Category: Research Commentary

Hot Topics: NIH Encourages Preprint Inclusion in Grant Proposals

Reporting Preprints and Other Interim Research Products

Office of Policy for Extramural Research Administration, National Institutes of Health. (2017). Reporting Preprints and Other Interim Research Products (Notice Number: NOT-OD-17-050). Retrieved from https://grants.nih.gov/grants/guide/notice-files/NOT-OD-17-050.html

Purpose
The NIH encourages investigators to use interim research products, such as preprints, to speed the dissemination and enhance the rigor of their work. This notice clarifies reporting instructions to allow investigators to cite their interim research products and claim them as products of NIH funding.

Definitions
Interim Research Products are complete, public research products that are not final.

A common form is the preprint, which is a complete and public draft of a scientific document. Preprints are typically unreviewed manuscripts written in the style of a peer-reviewed journal article. Scientists issue preprints to speed dissemination, establish priority, obtain feedback, and offset publication bias.

Another common type of interim product is a preregistered protocol, where a scientist publicly declares key elements of their research protocol in advance. Preregistration can help scientists enhance the rigor of their work.

Notes:

  • Awardees are not required to create interim research products through their NIH award.
  • Applicants are not required to cite interim research products as part of their grant applications.
  • Since preprints are not published in peer-reviewed journals, they do not fall under the NIH public access policy.
  • This guide notice does not apply to clinical trial registration. See ClinicalTrials.gov about registration of clinical trial protocols.

 

Posted in Hot Topics in Research, Research and Scholarly Communication, Research Commentary

Hot Topics: Peer-Reviewed Blog Introduces New Medical Researchers to Publishing

Coached Peer Review: Developing the Next Generation of Authors

Sidalak D, Purdy E, Luckett-Gatopoulos S, Murray H, Thoma B, Chan TM. Coached peer review: Developing the next generation of authors. Academic Medicine. 2017;92(2):201-204. http://dx.doi.org/10.1097/ACM.0000000000001224.

Problem
Publishing in academic journals is challenging for learners. Those who pass the initial stages of internal review by an editor often find the anonymous peer review process harsh. Academic blogs offer alternate avenues for publishing medical education material. Many blogs, however, lack a peer review process, which some consumers argue compromises the quality of materials published.

Approach
CanadiEM (formerly BoringEM) is an academic educational emergency medicine blog dedicated to publishing high-quality materials produced by learners (i.e., residents and medical students). The editorial team has designed and implemented a collaborative “coached peer review” process that comprises an open exchange among the learner–author, editors, and reviewers. The goal of this process is to facilitate the publication of high-quality academic materials by learner–authors while providing focused feedback to help them develop academic writing skills.

Outcomes
The authors of this Innovation Report surveyed (February–June 2015) their blog’s learner–authors and external expert “staff” reviewers who had participated in coached peer review for their reactions to the process. The survey results revealed that participants viewed the process positively compared with both traditional journal peer review and academic blog publication processes. Participants found the process friendly, easy, efficient, and transparent. Learner–authors also reported increased confidence in their published material. These outcomes met the goals of coached peer review.

Next Steps
CanadiEM aims to inspire continued participation in, exposure to, and high quality production of academic writing by promoting the adoption of coached peer review for online educational resources produced by learners.

Posted in Front Page, Hot Topics in Research, Research Commentary, Uncategorized

What’s Wrong with Human/Nonhuman Chimera Research?

Perspective: What’s Wrong with Human/Nonhuman Chimera Research?

The National Institutes of Health (NIH) is poised to lift its funding moratorium on research involving chimeric human/nonhuman embryos, pending further consideration by an NIH steering committee. The kinds of ethical concerns that seem to underlie this research and chimera research more generally can be adequately addressed.

 

Hyun I (2016) What’s Wrong with Human/ Nonhuman Chimera Research? PLoS Biol 14(8): e1002535. doi:10.1371/journal.pbio.1002535

Posted in Hot Topics in Research, Research Commentary, September

Finding the Why, Changing the How: Improving the Mental Health of Medical Students, Residents, and Physicians

Finding the Why, Changing the How: Improving the Mental Health of Medical Students, Residents, and Physicians

The poor mental health of residents, characterized by high rates of burnout, depression, and suicidal ideation, is a growing concern in graduate medical education. Research is needed to gain a deeper understanding of the sources of distress as well as the sources of sustenance in residency training. The study by Mata and colleagues contributes significantly to this understanding. In addition to this line of research, however, studies are needed that assess the impact of interventions to help residents deal more effectively with the stress of training and find meaning in their work. Given the stresses of residency training, this approach may not make a dramatic difference in mental health outcomes. Efforts directed at changing the educational and clinical environments are also needed to reduce unnecessary stressors and create more positive settings for learning and clinical care. Since 2011, Saint Louis University School of Medicine has been pursuing a multipronged strategy to address these issues in the preclinical years. These efforts have led to dramatic decreases in depression and anxiety symptoms in students. An essential component of these interventions is the ongoing measurement of mental health outcomes across all four years of the curriculum. Leaders of residency programs, medical schools, and hospitals need to have the courage to measure these kinds of outcomes to spur change and track the efficacy of programs.

 

Slavin, Stuart J. MD, MEd; Chibnall, John T. PhD

Academic Medicine
Issue: Volume 91(9), September 2016, p 1194-1196
Copyright: (C) 2016 by the Association of American Medical Colleges
DOI: 10.1097/ACM.0000000000001226
Posted in Hot Topics in Research, Psychology and Psychiatry, Research Commentary, September

An Official Critical Care Societies Collaborative Statement—Burnout Syndrome in Critical Care Health-care Professionals

An Official Critical Care Societies Collaborative Statement—Burnout Syndrome in Critical Care Health-care Professionals
A Call for Action

Burnout syndrome (BOS) occurs in all types of health-care professionals and is especially common in individuals who care for critically ill patients. The development of BOS is related to an imbalance of personal characteristics of the employee and work-related issues or other organizational factors. BOS is associated with many deleterious consequences, includingincreased rates of job turnover, reduced patient satisfaction, and decreased quality of care. BOS also directly affects the mental health and physical well-being of the many critical care physicians, nurses, and other health-care professionals who practice worldwide. Until recently, BOS and other psychological disorders in critical care health-care professionals remained relativelyunrecognized. To raise awareness of BOS, the Critical Care Societies Collaborative (CCSC) developed this call to action. The present article reviews the diagnostic criteria, prevalence, causative factors, and consequences of BOS. It also discusses potential interventions that may be used to prevent and treat BOS. Finally, we urge multiple stakeholders to help mitigate the development of BOS in critical care health-care professionals and diminish the harmful consequences of BOS, both for critical care health-care professionals and for patients.

Marc Moss, MD; Vicki S. Good, RN, MSN, CENP, CPPS; David Gozal, MD, MBA; Ruth Kleinpell, PhD, RN, FAAN, FCCM; and Curtis N. Sessler, MD, FCCP, FCCM

CHEST 2016; 150(1):17-26

 

 

Posted in August, Hot Topics in Research, Research Commentary

Engaging Doctors in the Health Care Revolution

Engaging Doctors in the Health Care Revolution

A health care revolution is under way, and doctors must be part of it. But many are deeply anxious and angry about the transformation, fearing loss of autonomy, respect, and income. Given their resistance, how can health system leaders engage them in redesigning care? In this article, Dr. Thomas H. Lee, Press Ganey’s chief medical officer, and Dr. Toby Cosgrove, the CEO of the Cleveland Clinic, describe a framework they’ve developed for encouraging buy-in. Adapting Max Weber’s “typology of motives,” and applying behavioral economics and other motivational principles, they describe four tactics leadership must apply in concert: engaging doctors in a noble shared purpose; addressing their economic self-interest; leveraging their desire for respect; and appealing to their sense of tradition. Drawing from experiences at the Mayo Clinic, Geisinger Health System, Partners Healthcare, the Cleveland Clinic, Ascension Health, and others, the authors show how the four motivational levers work together to bring this critical group of stakeholders on board. INSETS: Idea in Brief;Creating Incentives;Inspiring Shared Purposes.

 

Lee, T. H., & Cosgrove, T. (2014). Engaging Doctors in the Health Care Revolution. Harvard Business Review, 92(6), 104-111.

Posted in Hot Topics in Research, July, Research Commentary

Medical error—the third leading cause of death in the US

Medical error—the third leading cause of death in the US

Analysis. Medical error is not included on death certificates or in rankings of cause of death. Martin Makary and Michael Daniel assess its contribution to mortality and call for better reporting.

 

BMJ 2016;353:i2139

Posted in Hot Topics in Research, June, Research Commentary

Risk literacy in medical decision-making

Risk literacy in medical decision-making – How can we better represent the statistical structure of risk?

Imagine that you have received a positive result on a routine cancer screening test. Follow-up biopsies were inconclusive, and the decision to treat aggressively or monitor conservatively is yours. Consider the following information: 0.1% of the population has a terminal version of this form of cancer, 99% of those people will appear positive on the test you have been administered, and 5% of those without terminal cancer will still have a benign condition that tests positive. Given your test result, what is the probability that you have terminal cancer and should treat it aggressively? When judging risks and trying to predict the future, how should you decide? We need to better understand the structure of risks and how the human mind creates representations of risk and probability.

 

Posted in Hot Topics in Research, May, Research Commentary

10 top patient safety issues for 2016

10 top patient safety issues for 2016

Healthcare has no doubt made giant strides in patient safety in recent years: According to an HHS report released in December, hospital-acquired condition rates dropped 17 percent from 2010 to 2014, leading to 87,000 fewer patient deaths in hospitals.

 

Becker’s Hospital Review,  January 12, 2016

Shannon Barnet, Max Green and Heather Punke

Posted in Hot Topics in Research, May, Research Commentary

Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report

Antithrombotic Therapy for VTE Disease: CHEST Guideline and Expert Panel Report

BACKGROUND: We update recommendations on 12 topics that were in the 9th edition of these guidelines, and address 3 new topics.

METHODS: We generate strong (Grade 1) and weak (Grade 2) recommendations based on high- (Grade A), moderate- (Grade B), and low- (Grade C) quality evidence.

RESULTS: For VTE and no cancer, as long-term anticoagulant therapy, we suggest dabigatran (Grade 2B), rivaroxaban (Grade 2B), apixaban (Grade 2B), or edoxaban (Grade 2B) over vitamin K antagonist (VKA) therapy, and suggest VKA therapy over low-molecular-weight heparin (LMWH; Grade 2C). For VTE and cancer, we suggest LMWH over VKA (Grade 2B), dabigatran (Grade 2C), rivaroxaban (Grade 2C), apixaban (Grade 2C), or edoxaban (Grade 2C). We have not changed recommendations for who should stop anticoagulation at 3 months or receive extended therapy. For VTE treated with anticoagulants, we recommend against an inferior vena cava filter (Grade 1B). For DVT, we suggest not using compression stockings routinely to prevent PTS (Grade 2B). For subsegmental pulmonary embolism and no proximal DVT, we suggest clinical surveillance over anticoagulation with a low risk of recurrent VTE (Grade 2C), and anticoagulation over clinical surveillance with a high risk (Grade 2C). We suggest thrombolytic therapy for pulmonary embolism with hypotension (Grade 2B), and systemic therapy over catheter-directed thrombolysis (Grade 2C). For recurrent VTE on a non-LMWH anticoagulant, we suggest LMWH (Grade 2C); for recurrent VTE on LMWH, we suggest increasing the LMWH dose (Grade 2C).

CONCLUSIONS: Of 54 recommendations included in the 30 statements, 20 were strong and none was based on high-quality evidence, highlighting the need for further research.

 

CHEST 2016; 149(2):315-352

Clive Kearon, MD, PhD; Elie A. Akl, MD, MPH, PhD; Joseph Ornelas, PhD; Allen Blaivas, DO, FCCP; David Jimenez, MD, PhD, FCCP; Henri Bounameaux, MD; Menno Huisman, MD, PhD; Christopher S. King, MD, FCCP; Timothy A. Morris, MD, FCCP; Namita Sood, MD, FCCP; Scott M. Stevens, MD; Janine R. E. Vintch, MD, FCCP; Philip Wells, MD; Scott C. Woller, MD; and COL Lisa Moores, MD, FCCP

Posted in Blood, Hot Topics in Research, Lung, March, Research Commentary