The Canadian Association for Interventional Radiology (CAIR) and Canadian Association of Radiologists (CAR) Guidelines for Interventional Radiology Procedures for Patients With Suspected or Confirmed COVID-19.

The current coronavirus disease 2019 (COVID-19) pandemic is creating significant challenges to the Canadian health system, including the practice of interventional radiology (IR). Interventional radiology will continue to play an important role in patient care, during this crisis. This document serves to guide interventional and general radiologists in safely performing IR procedures on patients with suspected or confirmed COVID-19, using the best evidence, guidelines and expert recommendations available. These strategies include reviewing procedural indications, development of tactics to minimize cross contamination prior to the intervention, appropriate usage of personal protection equipment according to the type of procedure (along with defining aerosol-generating procedures in IR), along with developing the appropriate work environment during the COVID-19 pandemic. By adopting the policies described, hospitals will protect the interventional radiologists, medical radiation technologists, nurses, ancillary staff, along with patients who benefit from their care.

Meta-analysis of drug-eluting balloon angioplasty and drug-eluting stent placement for infrainguinal peripheral arterial disease.

PURPOSE: To perform a meta-analysis of randomized controlled trials (RCTs) of drug-eluting balloon (DEB) angioplasty and drug-eluting stents (DESs) for infrainguinal peripheral arterial disease. MATERIALS AND METHODS: Systematic searches were performed for all relevant RCTs. RESULTS: Eight RCTs for DEB angioplasty and 12 RCTs for a DES in peripheral arterial disease were identified. Meta-analysis demonstrated statistically significant superiority of DEB over plain balloon angioplasty of femoral-popliteal disease for late lumen loss, restenosis, and target lesion revascularization, with no benefit in major amputation or mortality. Statistically significant superiority of DEB over percutaneous transluminal angioplasty (PTA) was demonstrated for infrapopliteal disease for restenosis and target lesion revascularization. Drug-eluting stents showed statistically significant superiority over bare metal stents (BMSs) of femoral-popliteal disease for late lumen loss and restenosis, with no benefit in mortality or amputation. Drug-eluting stents showed statistically significant superiority over BMSs of infrapopliteal disease restenosis and target lesion revascularization, with no benefit in amputation or mortality. CONCLUSIONS: Drug-eluting balloon angioplasty and DESs demonstrated superior outcomes compared to PTA and BMS, with no difference in amputation or mortality.

Radiation passport: an iPhone and iPod touch application to track radiation dose and estimate associated cancer risks.

The rapid increase in the use of radiology and related exams and procedures has led to a concomitant increase in associated radiation risk. An application for the iPhone and iPod Touch called 'Radiation Passport' is described, which provides radiation dose estimates and associated cancer risks (non fatal and fatal) and serves as a method by which to track an individual's cumulative exposure.

Data integrity, reliability and fraud in medical research.

BACKGROUND: Data reliability in original research requires collective trust from the academic community. Standards exist to ensure data integrity, but these safeguards are applied non-uniformly so errors or even fraud may still exist in the literature. OBJECTIVE: To examine the prevalence and consequences of data errors, data reliability safeguards and fraudulent data among medical academics. METHODOLOGY: Corresponding authors of every fourth primary research paper published in the Journal of the American Medical Association (2001-2003), Canadian Medical Association Journal (2001-2003), British Medical Journal (1998-2000), and Lancet (1998-2000) were surveyed electronically. Questions focused on each author's personal experience with data reliability, data errors and data interpretation. RESULTS: Sixty-five percent (127/195) of corresponding authors responded. Ninety-four percent of respondents accepted full responsibility for the integrity of the last manuscript on which they were listed as co-author; however, 21% had discovered incorrect data after publication in previous manuscripts they had co-authored. Fraudulent data was discovered by 4% of respondents in their previous work. Four percent also noted 'smudged' data. Eighty-seven percent of respondents used data reliability safeguards in their last published manuscript, typically data review by multiple authors or double data entry. Twenty-one percent were involved in a paper that was submitted despite disagreement about the interpretation of the results, although the disagreeing author commonly withdrew from authorship. CONCLUSIONS: Data reliability remains a difficult issue in medical literature. A significant proportion of respondents did not use data reliability safeguards. Research fraud does exist in academia; however, it was not reported to be highly prevalent.

Honorary coauthorship: does it matter?

OBJECTIVE: To examine the perception of honorary coauthorship among medical academics and to determine whether a potential effect of honorary coauthorship exists on patient care. METHODS: Corresponding authors of every fourth primary research paper published in JAMA, Journal of the American Medical Association (2001-2003), Canadian Medical Association Journal (2001-2003), British Medical Journal (1998-2000), and Lancet (1998-2000) were surveyed electronically. Questions were focused on each author's personal experience and perception of honorary coauthorship. RESULTS: Sixty-five percent of corresponding authors responded (127/195). Fifty-five percent of respondents had published more than 50 peer-reviewed journal articles, and 52% had been listed with an honorary coauthor at some point in their career. Eighteen percent of respondents had been required at some point to list authors who had provided data via a commercial relationship. A majority of authors believed that there were potential negative effects of honorary coauthorship for both the authors themselves (73%) and for their coauthors (83%). These negative effects included personal liability for honorary authors (29%) and dilution of relative contribution for their coauthors (54%). Sixty-two percent of respondents said that honorary coauthorship may have a negative effect on patient care; however, only 2% had been involved in a case in which this phenomenon had actually occurred. CONCLUSION: Honorary coauthorship remains prevalent in the medical literature, even among highly published authors, and has the potential to negatively affect patient care. Respondents believed that a number of possible negative consequences of this phenomenon exist for honorary authors, their coauthors, and patients. Efforts to understand the true influence of honorary authorship on patient care may help further curb this practice in the literature.

Changing author counts in five major general medicine journals: effect of author contribution forms.

OBJECTIVES: Objective and indirect evidence was used to determine whether required author contribution forms were associated with a decrease in author counts in four major general medicine journals (British Medical Journal [BMJ], Journal of the American Medical Association [JAMA], Canadian Medical Association Journal [CMAJ], and the Lancet). The number of authors listed per article before and after the introduction of explicit author contribution requirements were counted and compared with that found for the New England Journal of Medicine (NEJM) that did not require such disclosure. The primary hypothesis was that author counts decreased more in the BMJ, CMAJ, JAMA, and the Lancet after introduction of the rules than they did in the NEJM. STUDY DESIGN AND SETTING: The number of authors listed per original research article published in the five general medical journals with the greatest 2004 Impact Factors in the first issue of each month in the years before and after introduction of required author contribution forms was compared. RESULTS: Introduction of the required author contribution forms by the four leading general medical journals did not result in a drop in the rate of increasing authors per article per year, or in the number of authors per article compared with the control. Overall, there was a trend of an increasing number of authors listed per article. CONCLUSION: Based on the presented objective and indirect evidence, required author contribution forms were not associated with a decrease in author counts.