Project description:BackgroundAs part of the Open Science movement, this study aims to analyze the current state of open access and open data policies concerning the availability of articles and raw data of the journals belonging to the category "Medicine, General & Internal" of the Science Citation Index Expanded.MethodsJournal data sharing policies were evaluated through the following variables: possibility of manuscript storage in repositories; reuse policy; publication on a website; and statement regarding complementary material. Subsequently, an analysis of the supplementary material associated with each article was performed through the PubMed Central repository. The study reported was assessed following the STROBE guidelines for observational studies.ResultsThis study shows that only one-third of the journals included in the category "Medicine, General & Internal" allow the depositing of their documents in repositories and its reuse, while approximately half of the journals agree to publish the document on a website as well as to deposit supplementary material along with the publication. However, the reality about this last variable is that only 9.5% of the articles analyzed contained supplementary material being the main journals involved, BMJ Open, JAMA Network Open, New England Journal of Medicine, Lancet and Plos Medicine.ConclusionsThe analysis of the opening policies of the journals concerning data availability in medical research reveals the unequal positioning of publishers towards the sharing of open data, the ambiguity regarding government policies about the obligation to deposit data and the need for ethical and standardization requirements in the typology/format of the data deposited without forgetting the important role that the researcher plays. Further studies based on journals indexed in medical databases other than Science Citation Index Expanded are needed.
Project description:To help authors design rigorous studies and prepare clear and informative manuscripts, improve the transparency of editorial decisions, and raise the bar on educational scholarship, the Deputy Editors of the Journal of General Internal Medicine articulate standards for medical education submissions to the Journal. General standards include: (1) quality questions, (2) quality methods to match the questions, (3) insightful interpretation of findings, (4) transparent, unbiased reporting, and (5) attention to human subjects' protection and ethical research conduct. Additional standards for specific study types are described. We hope these proposed standards will generate discussion that will foster their continued evolution.
Project description:We show that when ecologists act as reviewers their reported rejection rates recommended for manuscripts increases with their publication frequency in high impact factor journals. Rejection rate however does not relate to reviewer age. These results indicate that the likelihood of getting a paper accepted for publication may depend upon factors in addition to scientific merit. Multiple reviewer selection for a given manuscript therefore should consider not only appropriate expertise, but also reviewers that have variable publication experience with a range of different journals to ensure balanced treatment. Interestingly since age did not relate to rejection rates, more senior scientists are not necessarily more jaded in reviewing practices.
Project description:Many factors influence selection of a target journal for publishing scientific papers, including "fit" within the journal's scope, acceptance rate, readership, open access options, submission and publication costs, journal quality, and timeliness of publication. Timeliness of publication can be a critical factor affecting career development, but many journals are not transparent about turnaround times. Here we evaluated 49 journals publishing papers in zoological medicine and related fields between 2017 and 2022, and aggregated and examined distributions of turnaround time of journals that publicly provided the requisite data, in order to aid authors in selecting target journals that best meet their needs. Of 49 journals evaluated, 39 provided necessary dates for reconstructing turnaround times. Of these, median times to acceptance ranged from 37 to 338 days, and median times to publication ranged from 41 to 403.5 days. The percentage of papers published in greater than 1 year ("slow") ranged from 0 to 57.1%, while the percentage of papers published in under 6 months ("timely") ranged from 0.8 to 99.8%. Acceptance rates and times to first decision were available for only 22% and 20%, respectively, of journals evaluated. Results may prove useful for authors deciding where to submit their works, depending on how they prioritize the many factors involved.
Project description:BackgroundTo date, the outcomes of second opinions in internal medicine in terms of diagnostic yield and patient benefit have not been studied extensively. This retrospective study explores the outcomes of second opinions at a general internal medicine outpatient clinic in an academic hospital.MethodsA register of all patients referred to the general internal medicine outpatient clinic of the University Medical Center in Utrecht for a second opinion, was kept. All 173 patients referred between June 2016 and August 2018 were selected. Case records were analyzed for patient characteristics, referring doctor, chief complaint, performed investigations, follow-up time and, established diagnosis, additional diagnoses, initiated treatment and reported benefit.ResultsA new diagnosis was established in 13% of all patients. A new treatment was initiated in 56% of all patients: 91% and 51% of patients with and without a new diagnosis respectively (p < 0.001). Of all patients, 19% received an effective treatment (52% vs 14% of patients with vs without a new diagnosis, p < 0.001). Regardless of treatment, resolution or improvement of the chief complaint was achieved in 28% of all patients (52% vs 25% of patients with vs without a new diagnosis, p = 0.006). Regarding diagnostics, 23-33% of radiology, endoscopy and pathology tests performed during second opinion were a repetition of previously conducted investigations. Conventional blood tests were a repetition in 89% of cases. Median time to diagnosis was 64 days (IQR: 25-128 days) and median time to discharge was 75 days (IQR: 31-144 days).ConclusionSecond opinions in general internal medicine lead to the establishment of a new diagnosis in a small proportion of patients. However, the value of second opinions may not be limited to the establishment of diagnoses, as new treatments are often initiated and overall patients report improved symptomatology in 28% of cases.
Project description:General internal medicine (GIM) has predominantly been perceived as a joint specialty to be completed alongside specialty training in the United Kingdom. The Internal Medicine (IMT) Stage 2 curriculum was released in August 2022;1 in October 2022 the Round 2 Specialty Training recruitment included applications for the pilot GIM training programme, and in February 2023 NHS England commenced the 3-year programme. The GIM programme aims to provide run-through training for GIM to Certificate of Completion of Training (CTT). This report establishes the initial recruitment demographics of trainees, as well as an analysis of the successful applicants' perspectives on the programme and their motivations for applying.
Project description:ObjectiveTo study ICU trials published in the four highest-impact general medicine journals by comparing them with concurrently published non-ICU trials in the same journals.Data sourcesPubMed was searched for randomized controlled trials (RCTs) published between January 2014 and October 2021 in the New England Journal of Medicine , The Lancet , the Journal of the American Medical Association , and the British Medical Journal.Study selectionOriginal RCT publications investigating any type of intervention in any patient population.Data extractionICU RCTs were defined as RCTs exclusively including patients admitted to the ICU. Year and journal of publication, sample size, study design, funding source, study outcome, type of intervention, Fragility Index (FI), and Fragility Quotient were collected.Data synthesisA total of 2,770 publications were screened. Of 2,431 original RCTs, 132 (5.4%) were ICU RCTs, gradually rising from 4% in 2014 to 7.5% in 2021. ICU RCTs and non-ICU RCTs included a comparable number of patients (634 vs 584, p = 0.528). Notable differences for ICU RCTs were the low occurrence of commercial funding (5% vs 36%, p < 0.001), the low number of RCTs that reached statistical significance (29% vs 65%, p < 0.001), and the low FI when they did reach significance (3 vs 12, p = 0.008).ConclusionsIn the last 8 years, RCTs in ICU medicine made up a meaningful, and growing, portion of RCTs published in high-impact general medicine journals. In comparison with concurrently published RCTs in non-ICU disciplines, statistical significance was rare and often hinged on the outcome events of just a few patients. Increased attention should be paid to realistic expectations of treatment effects when designing ICU RCTs to detect differences in treatment effects that are reliable and clinically relevant.
Project description:BackgroundPrior literature demonstrates internal medicine residents have suboptimal competence in critical appraisal. Journal clubs are a common intervention to address this skill, but engagement and critical appraisal skill improvement are variable.ObjectiveWe evaluated journal club engagement and critical appraisal skills after implementation of a gamified format.MethodsThis was a single-arm study, conducted from July 1, 2020 to June 30, 2021, involving internal medicine residents at 2 US programs. Residents participated in a 12-month gamified journal club that sorted residents into 2 teams. Residents attended an orientation followed by 6 to 10 monthly, hour-long competitions. In each competition, a subset of the resident teams competed to answer a clinical prompt by critically appraising an original article of their choice. A chief medical resident or faculty member moderated each session and chose the winning team, which received a nominal prize of candy. The primary outcome was engagement, measured by a 7-question survey developed de novo by the authors with Likert scale responses at baseline and 12 months. The secondary outcome was critical appraisal skills assessed by the Berlin Questionnaire.ResultsSixty-one of 72 eligible residents (84.7%) completed both engagement surveys. Residents reported statistically significant improvements in most dimensions of engagement, including a higher likelihood of reading articles before sessions (posttest minus pretest score -1.08; 95% CI -1.34 to -0.82; P<.001) and valuing time spent (posttest minus pretest score -0.33; 95% CI -0.55 to -0.11; P=.004). Critical appraisal skills marginally improved at 12 months (posttest minus pretest score -0.84; 95% CI -1.54 to -0.14; P=.02).ConclusionsOur study demonstrates a gamified journal club was associated with improvements in engagement and minimal change in critical appraisal skills.
Project description:ObjectivePreexposure Prophylaxis (PrEP) is under-utilized in primary care. Given differences in treatment approaches for other conditions between family medicine (FM) and general internal medicine (GIM), this study compared PrEP-prescribing between FM and GIM physicians.MethodsDe-identified electronic health record data from a multi-state health care system was used in this retrospective observational study. The time period from 1/1/13 to 9/30/21 was used to identify PrEP eligible patients using measures of current sexually transmitted disease and condomless sex at the time of eligibility. Receipt of PrEP was measured in the 12 months after PrEP eligibility. The odds of receiving PrEP in GIM as compared to FM was computed before and after adjusting for demographics and physical and psychiatric comorbidities.ResultsThe majority of eligible patients were 18 to 39 years of age, 60.9% were female and 71.6% were White race. Among PrEP eligible patients, 1.1% received PrEP in the first year after index date. Receiving PrEP was significantly more likely among patients treated in GIM versus FM (OR = 2.30; 95% CI:1.63-3.25). After adjusting for covariates, this association remained statistically significant (OR = 2.02; 95% CI:1.41-2.89).ConclusionsPrEP is grossly under-utilized in primary care. The majority of Americans enter the health care system through primary care and not through HIV providers or other specialties. Therefore, educational interventions are needed to increase confidence and knowledge and to encourage PrEP prescribing by FM and GIM physicians.
Project description:OBJECTIVES:To improve the trustworthiness of evidence, studies should be prospectively registered and research reports should adhere to existing standards. We aimed to systematically assess the degree to which endocrinology and internal medicine journals endorse study registration and reporting standards for randomised controlled trials (RCTs), systematic reviews (SRs) and observational studies (ObS). Additionally, we evaluated characteristics that predict endorsement of reporting or registration mechanism by these journals. DESIGN:Meta-epidemiological study. SETTING:Journals included in the 'Endocrinology and Metabolism' and 'General and Internal Medicine' 2017 Journal Citation Reports. PARTICIPANTS:Journals with an impact factor of ?1.0, focused on clinical medicine, and those who publish RCTs, SRs and ObS were included. PRIMARY OUTCOMES:Requirement of adherence to reporting guideline and study registration as determined from the journals' author instructions. RESULTS:Of the 170 (82 endocrinology and 88 internal medicine) eligible journals, endorsing of reporting standards was the highest for RCTs, with 35 (43%) of endocrine journals and 55 (63%) of internal medicine journals followed by SRs, with 21 (26%) and 48 (55%), respectively, and lastly, by ObS with 41 (50%) of endocrine journals and 21 (24%) of internal medicine journals. In 78 (46%) journals RCTs were required to be registered and published in adherence to the Consolidated Standards of Reporting Trials statement. Only 11 (6%) journals required registration of SRs. Internal medicine journals were more likely to endorse reporting guidelines than endocrine journals except for Strengthening the Reporting of Observational Studies in Epidemiology. No other journal characteristic proved to be an independent predictor of reporting standard endorsement for RCTs besides trial registration. CONCLUSION:Our results highlight that study registration requirement and reporting guideline endorsement are suboptimal in internal medicine and endocrine journals. This malpractice may be further enhanced since endorsement does not imply enforcement, impairing the practice of evidence-based medicine.