Ultrasound-Only Percutaneous Nephrolithotomy Is Safe and Effective Compared to Fluoroscopy-Directed Percutaneous Nephrolithotomy.

Introduction: Outcomes after ultrasound-only percutaneous nephrolithotomy (PCNL), in which no fluoroscopy is used, are not well known. The goal of this study was to compare outcomes of ultrasound-only and fluoroscopy-directed PCNL. Materials and Methods: Prospectively collected data from the Registry for Stones of the Kidney and Ureter database were reviewed for all patients who underwent PCNL at one academic center from 2015 to 2021. Primary outcomes were complications and stone-free rates (no residual fragments ≥3 mm). Results: Of the 141 patients who underwent ultrasound-only PCNL and 147 who underwent fluoroscopy-directed PCNL, there was no difference in complication rates (15% vs 16%, p = 0.87) or stone-free status (71% vs 65%, p = 0.72), respectively. After adjusting for body mass index, American Society of Anesthesiologists (ASA), stone size, and stone complexity by Guy score, ultrasound-only PCNL was not associated with any increased odds of complications (odds ratio [OR] 0.7, 95% confidence interval [CI] 0.3-1.6, p = 0.41) or residual stone fragments ≥3 mm (OR 1.0, 95% CI 0.5-1.9, p = 0.972) compared with fluoroscopy-directed PCNL. Ultrasound-only PCNL was associated with shorter operative time (median 99.5 vs 126 minutes, p < 0.001), and the use of ultrasound remained a significant predictor of short operative time (<100 minutes) after controlling for supine positioning, stone size, and stone complexity by Guy score (OR 2.31, 95% CI 1.01-5.29, p = 0.048). Patients in the ultrasound-only group were spared a mean radiation exposure dose of 10 mGy per procedure. Conclusions: Ultrasound-only PCNL is safe and achieves similar stone-free rates compared with fluoroscopy-directed PCNL with the added benefit of avoidance of radiation.

An Evaluation of Self-Reported Publications in Orthopaedic Sports Medicine Fellowship Applications.

BACKGROUND: Orthopaedic sports medicine fellowship positions are increasing in popularity, as evidenced by the increasing number of applicants to these programs. As positions have become more competitive, greater emphasis has been placed on an applicant's research experience. However, there has been a lack of research evaluating the accuracy of self-reported publications from fellowship applications. PURPOSE: To evaluate the accuracy of self-reported research publications and the outcomes of studies submitted for publication by applicants to an Accreditation Council for Graduate Medical Education (ACGME)-accredited sports medicine fellowship in the United States (US). STUDY DESIGN: Cross-sectional study. METHODS: Demographic and research publication data were retrospectively collected from 435 applications to an ACGME-accredited orthopaedic sports medicine fellowship program at a single high-volume academic institution from 2013 to 2017. All self-reported manuscript publications and studies in progress were analyzed with a minimum 2-year follow-up. "Submitted" publications were reviewed by searching the originally submitted journal and all publicly available sources. Publications were verified on PubMed, MEDLINE, and other open access journals. Journal impact factors were collected through use of InCites Journal Citation Reports. RESULTS: Only 5.7% (85/1504) of papers reported as "completed" were inaccurately self-reported, with 44 (51.8%) remaining unverified and 41 (48.2%) reporting discordant authorship, in which the published study listed a different author order than reported on the application. Further, 28.3% (197/696) of papers self-reported as "submitted" remained unpublished, 21.8% (152/696) were published in a different journal than originally reported, and 7.6% (53/696) were published with a different authorship order than reported. Among 95 applicants whose papers were published in different journals than originally reported, the mean impact factor of the final accepting journal was significantly lower than that of the journal of original submission (0.97 ± 0.13 vs 3.91 ± 0.79, respectively; 95% CI of the difference, 1.34-4.54; P < .01). Univariate analysis showed no significant relationships between variables of interest (age, sex, US Medical Licensing Examination Step 1 score, American Orthopaedic Association membership, medical school ranking, and advanced degree) and the presence of an inaccuracy. CONCLUSION: There is a low rate of inaccurate self-reporting of "completed" publications on applications for orthopaedic sports medicine fellowships. The majority of papers listed as "submitted" on these applications were not published in the journals to which they were originally submitted.

The Outcomes of "Submitted" Publications From Applicants to Orthopaedic Surgery Residency Programs: A Retrospective Review of 1303 Residency Applications.

PURPOSE: To evaluate research listed as "Submitted" on orthopaedic surgery residency applications for eventual publication rates and quality. SIGNIFICANCE: As the orthopaedic surgery residency selection process becomes increasingly competitive, the number of research publications listed on applications continually increases. However, the utility of using publications listed as "Submitted" in the applicant evaluation process remains unknown. METHODS: Demographic and publication data were retrospectively collected from 1303 applications to an orthopaedic surgery residency program. The PubMed database was used to verify "Submitted" publications for (1) publication fruition or (2) publication mismatch, defined as discordance between the listed journal of submission and the eventual journal of publication. RESULTS: A total of 594 applications (45.6%) listed ≥1 publication as "Submitted." Out of 1636 "Submitted" publications, 565 were unverifiable (32.5%). Of the 1071 verified publications, 362 (33.8%) experienced publication mismatch. Within this subgroup, a significant difference existed between the mean impact factors of the listed journal of submission and the eventual journal of publication (1.5 ± 2.7 versus 3.0 ± 2.5, P < 0.01). Demographic data were not predictive of having an unverified publication. CONCLUSION: Publications listed as "Submitted" in orthopaedic surgery residency applications frequently remain unpublished or are published in less impactful journals than originally intended.