RESUMEN
PURPOSE: Rheumatologists and orthopedic surgeons frequently collaborate on difficult decisions regarding perioperative management of immunosuppression in rheumatic disease patients, balancing risk of postoperative infection with risk of disease flares. Current evidence-based guidelines pertain specifically to arthroplasty, thus we sought to understand the trends and common practices regarding peri-arthroscopic use of immunosuppression. METHODS: Rheumatologists and sports medicine surgeons, from a variety of New York hospitals and serving a broad range of demographics, were surveyed on immunosuppressive medication management in rheumatic disease patients undergoing arthroscopic surgeries. Physicians' preferences were elicited regarding the use of common anti-rheumatic medications with the lower risk meniscectomies and the higher risk anterior cruciate ligament (ACL) reconstructions and allografts. Physicians were asked specifically about peri-arthroscopic use of conventional synthetic diseasemodifying antirheumatic drugs (csDMARDs), biologics, and Janus kinase (JAK) inhibitors. RESULTS: During the survey period, 25 rheumatologists and 19 sports medicine fellowship-trained orthopedic surgeons completed the questionnaire. For lower-risk arthroscopies, rheumatologists favored continuing various csDMARDs (72% to 100%), biologics (50% to 64%) and JAK inhibitors (57%), while a majority of surgeons concurred for all three drug classes (csDMARDs 63%; biologics 53%; and JAK inhibitors 58%). For higher-risk arthroscopies, most rheumatologists preferred that patients continue csDMARDs (63% to 100%) but fewer supported the use of biologics (28% to 39%) or JAK inhibitors (22%). Surgeons were more hesitant to endorse any class of immunosuppressive antirheumatic medications (22% to 27%) around these higher risk surgeries. The rheumatologists were most concerned about surgeries taking place too soon after the last dose of rituximab, recommending these higher risk surgeries not take place for 7.7 ± 8.8 weeks following the last infusion. CONCLUSION: For lower-risk arthroscopies, most rheumatologists but only about half of orthopedic surgeons preferred patients continuing csDMARDs. Approximately half of both groups preferred patients hold biologics and JAK inhibitors. In more involved arthroscopies, most rheumatologists but few orthopedists supported the continued use of csDMARDs, and the consensus was to hold all other immunosuppression when possible. While the duration medications were held perioperatively were somewhat reflective of the current guidelines for arthroplasty, there is a need for evidencebased guidelines specifically regarding peri-arthroscopy immunosuppression in rheumatic disease patients.
Asunto(s)
Artroscopía , Inmunosupresores , Cirujanos Ortopédicos , Pautas de la Práctica en Medicina , Enfermedades Reumáticas , Reumatólogos , Humanos , Pautas de la Práctica en Medicina/tendencias , Pautas de la Práctica en Medicina/estadística & datos numéricos , Cirujanos Ortopédicos/tendencias , Cirujanos Ortopédicos/estadística & datos numéricos , Reumatólogos/tendencias , Inmunosupresores/uso terapéutico , Enfermedades Reumáticas/tratamiento farmacológico , Enfermedades Reumáticas/cirugía , Artroscopía/tendencias , Antirreumáticos/uso terapéutico , Antirreumáticos/efectos adversos , Encuestas y Cuestionarios , Productos Biológicos/uso terapéutico , Productos Biológicos/efectos adversos , Inhibidores de las Cinasas Janus/uso terapéutico , Medicina Deportiva/tendencias , Medicina Deportiva/estadística & datos numéricos , Encuestas de Atención de la SaludRESUMEN
BACKGROUND: Understanding the challenges and potential of telehealth visits (THVs) in a large population can inform future practice and policy discussion for pediatric orthopaedic and sports medicine (OSM) care. We comprehensively assess telehealth challenges and potential in a large pediatric OSM population based on access, visit completion, patient satisfaction, and technological challenges. METHODS: Demographics, address, insurance, visit information, patient feedback, experience with video visits, and technical challenges of all 2019 to 2020 visits at our hospital were assessed (3,278,006 visits). We evaluated the differences in rate of telehealth utilization, rate of patient adherence, disparities in care access and patient satisfaction, and technological issues. RESULTS: Compared with in-person prepandemic visits, THVs had lower ratios of non-White patients (by 5.8%; P <0.001), Hispanic patients (by 2.8%; P <0.001) and patients with public insurance (by 1.8%; P <0.001), and a higher mean distance between the patient's residence and clinic (by 18.8 miles; P <0.001). There were minimal differences in median household income (average $2297 less in THV; P <0.001) and social vulnerability index (average 0.01 points lower in THV; P <0.001) between groups. THVs had comparable patient satisfaction to in-person visits. Non-White patients, Hispanics, and those with public insurance had lower ratings for both in-person visits and THVs and had more technical difficulties during their THV. CONCLUSIONS: Telehealth is a viable method of care for a range of pediatric OSM conditions, providing a similar quality of care as in-person visits with a greater geographic reach. However, in its current format, reduced disparities were not observed in pediatric OSM THVs. LEVEL OF EVIDENCE: Level III.
Asunto(s)
Accesibilidad a los Servicios de Salud , Disparidades en Atención de Salud , Ortopedia , Satisfacción del Paciente , Medicina Deportiva , Telemedicina , Humanos , Telemedicina/estadística & datos numéricos , Niño , Disparidades en Atención de Salud/estadística & datos numéricos , Medicina Deportiva/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Masculino , Satisfacción del Paciente/estadística & datos numéricos , Adolescente , Femenino , Pediatría , Cooperación del Paciente/estadística & datos numéricos , PreescolarRESUMEN
OBJECTIVES: The proportion of women in orthopaedic surgery is low compared to other specialties, despite equal numbers of male and female students entering the medical profession. This gender disparity persists across various aspects of orthopaedic sports medicine, such as academic leadership, medical education, and on the sidelines. The purpose of this study was to conduct a comprehensive and updated global analysis of female representation in leadership positions within orthopaedic sports medicine and arthroscopy societies throughout the world. METHODS: Publicly available websites for orthopaedic sports medicine societies throughout the world were evaluated. For societies that met inclusion criteria, the following data were collected: types of leadership positions available and breakdown of male and female orthopaedic surgeons in those positions. RESULTS: There were a total of 55 societies analyzed from North America (5, 9.1%), South America (8, 14.5%), Europe (18, 32.7%), Asia (13, 23.6%), Africa (2, 3.6%), the Middle East (3, 5.5%) and Australia (3, 5.5%), as well as 3 international societies (5.5%). North America had the highest percentage of women in leadership positions with 19 of 97 positions (19.6%), followed by international societies with 11 of 92 (12.0%) positions filled by women. The Middle East and Australia had the fewest number of women, with all-male leadership. Globally, female orthopaedic surgeons served in 11 of 181 (6.1%) board of directors positions, 16 of 192 (8.3%) executive committees positions, 17 of 143 (11.9%) committee chair positions, 2 of 18 (11.1%) officer positions, 1 of 12 (8.3%) council positions, and 2 of 7 (28.6%) spokesperson positions. CONCLUSION: While some countries have higher representation than others, the number of women in leadership positions in orthopaedic sports medicine societies throughout the world is significantly less than their male counterparts. While this is a preliminary analysis, future studies should aim to evaluate these trends over time. Providing equitable opportunities for women to rise into high-ranking positions in orthopaedic sports medicine may contribute to the interest of women and other minorities in the field of sports medicine and help improve diversity. LEVEL OF EVIDENCE: Level V.
Asunto(s)
Liderazgo , Ortopedia , Médicos Mujeres , Sociedades Médicas , Medicina Deportiva , Humanos , Femenino , Medicina Deportiva/estadística & datos numéricos , Masculino , Médicos Mujeres/estadística & datos numéricos , Cirujanos Ortopédicos/estadística & datos numéricos , América del NorteRESUMEN
OBJECTIVE: Health disparities are widely prevalent; however, little has been done to examine and address their causes and effects in sports and exercise medicine (SEM). We aimed to summarise the focus areas and methodology used for existing North American health disparity research in SEM and to identify gaps in the evidence base. DESIGN: Scoping review. DATA SOURCES: Systematic literature search of PubMed, Scopus, SPORTDiscus, CINAHL Plus with Full Text, Web of Science Core Collection and Cochrane Central Register of Controlled Trials. ELIGIBILITY CRITERIA: Full-text, peer-reviewed manuscripts of primary research, conducted in North America; published in the year 2000 or after, in English; and focusing on organised sports were included. RESULTS: 103 articles met inclusion criteria. Articles were classified into five focus areas: access to and participation in sports (n=45), access to SEM care (n=28), health-related outcomes in SEM (n=24), provider representation in SEM (n=5) and methodology (n=1). Race/ethnicity (n=39), socioeconomic status (n=28) and sex (n=27) were the most studied potential causes of health disparities, whereas sexual orientation (n=5), location (rural/urban/suburban, n=5), education level (n=5), body composition (n=5), gender identity (n=4) and language (n=2) were the least studied. Most articles (n=74) were cross-sectional, conducted on youth (n=55) and originated in the USA (n=90). CONCLUSION: Health disparity research relevant to SEM in North America is limited. The overall volume and breadth of research required to identify patterns in a heterogeneous sports landscape, which can then be used to inform positive change, need expansion. Intentional research focused on assessing the intersectionality, causes and consequences of health disparities in SEM is necessary.
Asunto(s)
Disparidades en el Estado de Salud , Medicina Deportiva , Humanos , Medicina Deportiva/estadística & datos numéricos , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , América del Norte , Deportes/estadística & datos numéricos , Disparidades en Atención de Salud/estadística & datos numéricosRESUMEN
INTRODUCTION: Concussion is traumatic brain injury with associated tissue damage commonly produced by an indirect or direct head or facial trauma that can negatively impact an athletes' career and personal life. In this context, the importance on how to deal with a concussion has received attention from worldwide literature and has become a topic of enormous interest in the sports medicine arena. OBJECTIVE: This systematic review aimed to investigate how sports-related concussion is being managed regarding athletic injuries, athletes' age, clinical signs of concussion, adopted questionnaires, as well as decision making in sports medicine. METHODS: A systematic review of the literature was performed searching 10 electronic databases with no limitations for year of publication up to December 2019. The search terms used were: Brain Concussion, Athletes, Sports Medicine, Athletic Injuries, Clinical Decision-Making, and Decision Making. The articles were considered eligible when the studies related to populations of regular sports practitioners, professional or recreational, of any age; sports injury; articles reporting concussion evaluation in at least 30 athletes; and articles published in English, French, Portuguese, Italian. We excluded systematic review articles, reviews, editorials, sport-unrelated concussion, no questionnaire application, approaching retired athletes, consensus statement letters, author's reply to editorials, synopsis, and abstracts. RESULTS: The parameters adopted for decision-making and management were broadly variable and were based on a variety of clinical signs or scoring outcomes from a myriad of questionnaires with little consistency in protocol or management guidelines, which could guide the average clinician. CONCLUSION: This systematic review provides current evidence that post-concussion management in sports medicine has yet to accomplish a standardized protocol that clinicians could use to optimally care for athletes. The extensive number of manuscripts and studies addressing the topic confirms that sports-related concussion in the pediatric and adolescent population has come to the forefront in the sports medicine field.
Asunto(s)
Atletas/estadística & datos numéricos , Traumatismos en Atletas/terapia , Conmoción Encefálica/terapia , Medicina Deportiva/estadística & datos numéricos , Adolescente , Adulto , Factores de Edad , Traumatismos en Atletas/diagnóstico , Traumatismos en Atletas/etiología , Conmoción Encefálica/diagnóstico , Conmoción Encefálica/etiología , Niño , Femenino , Humanos , Masculino , Adulto JovenRESUMEN
Misuse of statistics in medical and sports science research is common and may lead to detrimental consequences to healthcare. Many authors, editors and peer reviewers of medical papers will not have expert knowledge of statistics or may be unconvinced about the importance of applying correct statistics in medical research. Although there are guidelines on reporting statistics in medical papers, a checklist on the more general and commonly seen aspects of statistics to assess when peer-reviewing an article is needed. In this article, we propose a CHecklist for statistical Assessment of Medical Papers (CHAMP) comprising 30 items related to the design and conduct, data analysis, reporting and presentation, and interpretation of a research paper. While CHAMP is primarily aimed at editors and peer reviewers during the statistical assessment of a medical paper, we believe it will serve as a useful reference to improve authors' and readers' practice in their use of statistics in medical research. We strongly encourage editors and peer reviewers to consult CHAMP when assessing manuscripts for potential publication. Authors also may apply CHAMP to ensure the validity of their statistical approach and reporting of medical research, and readers may consider using CHAMP to enhance their statistical assessment of a paper.
Asunto(s)
Investigación Biomédica , Lista de Verificación , Proyectos de Investigación , Estadística como Asunto , Atención a la Salud , Humanos , Revisión de la Investigación por Pares , Medicina Deportiva/estadística & datos numéricos , Estadística como Asunto/normasRESUMEN
BACKGROUND: Artificial intelligence (AI) technology has been incorporated into all walks of life, especially the integration of machine learning and health management has achieved very significant progress and results. It is very necessary to analyze personalized sports health management services and long-term assessment of health issues in the era of AI. METHODS: This paper explores AI + personalized sports management service system design ideas, system operation process, management stage design, taking common chronic diseases, and diabetes as examples. 150 patients were divided into an observation group and a control group, and the blood glucose, blood pressure, blood lipid, and knowledge awareness rate were compared. RESULTS: The blood glucose, blood pressure, and blood lipid levels of the observation group all reduced, and the awareness rate of diabetes knowledge increased, which proved that the AI research has great value in sports rehabilitation research coupled with long term health assessment and is worth further research. CONCLUSION: The AI research proposed in this paper is of far-reaching practical significance in helping the transformation and upgrading of the sports health management service industry, promoting the innovative development of sports health management service supply, and promoting national fitness and national health.
Asunto(s)
Inteligencia Artificial , Traumatismos en Atletas/rehabilitación , Deportes , Anciano , China , Biología Computacional , Diabetes Mellitus/fisiopatología , Diabetes Mellitus/terapia , Femenino , Humanos , Aprendizaje Automático , Masculino , Persona de Mediana Edad , Medicina de Precisión/métodos , Medicina de Precisión/estadística & datos numéricos , Medicina Deportiva/métodos , Medicina Deportiva/organización & administración , Medicina Deportiva/estadística & datos numéricosRESUMEN
BACKGROUND: The National Athletic Treatment, Injury and Outcomes Network Surveillance Program (NATION-SP) was established in 2011 to provide a comprehensive appraisal of injuries sustained by high school student-athletes who received services from athletic trainers (ATs). The purpose of this article is to update the surveillance methods of the NATION-SP for data reported during the 2014-2015 through 2018-2019 academic years. SURVEILLANCE SYSTEM STRUCTURE: The NATION-SP used a rolling recruitment model to identify a convenience sample of US high schools with access to ATs. The ATs at participating institutions volunteered to contribute data via electronic medical records systems; common data elements were then pushed to and maintained by the Datalys Center for Sports Injury Research and Prevention. The ATs completed detailed reports on each injury, including the condition and circumstances. The treatments component was used to comprehensively assess the services provided to athletes by ATs. The outcomes companion component was developed to monitor patient-reported outcomes after athletic injury. SUMMARY: The NATION-SP continues to serve a critical purpose in informing injury-prevention and treatment efforts among high school athletes.
Asunto(s)
Traumatismos en Atletas , Monitoreo Epidemiológico , Medicina Deportiva , Deportes , Adolescente , Traumatismos en Atletas/epidemiología , Traumatismos en Atletas/prevención & control , Traumatismos en Atletas/terapia , Femenino , Humanos , Incidencia , Masculino , Servicios Preventivos de Salud/métodos , Servicios Preventivos de Salud/normas , Mejoramiento de la Calidad , Proyectos de Investigación/tendencias , Deportes/clasificación , Deportes/estadística & datos numéricos , Medicina Deportiva/métodos , Medicina Deportiva/normas , Medicina Deportiva/estadística & datos numéricos , Estudiantes/estadística & datos numéricos , Estados Unidos/epidemiología , Adulto JovenAsunto(s)
Especialidad de Fisioterapia/estadística & datos numéricos , Medicina Deportiva/estadística & datos numéricos , Reconstrucción del Ligamento Cruzado Anterior/rehabilitación , Reconstrucción del Ligamento Cruzado Anterior/estadística & datos numéricos , Traumatismos en Atletas , Análisis de Datos , Ejercicio Físico/fisiología , Femenino , Humanos , Relaciones Interprofesionales , Masculino , Trastornos de la Menstruación/sangre , Análisis de Componente Principal/métodos , Estadística como Asunto/educación , Estadística como Asunto/métodos , Deficiencia de Vitamina DRESUMEN
To use an inadequate patient reported outcome measure (PROM) or use a PROM in an inappropriate way potentially influences the quality of measurement. The objectives of this study were to define potential inadequate uses of PROMs in sports research studies and estimate how often they occur. A consensus group consisting of medical researchers, statisticians, and psychometricians identified and defined potentially irregular applications of PROMs. Occurrence of these in 349 consecutive articles in sports medicine in which PROMs were used as primary outcomes was reviewed. In all, 14 different potential problems were defined, and one or several occurred in 172 of the articles (49%). These were as follows: using a PROM that was developed for a different patient group (100 cases), using two or more PROMs with identical questions (94), aggregation of domain sum scores (82), combinations of subjective and objective measures (27), using a PROM to diagnose or evaluate the individual patient (7), using a PROM for a single limb (3), recall bias (3), exclusion of domains or items (3), construction of a PROM for a specific occasion (2), categorization of the scale (2), and mixing different versions of a PROM (1). Adaption of scale scores (e. g., to percentage) when results are reported (144) carries a risk of miscalculation and distorted impression of results. Data related to uncertainty about completing the PROM and the handling of missing data were not provided in the manuscripts. In conclusion, potential problems in the use and reporting of PROMs are common in sports research, and this can influence the validity of reported results.
Asunto(s)
Consenso , Medición de Resultados Informados por el Paciente , Investigación , Medicina Deportiva , Traumatismos en Atletas , Sesgo , Humanos , Recuerdo Mental , Reproducibilidad de los Resultados , Medicina Deportiva/estadística & datos numéricos , IncertidumbreRESUMEN
Elseviers Scopus and Scimago Journal & Country Rank (SJR) are reporting inaccurate publication and citation metrics for the Journal of Orthopaedic & Sports Physical Therapy (JOSPT), particularly for the years 2018 and 2019. Despite repeated requests, Elsevier has failed to correct or explain this error to those who use these services, which misrepresents the JOSPT as having a lower impact in the field of musculoskeletal research and rehabilitation. For an accurate representation of the impact of the JOSPT in these fields, authors and readers should rely on the current Web of Science Journal Citation Reports (JCR) and Journal Impact Factor (JIF), which report the Journals current impact factor to be 3.839 and its 5-year impact factor to be 4.053. J Orthop Sports Phys Ther 2020;50(12):652. doi:10.2519/jospt.2020.50.12.652.
Asunto(s)
Factor de Impacto de la Revista , Ortopedia/estadística & datos numéricos , Especialidad de Fisioterapia/estadística & datos numéricos , Medicina Deportiva/estadística & datos numéricos , Investigación Biomédica/estadística & datos numéricos , EdiciónRESUMEN
CONTEXT: Researchers investigating collision and contact sport participation during high school have found mixed results. Understanding the association between current contact and collision sport participation and quality-of-life outcomes can enhance our knowledge about the risks and benefits of sport participation. OBJECTIVE: To examine quality-of-life outcomes among high school athletes who reported participation in collision and contact sports in the year preceding assessment compared with no- or limited-contact sport athletes. DESIGN: Cross-sectional study. SETTING: Preparticipation physical examination. PATIENTS OR OTHER PARTICIPANTS: High school athletes 13 to 18 years of age. MAIN OUTCOME MEASURE(S): We obtained sport participation and Patient-Reported Outcomes Measurement Information System (PROMIS) Pediatric-25 outcomes, which assess self-reported, quality-of-life domains in the preceding 7 days (ie, state assessment). Our grouping variable was collision and contact versus no- or limited-contact sport participation during the year preceding assessment. We used multivariable linear regression models to identify the associations between PROMIS scores and collision and contact sport participation and adjusted for sex; age; history of bone, muscle, ligament, or tendon injury; history of acute fracture or dislocation; and history of concussion. RESULTS: A total of 143 (51%) athletes reported collision and contact sport participation (24% female, mean age = 15.1 ± 1.7 years) and 138 (49%) reported no- or limited-contact sport participation (66% female, mean age = 15.4 ± 1.2 years). A higher proportion of collision and contact sport athletes reported a history of time loss for bone, muscle, ligament, and tendon injuries (51% versus 29%, P < .001) and for acute fracture or dislocation (46% versus 26%, P < .001) than did no- or limited-contact athletes. After adjusting for covariates, we found that collision and contact sport participation was significantly associated with lower state anxiety (ß = -1.072, 95% confidence interval = -1.834, -0.310, P = .006) and depressive (ß = -0.807, 95% confidence interval = -1.484, -0.130, P = .020) symptom scores. CONCLUSIONS: Collision and contact sport athletes reported fewer anxiety and depressive symptoms in the week preceding evaluation than did no- or limited-contact sport athletes, but they had more extensive orthopaedic injury histories. Potential benefits and risks are associated with collision and contact sport participation. These data reinforce the need to examine the assumption that youth collision and contact sports are associated with negative quality of life.
Asunto(s)
Ansiedad , Atletas , Traumatismos en Atletas , Depresión , Calidad de Vida , Medicina Deportiva , Adolescente , Ansiedad/etiología , Ansiedad/fisiopatología , Atletas/psicología , Atletas/estadística & datos numéricos , Traumatismos en Atletas/clasificación , Traumatismos en Atletas/diagnóstico , Traumatismos en Atletas/psicología , Estudios Transversales , Depresión/etiología , Depresión/fisiopatología , Femenino , Humanos , Masculino , Autoinforme , Medicina Deportiva/métodos , Medicina Deportiva/normas , Medicina Deportiva/estadística & datos numéricos , Deportes de EquipoRESUMEN
Background: Some NCAA conferences now require a press box-based Medical Observer for all football games to identify injuries missed by on-field providers. The objective of this study was to determine whether a Medical Observer identified injuries missed by the on-field medical personnel. Methods: This was a comparative observational study of injury identification methods which was done at nine NCAA football games. The athletes on a single institution's varsity football team participated. Eight games and one bowl game were studied. Observers were sports medicine Fellows (Orthopaedic, Primary Care). Injury logs were kept by the Medical Observer to document game day injuries. The athletic training staff collected injury reports in the days following games. These were compared with game day injury logs to identify any injuries that were not reported to the medical staff during competition. Results: A total of 41 game injuries were identified (4.56 injuries/ game). 29 injuries (29/41; 71%) were identified by both the sideline medical providers and the Observer, 12 (12/41; 29%) were identified by only the sideline medical providers and no injuries were identified by only the Observer. A total of 95 game-related injuries were evaluated in the training room on the day after each game. 27 injuries (27/95; 28%) had been identified during the game (9 [33%] by the sideline medical team and 18 [67%] by both the sideline medical team and the Observer). Fourteen game injuries were not severe enough to require care the following day. There were 68 (68/95; 72%) delayed self-reported injuries treated by the training room staff the next day. Conclusions: A press box-based Medical Observer did not identify any injuries missed by the on-field medical staff. This study did, however, identify a large number of unreported game-day injuries that were treated the following day.Level of Evidence: II.
Asunto(s)
Técnicos Medios en Salud/estadística & datos numéricos , Traumatismos en Atletas/diagnóstico , Fútbol Americano/lesiones , Medicina Deportiva/estadística & datos numéricos , Humanos , UniversidadesRESUMEN
CONTEXT: The drive for a quick return to sport after injury can be great. Athletes look to their sports medicine provider for guidance on a speedy and effective recovery. The sports medicine physician has a number of different treatment options to consider when they turn to their medical armamentarium. One of those treatment choices is complementary and alternative medicine (CAM). Unfortunately, there is limited evidence for many of the CAM modalities. Furthermore, CAM prescribing practices among sports medicine physicians is unknown. The aim of this study is to determine the prescribing practices of CAM among physicians for common sports medicine pathologies. METHODS: An online survey of the prescribing practices of CAM by physician members of the American Medical Society for Sports Medicine. RESULTS: A total of 257 physicians answered the question on prescribing CAM for a response rate of 11%. Of those who responded, 88% prescribed at least one type of CAM in the last one year. The responders identified 23 different CAM modalities they prescribed. Of those modalities prescribed, chiropractic/osteopathic manipulation was the most common followed by acupuncture/electroacupuncture and yoga. Less commonly prescribed CAM included omega-3 fatty acids, riboflavin, and meditation. Providers utilized CAM for common sports medicine pathologies including ligamentous, tendinous and muscle injury, concussion, and low back pain among others. The survey participants believed many of these CAM modalities to be effective. CONCLUSIONS: Among responders, the prescribing prevalence of at least one CAM therapy was high. Sports medicine physicians utilized a number of different CAM modalities to treat common sports medicine pathologies.
Asunto(s)
Traumatismos en Atletas/terapia , Terapias Complementarias/estadística & datos numéricos , Enfermedades Musculoesqueléticas/terapia , Médicos/psicología , Pautas de la Práctica en Medicina/estadística & datos numéricos , Medicina Deportiva/métodos , Deportes/psicología , Terapia por Acupuntura , Electroacupuntura , Humanos , Dolor de la Región Lumbar , Osteopatía , Prevalencia , Medicina Deportiva/estadística & datos numéricos , Encuestas y Cuestionarios , YogaRESUMEN
CONTEXT: Sports Health: A Multidisciplinary Approach, now 10 years into production, has been ranked a top-25 journal in sport sciences and has tripled its impact throughout its existence. OBJECTIVE: To evaluate authorship trends and levels of evidence (LOE) of articles published in Sports Health from 2009 to 2018. The secondary aim was to analyze funding sources and internationalization throughout the journal's tenure. DATA SOURCES: All clinical studies published in Sports Health between the years 2009 and 2018 were examined. STUDY SELECTION: All publications from the provided years were electronically reviewed by 2 reviewers and evaluated for inclusion criteria. Editorials, society news, memorials, letters to the editor, and corrigenda were excluded. STUDY DESIGN: Systematic review. LEVEL OF EVIDENCE: Level 5. DATA EXTRACTION: Articles were examined for number of authors, presence of female authorship, funding, country of origin, international collaboration, academic degree or certification of first and senior authors, and LOE. Clinical articles were assigned LOE based on guidelines from the University of Oxford's Centre for Evidence-Based Medicine. RESULTS: A total of 654 articles were examined. The percentage of high-LOE studies increased throughout the study period. The percentage of publications with female authors also increased throughout the study period. The mean number of authors per article increased from 3.2 to 4.6 over the 10-year period (P < 0.05). The percentage of publications with international collaboration stayed consistent, while the number of countries per year increased during the study period. Overall, institutions from 23 countries have published in Sports Health since its inception to the time of this study. CONCLUSION: Female authorship in Sports Health surpasses industry standards, and the percentage of high-LOE studies remains remarkably high. Sports Health has stayed true to its multidisciplinary scope, as evidenced by the authors' varying degrees and numerous countries that publish in the journal.
Asunto(s)
Autoria , Medicina Basada en la Evidencia/tendencias , Edición/tendencias , Medicina Deportiva/tendencias , Deportes/tendencias , Humanos , Edición/estadística & datos numéricos , Apoyo a la Investigación como Asunto , Deportes/estadística & datos numéricos , Medicina Deportiva/estadística & datos numéricosRESUMEN
Magnitude-based inference (MBI) is a controversial statistical method that has been used in hundreds of papers in sports science despite criticism from statisticians. To better understand how this method has been applied in practice, we systematically reviewed 232 papers that used MBI. We extracted data on study design, sample size, and choice of MBI settings and parameters. Median sample size was 10 per group (interquartile range, IQR: 8-15) for multi-group studies and 14 (IQR: 10-24) for single-group studies; few studies reported a priori sample size calculations (15%). Authors predominantly applied MBI's default settings and chose "mechanistic/non-clinical" rather than "clinical" MBI even when testing clinical interventions (only 16 studies out of 232 used clinical MBI). Using these data, we can estimate the Type I error rates for the typical MBI study. Authors frequently made dichotomous claims about effects based on the MBI criterion of a "likely" effect and sometimes based on the MBI criterion of a "possible" effect. When the sample size is n = 8 to 15 per group, these inferences have Type I error rates of 12%-22% and 22%-45%, respectively. High Type I error rates were compounded by multiple testing: Authors reported results from a median of 30 tests related to outcomes; and few studies specified a primary outcome (14%). We conclude that MBI has promoted small studies, promulgated a "black box" approach to statistics, and led to numerous papers where the conclusions are not supported by the data. Amidst debates over the role of p-values and significance testing in science, MBI also provides an important natural experiment: we find no evidence that moving researchers away from p-values or null hypothesis significance testing makes them less prone to dichotomization or over-interpretation of findings.
Asunto(s)
Ciencia/estadística & datos numéricos , Medicina Deportiva/estadística & datos numéricosRESUMEN
OBJECTIVE: To identify the characteristics of retracted publications in rehabilitation and sport sciences journals. DATA SOURCES: The Web of Science, PubMed, and Retraction Watch databases were searched from inception to August 2019. STUDY SELECTION: Retracted publications published in rehabilitation or sport sciences journals, indexed in the Science Citation Index Expanded (SCIE) and Social Sciences Citation Index (SSCI) were included. DATA EXTRACTION: One author extracted the data. Two other authors checked the data. DATA SYNTHESIS: A total of 37 and 52 retracted publications and their retraction notices were identified for rehabilitation and sport sciences, respectively. The majority of retracted publications (68% of all retracted papers in rehabilitation and 54% of all retracted papers in sport sciences) were published in the past decade. Retracted publications in rehabilitation and sport sciences were published in 21 and 22 different journals and originated from 18 and 21 different countries, respectively. The full-text of the retracted publications was available with a retraction watermark or note for 59% of cases in rehabilitation and 58% in sport sciences. The reasons for the retractions were more often attributed to misconduct (79% and 61%) than to honest error (21% and 39%) in rehabilitation and sport sciences, respectively. However, a reason was not stated for 15% of the publications. The median time interval between publication and retraction was 622 days in rehabilitation and 607 days in sport sciences publications. CONCLUSIONS: The total number of retracted publications in rehabilitation and sport sciences journals was small. The retracted publications have been published in a variety of rehabilitation and sport sciences journals and came from different countries across the world. Several retracted publications and retraction notices failed to adhere to The Committee on Publication Ethics guidelines in the handling of full-text (retain with a watermark or note) or stating the underlying reasons for the retraction.
Asunto(s)
Publicaciones Periódicas como Asunto/estadística & datos numéricos , Medicina Física y Rehabilitación/estadística & datos numéricos , Retractación de Publicación como Asunto , Medicina Deportiva/estadística & datos numéricos , HumanosRESUMEN
OBJECTIVE: To update information regarding practice patterns of family physicians with a certificate of added qualifications (CAQ) in Sports Medicine (SM), because it has been over 10 years since the last comprehensive study. DESIGN: Cross-sectional analysis of 2017 and 2018 American Board of Family Medicine (ABFM) Family Medicine Certification and SM CAQ examination registration practice demographic questionnaire data. SETTING: N/A. PARTICIPANTS: Family physicians with a CAQ in SM [sports medicine family physicians (SM-FPs)] and family physicians without a CAQ registering for the ABFM Family Medicine Certification or SM CAQ examinations. INTERVENTION: N/A. MAIN OUTCOMES: Self-reported time spent practicing SM, activities in SM, scope of practice, and practice setting. RESULTS: Sports medicine family physicians are predominately men (78.7%) and below 49 years (65.8%). Most SM-FPs spend 60% of their time or less practicing SM and the scope of practice of SM-FPs is only slightly narrower than that of their family physician counterparts without a CAQ. In addition, 92.8% of SM-FPs are practicing in an urban setting. CONCLUSIONS: The similarity of scope of practice for SM-FPs and family physicians without a CAQ and the time spent practicing SM by SM-FPs suggests that most SM-FPs are spending a significant amount of time continuing to practice their primary specialty. Sports medicine family physicians are largely attracted to urban practice settings, most likely because of the higher likelihood of employment opportunities. Finally, factors that may be dissuading women from entering the field of SM deserve further investigation.
Asunto(s)
Certificación , Médicos de Familia/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Medicina Deportiva/estadística & datos numéricos , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Médicos de Familia/normas , Medicina Deportiva/normas , Estados UnidosRESUMEN
BACKGROUND: Physical therapy and surgery are viable treatment options for nonarthritic hip disease (NAHD). Interdisciplinary collaboration can help patients make informed treatment decisions. Understanding how each provider can contribute is a critical first step in developing collaborative evaluation efforts. OBJECTIVE: The objective of this study was to describe the current evaluation of NAHD by both physical therapists and physicians, and evaluate national use of expert-recommended evaluation guidelines. DESIGN: A national survey study distributed in the United States was implemented to accomplish the objective. METHODS: A survey was distributed to 25,027 potential physical therapist and physician respondents. Respondents detailed their evaluation content for patients with NAHD across the following domains: patient-reported outcomes, patient history, special tests, movement assessment, clinical tests, and imaging. Respondents ranked importance of each domain using a 5-point Likert scale (not important, slightly important, important, very important, or extremely important). Odds ratios (ORs [95% CIs]) were calculated to identify the odds that physical therapists, compared with physicians, would report each evaluation domain as at least very important. Fisher exact tests were performed to identify statistically significant ORs. RESULTS: Nine hundred and fourteen participants (3.6%) completed the survey. Physical therapists were more likely to indicate movement assessment (OR: 4.23 [2.99-6.02]) and patient-reported outcomes (OR: 2.56 [1.67-3.99]) as at least very important for determining a diagnosis and plan of care. Physical therapists had lower odds of rating imaging (OR: 0.09 [0.06-0.14]) and special tests (OR: 0.72 [0.53-0.98]) as at least very important compared with physicians. LIMITATIONS: This survey study did not include many orthopedic surgeons and thus, primarily represents evaluation practices of physical therapists and nonsurgical physicians. CONCLUSIONS: Physical therapists were more likely to consider movement assessment very important for the evaluation of patients with NAHD, whereas physicians were more likely to consider imaging and special testing very important.