High Impact Factor Medical Journals Research Articles

Response time of high impact factor medical journals versus an expert-curated, online oncology platform before and during the COVID-19 pandemic.

465 Background: The objective of this study was to characterize the publication speed of high impact factor medical journals (HIFMJ) compared with the dissemination speed of a private, expert-curated, online platform (ECOP) designed for oncologists. We also aimed to describe determinants of response speed to questions on this platform. Methods: We selected 100 HIFMJ and calculated their reported peer review time (Submission to Acceptance [STA]). The platform database was queried between the dates 2017 and 2022 with information collected about day of query, response time (RespT), and poster gender, region, and medical school graduation year. This data was analyzed utilizing univariable median regression analyses and two t-tests as appropriate. Results: Of the 26 available medical journal response times, the average STA was 57.36 days (range: 2.6 - 204 days). Of the 4,346 online platform questions and answers (Q+A), the mean RespT was noted to be significantly lower at 2.63 days (CI, 2.19 - 3.07 days). With the ECOP, the mean RespT for male posters (mean: 2.58 days; CI, 2.08 - 3.08) and female posters (mean: 2.72 days, CI, 1.89 - 3.56) was not significantly different (p=0.61). RespT from 2017 to 2019 increased slightly (p<0.001) before trending down during the COVID pandemic (p<0.02). Mean RespT before the Covid pandemic in the United States, March 15, 2020 (2.68 days, CI, 2.11 - 3.25), was non-significantly reduced as compared with questions after March 15, 2020 (2.17 days, CI, 1.88 - 2.46, p=0.13). Conclusions: Traditional peer review proves a lengthy process in contrast to real-time, Q+A-based oncology platforms. An ECOP allows physicians the ability to provide their expertise regarding rare, nuanced patient cases in order to better ensure all patients receive the highest level of clinical care. During the onset of the COVID-19 pandemic, the ability to share medically curated information to ensure safe and effective oncologic care in a timely manner proved imperative, as information regarding the virus was evolving rapidly. During this unprecedented time, this platform provided oncologists with a novel way to quickly vet case reports and disseminate scientific information. This, in turn, translated into cancer care “best practices” during a rapidly evolving crisis.

Increased endorsement of TRIPOD and other reporting guidelines by high impact factor journals: survey of instructions to authors

ObjectivesTo assess the endorsement of reporting guidelines by high impact factor journals over the period 2017–2022, with a specific focus on the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) statement. Study Design and SettingWe searched the online ‘instructions to authors’ of high impact factor medical journals in February 2017 and in January 2022 for any reference to reporting guidelines and TRIPOD in particular. ResultsIn 2017, 205 out of 337 (61%) journals mentioned any reporting guideline in their instructions to authors and in 2022 this increased to 245 (73%) journals. A reference to TRIPOD was provided by 27 (8%) journals in 2017 and 67 (20%) in 2022. Of those journals mentioning TRIPOD in 2022, 22% provided a link to the TRIPOD website and 60% linked to TRIPOD information on the Enhancing the QUAlity and Transparency Of health Research (EQUATOR) Network website. Twenty-five percent of the journals required adherence to TRIPOD. ConclusionAbout three-quarters of high-impact medical journals endorse the use of reporting guidelines and 20% endorse TRIPOD. Transparent reporting is important in enhancing the usefulness of health research and endorsement by journals plays a critical role in this.

Comparing scientific abstracts generated by ChatGPT to real abstracts with detectors and blinded human reviewers

Large language models such as ChatGPT can produce increasingly realistic text, with unknown information on the accuracy and integrity of using these models in scientific writing. We gathered fifth research abstracts from five high-impact factor medical journals and asked ChatGPT to generate research abstracts based on their titles and journals. Most generated abstracts were detected using an AI output detector, ‘GPT-2 Output Detector’, with % ‘fake’ scores (higher meaning more likely to be generated) of median [interquartile range] of 99.98% ‘fake’ [12.73%, 99.98%] compared with median 0.02% [IQR 0.02%, 0.09%] for the original abstracts. The AUROC of the AI output detector was 0.94. Generated abstracts scored lower than original abstracts when run through a plagiarism detector website and iThenticate (higher scores meaning more matching text found). When given a mixture of original and general abstracts, blinded human reviewers correctly identified 68% of generated abstracts as being generated by ChatGPT, but incorrectly identified 14% of original abstracts as being generated. Reviewers indicated that it was surprisingly difficult to differentiate between the two, though abstracts they suspected were generated were vaguer and more formulaic. ChatGPT writes believable scientific abstracts, though with completely generated data. Depending on publisher-specific guidelines, AI output detectors may serve as an editorial tool to help maintain scientific standards. The boundaries of ethical and acceptable use of large language models to help scientific writing are still being discussed, and different journals and conferences are adopting varying policies.

An Audit of Interim Analyses of Randomized Controlled Trials (RCTs) Published in Three High Impact Factor Medical Journals Over a Seven- year Period (2012-2018).

Interim analysis is an integral component of clinical research and drug development in particular and helps reduce 'time to market' for an intervention or stop further development of unsafe and ineffective interventions. In this audit, we evaluated the extent of use of interim analyses in published RCTs in three leading journals and their impact on regulatory approval. RCTs published in JAMA, NEJM and Lancet in the year 2012 to 2018 were extracted. Each RCT was scrutinized using the filter term 'Interim'. Both descriptive and inferential statistics were used to analyze the data. The factors (therapeutic areas, nature of interventions, source of funding and phases of trials) associated with Interim analysis and its impact on drug approval were analyzed. The majority of RCTs with interim analysis belonged to oncology (27%) and cardiology (17.2%) and were related to drugs (70%). Majority of the RCTs were in phase 3 (56.3%) and funded exclusively by Pharmaceutical industry (36.2%). A total of 2% and 14% studies led to accelerated approval and normal regulatory approval. The choice of alpha spending function was not mentioned in 44.8% studies and 21% studies used O-Brien Fleming method. A total of 18.5% studies were stopped early. The oncology trials, drug as intervention and Phase 3 trials were associated with the conduct of interim analysis which was associated with significantly higher numbers of accelerated and routine regulatory approvals. Majority of the RCTs with interim analysis were from oncology and most did not report a stopping rule. Interventions that were drugs (rather than devices or surgical procedures). and phase 3 trials (relative to other phases of RCTs). were associated with significantly higher number of interim analyses which was also associated with significantly higher number of regulatory approvals.

Caveat medicus: Harrowing experiences of clinicians who identify and publish near-fatal oncology associated adverse drug reactions.

6584 Background: Less than 1-10% of adverse drug reactions are reported. It is even more rare to find clinicians who choose to publish these reports in the literature. We identified clinicians who had treated a patient for an oncology-associated serious adverse drug reaction and published these findings. This is the first study that has investigated personal experiences of clinicians choosing to publish information about serious oncology-associated drug reactions they see in their patients. Methods: Clinicians treating individual patients who developed oncology-associated serious adverse drug events were asked to participate. Inclusion criteria included having index patient information, reporting case series, and being collaborative with investigators from two National Institutes of Health funded pharmacovigilance networks. Thirty-minute interviews addressed feedback from pharmaceutical manufacturers, FDA personnel, and academic leadership, and recommendations for improving pharmacovigilance. Responses were analyzed using constant comparative methods of qualitative analysis. Results: 18 clinicians met inclusion criteria and 14 interviewees are included. Toxicities included central nervous system infections, arterial/venous thromboembolism, gastrointestinal toxicity, cardiac arrhythmias, and cancer development/progression. These investigations were frequently followed by label warnings and/or convening of Food and Drug Administration (FDA) Advisory Committee reviews of safety findings. Five studies were disseminated in four high-impact factor medical journals (JAMA, Lancet, Annals of Internal Medicine, and New England Journal of Medicine). Six clinicians received feedback characterized as supportive from academic leaders, while four clinicians received feedback characterized as negative. Responses from pharmaceutical manufacturers were characterized as negative by 12 clinicians. Responses from FDA employees were characterized as negative by six clinicians. Three clinicians recommended that pharmacovigilance should include simplified clinician reporting systems. Conclusions: Our study finds that clinicians who published reports of serious oncology-associated drug reactions experienced negative feedback from pharmaceutical manufacturers. Feedback from FDA employees and academic clinicians were viewed as supportive by some and negative by others. Most clinicians recommended that future pharmacovigilance involve big data analyses.

Publications on Clinical Research in Otolaryngology-A Systematic Analysis of Leading Journals in 2010.

Background: We wanted to asses and characterize the volume of Otolaryngology publications on clinical research, published in major journals.Methods and Material: To assess volume and study type of clinical research in Otolaryngology we performed a literature search in high impact factor journals. We included 10 high impact factor Otolaryngology journals and 20 high impact factor medical journals outside this field (2011). We extracted original publications and systematic reviews from 2010. Publications were classified according to their research question, that is therapy, diagnosis, prognosis or etiology.Results: From Otolaryngology journals (impact factor 1.8 to 2.8) we identified 694 (46%) publications on original observations and 27 (2%) systematic reviews. From selected medical journals (impact factor 6.0 to 101.8) 122 (2%) publications related to Otolaryngology, 102 (83%) were on original observations and 2 (0.04%) systematic reviews. The most common category was therapy (40%).Conclusion: Half of publications in Otolaryngology concerns clinical research, which is higher than other specialties. In medical journals outside the field of Otolaryngology, a small proportion (2%) of publications is related to Otolaryngology. Striking is that systematic reviews, which are considered high level evidence, make up for only 2% of publications. We must ensure an increase of clinical research for optimizing medical practice.

Year in Review: Synopsis of Selected Articles in Neuroanesthesia and Neurocritical Care from 2018

AbstractThis review is a synopsis of selected articles from neuroscience, neuroanesthesia, and neurocritical care from the year 2018 (January–October 2018). The journals reviewed included anesthesia journals, critical care medicine journals, neurosurgical journals as well as high-impact factor medical journals such as Lancet, Journal of American Medical Association (JAMA), New England Journal of Medicine (NEJM), and Stroke. This summary of important articles will serve to update the knowledge of anesthesiologists and other perioperative physicians who provide care to neurosurgical and neurocritical patients.

The Use of the Number Needed to Treat (NNT) to Assess the Effects of Medicinal Interventions: A Quality Assessment

The number needed to treat (NNT) is interpreted as the number of patients needed to treat with one therapy versus another for one patient to encounter an additional outcome of interest over a given period of time1-2. There are few methods to calculate NNTs, which use depends on the study design. This study aims to describe how NNT has been reported in medical literature, and assess the appropriateness of calculating methods according to different study designs and type of variables. Top-25 high impact-factor medical journals were screened to identify studies (2006-2015), assessing medicines and reporting NNTs. Studies were categorized according to their design, and type of variables (binary or time-to-event). NNT estimates were assessed for completeness (baseline risk, time-horizon, and confidence intervals [CI]). The appropriateness of methods used for calculating NNTs was assessed based on published evidence. Data analyses comprehended descriptive statistics. Further the chi-square test was used to test differences between study designs and also type of variables on the likelihood of applying inadequate methods. The search returned 138 citations; 57 were selected. Nearly half were meta-analyses (49.1%), followed by clinical trials (29.9%), cohort (17.5%) and case-control studies (3.5%). Binary variables were more common (82.5%) than time-to-event (17.5%) outcomes. Baseline risk (64.9%), time-horizon (68.4%) and CI (57.9%) for NNT were not always reported. Overall, 29% of studies applied inadequate methods for calculating NNTs; this proportion was higher in meta-analyses (54%) as compared to other research designs (P=0.003). No differences were found between type of variables and appropriateness of methods (p=0.972). A considerable proportion of studies, particularly meta-analyses, applied inadequate methods for calculating NNTs. Despite their usefulness in assisting clinical decisions, NNTs are uninterpretable if incompletely reported, and may be misleading if calculating methods are inadequate to study designs and variables under evaluation.

Global collaborative networks on meta-analyses of randomized trials published in high impact factor medical journals: a social network analysis

BackgroundResearch collaboration contributes to the advancement of knowledge by exploiting the results of scientific efforts more efficiently, but the global patterns of collaboration on meta-analysis are unknown. The purpose of this research was to describe and characterize the global collaborative patterns in meta-analyses of randomized trials published in high impact factor medical journals over the past three decades.MethodsThis was a cross-sectional, social network analysis. We searched PubMed for relevant meta-analyses of randomized trials published up to December 2012. We selected meta-analyses (including at least randomized trials as primary evidence source) published in the top seven high impact factor general medical journals (according to Journal Citation Reports 2011): The New England Journal of Medicine, The Lancet, the BMJ, JAMA, Annals of Internal Medicine, Archives of Internal Medicine (now renamed JAMA Internal Medicine), and PLoS Medicine. Opinion articles, conceptual papers, narrative reviews, reviews without meta-analysis, reviews of reviews, and other study designs were excluded.ResultsOverall, we included 736 meta-analyses, in which 3,178 authors, 891 institutions, and 51 countries participated. The BMJ was the journal that published the greatest number of articles (39%), followed by The Lancet (18%), JAMA (15%) and the Archives of Internal Medicine (15%). The USA, the UK, and Canada headed the absolute global productivity ranking in number of papers. The 64 authors and the 39 institutions with the highest publication rates were identified. We also found 82 clusters of authors (one group with 55 members and one group with 54 members) and 19 clusters of institutions (one major group with 76 members). The most prolific authors were mainly affiliated with the University of Oxford (UK), McMaster University (Canada), and the University of Bern (Switzerland).ConclusionsOur analysis identified networks of authors, institutions and countries publishing meta-analyses of randomized trials in high impact medical journals. This valuable information may be used to strengthen scientific capacity for collaboration and to help to promote a global agenda for future research of excellence.

Endorsement of the CONSORT Statement by high impact factor medical journals: a survey of journal editors and journal 'Instructions to Authors'.

BackgroundThe CONSORT Statement provides recommendations for reporting randomized controlled trials. We assessed the extent to which leading medical journals that publish reports of randomized trials incorporate the CONSORT recommendations into their journal and editorial processes.MethodsThis article reports on two observational studies. Study 1: We examined the online version of 'Instructions to Authors' for 165 high impact factor medical journals and extracted all text mentioning the CONSORT Statement or CONSORT extension papers. Any mention of the International Committee of Medical Journal Editors (ICMJE) or clinical trial registration were also sought and extracted. Study 2: We surveyed the editor-in-chief, or editorial office, for each of the 165 journals about their journal's endorsement of CONSORT recommendations and its incorporation into their editorial and peer-review processes.ResultsStudy 1: Thirty-eight percent (62/165) of journals mentioned the CONSORT Statement in their online 'Instructions to Authors'; of these 37% (23/62) stated this was a requirement, 63% (39/62) were less clear in their recommendations. Very few journals mentioned the CONSORT extension papers. Journals that referred to CONSORT were more likely to refer to ICMJE guidelines (RR 2.16; 95% CI 1.51 to 3.08) and clinical trial registration (RR 3.67; 95% CI 2.36 to 5.71) than those journals which did not.Study 2: Thirty-nine percent (64/165) of journals responded to the on-line survey, the majority were journal editors. Eighty-eight percent (50/57) of journals recommended authors comply with the CONSORT Statement; 62% (35/56) said they would require this. Forty-one percent (22/53) reported incorporating CONSORT into their peer-review process and 47% (25/53) into their editorial process. Eighty-one percent (47/58) reported including CONSORT in their 'Instructions to Authors' although there was some inconsistency when cross checking information on the journal's website. Sixty-nine percent (31/45) of journals recommended authors comply with the CONSORT extension for cluster trials, 60% (27/45) for harms and 42% (19/45) for non-inferiority and equivalence trials. Few journals mentioned these extensions in their 'Instructions to Authors'.ConclusionJournals should be more explicit in their recommendations and expectations of authors regarding the CONSORT Statement and related CONSORT extensions papers.

Abstracts in high profile journals often fail to report harm

BackgroundTo describe how frequently harm is reported in the abstract of high impact factor medical journals.MethodsDesign and population: We carried out a blinded structured review of a random sample of 363 Randomised Controlled Trials (RCTs) carried out on human beings, and published in high impact factor medical journals in 2003. Main endpoint: 1) Proportion of articles reporting harm in the abstract; and 2) Proportion of articles that reported harm in the abstract when harm was reported in the main body of the article. Analysis: Corrected Prevalence Ratio (cPR) and its exact confidence interval were calculated. Non-conditional logistic regression was used.Results363 articles and 407 possible comparisons were studied. Overall, harm was reported in 135 abstracts [37.2% (CI95%:32.2 to 42.4)]. Harm was reported in the main text of 243 articles [66.9% (CI95%: 61.8 to 71.8)] and was statistically significant in 54 articles [14.9% (CI95%: 11.4 to 19.0)]. Among the 243 articles that mentioned harm in the text, 130 articles [53.5% (CI95% 47.0 to 59.9)] reported harm in the abstract; a figure that rose to 75.9% (CI95%: 62.4 to 86.5) when the harm reported in the text was statistically significant. Harm in the abstract was more likely to be reported when statistically significant harm was reported in the main body of the article [cPR = 1.70 (CI95% 1.47 to 1.92)] and when drug companies (not public institutions) funded the RCTs [cPR = 1.29 (CI95% 1.03 to 1.67)].Conclusions published in high impact factor medical journals underreport harm, even when harm is reported in the main body of the article.

Trends in Evidence-Based Medicine for Herbal Remedies and Media Coverage

Complementary and Alternative Medicines [CAM] are interventions that are not widely taught in medical schools and are not part of the usual arsenal of treatments and medications recommended and prescribed by physicians and available in hospitals. (1) CAM is big business ($30 billion in the US) with aggressive marketing. Their use in Europe and North America is increasing significantly. (2) For example, a 1998 phone survey of 1539 adults found that 42.1% in the United States had used at least one CAM within a twelve month period and that use had increased since 1990; the most used treatments were herbal medicine, massage, megavitamins, self-help groups, folk remedies, energy healing and homeopathy. (3) In 2003, 20% of all Canadians visited a CAM practitioner, up from 15% in 1994/5. (4) Users of CAM are more likely to have higher education levels and report lower health status. (5) Common health problems treated with CAM are anxiety, back problems, chronic pain, and urinary tract problems. Use of CAM is dependent, not on dissatisfaction with conventional medicine as it is most commonly used in association with conventional medicine, but on philosophical orientations towards health and life, such as feminism, spirituality, and personal growth. (6) Other studies suggest that CAM use allows patients and consumers greater control over their health and a level of self-empowerment. (7) For these reasons, it has become increasingly important to understand the nature and impact of popular representations of CAM in this context. The combination of educated and self-empowered users of CAM suggests a high degree of reliance on information sources outside of mainstream medical practitioners. Not surprisingly, coverage in sources including newspapers, television, magazines, other media, and the internet has increased to meet the demand for information. A vast quantity of information of varying quality exists in the media and on the internet. (8) There are concerns, however, that the media and internet provide too rosy a picture of CAM (9) and downplay adverse reactions to CAM, which can be dangerous and potentially fatal. (10) Such coverage augments the common misperception that CAM is natural and therefore, less harmful than conventional medical treatments. (11) Indeed, Barnes et al. (1998) found that users of CAM were less likely to report adverse effects than users of over-the-counter medicines. (12) These factors suggest that significant improvements need to be made to knowledge translation mechanisms for the public, healthcare professionals, and policy makers. The response of the medical and scientific community has been an increasing interest in CAM issues. There has been an increase in the number and proportion of clinical trials of CAM, which suggests a trend toward an evidence-based approach. The cumulative number of clinical trial articles indexed on MEDLINE, however, remains small (0.4%), and more high-quality original research is needed. (13) Further, the proportion of those articles on CAM indexed as clinical trial-type studies is 2.1%, but rising. (14) The lack of clinical trials may be due to a number of factors. There may be little incentive for commercial manufacturers of CAM products to run expensive clinical trials. However, the recent move to evidence-based health claims for CAM labeling and advertising in Canada (15) may drive an increase in CAM clinical trials in that country. Some authors have suggested that there may be a publishing bias from mainstream medical journals during peer review or editorial process, in either rejecting CAM studies outright or favouring CAM studies with negative results. (16) However, others suggest that most CAM studies may simply be of insufficient quality to be published in high impact factor medical journals. (17) At least 50% of CAM articles were published in journals with no impact factor. (18) Here we present preliminary data from a study that explores how knowledge is translated in the socio-economic-political context of CAM. …