Do Academic Oral and Maxillofacial Surgeons Comply With Best Practices for Reporting the Results of Randomized Clinical Trials?

PURPOSE: To address the shortcoming of reporting P values, several leading medical journals have revised their guidelines for reporting results, specifically mandating the use of confidence intervals (CIs). The purpose of the present study was to evaluate the frequency of reporting CIs in randomized clinical trials (RCTs) by academic oral and maxillofacial surgeons. MATERIALS AND METHODS: We implemented a retrospective cohort study and enrolled a sample composed of RCTs reported in 3 oral and maxillofacial surgery (OMS) journals in 2009, 2012, 2015, and 2018. We identified RCTs using a Medical Subject Headings (MeSH) search in Medline. Studies were included in the sample if they were randomized and reported a measure of association. Predictor variables included the year of publication, journal, OMS focus area (eg, dentoalveolar surgery, anesthesia/facial pain, craniomaxillofacial trauma), reported confounding factors, funding sources, conflict of interest, study region, number of institutions involved, number of authors, and academic rank of the authors. The primary outcome of interest was reporting of the CI. Descriptive and bivariate statistics were computed. A P value of ≤ .05 was considered significant. RESULTS: The sample included 102 reports. The P value was uniformly reported (100%) in all 102 publications. CIs were reported in 29 reports (28.4%; 95% CI, 19.9 to 38.2). The OMS focus area was associated with reporting CIs (P = .02). Anesthesia/facial pain studies were significantly less likely to report the CIs (12.0%) compared with studies of craniomaxillofacial deformities (100%; Bonferroni P = .02). No other significant associations were found between the predictors and CI reporting (P ≥ .08). CONCLUSIONS: CIs have been reported in a small proportion of RCTs within OMS. Given the shortcomings of reporting only the P values, a significant need exists for improving the statistical reporting standards among OMS journals.

Perceptions of Sexual Harassment in Oral and Maxillofacial Surgery Training and Practice.

PURPOSE: Despite increased awareness of sexually harassing behavior (SHB) and national movements such as #MeToo, SHB remains a persistent problem for women training in medical and surgical fields. The aims of the present study were to 1) estimate the prevalence and nature of SHBs in a set of female oral and maxillofacial surgery (OMS) residents and practicing surgeons in the United States; 2) measure and describe the subjective effects of SHBs on the professional development of female OMSs; and 3) measure the effect of SHB education in training programs and its association with its prevalence. MATERIALS AND METHODS: A cross-sectional study was conducted using an adapted validated Sexual Experiences questionnaire. The 22-question survey was e-mailed to female members of the American Association of Oral and Maxillofacial Surgeons' women's clinical interest group. Descriptive statistics and bivariate analyses were computed using age and SHB training as predictor variables for the prevalence of SHBs. RESULTS: A total of 89 participants were e-mailed, and 67 responded (75%). Of the 67 respondents, 53 were practicing OMSs (79%) and 14 were OMS residents (21%). Of the 67 respondents, 96% had experienced at least 1 form of SHB. Specifically, 96% reported gender harassment, 52% unwanted sexual attention, and 9% sexual coercion. An "intimidating, hostile, or offensive environment" was associated with "having a negative effect on yourself as a professional" (P < .01). Of the respondents, 61% had not received education on SHBs during training, with those older than 35 years least likely to have received SHB training (P = .001). CONCLUSIONS: Our results have shown that SHBs received by female OMSs is common. Our findings suggest that SHBs erodes the personal confidence and career development of female OMS practitioners and residents. We recommend SHB educational training for all residents, faculty, and staff to ensure personal and academic growth in a safe environment.

Is Gender Associated With Success in Academic Oral and Maxillofacial Surgery?

PURPOSE: Several studies of surgical specialties have shown disparities in measures of research productivity and academic rank between female and male surgeons. The purpose of this work was to measure the role of surgeon gender in academic success in oral and maxillofacial surgery. MATERIALS AND METHODS: We performed a cross-sectional study of full-time academic oral and maxillofacial surgeons (OMSs) in the United States as of June 2017. The primary study variable was surgeon gender (male or female). The primary outcome variable was research productivity assessed using 2 different parameters: 1) h index (number of publications h with at least h citations each) and 2) academic rank. The other study variables were demographic characteristics potentially related to the outcome measures. Descriptive, bivariate, and regression statistics were computed. RESULTS: The study sample comprised 306 full-time academic OMSs, 53 (17.3%) of whom were women. On average, female OMSs had shorter academic careers (mean time since completion of training, 11.0 ± 8.2 years for female OMSs vs 22.0 ± 14.1 years for male OMSs; P < .001). There were no other significant differences between male and female OMSs regarding the secondary measures (P ≥ .23). Male OMSs had a higher mean h index than female OMSs (7.1 ± 8.6 vs 5.1 ± 7.9, P = .01). Academic rank was statistically significantly different between female and male OMSs, with a greater proportion of higher ranks seen in male OMSs (P = .001). After adjustment for career length and other confounders or effect modifiers, gender was not an independent predictor of the h index or academic rank (P ≥ .22). CONCLUSIONS: Although female surgeons represent a minority of full-time academic OMSs, academic success measured using research productivity and academic rank was not associated with gender.

Which Factors Affect Citation Rates in the Oral and Maxillofacial Surgery Literature?

PURPOSE: Citation rate is one of several tools to measure academic productivity. The purposes of this study were to estimate and identify factors associated with citation rates in the oral and maxillofacial surgery (OMS) literature. MATERIALS AND METHODS: This was a retrospective longitudinal study of publications in the Journal of Oral and Maxillofacial Surgery (JOMS), International Journal of Oral and Maxillofacial Surgery (IJOMS), and Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology (OOOO) from January through December 2012. The predictor variables were author- and article-specific factors. The outcome variable was the citation rate, defined as the total number of citations for each article over a 4-year period. Descriptive, bivariate, and multiple regression statistics were computed. RESULTS: The authors identified 993 articles published during 2012. The mean number of citations at 4 years after publication was 5.6 ± 5.3 (median, 4). In bivariate analyses, several author- and article-specific factors were associated with citation rates. In a multiple regression model adjusting for potential confounders and effect modifiers, first author H-index, number of authors, journal, OMS focus area, and Oxford level of evidence were significantly associated with citation rate (P ≤ .002). CONCLUSION: The authors identified 5 factors associated with citation rates in the OMS literature. These factors should be considered in context when evaluating citation-based metrics for OMS. Studies that focus on core OMS procedures (eg, dentoalveolar surgery, dental implant surgery), are published in specialty-specific journals (eg, JOMS or IJOMS), and have higher levels of evidence are more likely to be cited.