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Can Artificial Intelligence Fool Residency Selection Committees? Analysis of Personal Statements by Real Applicants and Generative AI, a Randomized, Single-Blind Multicenter Study. 人工智能能否愚弄住院医师遴选委员会?一项随机、单盲多中心研究:真实申请者的个人陈述与生成式人工智能分析。
IF 2.3
JBJS Open Access Pub Date : 2024-10-24 eCollection Date: 2024-10-01 DOI: 10.2106/JBJS.OA.24.00028
Zachary C Lum, Lohitha Guntupalli, Augustine M Saiz, Holly Leshikar, Hai V Le, John P Meehan, Eric G Huish
{"title":"Can Artificial Intelligence Fool Residency Selection Committees? Analysis of Personal Statements by Real Applicants and Generative AI, a Randomized, Single-Blind Multicenter Study.","authors":"Zachary C Lum, Lohitha Guntupalli, Augustine M Saiz, Holly Leshikar, Hai V Le, John P Meehan, Eric G Huish","doi":"10.2106/JBJS.OA.24.00028","DOIUrl":"https://doi.org/10.2106/JBJS.OA.24.00028","url":null,"abstract":"<p><strong>Introduction: </strong>The potential capabilities of generative artificial intelligence (AI) tools have been relatively unexplored, particularly in the realm of creating personalized statements for medical students applying to residencies. This study aimed to investigate the ability of generative AI, specifically ChatGPT and Google BARD, to generate personal statements and assess whether faculty on residency selection committees could (1) evaluate differences between real and AI statements and (2) determine differences based on 13 defined and specific metrics of a personal statement.</p><p><strong>Methods: </strong>Fifteen real personal statements were used to generate 15 unique and distinct personal statements from ChatGPT and BARD each, resulting in a total of 45 statements. Statements were then randomized, blinded, and presented to a group of faculty reviewers on residency selection committees. Reviewers assessed the statements by 14 metrics including if the personal statement was AI-generated or real. Comparison of all metrics was performed.</p><p><strong>Results: </strong>Faculty correctly identified 88% (79/90) real statements, 90% (81/90) BARD, and 44% (40/90) ChatGPT statements. Accuracy of identifying real and BARD statements was 89%, but this dropped to 74% when including ChatGPT. In addition, the accuracy did not increase as faculty members reviewed more personal statements (area under the curve [AUC] 0.498, p = 0.966). BARD performed poorer than both real and ChatGPT across all metrics (p < 0.001). Comparing real with ChatGPT, there was no difference in most metrics, except for Personal Interests, Reasons for Choosing Residency, Career Goals, Compelling Nature and Originality, and all favoring the real personal statements (p = 0.001, p = 0.002, p < 0.001, p < 0.001, and p < 0.001, respectively).</p><p><strong>Conclusion: </strong>Faculty members accurately identified real and BARD statements, but ChatGPT deceived them 56% of the time. Although AI can craft convincing statements that are sometimes indistinguishable from real ones, replicating the humanistic experience, personal nuances, and individualistic elements found in real personal statements is difficult. Residency selection committees might want to prioritize these particular metrics while assessing personal statements, given the growing capabilities of AI in this arena.</p><p><strong>Clinical relevance: </strong>Residency selection committees may want to prioritize certain metrics unique to the human element such as personal interests, reasons for choosing residency, career goals, compelling nature, and originality when evaluating personal statements.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11498924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Operative First Web Contracture Management: Current Strategies. 手术治疗第一蹼挛缩:当前策略。
IF 2.3
JBJS Open Access Pub Date : 2024-10-22 eCollection Date: 2024-10-01 DOI: 10.2106/JBJS.OA.24.00025
Doyle R Wallace, Waldo E Floyd
{"title":"Operative First Web Contracture Management: Current Strategies.","authors":"Doyle R Wallace, Waldo E Floyd","doi":"10.2106/JBJS.OA.24.00025","DOIUrl":"https://doi.org/10.2106/JBJS.OA.24.00025","url":null,"abstract":"<p><p>» First web contractures can be due to nonthermal trauma, burns, congenital differences, and Dupuytren contracture.» Mild cases are managed with contracture release and full-thickness skin graft or when surrounding skin is pliable, Z-plasty.» Release of severe contractures creates a tetrahedral void that may require local or distant flap coverage. Reconstructive options include dorsal transposition flaps, regional rotation flaps, free tissue transfer, first metacarpal distraction osteogenesis with web deepening, or pollicization.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Musculoskeletal Learning and Knowledge Retention Among Postgraduate Physicians: Evaluating the Long-Term Impact of a New Preclerkship Curriculum at a Nationally Accredited Medical Program. 研究生医生的肌肉骨骼学习和知识保留:评估国家认可医学项目新实习前课程的长期影响。
IF 2.3
JBJS Open Access Pub Date : 2024-10-22 eCollection Date: 2024-10-01 DOI: 10.2106/JBJS.OA.24.00117
Taylor Orchard, Alexa Hryniuk, Jason Peeler
{"title":"Musculoskeletal Learning and Knowledge Retention Among Postgraduate Physicians: Evaluating the Long-Term Impact of a New Preclerkship Curriculum at a Nationally Accredited Medical Program.","authors":"Taylor Orchard, Alexa Hryniuk, Jason Peeler","doi":"10.2106/JBJS.OA.24.00117","DOIUrl":"https://doi.org/10.2106/JBJS.OA.24.00117","url":null,"abstract":"<p><strong>Introduction: </strong>Musculoskeletal (MSK) injuries and disorders are exceptionally prevalent in the clinical setting. Despite this, physician training in MSK medicine has been historically inadequate contributing to a lack of MSK knowledge, confidence, and clinical skills among postgraduate physicians. The goal of this investigation was to examine the long-term impact of a new preclerkship MSK curriculum implemented by a nationally accredited medical program on postgraduate physician's learning and knowledge retention in the area of MSK medicine.</p><p><strong>Methods: </strong>Five hundred sixty-eight postgraduate physicians (years 1-6) who had previously completed the new curriculum over a 6-year period were recruited to complete a standardized and validated MSK examination that consisted of 30 multiple-choice questions on core or must-know topics in MSK medicine that could be directly mapped to learning objectives within the new preclerkship MSK curriculum.</p><p><strong>Results: </strong>Ninety postgraduate physicians completed the examination, obtaining an average score of 75.0% (±10.2; range 57.0-100.0). Physicians who completed MSK-related electives during clerkship training or specialized in fields related to MSK medicine (i.e., orthopaedics, PM&R, sports medicine, and rheumatology) performed significantly better on the MSK examination (p ≤ 0.01).</p><p><strong>Conclusion: </strong>Data indicated that the program's new preclerkship curriculum supports high levels of MSK learning and knowledge retention among postgraduate physicians. These findings are expected to assist with the establishment of minimum curriculum standards and can be used to guide MSK curricular reform at other medical programs.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Disparities in Rotator Cuff Tear Progression Definitions and Rates: A Systematic Review. 肩袖撕裂进展定义和比率的差异:系统回顾。
IF 2.3
JBJS Open Access Pub Date : 2024-10-22 eCollection Date: 2024-10-01 DOI: 10.2106/JBJS.OA.24.00097
Mason J Garcia, Daniela Caro, Maria Velasquez Hammerle, Juan B Villarreal, Joseph P DeAngelis, Arun J Ramappa, Ara Nazarian
{"title":"Disparities in Rotator Cuff Tear Progression Definitions and Rates: A Systematic Review.","authors":"Mason J Garcia, Daniela Caro, Maria Velasquez Hammerle, Juan B Villarreal, Joseph P DeAngelis, Arun J Ramappa, Ara Nazarian","doi":"10.2106/JBJS.OA.24.00097","DOIUrl":"https://doi.org/10.2106/JBJS.OA.24.00097","url":null,"abstract":"<p><strong>Background: </strong>While rotator cuff tears are prevalent in the general population, the natural history of this disease is unclear. Understanding rotator cuff tear progression is crucial for refining surgical indications and evaluating the necessity of early interventions. This study presents an in-depth analysis of the existing literature on the definitions and progression rates of rotator cuff tears, aiming to enhance clinical decision making and patient outcomes.</p><p><strong>Methods: </strong>A systematic literature search was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using Medline (PubMed), Embase (Elsevier), and Web of Science databases on January 12, 2023. Articles were identified as relevant to the natural history and progression of asymptomatic and symptomatic partial-thickness (PT) and full-thickness (FT) rotator cuff tears. Those written in English reporting rotator cuff progression rates of tears in adults, based on magnetic resonance imaging (MRI) or ultrasound, were included. After reviewing the articles, the data on the rates of tear progression and associated risk factors were extracted, compiled, and analyzed. The risk of bias was determined using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Twenty-one articles met the inclusion criteria, with 1,831 tears included. The progression rate for all partial thickness tears was 26.7% ± 12.8% at an average follow-up of 2.2 ± 0.9 years, with 5 definitions for tear progression. For FT tears, the progression rate was 54.9% ± 18.6% at a follow-up time of 3.0 ± 2.0 years, with 8 definitions for tear enlargement. A significant difference (p < 0.0001) was found between the progression rates of PT and FT tears. Patients who were initially asymptomatic and became symptomatic had higher progression rates (33%-63%) than those who remained asymptomatic (4%-38%).</p><p><strong>Conclusion: </strong>Further research would benefit by identifying a clinically relevant and standardized definition of rotator cuff tear progression, to describe the natural history of rotator cuff disease, making results more comparable and optimizing treatment planning.</p><p><strong>Level of evidence: </strong>Level II. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Professional Behavior Assessment During Residency Training: Can We Identify Outliers? 住院医师培训期间的职业行为评估:我们能否识别异常值?
IF 2.3
JBJS Open Access Pub Date : 2024-10-22 eCollection Date: 2024-10-01 DOI: 10.2106/JBJS.OA.24.00102
Ann Van Heest, Steven Frick, John Harrast, David Martin, Mona Saniei, Lisa Taitsman, April Armstrong
{"title":"Professional Behavior Assessment During Residency Training: Can We Identify Outliers?","authors":"Ann Van Heest, Steven Frick, John Harrast, David Martin, Mona Saniei, Lisa Taitsman, April Armstrong","doi":"10.2106/JBJS.OA.24.00102","DOIUrl":"https://doi.org/10.2106/JBJS.OA.24.00102","url":null,"abstract":"<p><strong>Introduction: </strong>The American Board of Orthopaedic Surgery (ABOS) Knowledge, Skills, and Behavior (KSB) project sets up a framework for competency-based medical education for orthopaedic surgery residency training. The Behavior aspect of KSB includes use of the American Board of Orthopaedic Surgery Behavior Tool (ABOSBT) to assess 5 domains of professional behavior. The purpose of this study was to analyze the results of 2 years of ABOSBT assessments and to characterize the low score ratings.</p><p><strong>Methods: </strong>All ABOSBT assessments from January 1, 2022, to December 31, 2023, were reviewed totaling 51,678 completed assessments with 48,648 (94%) assessments from a 360° process and 3,030 (6%) as end-of-rotation assessments.</p><p><strong>Results: </strong>Distribution of 51,678 ABOSBT assessments with 258,390 scores demonstrated low scores (disagree or strongly disagree) in 0.9% of assessments. All 5 domains identified low scores in a small percentage at all years-in-training with the greatest number in second- and third-year residents. Comparison of scores from 360° vs. end-of-rotation requests demonstrated a higher percentage of low scores given during the 360° process (p < 0.0001). Three thousand seven hundred seven unique evaluators completed ABOSBT assessments, with attending physicians as the most frequent evaluator type (44%); inpatient nurses assessed residents with low ABOSBT scores more frequently (4.5%) than any other evaluator type. Residents with 2 or more low scores by 2 or more different evaluators were analyzed for each of the 5 domains; low scores were most frequently observed in the reliability domain.</p><p><strong>Discussion: </strong>The ABOSBT was originally validated 5 years ago in 18 programs with 9,892 assessments; this article updates results using the ABOSBT across 95 programs assessing 2,397 residents with 3,707 evaluators. The ABOSBT demonstrates that most residents demonstrate professional behavior across 5 domains of assessment; the ABOSBT identifies residents with low scores. A strength of KSB is the ability to identify professionalism deficiencies while residents are in training and can focus on individualized educational improvement. Tracking residents with low scores on the ABOSBT assessment over time will help determine its effectiveness in identifying unprofessional behavior.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Increasing Diversity in Orthopaedic Surgery Residency: A Case Report of One Program's Experience Using Pipeline Programs. 增加矫形外科住院医生的多样性:一个项目使用管道计划的经验案例报告。
IF 2.3
JBJS Open Access Pub Date : 2024-10-04 eCollection Date: 2024-10-01 DOI: 10.2106/JBJS.OA.24.00077
Hans K Owuor, Eric J Strauss, Toni McLaurin, Joseph D Zuckerman, Kenneth A Egol
{"title":"Increasing Diversity in Orthopaedic Surgery Residency: A Case Report of One Program's Experience Using Pipeline Programs.","authors":"Hans K Owuor, Eric J Strauss, Toni McLaurin, Joseph D Zuckerman, Kenneth A Egol","doi":"10.2106/JBJS.OA.24.00077","DOIUrl":"10.2106/JBJS.OA.24.00077","url":null,"abstract":"<p><strong>Introduction: </strong>African American, Hispanic, Asian, and Pacific Islanders are groups who are underrepresented in medicine (URM groups). Similarly, although women comprise more than 50% of medical students in the United States, women comprise a smaller percentage of all orthopaedic surgery trainees. Therefore, underrepresented in orthopaedics (URiO) represents the URM groups and women. The purpose of this study is to examine the impact of specific steps to recruit a qualified, diverse trainee complement within a single academic orthopaedic surgery residency program between 2000 and 2023. We aim to explore changes in the representation of URiO during this period as well as explore the strategies and programs implemented by the department that may have impacted recruitment of a diverse complement of trainees.</p><p><strong>Methods: </strong>Match lists from a large, academic, orthopaedic surgery residency between 2000 and 2023 were collected and reviewed for racial and gender data. Match lists were then divided into 6-year quantiles to identify any trends in the recruitment of URiO students. Self-reported racial and gender data from Electronic Residency Application Service applicant reports and the Accreditation Council for Graduate Medical Education (ACGME) data books between 2018 and 2022 were collected and reviewed. In addition, the department's strategies implemented during the study period with the goal of enhancing URiO exposure to orthopaedic surgery were also explored.</p><p><strong>Results: </strong>The department implemented proactive strategies to increase exposure to orthopaedic surgery for URiO students. An increase in URiO representation was noted between 2000 and 2023 with Hispanic, Black/African American, and Native Hawaiian/Pacific Islander resident representation increasing by 5%, 11%, and 1%, respectively. In addition, women representation increased by 27% between 2000 and 2023. The overall attrition rate among URiO residents was 1% with only one resident not completing the program. Self-reported racial and gender data from ACGME data books demonstrated that Black/African American, Hispanic, and Native Hawaiian/Pacific Islander residents comprised 5%, 4%, and 0.04%, respectively, of orthopaedic surgery residents between 2018 and 2022.</p><p><strong>Conclusions: </strong>These results provide insight for other programs to use similar strategies to potentially improve recruitment, retain, and provide support to URiO residents.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Exploring Impact and Variability of Research Productivity Among Academic Orthopaedic Leaders. 探讨骨科学术带头人科研生产力的影响和可变性。
IF 2.3
JBJS Open Access Pub Date : 2024-10-03 eCollection Date: 2024-10-01 DOI: 10.2106/JBJS.OA.24.00085
Hassan Farooq, Andrew Gaetano, Krishin Shivdasani, Nickolas Garbis, Dane Salazar
{"title":"Exploring Impact and Variability of Research Productivity Among Academic Orthopaedic Leaders.","authors":"Hassan Farooq, Andrew Gaetano, Krishin Shivdasani, Nickolas Garbis, Dane Salazar","doi":"10.2106/JBJS.OA.24.00085","DOIUrl":"10.2106/JBJS.OA.24.00085","url":null,"abstract":"<p><strong>Introduction: </strong>Assessing scholarly contributions in academic orthopaedic surgery remains challenging, despite the importance of publication productivity in evaluating academic leaders. The Hirsch (h)-index and its derivative, the m-index, offer objective measures to compare and evaluate publication productivity. The primary aims of this study were to compare h- and m-indices of department chairs and residency program directors of orthopaedic training programs in the United States and assess the association between h-index and program rank.</p><p><strong>Methods: </strong>A publicly available Doximity report was used to identify and rank orthopaedic surgery residency programs in the United States. Internet-based searches of institution-specific websites were performed to confirm current department chairs and residency program directors as of January 2024. H-index data were collected from a publicly available database known as Scopus. The m-index was calculated as the quotient of h-index and years in practice. Gender and years in practice were obtained through available biographies on institution-specific websites.</p><p><strong>Results: </strong>Department chairs had significantly higher h- and m-indices at both the career and 5-year time intervals compared with program directors. Upon subgroup analysis, department chairs and program directors at top-10 ranked programs had significantly higher h- and m-indices compared with the entire population of department chairs and program directors. Linear regression analyses demonstrated a direct linear association between department chair/program director h- and m-indices and program rank.</p><p><strong>Conclusions: </strong>Publication productivity was higher for department chairs than residency program directors. Orthopaedic leaders at top-10 institutions had higher publication productivity compared with those at institutions outside of the top 10, per Doximity rankings. Finally, there is substantial variation in publication productivity of orthopaedic surgeons in leadership roles at academic institutions in the United States.</p><p><strong>Clinical relevance: </strong>This study highlights the publication productivity of orthopaedic surgery department chairs and residency program directors and describes the linear association between publication productivity of academic orthopaedic leaders and program rank. This information can be utilized by those interested in learning more about the publication productivity among academic orthopaedic surgeons across different institutions and can assist those who are involved in the hiring and promotion process at these academic institutions.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intrarater and Inter-rater Reliability of Tibial Plateau Fracture Classifications: Systematic Review and Meta-Analysis. 胫骨平台骨折分类的评分者内部和评分者之间的可靠性:系统回顾与元分析。
IF 2.3
JBJS Open Access Pub Date : 2024-10-03 eCollection Date: 2024-10-01 DOI: 10.2106/JBJS.OA.23.00181
Fardis Vosoughi, Iman Menbari Oskouie, Nazanin Rahimdoost, Amir Kasaeian, Arash Sherafat Vaziri
{"title":"Intrarater and Inter-rater Reliability of Tibial Plateau Fracture Classifications: Systematic Review and Meta-Analysis.","authors":"Fardis Vosoughi, Iman Menbari Oskouie, Nazanin Rahimdoost, Amir Kasaeian, Arash Sherafat Vaziri","doi":"10.2106/JBJS.OA.23.00181","DOIUrl":"10.2106/JBJS.OA.23.00181","url":null,"abstract":"<p><strong>Background: </strong>The interobserver and intraobserver reliability of various tibial plateau fracture (TPF) classifications has been examined in recent literature using radiography, computed tomography, and magnetic resonance imaging. The question remains as to which classification system provides the highest reliability. In this systematic review, we are going to evaluate the overall interobserver and intraobserver reliability of various TPF classifications in different imaging modalities.</p><p><strong>Methods: </strong>We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In February 2023, predefined terms were used for database search (Embase, PubMed, Scopus, Cochrane, and Web of Science). Meta-analysis of intrarater and inter-rater kappa coefficients was performed for each of the classifications in each modality.</p><p><strong>Results: </strong>Thirty-four studies were included in this review. Schatzker's classification was more frequently used than others. It had a better intrarater kappa coefficient than the Hohl and Moore and Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association (AO/OTA) classifications in radiography (κ = 0.72, 95% confidence interval [CI] = 0.67-0.76, p < 0.01). The Schatzker and AO/OTA classifications had similar inter-rater reliability in the radiography modality (κ = 0.53, 95% CI = 0.51-0.54, p < 0.01; κ = 0.53, 95% CI = 0.5-0.55, p < 0.01; respectively). In 3-dimensional computed tomography, the Luo classification system showed the highest intrarater (κ = 0.85, 95% CI = 0.35-0.66) and inter-rater (κ = 0.77, 95% CI = 0.73-0.81) kappa coefficients.</p><p><strong>Conclusion: </strong>Three-column classification proposed by Luo et al. was able to reach the highest degree and was the only classification with near-excellent inter-rater reliability.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Declining Rate of International Medical Graduates Matching Into Orthopedic Surgery Residency Programs in the United States: A 17-Year Analysis. 国际医学毕业生进入美国骨科住院医师项目的匹配率下降:17年分析。
IF 2.3
JBJS Open Access Pub Date : 2024-09-20 eCollection Date: 2024-07-01 DOI: 10.2106/JBJS.OA.24.00095
Anisha Tyagi, Suleiman Y Sudah, Kathryn Whitelaw, Brett D Haislup, Tej Joshi, Pablo Sanchez-Urgelles, Joaquin Sanchez-Sotelo, Mariano E Menendez
{"title":"Declining Rate of International Medical Graduates Matching Into Orthopedic Surgery Residency Programs in the United States: A 17-Year Analysis.","authors":"Anisha Tyagi, Suleiman Y Sudah, Kathryn Whitelaw, Brett D Haislup, Tej Joshi, Pablo Sanchez-Urgelles, Joaquin Sanchez-Sotelo, Mariano E Menendez","doi":"10.2106/JBJS.OA.24.00095","DOIUrl":"10.2106/JBJS.OA.24.00095","url":null,"abstract":"<p><strong>Introduction: </strong>International medical graduates (IMGs) continue to play an important role in the US health care system, but little is known about their trends of matching into highly competitive residencies such as orthopedic surgery. The purpose of this study was to analyze temporal trends of IMG applicants matching into US orthopedic residency programs between 2008 and 2024 and compare them with US allopathic (MD) and osteopathic (DO) graduates.</p><p><strong>Methods: </strong>Orthopedic residency specific data for years 2008 to 2024 was obtained from the National Resident Match Program and Electronic Residency Application Service. Variables collected included total number of programs, total positions offered, number of applicants (MD, DO, and IMG), positions filled, and fill rate for each group. Trends were examined using simple linear regression modeling.</p><p><strong>Results: </strong>The number of orthopedic residency programs increased from 160 (2008) to 218 (2024), with total positions increasing from 636 (2008) to 916 (2024). The IMG fill rate decreased from 2.99% in 2008 to 0.87% in 2024 (<i>p</i> < 0.01 for linear trend; β -0.069). This corresponds to an absolute number decrease of 19 IMGs in 2008 to 8 in 2024. More specifically, the proportion of US IMGs decreased from 0.94% to 0.66%, and the proportion of non-US IMGs decreased from 2.04% to 0.21%. Over the 17-year study period, a total of 105 US IMGs and 110 non-US IMGs matched into orthopedic surgery. The US MD applicant fill rate decreased significantly from 96.5% to 85.0% (<i>p</i> < 0.001; β -0.944). The DO applicant fill rate increased significantly from 0.31% to 13.97% (<i>p</i> < 0.0001; β 0.990).</p><p><strong>Conclusion: </strong>The declining rate of IMGs matching into orthopedic residency programs in the United States underscores the growing challenges faced by IMGs in accessing training in this competitive specialty. The notable increase in DO graduates securing orthopedic residency positions likely reflects the integration of a unified accreditation system for MD and DO residency programs established in 2020.</p><p><strong>Level of evidence: </strong>Retrospective Cohort Study; IV.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11412703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Use of Artificial Intelligence for Orthopedic Surgical Backlogs Such as the One Following the COVID-19 Pandemic: A Narrative Review. 人工智能在骨科手术积压(如 COVID-19 大流行后的积压)中的应用:叙事回顾。
IF 2.3
JBJS Open Access Pub Date : 2024-09-19 eCollection Date: 2024-07-01 DOI: 10.2106/JBJS.OA.24.00100
Adam P Henderson, Paul R Van Schuyver, Kostas J Economopoulos, Joshua S Bingham, Anikar Chhabra
{"title":"The Use of Artificial Intelligence for Orthopedic Surgical Backlogs Such as the One Following the COVID-19 Pandemic: A Narrative Review.","authors":"Adam P Henderson, Paul R Van Schuyver, Kostas J Economopoulos, Joshua S Bingham, Anikar Chhabra","doi":"10.2106/JBJS.OA.24.00100","DOIUrl":"https://doi.org/10.2106/JBJS.OA.24.00100","url":null,"abstract":"<p><p>➤ The COVID-19 pandemic created a persistent surgical backlog in elective orthopedic surgeries. ➤ Artificial intelligence (AI) uses computer algorithms to solve problems and has potential as a powerful tool in health care. ➤ AI can help improve current and future orthopedic backlogs through enhancing surgical schedules, optimizing preoperative planning, and predicting postsurgical outcomes. ➤ AI may help manage existing waitlists and increase efficiency in orthopedic workflows.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11410334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142297446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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