Are There Distinct Statistical Groupings of Mental Health Factors and Pathophysiology Severity Among People with Hip and Knee Osteoarthritis Presenting for Specialty Care?

Background: There is mounting evidence that objective measures of pathophysiology do not correlate well with symptom intensity. A growing line of inquiry identifies statistical combinations (so-called "phenotypes") of various levels of distress and unhelpful thoughts that are associated with distinct levels of symptom intensity and magnitude of incapability. As a next step, it would be helpful to understand how distress and unhelpful thoughts interact with objective measures of pathologic conditions such as the radiologic severity of osteoarthritis.

The Performance and Trajectory of Medical Students With Disabilities: Results From a Multisite, Multicohort Study.

Purpose: To conduct a post-Americans with Disabilities Act Amendments Act of 2008 multisite, multicohort study called the Pathways Project to assess the performance and trajectory of medical students with disabilities (SWDs).

Method: From June to December 2020, the authors conducted a matched cohort study of SWDs and nondisabled controls from 2 graduating cohorts (2018 and 2019) across 11 U.S.

Patient and Health Care Worker Perceptions of Communication and Ability to Identify Emotion When Wearing Standard and Transparent Masks.

Importance: Adoption of mask wearing in response to the COVID-19 pandemic alters daily communication.

Objective: To assess communication barriers associated with mask wearing in patient-clinician interactions and individuals who are deaf and hard of hearing.

Design, Setting, And Participants: This pilot cross-sectional survey study included the general population, health care workers, and health care workers who are deaf or hard of hearing in the United States.

The development and implementation of a "B-Team" (buprenorphine team) to treat hospitalized patients with opioid use disorder.

IMPLEMENTATION INSIGHTS.

Uncomplicated Distal Radius Fractures: An Opportunity to Reduce Emergency Medicine Opioid Prescribing?

Objectives: To assess emergency physician prescribing for simple extremity fractures-specifically, distal radius fractures-and describe the opportunity for reducing opioid prescribing.

Methods: An electronic survey was distributed to 1238 emergency physicians employed by a nationwide practice serving 220 sites in 20 states. The survey presented two plain film views of a simple Colles fracture and asked: "For the last patient you discharged .

Statistics From A (Agreement) to Z (z Score): A Guide to Interpreting Common Measures of Association, Agreement, Diagnostic Accuracy, Effect Size, Heterogeneity, and Reliability in Medical Research.

Researchers reporting results of statistical analyses, as well as readers of manuscripts reporting original research, often seek guidance on how numeric results can be practically and meaningfully interpreted. With this article, we aim to provide benchmarks for cutoff or cut-point values and to suggest plain-language interpretations for a number of commonly used statistical measures of association, agreement, diagnostic accuracy, effect size, heterogeneity, and reliability in medical research. Specifically, we discuss correlation coefficients, Cronbach's alpha, I2, intraclass correlation (ICC), Cohen's and Fleiss' kappa statistics, the area under the receiver operating characteristic curve (AUROC, concordance statistic), standardized mean differences (Cohen's d, Hedge's g, Glass' delta), and z scores.

Association Between Surgical Volume and Survival Among Patients With Variant Histologies of Bladder Cancer.

Objective: To examine the relationship between hospital volume and the management of bladder cancer variant histology. Variant histologies of bladder cancer are rare which limits the ability for providers to develop expertise however there is a clear hospital and/or surgeon-volume relationship for management of rare or complex surgical and/or medical diseases.

Methods: We queried the National Cancer Database from 2004-2016 for all cases of bladder cancer, identifying cases of variant histology.

Shoulder Latarjet Surgery Shows Wide Variation in Reported Indications, Techniques, Perioperative Treatment, and Definition of Outcomes, Complications, and Failure: A Systematic Review.

Purpose: To systematically review and compare the surgical indications, technique, perioperative treatment, outcomes measures, and how recurrence of instability was reported and defined after coracoid transfer procedures.

Methods: A systematic review of the literature examining open coracoid transfer outcomes was conducted according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the Cochrane registry, MEDLINE, and EMBASE databases from 2010 to 2020. Inclusion criteria included open coracoid transfer techniques, including the Bristow or Latarjet technique, full text availability, human studies, and English language.

Is Grit Associated with Burnout and Well-being in Orthopaedic Resident and Faculty Physicians? A Multi-institution Longitudinal Study Across Training Levels.

Background: Grit has been defined as "perseverance and passion for long-term goals" and is characterized by maintaining focus and motivation toward a challenging ambition despite setbacks. There are limited data on the impact of grit on burnout and psychologic well-being in orthopaedic surgery, as well as on which factors may be associated with these variables.

Questions/purposes: (1) Is grit inversely correlated with burnout in orthopaedic resident and faculty physicians? (2) Is grit positively correlated with psychologic well-being in orthopaedic resident and faculty physicians? (3) Which demographic characteristics are associated with grit in orthopaedic resident and faculty physicians? (4) Which demographic characteristics are associated with burnout and psychologic well-being in orthopaedic resident and faculty physicians?

Methods: This study was an institutional review board-approved interim analysis from the first year of a 5-year longitudinal study of grit, burnout, and psychologic well-being in order to assess baseline relationships between these variables before analyzing how they may change over time.

Generalized case-control sampling under generalized linear models.

A generalized case-control (GCC) study, like the standard case-control study, leverages outcome-dependent sampling (ODS) to extend to nonbinary responses. We develop a novel, unifying approach for analyzing GCC study data using the recently developed semiparametric extension of the generalized linear model (GLM), which is substantially more robust to model misspecification than existing approaches based on parametric GLMs. For valid estimation and inference, we use a conditional likelihood to account for the biased sampling design.

Perioperative pain management and outcomes in patients who -discontinued or continued pre-existing buprenorphine therapy.

Objective: This study compared opioid utilization and clinical outcomes in surgical patients receiving maintenance buprenorphine therapy who discontinued versus those who continued buprenorphine treatment perioperatively. Lack of high-quality evidence, conflicting results in previous studies, and the possible need for reinduction after discontinuing therapy present clinicians with the complicated dilemma of choosing the best strategy to control post-operative pain in patients receiving buprenorphine.

Design: A multicenter, retrospective cohort study.

Is American Joint Replacement Registry Data Representative of National Data? A Comparative Analysis.

Introduction: The American Academy of Orthopaedic Surgeons American Joint Replacement Registry (AJRR) is the largest registry of total hip and knee arthroplasty (THA and TKA) procedures performed in the United States. The purpose of this study was to examine whether AJRR data are representative of the national experience with hip and knee arthroplasty as represented in the National (Nationwide) Inpatient Sample (NIS).

Methods: All patients undergoing a THA or TKA procedure between 2012 to 2018 (AJRR) and 2012 to 2016 (NIS) were identified.