“Peer reviewing in foot and ankle; are you doing your part? – Literature insights and longitudinal editorial data from 2013–2025”

Keywords: percutaneous coronary intervention; structural heart disease intervention; congential heart disease; adults; congenital heart disease; pediatrics

ABSTRACTThe modern peer review process relies on review by independent experts; however, it is threatened by time constraints and increasing review demands placed on a limited number of involved individuals. To expand the pool of reviewers in paediatric urology, a joint effort was undertaken by the Journal of Urology and Journal of Paediatric Urology via a mentorship program occurring at the 2022 Paediatric Urology Fall Congress. The objective was to increase participants' knowledge and comfort with the review process. Our experience could serve as a pilot for other academic groups looking to expand their peer review pool. Overall, 39 individuals attended the program. An increase in comfort with performing a journal review was noted by 14/23 respondents (61%), with an average increase of 1.2 points on a 10‐point Likert scale. The average rating of satisfaction with the journal review program on a 10‐point scale was 9.7, with 77% (23/30) rating the program 10/10. When asked for specific elements of the program that participants particularly liked, the most common responses were networking with senior mentors in a small group setting and the panel discussion led by editors describing specifics of what they are looking for in a review. Previous programs with goals similar to ours have required more long‐term commitment from both mentors and mentees in developing their skills as peer reviewers. Our program benefited from a short‐term commitment at a large national conference. Long term results will need to be collected moving forward. However, initial feedback was positive and participants describe increased comfort and knowledge in the review process. Our program evaluation was limited by lack of validated surveys and a lack of longitudinal data on future completion of reviews. This pilot program inspired enthusiasm and increased interest in the peer review process among young paediatric urologists. This program could serve as a model for improving recruitment of peer reviewers and could impact reviewer quality.

The World Federation of Chiropractic and the Association of Chiropractic Colleges have hosted a biennial joint education conference for ten years with this being the second time that the proceedings were published in a peer-reviewed journal. The Journal of Chiropractic Education was delighted to sponsor the meeting by donating the work necessary to edit the proceedings for publication and post-production indexing, thereby making these proceedings available in indexing systems searched by academics at universities worldwide, including PubMed, Emerging Sources Citation Index, Scopus, the Index to Chiropractic Literature, the Cumulative Index to Nursing and Allied Health Literature, the Allied and Complementary Medicine Database, and MANTIS. Brighthall Inc, managed the call for papers, submissions, and administration of the peer-review process.The conference organizers recognized the international development of chiropractic training programs and the value of interactive formats and agreed to provide 4 different types of presentations for researchers to submit their work for peer review: platform presentation, poster presentation, innovation panels, and workshops.The call for papers was distributed in March 2018 and submissions were due May 1, 2018. All submissions were peer reviewed within a month by 45 independent reviewers from nearly every chiropractic training program around the world, represented by reviewers from 16 different countries. The peer-review committee is commended for exemplary work performed over a very short time. The peer reviewers included: Hasan Kerem Alptekin, MD, Bahçesehir Üniversity; Fernando R.M. Azevedo, DC, Universidade Anhembi Morumbi; Richard Brown, DC, LLM, World Federation of Chiropractic; David Byfield, DC, MPhil, Welsh Institute of Chiropractic; Robert Cooperstein, MA, DC, Palmer College of Chiropractic West; Barry Draper, DC, PhD, Central Queensland University; Ana Facchinato, DC, MHS, Southern California University of Health Sciences; Ricardo Fujikawa, MD, DC, Real Centro Univeristario Escorial Maria Cristina; Rosemary Giuriato, DC, DO, Macquarie University; Dominic Giuliano, DC, Canadian Memorial Chiropractic College; Chris Good, DC, MAEd, University of Bridgeport College of Chiropractic; Bart Green, DC, MSEd, PhD, Stanford Health Care, National University of Health Sciences; Julie-Marthe Grenier, DC, Université du Québec à Trois-Rivières; Navine Haworth, DC, PhD, Victoria University; Michael Haneline, DC, MPH, International Medical University; Xiaohua He, MD, MS, Palmer College of Chiropractic Florida; Sean Herrin, DC, University of Western States; Kelly Holt, BSc, PhD, New Zealand College of Chiropractic; Adrian Hunnisett, PhD, MPhil, McTimoney College of Chiropractic; Claire Johnson, DC, MSEd, PhD, National University of Health Sciences; HanSuk Jung, DC, PhD, HanSeo University; Martha Kaeser, DC, Med, Logan University; Amilliah Kenya, DC, MS, Sherman College of Chiropractic; Charmaine Korporaal, MTech, Durban University of Technology; Arnaud Lardon, DC, PhD, Institut Franco-Européen de Chiropratique; Henrik Hein Lauridsen, DC, MSc, PhD, Syddansk Universitet Odense; Deborah Barr, MS, SCD, New York Chiropractic College; Clay McDonald, DC, MBA, JD, Logan University; John Mrozek, DC, Med, Texas Chiropractic College; Daniel Mühlemann, DC, University of Zurich; David Newell, PhD, AECC University College; Per J. Palmgren, RC, MMedEd, PhD, Karolinska Institutet; Lisa Rubin, PhD, Life University; Eric Russell, DC, Parker University; Thiana Paula Schmidt dos Santos, DC, Centro Universitario Feevale; Monica Smith, DC, PhD, Life Chiropractic College West; Christopher Smoley, DC, D'Youville College; Michael Tunning, DC, ATC, MS, Palmer College of Chiropractic; Adrian Wenban, DC, MMedSc, Barcelona College of Chiropractic; Stephney Whillier, BSc, BEd, PhD, Macquarie University; Michael Wiles, DC, MEd, MS, Keiser University; Chris Yelverton, MTech, University of Johannesburg; Kenneth Young, DC, MAppSc, Murdoch University.Tobias Barnard, Atheesha Singh, Shelley Blundell, Christopher YelvertonProper hand hygiene has been described as an important barrier in the defense against hospital acquired infections, along with the spread of antimicrobial resistance in the bacteria that cause these infections. Research has shown that although healthcare workers understand the principles and importance of hand hygiene, they do not always practice proper hand hygiene. The aim of this pre-post intervention study was to monitor the changes in the bacterial population on the hands of chiropractic students at a Chiropractic Clinic pre and post a hand hygiene education intervention. Sixty participants completed the World Health Organization hand hygiene survey to determine their hand hygiene knowledge, attitude and practices (KAP), and had their hands sampled to quantify the bacterial population present. The bacterial population was quantified using flow cytometry and reported as total, live and dead bacteria present. The survey answers showed that the participants reported knowledge, attitudes and practices did improve after the education intervention (presentations and posters in toilets and consultation rooms). The microbiological data showed that although there was a decrease in the total bacterial population after the intervention, the portion live cells increased after the intervention. Comparing the change in microbiological data with the change in KAP answers provided (pre- and post-intervention), showed that although the participants understood the importance of proper hand hygiene practices, it was not supported by the microbiological data. The data showed that the effectiveness of hand hygiene education need to be monitored using a microbiological method to properly combat the spread of infections. (This is a conference presentation abstract and not a full work that has been published.)Lydia Brodie, Pierre Côté, Christine Mechamalil, Sheilah Hogg-Johnson, Canadian Memorial Chiropractic College; Kathy Smith, Craig Jacobs, Linda CarrollObjective: To determine the one-week prevalence of neck pain and low back pain in this population. To determine whether neck and low back pain is correlated with psychological stress in undergraduate chiropractic students attending the Canadian Memorial Chiropractic College (CMCC). Methods: We conducted a cross-sectional study of the CMCC students during the fall semester 2017. We collected data using the CMCC Mental Health and Wellness Questionnaire, an electronic questionnaire designed for in-class administration. The questionnaire includes measures of neck and low back pain intensity (0-10 Numeric Pain Rating Scale) and psychological stress (DASS-21 scale - Depression, Anxiety and Stress Scale). The questionnaire also includes instruments to measure lifestyle factors. We measured the correlation between neck pain, low back pain and stress using Pearson's correlation. Results: We recruited 510 students, for a participation rate of 67%. The mean age of our sample was 24.6 years with 60% female. Overall, the one week prevalence of neck pain was 76.9%, 95% CI [73,81] and of low back pain 69.0%, 95% CI [65,73]. Stress was reported as normal in 63.3%, mild 14.9%, moderate 16.7%, severe 3.9% and extremely severe 1.2% over one week. We found that neck pain and stress (r=0.348) and low back pain and stress (r=0.259) were positively correlated. Conclusion: A significant number of CMCC students report experiencing neck pain, low back pain and symptoms of psychological stress. Understanding whether pain and psychological stress are associated may inform the management and prognosis of neck and back pain in chiropractic students. (This is a conference presentation abstract and not a full work that has been published.)Danny Clegg, David Byfield, Alister DuRosePsychomotor skills training is a key component of a Chiropractic education programme, and is considered an educational challenge. As well as individual proficiency issues, students often report difficulties with time-distribution of tutors, particularly when they are seeking reinforcement that they are making progress. Learning complex psychomotor skills requires time and repetition, therefore feedback is an important learning tool for students. In order to address these issues, a digital platform was sourced and adapted for the purpose of increasing student feedback through self-directed and directed mediums. VEO is a digital application which allows videos recorded by instructors and students to be uploaded from any device to a secure, dedicated server, for self-assessment and direct tutor feedback as required. VEO was introduced as part of the year 2 Chiropractic manual skills module during the 2017-18 academic year, with students voluntarily invited to participate as both part of, and an adjunct to, classroom learning. Standard setting of all VIVA examination assessment points was completed between the assessors prior to examination, and none of the assessors were aware of VEO engagement data. The initial cross-sectional study identified a significant positive correlation between the number of videos students engaged in and VIVA 1 performance (r=0.273, p=0.038). Follow-up analysis included performance for VIVA 1 and VIVA 2. Significant positive correlation was again identified between the number of videos students engaged in with both VIVA 2 (r=0.272, p=0.039), and overall VIVA outcomes (r=0.350, p=0.007). Further significant positive correlation was identified between overall VIVA outcomes and total number of videos uploaded directly by students for adjunctive feedback (r=0.340, p=0.009). This study indicates that employing VEO enhances manipulative psychomotor skill support and acquisition. (This is a conference presentation abstract and not a full work that has been published.)David Côté, Kathy Smith, Pierre CôtéObjective: To measure the one-week prevalence of moderate to extremely severe psychological distress (depression, anxiety and stress) and three-month prevalence of substance use (alcohol, tobacco, cannabis, amphetamines and hallucinogens) in chiropractic students enrolled at the Canadian Memorial Chiropractic College (CMCC). We also measured the association between psychological distress and substance use. Methods: We conducted the CMCC Mental Health and Wellness Cross-sectional Study in the Fall of 2017. Enrolled students at CMCC were eligible for participation. We measured depression, anxiety and stress using the Depression, Anxiety, Stress Scales-21 and substance using the WHO ASSIST questionnaire. We report the prevalence of psychological distress and substance use. We used multivariable logistic regression to measure the association between psychological distress and substance use. Results: The participation rate was 67% (510/766). The mean age was 24.6 years, and 60% were females. The one-week prevalence of moderate to extremely severe symptoms was 19.0% for depression, 32.6% for anxiety and 21.8% for stress. In the past three months, 91.0% reported using alcohol, 33.1% used cannabis, 18.0 % used tobacco, 5.1% used amphetamines and 4.5% used hallucinogens. The associations between substance use and mental health outcomes will be presented at the conference. Conclusions: A significant proportion of CMCC students report moderate to extremely severe symptoms of depression anxiety, stress. We fond that the consumption of alcohol, cannabis, and tobacco is high. Understanding the prevalence of psychological distress and substance use in chiropractic students is important for educators because they impact academic performance and attainment of future career goals. (This is a conference presentation abstract and not a full work that has been published.)Ian Coulter, Gery Ryan, Lea Xenakis, Lisa Kraus, Lara HiltonIn deconstructing the placebo scholars have elevated the importance of the context of the health encounter recognizing that the encounter may not simply be a non-specific effect. This study developed a rapid ethnographic observation method to study the context of the encounter. What kinds of contextual factors are patients exposed to during chiropractic encounters; how do you measure such contextual factors reliably via observation and/or patient and provider recall; how do you assess the degree to which contextual factors might vary within and across practice sites, providers, and individual patients. We defined healthcare encounters as what patients experience between when they arrive at a practice site to when they exit the building. Any given encounter can be described along 5 key logical dimensions: (1) where patients are (space), (2) with whom they interact (social), (3) what is communicated between them (communication), (4) what patients do or what is done to them (behavior), and (5) for how long and in what order 1-4 occur (time). This study was conducted in three phases. In Phase 1, we conducted focus groups with chiropractic patients to delineate these features of the health encounter thought to be important to patients. In Phase 2, we conducted a pilot rapid ethnographic observation study of a single chiropractic clinic to determine how to measure the elements of the encounter identified by the patient focus groups. In Phase 3, we conducted a national study in three states using a representative sample in each state. (This is a conference presentation abstract and not a full work that has been published.)Ian Douglass Coulter, Patricia HermanObjective: To expand the RAND/UCLA appropriateness of care methodology to include patient preferences and resource utilization, and the impact of care appropriateness on patient outcomes. Data Sources/Study Setting Primary data from expert panels, focus groups, chiropractors, chiropractic patients with chronic low back pain (CLBP) and chronic cervical pain (CCP), and from internet “workers” via crowdsourcing. Study setting is a cluster sample of 125 chiropractic clinics from six US regions. Study Design This multicomponent methods study includes analysis of longitudinal data on patient outcomes, preferences, CLBP and CCP symptoms and healthcare utilization. Data Collection/Extraction Methods: Data were collected bi-weekly on 2025 patients for 3 months via online surveys that included both new and legacy measures, including PROMIS and CAHPS. Principle Findings: Appropriateness panels generated ratings for 450 CLBP and 180 CCP indications which were then applied to patient charts. Data was collected from 2025 patients and from 3000 patient files. Conclusions: Patient-centered care is a significant policy initiative but translating it into policy that has been clinician and research-expert based, poses significant methodological issues. Nonetheless, we make the case that patient preferences, self-reported outcomes, and financial burden should be considered in the evaluation of the appropriateness of healthcare. (This is a conference presentation abstract and not a full work that has been published.)Owis Eilayyan, Aliki Thomas, Sara Ahmed, Anthony Tibbles, Craig Jacobs, Fadi Alzoubi, Andre BussieresIntroduction: Despite guidelines recommending clinicians use Self-Management Support (SMS), uptake is suboptimal. Previously identified barriers to using SMS among chiropractors, interns and patients informed the design of a knowledge translation (KT) intervention for use in chiropractic teaching clinics. Objective: To estimate the feasibility and potential effectiveness of a KT intervention to promote the use of SMS among chiropractors, interns and patients with spine pain compared to control. Methods: Pilot clinical trial across 4 outpatient-teaching clinics. Twenty Patient Management Teams (PMTs), each composed of 6-9 interns supervised by a clinician, were allocated to either the intervention (training workshop, webinar, e-educational module, and opinion leader) or wait-list. We assessed clinicians' and interns' SMS perceived importance, skills and confidence. Results: Sixteen (84%) clinicians and 39 (29%) interns agreed to participate. Clinicians (n=7 and n=9) and interns (n=17 and n=22) were allocated to the KT intervention and control groups respectively. Nearly all clinicians completed baseline and first follow-up surveys. 16 and 15 interns in the intervention and control group completed the baseline surveys respectively, while 11 and 10 interns completed second follow-up surveys. Preliminary estimates showed that intervention group clinicians had greater improvements in SMS perceived importance (mean change 0.24vs-0.02), skills (1.1vs0.43), and confidence (0.51vs0.35) compared to controls. Interns in both groups had mixed results. Conclusion: Preliminary results of this ongoing trial suggest that conducting a larger implementation trial in this setting is feasible. Theory-based tailored KT interventions may increase the likelihood of effective uptake and application of guideline recommendations within academic teaching institutions. (This is a conference presentation abstract and not a full work that has been published.)Karin Hammerich, Kent Stuber, Anser Abbas, Martin Harris, Sheilah Hogg-Johnson, Henrik Hein Lauridsen,Nadege Lemeunier, Michele MaiersBackground: A patient-centered approach is desirable in patient care. Attitudes of students towards patient-centred care in other health professions has been assessed; however, what chiropractic student attitudes are towards patient-centered care and variations between programs is unknown. Objective: To assess student attitudes towards patient-centred care among selected chiropractic programs worldwide. Methods: Students from seven chiropractic educational programs completed an online survey consisting of demographics and the Patient-Practitioner Orientation Scale (PPOS). PPOS assesses patient-centred attitudes towards the doctor-patient relationship. The PPOS provides scores between 1 and 6, (lower scores suggesting a more doctor-centred approach; higher scores, a more patient-centred approach). Results were analyzed descriptively and inferentially for overall, sharing and caring subscales. A general linear regression model identified factors associated with PPOS scores. Results: There were 1858 respondents (50.8% response rate). Student average age was 24.7 (range=17-58) years and 56.2% were female. The average overall PPOS score was 4.18 (SD=0.48), while the average sharing and caring subscale scores were 3.89 (SD=0.64) and 4.48 (SD=0.52), respectively. Gender, age, and program contributed small but significant differences in all PPOS scores. Year/semester of study within program typically did not significantly affect scores, neither did history of previous chiropractic care or having family members who are health professionals. Conclusion: We found small but significantly different PPOS scores between programs. Average scores tended to trend slightly lower than those reported in other health professions. Research exploring other factors, including curricular content and student beliefs, may help explain the observed student patient-centred attitudes. (This is a conference presentation abstract and not a full work that has been published.)Igor Himelfarb, Bruce ShottsThe assumption of local independence (LID) is violated when several items refer to the same vignette or items are related in other ways. The NBCE Written Clinical Competency Exam (Part III) consists of two sections, with a total of 110 multiple-choice questions and 10 case vignettes. The nature of the vignette items violates the assumption of LID for items nested within a vignette. We consider these items testlets. Due to the close relevance of within-testlet items, the LID assumption is violated, ignoring what often results in item parameter estimation bias (Wainer, Sheehan, and Wang, and of and The of this is to a model for items with of The model is on the by and The approach on LID by the estimation of the at In this we a estimation which of their approach while the We several to whether our model provides estimates than for We to to a and the to the data. we our model using the and the parameter estimates and to the generated (This is a conference presentation abstract and not a full work that has been Hunnisett, The aim of this study was to student preferences and in the of academic with the classroom Methods: students were into 2 groups on 2 one group a classroom model the second group a classroom a at prior to a was assessed by a at the of the and students completed a small survey exploring on the teaching model the second the groups were Results: significant was in knowledge between the 2 groups Student was slightly higher in the group although not The for increased was of case to the to was increased in the Conclusions: This small scale pilot study the approach has over in of knowledge acquisition. there do to be for the student experience that may improve Further over and with larger is (This is a conference presentation abstract and not a full work that has been David developed for with are on for the general population. of and questions in and data. The PROMIS Health assessment is and for the general population but there are that that focus on use for with in a To and how Logan at patients to each of the assessment to for this population in this Methods: This study reviewed patient from Cross-sectional data analysis at the correlation between PROMIS scores and Results: who presented with a history of reported the in their scores from baseline with the in their score for showed the from baseline in all groups MS, and over the age of showed the overall in scores across all and pain scores showed the among all age groups. The in scores were in the age showed the in scores. showed the in health scores. Conclusion: This pilot with support the need for in this an assessment PROMIS can be to measure overall health and in this we can understand what methods across of health care are effective in health and for with (This is a conference presentation abstract and not a full work that has been Clinical are used in the education of healthcare to assess their performance during patient for and are by selected response questions to assess clinical and provide This the methods of setting a and the results The National of Chiropractic to examination using and a approach Methods: The examination item were using The were within of the All encounter and selected response questions from each of the three and Chiropractic were in order of in A representative committee chiropractic clinical members was and members to a which the to a to Results: The three each 3 of to to an The was completed in Conclusion: This approach to setting and to be and on the than the previous which used and a (This is a conference presentation abstract and not a full work that has been In healthcare health need to work in to improve of care. an was developed to improve individual and support care. the through to and attainment clinical Methods: The was in the performance and due for their and their were education of an and on the for groups completed and a meeting and a survey was to completed a key analyzed for Results: and two were completed the All reported they understood the and that the with the of the was moderate to confidence in all had a of the and recognized the importance of these in the identified two and the need support for the new Conclusions: completed the knowledge the and had confidence in the the importance of the practice context and of support for the as elements in the of this (This is a conference presentation abstract and not a full work that has been Lemeunier, Pierre CôtéObjective: Chiropractic students their time and in examination to of these have or or We aim to the of teaching these to chiropractic students and a to this We conducted on the and of used to assess neck and low back pain patients. We the using A of clinical and used the to recommendations the use of these and with and informed the development of Results: clinical used by to assess neck and low back pain patients have and these are in chiropractic We that educators and clinicians focus on teaching the use of that have and and clinicians need to understand the impact of and impact on patient care. Conclusion: results will help to the approach to used for patients with neck and low back (This is a

This article surveys, discusses and classifies methods for ex-post evaluation of the efficiency of competition authorities: court appeals, peer reviews, case studies, event studies, (authorities’ own) bottom-up calculations of consumer gains, deadweight-loss estimates, cross-country panel studies etc. Based on empirical estimates from other types of studies and on a simple oligopoly model, one conclusion is that many bottom-up calculations are based on exaggerated estimates of gains from cartel enforcement, relative to those from merger enforcement. Another conclusion is that authorities’ ex-post self evaluations are of limited value, relative to external evaluations.

Previously, we showed that 3% (31/1032)of asymptomatic healthcare workers (HCWs) from a large teaching hospital in Cambridge, UK, tested positive for SARS-CoV-2 in April 2020. About 15% (26/169) HCWs with symptoms of coronavirus disease 2019 (COVID-19) also tested positive for SARS-CoV-2 (Rivett et al., 2020). Here, we show that the proportion of both asymptomatic and symptomatic HCWs testing positive for SARS-CoV-2 rapidly declined to near-zero between 25th April and 24th May 2020, corresponding to a decline in patient admissions with COVID-19 during the ongoing UK ‘lockdown’. These data demonstrate how infection prevention and control measures including staff testing may help prevent hospitals from becoming independent ‘hubs’ of SARS-CoV-2 transmission, and illustrate how, with appropriate precautions, organizations in other sectors may be able to resume on-site work safely.

Decision letter: Effective control of SARS-CoV-2 transmission between healthcare workers during a period of diminished community prevalence of COVID-19

The Authors Reply:— Drs. Dawson and Arkes are to be commended on their detailed analysis of our paper. However, as our response indicates, their analysis fails to affect the interpretation of the data we reported. Drs. Dawson and Arkes express concern that our study did not provide the opportunity for residents to list a differential diagnosis for the patient’s chest pain and that we interpreted cross-sectional data as if they were longitudinal data. What they fail to realize is that in the emergency setting, even with a differential diagnosis in mind, a physician must ultimately make a decision as to whether or not to recommend thrombolysis. At least five studies (not conducted by any of us) have demonstrated that African-American patients are less likely to receive thrombolysis under this circumstances. Our concern was not with the role of race in the recommendation of thrombolysis. Rather, we were interested in the degree to which racial bias as measured by a test of implicit race attitude (the IAT) would predict physicians’ recommendation of thrombolysis to black versus white patients. As is routine in such studies (and in the situations physicians commonly face), we designed the vignette to be ambiguous so as to test the direction of decisions that individual doctors would follow. Indeed, we found that IAT scores are correlated with treatment decisions, and that this correlation is opposite for black and white patients. Additionally, given that these are cross-sectional data, we carefully offered no causal claims in the article. Nor do we make any claim regarding the mechanism that produces this relationship. Regarding the use of terms such as “increasing time for association,” “racial preference,” “racial bias,” and “pro-white/pro-black scores,” we agree that these do not represent a sequence of synonyms. However, these terms are appropriate for the context in which they appear in the manuscript and did not seem to mislead our own internal reviewers, the JGIM peer reviewers, or the editors. Regarding our analyses, we understand why Dawson and Arkes were tempted to interpret the interaction plot the way they did. Across social and medical science it is common for scientists to graph interactions with plots depicting both the interaction variance and the main effect variance even though the statistical test of the interaction refers only to the pure (i.e., unique) interaction variance. As such, one is tempted to interpret the means (in the case of a bar graph) or the data points on a line graph (i.e., the four data points the authors refer to and for which a bar graph was provided). However, it is a mistake to interpret the means as part of the interaction when one is interested purely in the nature of the interaction. Interaction plots such as these are not pure interaction plots; they contain variance from main effects. To the extent that main effects are non-zero, an interaction graph will not appear to be a crossover interaction. Any pure interaction looks exactly the same; as a cross-over pattern (see Ralph Rosnow and Robert Rosenthal, 1991).1 Thus, a re-interpretation of our result on this basis is incorrect. Our data show that as physicians’ bias against blacks increased, recommendations decreased. This was the reverse for white patients. This was our modest conclusion, and the one we stand by. We cannot abide by Dawson and Arkes’ suggestion to interpret the behavior of doctors at specific points along the continuum. Finally, due to space limitations, we did not include a detailed discussion of alternative hypotheses. This limitation cannot affect the integrity of the study itself, and we appreciate that Dawson and Arkes have provided these on our behalf.

The challenges of open access data

Recommendations for Reporting of Clinical Research Studies