of all disciplined physicians from 2000 to 2013 in Canada. Disciplinary rate differences (RDs) were calculated for IM physicians and compared with other physicians.From 2000 to 2013, overall disciplinary rates were low (9.6 cases per 10,000 physician years). There were 899 disciplinary cases, 49 of which involved 45 different IM physicians. IM physicians comprised 10.8% of all disciplined physicians and were disciplined at a lower rate than non-IM physicians, incurring 5.18 fewer cases per 10,000 physician years than other physicians (95% confidence interval CI 3.62-6.73; P < 0.001). They were significantly less likely to be disciplined for: unprofessional conduct (RD 1.16; CI 0.45-1.87; P = 0.001); unlicensed activity (RD 0.78; CI 0.37-1.19; P < 0.001); standard of care issues (RD 1.37; CI 0.49-2.26; P = 0.002); sexual misconduct (RD 1.65; CI 0.90-2.40; P < 0.001); miscellaneous (RD 0.80; CI 0.11-1.50; P = 0.020); mental illness (RD 0.06; CI 0.01-0.12; P = 0.025); inappropriate prescribing (RD 0.74; CI 0.15-1.33; P = 0.010); and criminal conviction (RD 0.33; CI 0.00-0.65; P = 0.048). No significant differences were found with respect to unclear violations, fraudulent behavior/prevarication, or offenses involving drugs/alcohol (all RDs less than 0.32). IM physicians were also less likely to incur the following penalties: voluntary license surrender (RD 0.53; CI 0.37-0.69; P < 0.001); suspension (RD 2.39; CI 1.26-3.51; P < 0.001); retraining/assessment (RD 1.58; CI 0.77-2.39; P < 0.001); restriction (RD 1.60; CI 0.74-2.46; P < 0.001); other (RD 0.52; CI 0.07-0.97; P = 0.030); formal reprimand (RD 2.78; CI 1.77-3.79; P < 0.001); or fine (RD 3.28; CI 1.89-4.67; P < 0.001). No significant differences were found with respect to revocation or mandated counseling/rehabilitation (all RDs less than 0.46).Generally, disciplinary rates among physicians were low. Compared with other physicians, IM physicians have significantly lower disciplinary rates overall and are less likely to incur the majority of disciplinary offenses and penalties.
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