Features of Knee and Multijoint Osteoarthritis by Sex and Race and Ethnicity: A Preliminary Analysis in the Johnston County Health Study.

OBJECTIVE: To evaluate knee osteoarthritis (KOA) and multijoint osteoarthritis (MJOA), and to compare features by sex and race and ethnicity in a population-based cohort. METHODS: Participants (n = 544) enrolled in the Johnston County Health Study (JoCoHS) as of January 2023 were categorized by radiographic and symptomatic KOA and MJOA phenotypes, and frequencies were compared by sex and race and ethnicity. Symptoms were assessed according to the Knee Injury and Osteoarthritis Outcome Score (KOOS) and pain, aching, and stiffness (PAS) scores at various joints. Models produced estimates (odds ratio [OR] or mean ratios [MR] and 95% CI) adjusted for age, BMI (kg/m2), and education. RESULTS: Men had twice the odds of having MJOA-6 (≥ 3 lower extremity joints affected); there were no significant differences in MJOA phenotypes by race and ethnicity. Women had 50% higher odds of having KOA or having various features of KOA. Women reported significantly worse KOOS Symptoms scores (MR 1.25). Black participants had higher odds of more severe KOA (OR 1.47), subchondral sclerosis (OR 2.06), and medial tibial osteophytes (OR 1.50). Black participants reported worse KOOS Symptoms than White participants (MR 1.18). Although not statistically significant, Hispanic participants (vs non-Hispanic participants) appeared to have lower odds of radiographic changes but reported worse symptoms. CONCLUSION: Preliminary findings in the diverse JoCoHS cohort suggest more lower extremity- predominant MJOA in men compared to women. Women and Black participants had more KOA features and more severe symptoms. Hispanic participants appear to have higher pain and symptoms scores despite having fewer structural changes. Studies in diverse populations are needed to understand the burden of OA.

Online Information for Treatment for Low-Risk Thyroid Cancer: Assessment of Timeliness, Content, Quality, and Readability.

The Internet is a key source of health information, yet little is known about resources for low-risk thyroid cancer treatment. We examined the timeliness, content, quality, readability, and reference to the 2015 American Thyroid Association (ATA) guidelines in websites about thyroid cancer treatment. We identified the top 60 websites using Google, Bing, and Yahoo for "thyroid cancer." Timeliness and content analysis identified updates in the ATA guidelines (n = 6) and engaged a group of stakeholders to develop essential items (n = 29) for making treatment decisions. Website quality and readability analysis used 4 validated measures: DISCERN; Journal of the American Medical Association (JAMA) benchmark criteria; Health on the Net Foundation certification (HONcode); and the Suitability Assessment of Materials (SAM) method. Of the 60 websites, 22 were unique and investigated. Content analysis revealed zero websites contained all updates from the ATA guidelines and rarely (18.2%) referenced them. Only 31.8% discussed all 3 treatment options: total thyroidectomy, lobectomy, and active surveillance. Websites discussed 28.2% of the 29 essential items for making treatment decisions. Quality analysis with DISCERN showed "fair" scores overall. Only 29.9% of the JAMA benchmarks were satisfied, and 40.9% were HONcode certified. Readability analysis with the SAM method found adequate readability, yet 90.9% scored unsuitable in literacy demand. The overall timeliness, content, quality, and readability of websites about low-risk thyroid cancer treatment is fair and needs improvement. Most websites lack updates from the 2015 ATA guidelines and information about treatment options that are necessary to make informed decisions.

Readability of Patient Education Materials From RadiologyInfo.org: Has There Been Progress Over the Past 5 Years?

OBJECTIVE. As patients increasingly turn to the Internet for healthcare information, it is imperative that patient educational materials be written at an appropriate readability level. Although RadiologyInfo.org, a patient education library sponsored by the American College of Radiology (ACR) and Radiological Society of North America, was shown in 2012 to be written at levels too high for the average patient to adequately comprehend, it is unclear if there has been progress made in the past 5 years. The purpose of this study was to provide a 5-year update on the readability of patient education materials from RadiologyInfo.org. MATERIALS AND METHODS. All patient education articles available in 2017 from the ACR and RSNA-sponsored RadiologyInfo.org patient education library were reviewed. We assessed each article for readability using 6 quantitative readability scales: the Flesch-Kincaid (FK) grade level, Flesch Reading Ease, Gunnin-Fog Index, Coleman-Liau Index, Automated Readability Index, and the Simple Measure of Gobbledygook (SMOG). The number of articles with readability ≤ the 8th grade level (average reading ability of US adults) and the 6th-grade level (NIH-recommended level for patient materials) were determined. RESULTS. 131 patient education articles were reviewed. The mean readability grade level was greater than the 11th grade reading level for all readability scales. None of the articles were written at less than the 8th-grade or the 6th-grade levels. CONCLUSION. Although there has been an increasing awareness of the issue of readability of patient educational materials within the radiological community, the patient educational materials within the ACR and RSNA-sponsored RadiologyInfo.org website are still written at levels too high for the average patient. Future efforts should be made to improve the readability of those patient education materials.

Readability of Spanish-Language Patient Education Materials From RadiologyInfo.org.

PURPOSE: Readability of patient education materials has been linked to health outcomes, and reports on patient education materials in radiology have demonstrated readability levels higher than recommended. Few studies in radiology, however, have assessed patient comprehension of Spanish-language health care educational materials. The purpose of this study was thus to assess the readability of patient education materials written in Spanish from RadiologyInfo.org. METHODS: All patient education materials written in Spanish available in July 2017 from the RadiologyInfo.org patient education library were compiled into a database over a 1-day period. After modification and editing to minimize artificial changes in readability levels, four readability scales were used to assess the texts: the Gilliam-Peña-Mountain scale, the Läsbarhets formula, the rate index formula, and the SOL formula. Readability was compared among scales using analysis of variance, and inter- and intrarater variability was assessed using intraclass correlation coefficients. RESULTS: In total, 134 patient education articles written in Spanish were included from the RadiologyInfo.org patient education library. The mean readability grade level was the 10th grade reading level or higher for all scales (average, 12th grade); only one article was written below the 8th grade level. There was no significant difference in readability level on the basis of readability scale used. CONCLUSIONS: Spanish-language patient educational materials provided at the RadiologyInfo.org website are written at levels too high for the average patient. Future efforts should be made to improve the readability of these patient education materials for English and Spanish speakers alike.

Total Synthesis of Tryprostatin B: Synthesis and Asymmetric Phase-Transfer-Catalyzed Reaction of Prenylated Gramine Salt.

A concise and efficient total synthesis of microtubule inhibitor tryprostatin B (1) is described. The key step is the preparation of a diprenylated gramine salt 9a. In this step, the prenyl group is incorporated at the 2-position of the indole moiety by direct lithiation of the Boc-protected gramine. We also developed and optimized the asymmetric phase-transfer-catalyzed reaction with salt 9a to provide the C2-prenyl tryptophan intermediate 2 resulting in 93% enantiomeric excess (ee) and 65% yield. The total synthesis of 1 is done in six steps with 35% overall yield.

How comprehensive are nuclear medicine residency websites?

Our goal for this study was to evaluate the comprehensiveness of nuclear medicine (NM) residency websites from the USA and Canada. The authors searched all the existing NM residency programs as listed in the Fellowship and Residency Electronic Interactive Database and the Canadian Residency Matching Service. We analyzed each website for the presence or absence of 44 elements previously identified as important considerations for medical students applying to residency. We compared criteria prevalence between regions and program size using t-tests and analysis of variance. Our results showed that, of 47 NM residencies, 9 did not have a dedicated website, leaving a total of 38 websites available for evaluation. The individual websites in the USA had a mean of 15 of 44 elements sought; in contrast, Canadian programs had 26 of 44 elements sought. The most common elements included contact e-mail, mailing address, and comprehensive faculty listings. Information about resident hometown, academic interests, and extracurricular interests was only included in 3% of the websites. Only 3% of websites included case description and 11% included rotation schedule. Courses attended were included in 5%, educational resources in 8%, and resident education was included in 5% of the websites. In conclusion, about one in five NM residency programs do not have a publicly available website. The websites that do exist are incomprehensive, containing an average of only 32% of elements sought for the USA programs and 41% of elements sought in Canadian programs. Residency program websites are an important tool in recruiting medical students. Addressing the lack of available websites as well as the gap in content of the websites that does exist may improve recruitment of students to NM residency programs.

How Does the Current Generation of Medical Students View the Radiology Match?: An Analysis of the AuntMinnie and Student Doctor Network Online Forums.

RATIONALE AND OBJECTIVES: The AuntMinnie (AM) and the Student Doctor Network (SDN) online forums are popular resources for medical students applying for residency. The purpose of this study was to describe medical student radiology-related posts on AM and SDN to better understand the medical student perspective on the application and Match process. MATERIALS AND METHODS: We reviewed all posts made on the AM and SDN online forums over 5 consecutive academic years from July 2012 to July 2017. Each thread was organized into one of six major categories. We quantified forum utilization over the past 5 years by the total number of and the most frequently posted and viewed thread topics. RESULTS: We reviewed 2683 total threads with 5,723,909 views. Total number of threads posted and viewed fell by 46% and 63%, respectively, from 2013-2014 to 2014-2015, after which they returned near baseline by 2016-2017, along with an increase in interventional radiology-related posts between 2012-2013 (13%) and 2016-2017 (32%) (P < .001). The most common application-related topics were preapplication and program ranking advice (20% of all threads and views). Many posts were related to postinterview communication with residency programs (2% of all threads and views). CONCLUSIONS: After a drop in 2013-2014, utilization of AM and SDN increased in 2016-2017, along with increased interest in interventional radiology. Addressing the student concerns identified in our study, especially in preparing residency applications, ranking programs, and navigating difficult situations, such as postinterview program communication, may improve the radiology application process for future medical students and their advisors.

Integrated Interventional Radiology Residency Program Websites: A Development in Progress.

OBJECTIVE: The purpose of this study is to evaluate the comprehensiveness of interventional radiology (IR) residency program websites. MATERIALS AND METHODS: We determined whether all integrated IR residency programs approved in 2016 by the Society for Interventional Radiology had a dedicated residency program website. On each website, we searched for 38 elements identified as important considerations for medical students applying to diagnostic radiology residency and IR fellowship programs. With the use of t tests and ANOVA, both the prevalence of criteria between regions and program sizes were compared. RESULTS: Of 61 IR residency programs that were identified, 44 (72%) had dedicated websites. On average, the websites included 38% of the 38 elements evaluated. Only two residency program websites (5%) included more than 50% of the criteria assessed. The information most commonly found was a contact e-mail (95% of websites), a mailing address (91%), and a comprehensive listing of faculty (75%). The information that was least commonly included was clinical responsibility progression (7%), a description of didactics (5%), and simulation experience (5%). No significant difference in website comprehensiveness was noted between regions (p = 0.590) or between different quartiles of ranking of IR fellowship on an online social networking service for U.S. clinicians (p = 0.198). CONCLUSION: Nearly one-third of integrated IR residency programs do not have a dedicated website. Those that do exist are inadequately comprehensive, with less than 40% of assessed criteria present. Contact information and information about life outside of work were the most commonly included elements, with a description of clinical training opportunities less frequently included. Addressing these gaps in website content will help IR residency programs better inform prospective students and may increase the number of applicants.