Reliability of Peer Review of Abstracts Submitted to Academic Family Medicine Meetings.

PURPOSE: To assess the reliability of peer review of abstracts submitted to academic family medicine meetings in North America. METHODS: We analyzed reviewer ratings of abstracts submitted: 1) as oral presentations to the North American Primary Care Research Group (NAPCRG) meeting from 2016 to 2019, as well as 2019 poster session or workshop submissions; and 2) in 12 categories to the Society of Teachers of Family Medicine (STFM) Spring 2018 meeting. In each category and year, we used a multi-level mixed model to estimate the abstract-level intraclass correlation coefficient (ICC) and the reliability of initial review (using the abstract-level ICC and the number of reviewers per abstract). RESULTS: We analyzed review data for 1554 NAPCRG oral presentation abstracts, 418 NAPCRG poster or workshop abstracts, and 1145 STFM abstracts. Across all years, abstract-level ICCs for NAPCRG oral presentations were below 0.20 (range, 0.10 in 2019 to 0.18 in 2016) and were even lower for posters and workshops (range, 0.00-0.10). After accounting for the number of reviewers per abstract, reliabilities of initial review for NAPCRG oral presentations ranged from 0.24 in 2019 to 0.30 in 2016 and 0.00 to 0.18 for posters and workshops in 2019. Across 12 STFM submission categories, the median abstract-level ICC was 0.21 (range, 0.12-0.50) and the median reliability was 0.42 (range, 0.25-0.78). CONCLUSIONS: For abstracts submitted to North American academic family medicine meetings, inter-reviewer agreement is often low, compromising initial review reliability. For many submission categories, program committees should supplement initial review with independent postreview assessments.

Prevention in adulthood: forging a doctor-patient partnership.

In this ever-changing health care system, Americans still retain confidence in their individual physicians [11]. This confidence represents an impressive fact when placed in the context of today's threats to the physician-patient relationship. In this chapter, we have explored these threats, principle among which are the appearance of the hospitalist, the information and technology revolution and the preeminence of managed care. We have further attempted to describe particular physician characteristics that may affect the quality of the physician-patient relationship. Individual physician awareness and characteristics seem to form the cornerstone for the quality of the relationship. We certainly believe in and stress the importance of shared mutual obligations in the good physician-patient relationship. Descriptors such as patients' trust and physicians' empathy enable meaningful relationships to be nurtured over time. A key component worthy of the primary care physician's consideration is that of longitudinal, continuity of care. In a study that examined patients' trust in their physicians, nearly three fourths of those surveyed were confident that their physicians would "put (the patient's) needs above all other considerations" [12]. Despite the limitations inherent in the modern American medical environment, it is still possible for physicians to nurture trusting, effective relationships with their patients and ultimately enhance health outcomes.