Estrategia para la gestión de las Investigaciones en Servicios y Sistemas de Salud. Villa Clara. 2017-2020 / Strategy for managing Investigations in Health Systems and Services. Villa Clara. 2017-2020

Introducción: Las Investigaciones en Servicios y Sistemas de Salud constituyen un componente esencial para lograr mayor eficiencia y efectividad del sistema de salud, sin embargo, su utilización es insuficiente. Objetivo: Desarrollar una estrategia para la gestión de las Investigaciones en Servicios y Sistemas de Salud. Métodos: Se realizó una intervención organizacional en la Dirección de Ciencia e Innovación Tecnológica de la Universidad de Ciencias Médicas de Villa Clara, desde el año 2017 hasta marzo de 2020. Participaron 52 directivos de Asistencia Médica Provincial, metodólogos, vicedirectores docentes y 46 profesionales que cursaron maestrías. La investigación se llevó a cabo en tres etapas: La primera, el diagnóstico organizacional para identificar las principales problemáticas en la gestión de los servicios, la segunda, dedicada a los talleres metodológicos sobre la Investigación en Servicios y Sistemas de Salud y la tercera, correspondió a la evaluación de los resultados mediante el registro de proyectos en este campo, y los aportes de las tesis de maestrías, respecto a la solución de los problemas identificados en los servicios de salud. Las técnicas utilizadas fueron: La observación, la entrevista, la revisión de documentos, el grupo focal y la lluvia de ideas. Resultados: Se identificaron 221 proyectos de investigación en este campo, y la ejecución y evaluación de 46 tesis de maestrías, con resultados satisfactorios en la solución de las problemáticas de salud estudiadas. Conclusiones: La estrategia desarrollada posibilitó la gestión de proyectos de investigación en Servicios y Sistemas de Salud, y la ejecución de tesis de maestrías para solucionar problemas prioritarios.

Introduction: investigations in Health Systems and Services constitute an essential component to achieve greater efficiency and effectiveness; however, its use is still insufficient. Objective: to develop a strategy for managing investigations in Health Systems and Services. Methods: an organizational intervention was carried out in the Directorate of Science and Technological Innovation at the University of Medical Sciences of Villa Clara, from 2017 to March 2020. Fifty-two managers of the Provincial Medical Assistance, methodologists, teaching vice-directors and forty-six professionals who took master's degrees participated. The investigation was carried out in three stages; the first, referring to the organizational diagnosis to identify the main problems in the management of services; the second, dedicated to methodological workshops on Investigations in Health Systems and Services and the third ones, corresponded to the evaluation of the results, through the registration of projects in this field and the contributions of the master's theses, regarding the solution of the identified problems. Observation, interview, document review, focus group and brainstorming were the techniques used. Results: a number of 221 research projects were identified in this field, as well as the execution and evaluation of 46 master's theses, with satisfactory results in the solution of the health problems studied. Conclusions: the developed strategy made possible the management of research projects in Health Systems and Services, and the execution of master's theses to solve priority problems.

Racial Health Disparities Research in Cardiothoracic Surgery Under-represented in Major Meetings.

INTRODUCTION: Black/African Americans and Latinos face significant health disparities and systemic inequities. Heart and lung disease are leading factors affecting morbidity and mortality in these groups. Given this disparity, we sought to determine how often this topic is presented at the most relevant United States annual cardiothoracic surgery meetings. METHODS: Specialty-specific annual meeting abstract books were queried between 2015 and 2021. We included the Society of Thoracic Surgeons, American Association for Thoracic Surgery, Western Thoracic Surgical Association, and the Southern Thoracic Surgical Association. Scientific abstract titles and content were searched for the following keywords and phrases: "racial health disparities," "race," "racism," "racial bias," "institutional racism," and "health disparities". If an abstract included a keyword or phrase, it was counted as a racial health disparity abstract. We calculated the proportion of racial health disparity abstracts and abstracts published as manuscripts in the meeting-associated journals. RESULTS: A total of 3664 abstracts were presented between 2015 and 2021. Of those, 0.90% (33/3664) abstracts presented contained at least one of the keywords or phrases. Of these abstracts, the percentage that went on to publication represented 0.38% (14/3664) of the total number of abstracts presented. CONCLUSIONS: Abstracts on racial health disparities in cardiothoracic surgery represent a very small fraction of total meeting peer-reviewed content. There is a significant gap in research to identify and develop best practice strategies to address these disparities and mitigate structural racism within the care of underserved patients with cardiothoracic diseases.

The consistency of peer-reviewers: Assessment of separate parts of the manuscripts vs final recommendations.

Delving into the review reports, this paper is aimed at analyzing reviewers` attitudes toward different sections of the manuscripts they review. The research focuses on the consistency of reviewers` evaluation through analysis of their assessment of separate parts of a paper, if it corresponds with the recommendations they made to the editors and whether a paper needs revision or should be accepted/rejected. It is assumed that the assessment of separate parts of a paper should be consistent with the final decision regarding the acceptance or rejection of a manuscript. Based on the analysis presented in this paper it can be concluded that the assessments of separate parts of articles in the evaluation sheets do not fully reflect the final recommendations of the reviewers. The results showed that the most correlated and therefore the most significant sections for the reviewers are the main text and the conclusions. The conditional probability analysis showed that the decision of reviewers, when number of points in the evaluation sheet is taken into consideration, is slightly unpredictable. No significant differences in the reviewers` recommendations based on gender or country of origin of the reviewers were found.

Peer review experiences of academic chemists in Ph.D. granting institutions in the United States.

Academic chemists at Ph.D. granting institutions in the United States were surveyed on the time and effort they spend on peer reviews and how they rate themselves as reviewers. Thirty percent of the respondents reviewed 16 or more papers yearly. This seemingly high number is consistent with the number of papers some scientists publish, and the rough estimate of two to three reviews is obtained per manuscript submission. Approximately 30% of the respondents reported that they spent two hours or less per review; that 60% rate themselves as strong or very strong reviewers; that the youngest reviewers are more likely to be compulsive in their reviewing; and that respondents who spend more time on reviews complete fewer reviews per year. Sixty percent of the respondents categorized themselves as strong or very strong reviewers, suggesting that most scientists see reviewing papers as an essential component of their professional responsibilities. These ratings suggest an opportunity to improve peer review quality. Good citizenship within the scientific community suggests that each scientist should review ca. two to three times as many papers each year as they submit, and that reviewers need to see reviewing as "providing to others what authors hope reviewers will provide to them."

Valoración de una metodología para integrar software educativo en la asignatura Rehabilitación estomatológica / Assessment of a methodology to integrate educational software in Stomatological Rehabilitation Subject

Introducción: Al elaborar una metodología resulta importante obtener los criterios de expertos antes de su aplicación. En un periodo precedente a esta investigación se elaboró una metodología con etapas y procedimientos para el desarrollo de software educativo. Objetivo: Valorar la pertinencia de la metodología para la integración de software educativo en el proceso de enseñanza-aprendizaje de las asignaturas Rehabilitación I y II de Estomatología. Método: Se realizó una investigación pedagógica en la Universidad de Ciencias Médicas de Holguín. Para valorar la pertinencia de la metodología se aplicó el método Delphi, a partir del cual, mediante una encuesta aplicada a 17 expertos seleccionados por su alto coeficiente de competencia en la temática, se pudo llegar a un consenso sobre el tema explorado. Resultados: La aplicación del cuestionario reveló que la mayoría de los expertos consideró cada indicador de la dimensión validez como muy adecuado, solo uno evaluó el indicador etapas de la metodología como adecuado y los procedimientos de la etapa dos como bastante adecuados. Para la dimensión viabilidad casi la totalidad consideró muy adecuados los indicadores factibilidad de aplicación y posibilidad de generalización; esta última fue evaluada por un experto como adecuada. Al comparar los resultados de los siete indicadores con los puntos de corte se aprecia que los expertos en su conjunto los definen como muy adecuados. Conclusiones: La pertinencia de la metodología se constató con el criterio consensuado de los expertos, quienes consideraron muy adecuados los aspectos valorados, y realizaron aportes que permitieron perfeccionarla antes de su implementación. Sobre estas bases no fue necesaria una segunda etapa de aplicación del método(AU)

Introduction: When developing a methodology, it is important to obtain the criteria of experts before its application. In a period preceding this research, a methodology with stages and procedures was defined for the development of educational software. Objective: To assess the relevance of the methodology for the integration of educational software in the teaching-learning process of the subjects Rehabilitation I and II of Stomatology. Method: A pedagogical research was carried out at the University Of Medical Sciences Of Holguín. To assess the relevance of the methodology, the Delphi method was applied, from which, through a survey applied to 17 experts selected for their high coefficient of competence in the subject, a consensus could be reached on the explored topic. Results: The application of the questionnaire revealed that most of the experts considered each indicator of the validity dimension as very adequate; only one evaluated the indicator stages of the methodology as adequate and the procedures of stage two as quite adequate. For the feasibility dimension, almost all considered the feasibility of application and possibility of generalization indicators to be very adequate; the latter was evaluated by an expert as adequate. When comparing the results of the seven indicators with the cut-off points, it can be seen that the experts as a whole define them as very adequate. Conclusions: The relevance of the methodology was verified with the agreed criteria of the experts, who considered the aspects evaluated to be very adequate, and made contributions that allowed it to be perfected before its implementation. On these bases, a second stage of application of the method was not necessary(AU)

Peer review: Risk and risk tolerance.

Peer review, commonly used in grant funding decisions, relies on scientists' ability to evaluate research proposals' quality. Such judgments are sometimes beyond reviewers' discriminatory power and could lead to a reliance on subjective biases, including preferences for lower risk, incremental projects. However, peer reviewers' risk tolerance has not been well studied. We conducted a cross-sectional experiment of peer reviewers' evaluations of mock primary reviewers' comments in which the level and sources of risks and weaknesses were manipulated. Here we show that proposal risks more strongly predicted reviewers' scores than proposal strengths based on mock proposal evaluations. Risk tolerance was not predictive of scores but reviewer scoring leniency was predictive of overall and criteria scores. The evaluation of risks dominates reviewers' evaluation of research proposals and is a source of inter-reviewer variability. These results suggest that reviewer scoring variability may be attributed to the interpretation of proposal risks, and could benefit from intervention to improve the reliability of reviews. Additionally, the valuation of risk drives proposal evaluations and may reduce the chances that risky, but highly impactful science, is supported.

An Empirical Assessment of Reviewer 2.

According to research lore, the second peer reviewer (Reviewer 2) is believed to rate research manuscripts more harshly than the other reviewers. The purpose of this study was to empirically investigate this common belief. We measured word count, positive phrases, negative phrases, question marks, and use of the word "please" in 2546 open peer reviews of 796 manuscripts published in the British Medical Journal. There was no difference in the content of peer reviews between Reviewer 2 and other reviewers for word count (630 vs 606, respectively, P = .16), negative phrases (8.7 vs 8.4, P = .29), positive phrases (4.2 vs 4.1, P = .10), question marks (4.8 vs 4.6, P = .26), and uses of "please" (1.0 vs 1.0, P = .86). In this study, Reviewer 2 provided reviews of equal sentiment to other reviewers, suggesting that popular beliefs surrounding Reviewer 2 may be unfounded.

Longitudinal analysis of National Institutes of Health funding for academic thoracic surgeons.

OBJECTIVE: National Institutes of Health (NIH) funding for academic (noncardiac) thoracic surgeons at the top-140 NIH-funded institutes in the United States was assessed. We hypothesized that thoracic surgeons have difficulty in obtaining NIH funding in a difficult funding climate. METHODS: The top-140 NIH-funded institutes' faculty pages were searched for noncardiac thoracic surgeons. Surgeon data, including gender, academic rank, and postfellowship training were recorded. These surgeons were then queried in NIH Research Portfolio Online Reporting Tools Expenditures and Results for their funding history. Analysis of the resulting grants (1980-2019) included grant type, funding amount, project start/end dates, publications, and a citation-based Grant Impact Metric to evaluate productivity. RESULTS: A total of 395 general thoracic surgeons were evaluated with 63 (16%) receiving NIH funding. These 63 surgeons received 136 grants totaling $228 million, resulting in 1772 publications, and generating more than 50,000 citations. Thoracic surgeons have obtained NIH funding at an increasing rate (1980-2019); however, they have a low percentage of R01 renewal (17.3%). NIH-funded thoracic surgeons were more likely to have a higher professorship level. Thoracic surgeons perform similarly to other physician-scientists in converting K-Awards into R01 funding. CONCLUSIONS: Contrary to our hypothesis, thoracic surgeons have received more NIH funding over time. Thoracic surgeons are able to fill the roles of modern surgeon-scientists by obtaining NIH funding during an era of increasing clinical demands. The NIH should continue to support this mission.

An experimental test of the effects of redacting grant applicant identifiers on peer review outcomes.

Background: Blinding reviewers to applicant identity has been proposed to reduce bias in peer review. Methods: This experimental test used 1200 NIH grant applications, 400 from Black investigators, 400 matched applications from White investigators, and 400 randomly selected applications from White investigators. Applications were reviewed by mail in standard and redacted formats. Results: Redaction reduced, but did not eliminate, reviewers' ability to correctly guess features of identity. The primary, preregistered analysis hypothesized a differential effect of redaction according to investigator race in the matched applications. A set of secondary analyses (not preregistered) used the randomly selected applications from White scientists and tested the same interaction. Both analyses revealed similar effects: Standard format applications from White investigators scored better than those from Black investigators. Redaction cut the size of the difference by about half (e.g. from a Cohen's d of 0.20-0.10 in matched applications); redaction caused applications from White scientists to score worse but had no effect on scores for Black applications. Conclusions: Grant-writing considerations and halo effects are discussed as competing explanations for this pattern. The findings support further evaluation of peer review models that diminish the influence of applicant identity. Funding: Funding was provided by the NIH.

Gender inequities in the online dissemination of scholars' work.

Unbiased science dissemination has the potential to alleviate some of the known gender disparities in academia by exposing female scholars' work to other scientists and the public. And yet, we lack comprehensive understanding of the relationship between gender and science dissemination online. Our large-scale analyses, encompassing half a million scholars, revealed that female scholars' work is mentioned less frequently than male scholars' work in all research areas. When exploring the characteristics associated with online success, we found that the impact of prior work, social capital, and gendered tie formation in coauthorship networks are linked with online success for men, but not for women-even in the areas with the highest female representation. These results suggest that while men's scientific impact and collaboration networks are associated with higher visibility online, there are no universally identifiable facets associated with success for women. Our comprehensive empirical evidence indicates that the gender gap in online science dissemination is coupled with a lack of understanding the characteristics that are linked with female scholars' success, which might hinder efforts to close the gender gap in visibility.