Publications by authors named "Joshua D Proal"
Background: Division chiefs (DCs) and department leadership play an integral role within the service, and in the department as a whole. The goal of this study was to assess the demographics and academic characteristics of the leadership in orthopedic shoulder and elbow services across academic centers in the United States and comment on the diversity within these leadership positions.
Methods: Academic medical centers were identified using the FRIEDA database.
Purpose: FDA investigational device exemption (IDE) studies are considered a gold standard of assessing safety and efficacy of novel devices through RCTs. The fragility index (FI) has emerged as a means to assess robustness of statistically significant study results and inversely, the reverse fragility index (RFI) for non-significant differences. Previous authors have defined results as fragile if loss to follow up is greater than the FI or RFI.
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- * Out of 196 academic centers and 223 pediatric hospitals, only 98 had a DC; the majority were male (85.7%) and predominantly white (83.7%), with more female DCs in academic hospitals than nonacademic ones.
- * The research highlights a significant lack of diversity in leadership roles, indicating the need for further studies to better understand these dynamics in both academic and private sectors.
Study Design: Prospective cohort study.
Objective: This study determined (1) the surgeon accuracy of psychological assessment in patients in spine clinic, (2) the impact of psychological distress on surgical recommendation, and (3) the correlation between patient-reported disability and psychological distress.
Summary Of Background Data: Psychological distress is common among patients presenting for spine surgery.
Purpose: Conventional triggered electromyography (EMG) in percutaneous pedicle screw (PPS) systems may be unreliable due to the interaction between the insertion apparatus and patient's soft tissue. Our aim was 1) to describe a modified technique of triggered EMG monitoring using insulated Kirschner wire (K-wires), 2) to compare EMG potentials with conventional techniques, and 3) to demonstrate the relationship between patient body mass index (BMI) and triggered EMG potentials.
Methods: This was a prospective cross-sectional study of 50 patients undergoing minimally invasive PPS placement.
Study Design: Retrospective review of spine surgery malpractice cases.
Objectives: The aim was to compare medical malpractice outcomes among different types of spine surgery and identify predictors of litigation outcomes.
Summary Of Background Data: Spine surgery is highly litigious in the United States with data suggesting favorable outcomes for defendant surgeons.
Background: Intrawound vancomycin powder (VP) has been rapidly adopted in spine surgery with apparent benefit demonstrated in limited, retrospective studies. Randomized trials, basic science, and dose response studies are scarce.
Purpose: This study aims to test the efficacy and dose effect of VP over an extended time course within a randomized, controlled in vivo animal experiment.
Article Synopsis
- The study highlights the importance of expert witness testimony in orthopaedic surgery malpractice cases and examines the characteristics of these witnesses from 2013 to 2017.
- The research found that a greater number of expert witnesses testified for plaintiffs compared to defendants, with general orthopaedists being the most common type on both sides.
- Key differences emerged between plaintiff and defense witnesses, including years of experience, academic involvement, fellowship training, and scholarly impact, indicating potential biases in expert testimony.