Publication pressure in medical imaging.

PURPOSE: To investigate the degree of perceived publication pressure in medical imaging. METHOD: Corresponding authors who published an article in one of the top 12 general radiology journals were invited to complete a survey about publication pressure. The revised Publication Pressure Questionnaire (PPQr) was used. Higher PPQr scores (5-point Likert scale) indicate a more negative view towards the various domains of publication pressure. RESULTS: 203 corresponding authors participated. Median PPQr scores in the domains "publication stress", "publication attitude", and "publication resources" were 3.33, 3.50, and 3.67, respectively. Age 25-34 years (ß coefficient 0.366, P = 0.047), female gender (ß coefficient 0.293, P = 0.020), and 5-10 years of research experience (ß coefficient 0.370, P = 0.033) were associated with a higher level of perceived publication stress, whereas age ≥ 65 years was negatively associated with perceived publication stress (ß coefficient -0.846, P < 0.001). Age 55-64 years and age > 65 years were associated with a more positive view towards the publication climate (ß coefficients -0.391 and -0.663, P = 0.018 and P = 0.002, respectively). Age 45-54 years was associated with a perception of fewer factors available to alleviate publication pressure (ß coefficient 0.301, P = 0.014), whereas age 25-34 years was associated with a perception of more factors available to alleviate publication pressure (ß coefficient -0.352, P = 0.012). CONCLUSION: Perceived publication pressure among medical imaging researchers appears to be appreciable and is associated with several (academic) demographics.

Assessing Authorship Rates over Time in Original Radiologic Research Publications.

Background Previous studies have shown an increase in the number of authors on radiologic articles between 1950 and 2013, but the cause is unclear. Purpose To determine whether authorship rate in radiologic and general medical literature has continued to increase and to assess study variables associated with increased author numbers. Materials and Methods PubMed/Medline was searched for articles published between January 1998 and October 2022 in general radiology and general medical journals with the top five highest current impact factors. Generalized linear regression analysis was used to calculate adjusted incidence rate ratios (IRRs) for the numbers of authors. Wald tests assessed the associations between study variables and the numbers of authors per article. Combined mixed-effects regression analysis was performed to compare general medicine and radiology journals. Results There were 3381 original radiologic research articles that were analyzed. Authorship rate increased between 1998 (median, six authors; IQR, 4) and 2022 (median, 11 authors; IQR, 8). Later publication year was associated with more authors per article (IRR, 1.02; 95% CI: 1.01, 1.02; P < .001) after adjusting for publishing journal, continent of origin of first author, number of countries involved, PubMed/Medline original article type, study design, number of disciplines involved, multicenter or single-center study, reporting of a priori power calculation, reporting of obtaining informed consent, study sample size, and number of article pages. There were 1250 general medicine original research articles that were analyzed. Later publication year was also associated with more authors after adjustment for the study variables (IRR, 1.04; 95% CI: 1.03, 1.05; P < .001). There was a stronger increase in authorship by publication year for general medicine journals compared with radiology journals (IRR, 1.02; 95% CI: 1.01, 1.02; P < .001). Conclusion An increase in authorship rate was observed in the radiologic and general medical literature between 1998 and 2022, and the number of authors per article was independently associated with later year of publication. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Arrivé in this issue.

Erosive hand osteoarthritis and sarcopenia: data from Osteoarthritis Initiative cohort.

OBJECTIVES: There is no evidence linking specific osteoarthritis (OA) types, such as erosive hand OA (EHOA), with distant generalised changes in muscle composition (sarcopenia), which can potentially be modified. This study pioneers the exploration of the association between EHOA and sarcopenia, both of which are predominantly observed in the older adults. METHODS: Using the Osteoarthritis Initiative cohort, we selected hand OA (modified Kellgren and Lawrence (grade ≥2 in ≥1 hand joint) participants with radiographic central erosions in ≥1 joints (EHOA group) and propensity score-matched hand OA participants with no erosion (non-EHOA group). MRI biomarkers of thigh muscles were measured at baseline, year 2 and year 4 using a validated deep-learning algorithm. To adjust for 'local' effects of coexisting knee OA (KOA), participants were further stratified according to presence of radiographic KOA. The outcomes were the differences between EHOA and non-EHOA groups in the 4-year rate of change for both intramuscular adipose tissue (intra-MAT) deposition and contractile (non-fat) area of thigh muscles. RESULTS: After adjusting for potential confounders, 844 thighs were included (211 EHOA:633 non-EHOA; 67.1±7.5 years, female/male:2.9). Multilevel mixed-effect regression models showed that EHOA is associated a different 4-year rate of change in intra-MAT deposition (estimate, 95% CI: 71.5 mm2/4 years, 27.9 to 115.1) and contractile area (estimate, 95% CI: -1.8%/4 years, -2.6 to -1.0) of the Quadriceps. Stratified analyses showed that EHOA presence is associated with adverse changes in thigh muscle quality only in participants without KOA. CONCLUSIONS: EHOA is associated with longitudinal worsening of thigh muscle composition only in participants without concomitant KOA. Further research is needed to understand the systemic factors linking EHOA and sarcopenia, which unlike EHOA is modifiable through specific interventions.

Integrity of Clinical Neuroradiological Research.

PURPOSE: It is unclear if undesired practices such as scientific fraud, publication bias, and honorary authorship are present in neuroradiology. Therefore, the objective was to explore the integrity of clinical neuroradiological research using a survey method. METHODS: Corresponding authors who published in one of four top clinical neuroradiology journals were invited to complete a survey about integrity in clinical neuroradiology research. RESULTS: A total of 232 corresponding authors participated in our survey. Confidence in the integrity of published scientific work in clinical neuroradiology (0-10 point scale) was rated as a median score of 8 (range 3-10). In linear regression analysis, respondents from Asia had significantly higher confidence (beta coefficient of 0.569, 95% confidence interval, CI: 0.049-1.088, P = 0.032). Of the respondents 8 (3.4%) reported to have committed scientific fraud in the past 5 years, whereas 66 respondents (28.4%) reported to have witnessed or suspected scientific fraud by anyone from their department in the past 5 years. A total of 192 respondents (82.8%) thought that a study with positive results is more likely to be accepted by a journal than a similar study with negative results and 96 respondents (41.4%) had an honorary author on any of their publications in the past 5 years. CONCLUSION: Experts in the field have overall high confidence in published clinical neuroradiology research; however, scientific integrity concerns are not negligible, publication bias is a problem and honorary authorship is common. The findings from this survey may help to increase awareness and vigilance among anyone involved in clinical neuroradiological research.

[Rupture of the flexor carpi radialis tendon after corticosteroid injection of a ganglion cyst]. / Peesruptuur na injectie van corticosteroïden in ganglioncyste.

BACKGROUND: Although corticosteroid injections are frequently used in practice to treat tendinopathies, there are many adverse effects. CASE DESCRIPTION: A 62-year-old woman received an aspiration and corticosteroid injection of a ganglion on the volar side of the left wrist. A few weeks later, she presented with severe pain and loss of function of the left wrist. On physical examination, here was a notable swelling with hematoma formation, along the course of the flexor carpi radialis. An MRI confirmed complete rupture of the flexor carpi radialis (FCR) tendon. She was treated non operatively with analgesics and a protective brace. During final check-up minimal loss of function was seen. CONCLUSION: Cautiousness and judicious restraint are imperative when considering corticosteroid infiltrations targeting a volar ganglion at the level of the FCR. Aspiration combined with corticosteroid infiltration is not recommended for patients exhibiting (subclinical) STT-/CMC-1 osteoarthritis, as it may cause FCR tendon ruptures.

The peer review process: A survey among scientists in radiology.

PURPOSE: To map the experience and view of scientists in radiology on the peer review process. METHOD: A survey with 12 closed-ended questions and 5 conditional sub-questions was conducted among corresponding authors who published in general radiology journals. RESULTS: 244 corresponding authors participated. In considering a peer review invitation, most respondents found the topic and the availability of time very important (62.1% [144/132] and 57.8% [134/232], respectively), the quality of the abstract, the prestige/impact factor of the journal, and the sense of professional duty important (43.7% [101/231], 42.2% [98/232], and 53.9% [125/232], respectively), and were indifferent about a reward (35.3% [82/232]). However, 61.1% (143/234) believed that a reviewer should be rewarded. Direct financial compensation (27.6% [42/152]), discounted fees for society memberships, conventions, and/or journal subscriptions (24.3% [37/152]), and Continuing Medical Education credits (23.0% [35/152]) were the most frequently desired rewards. 73.4% (179/244) of respondents never received formal peer review training, of whom 31.2% (54/173) would like to, particularly less experienced researchers (Chi-Square P = 0.001). The median reported review time per article was 2.5 h. 75.2% (176/234) of respondents found it acceptable that a manuscript is rejected by an editor without formal peer review. The double-blinded peer review model was preferred by most respondents (42.3% [99/234]). A median of 6 weeks was considered the maximum acceptable time from manuscript submission to initial decision by a journal. CONCLUSION: Publishers and journal editors may use the experiences and views of authors that were provided in this survey to shape the peer review process.

Diagnostic radiology and its future: what do clinicians need and think?

OBJECTIVE: To investigate the view of clinicians on diagnostic radiology and its future. METHODS: Corresponding authors who published in the New England Journal of Medicine and the Lancet between 2010 and 2022 were asked to participate in a survey about diagnostic radiology and its future. RESULTS: The 331 participating clinicians gave a median score of 9 on a 0-10 point scale to the value of medical imaging in improving patient-relevant outcomes. 40.6%, 15.1%, 18.9%, and 9.5% of clinicians indicated to interpret more than half of radiography, ultrasonography, CT, and MRI examinations completely by themselves, without consulting a radiologist or reading the radiology report. Two hundred eighty-nine clinicians (87.3%) expected an increase in medical imaging utilization in the coming 10 years, whereas 9 clinicians (2.7%) expected a decrease. The need for diagnostic radiologists in the coming 10 years was expected to increase by 162 clinicians (48.9%), to remain stable by 85 clinicians (25.7%), and to decrease by 47 clinicians (14.2%). Two hundred clinicians (60.4%) expected that artificial intelligence (AI) will not make diagnostic radiologists redundant in the coming 10 years, whereas 54 clinicians (16.3%) thought the opposite. CONCLUSION: Clinicians who published in the New England Journal of Medicine or the Lancet attribute high value to medical imaging. They generally need radiologists for cross-sectional imaging interpretation, but for a considerable proportion of radiographs, their service is not required. Most expect medical imaging utilization and the need for diagnostic radiologists to increase in the foreseeable future, and do not expect AI to make radiologists redundant. CLINICAL RELEVANCE STATEMENT: The views of clinicians on radiology and its future may be used to determine how radiology should be practiced and be further developed. KEY POINTS: • Clinicians generally regard medical imaging as high-value care and expect to use more medical imaging in the future. • Clinicians mainly need radiologists for cross-sectional imaging interpretation while they interpret a substantial proportion of radiographs completely by themselves. • The majority of clinicians expects that the need for diagnostic radiologists will not decrease (half of them even expect that we need more) and does not believe that AI will replace radiologists.

Which factors are associated with fraud in medical imaging research?

PURPOSE: To investigate the determinants of fraud in medical imaging research. METHOD: This study analyzed aggregated survey data on scientific integrity completed by 877 corresponding authors who published in imaging journals in 2021. Multivariate regression analyses were performed to determine the association of scientific fraud with the following variables: survey participants' age (<18, 18-24, 25-34, 35-44, 45-54, 55-64, or > 65 years), gender (male, female, or other), Corruption Perceptions Index (CPI) of their country of work (linear 0-100 scale), academic degree (medical doctor or other), academic position (none, fellow/resident, instructor/ lecturer, assistant professor, associate professor, full professor, or other), and years of research experience (<5, 5-10, or > 10 years). RESULTS: Thirty-seven survey participants (4.2%) indicated they had committed scientific fraud in the past 5 years, and 223 (25.4%) indicated they had witnessed or suspected scientific fraud by departmental colleagues in the past 5 years. Instructors/lecturers were significantly more likely (P = 0.029) and fellows/residents were nearly significantly more likely (P = 0.050) to have committed scientific fraud, with odds ratios (ORs) of 4.954 and 5.156, respectively (Nagelkerke R2 of 0.114). Survey participants > 65 years of age and survey participants working in less corrupt countries were significantly less likely (P = 0.022 and P = 0.044, respectively) to have witnessed or suspected scientific fraud committed by their departmental colleagues, with ORs of 0.412 and 0.988 (per unit increase in CPI), respectively (Nagelkerke R2 of 0.064). CONCLUSIONS: Fraud in medical imaging research appears to be more common among junior faculty and in more corrupt countries.

Radiographically detectable intra-articular mineralization: Predictor of knee osteoarthritis outcomes or only an indicator of aging? A brief report from the osteoarthritis initiative.

Objective: To determine the association between Intra-articular mineralization (IAM) and knee osteoarthritis (OA) outcomes stratified according to participants' age. Methods: Participants from the Osteoarthritis Initiative (OAI) with baseline radiographic OA (i.e., Kellgren-Lawrence grade ≥2 with Osteoarthritis Research Society International (OARSI) atlas joint space narrowing (JSN)) in either knee were identified. Both knees and dominant hand baseline radiographs were evaluated for the presence of IAM. Whole-grade OARSI-JSN radiographic progression and increased Western Ontario and McMaster universities osteoarthritis index scores of the knees with baseline radiographic OA (assessed annually) were defined as radiographic and symptomatic progression, respectively. Cox proportional-hazards and longitudinal multilevel regression models investigated radiographic and symptomatic progression, respectively. Results: 2010 participants with baseline radiographic OA in either one or both knees (N â€‹= â€‹2976) were identified. 178 participants had baseline IAM (hand radiographs â€‹= â€‹46, knee radiographs â€‹= â€‹166, both â€‹= â€‹34). An adjusted logistic regression model suggests an association between age and IAM (Odds Ratio: 1.06, 95% Confidence Interval (CI): 1.04-1.08). Presence of any IAM was not associated with whole-grade OARSI-JSN (Hazard Ratio (HR): 1.00, 95% CI: 0.73-1.37) or symptomatic progression (Estimated difference: 1.24, p-value: 0.13) in all participants. Using stratification analysis, in younger participants <60 years old, presence of any IAM was associated with radiographic progression (HR: 1.90, 95% CI: 1.01-3.60). Conclusion: Although the presence of any radiographic IAM increases with higher age and does not predict knee OA outcomes across the entire sample of OAI participants, it is associated with knee OA radiographic progression in participants aged <60.

Integrity in cardiovascular imaging research.

OBJECTIVE: To gain more insight in scientific integrity in the field of cardiovascular imaging research by conducting a survey among all corresponding authors who published in cardiovascular imaging journals. METHODS: Corresponding authors who published in one of eight major cardiovascular imaging journals in 2021 were requested to complete a questionnaire about scientific integrity in the field of cardiovascular imaging. RESULTS: Responses from 160 corresponding authors were received. The majority of respondents had a medical doctor degree (81.1%), held an academic position (93.8%, of which 44.0% as full professor), and had >10 years of research experience (72.5%). Overall confidence in the integrity of published scientific work in cardiovascular imaging was high, with a median score of 8 out of 10 (IQR 2). 5 respondents (3.1%) declared having committed scientific fraud in the past 5 years and 38 respondents (23.8%) declared having witnessed or suspected scientific fraud by anyone from their department in the past 5 years. 85.6% of respondents think that publication bias is present. 50% of respondents declared that any of their publications in the past 5 years had a co-author who actually did not deserve this co-authorship. CONCLUSION: Experts in the field report that several forms of scientific fraud, publication bias, and honorary authorship are present in cardiovascular imaging research. Despite these reports of academic dishonesty, overall confidence in the integrity of cardiovascular imaging research is deemed high.

Retracted Publications in Medical Imaging Literature: an Analysis Using the Retraction Watch Database.

RATIONALE AND OBJECTIVE: It is currently unknown how many publications in the medical imaging literature are retracted and for which reasons. The purpose of this study was to perform an updated analysis on retracted medical imaging publications using the Retraction Watch Database. MATERIALS AND METHODS: The Retraction Watch Database was searched for all retracted publications in the subject category "Radiology/Imaging" (no beginning date limit, search update until April 27, 2022). Reasons for retraction were extracted using standardized coding taxonomy. The number of citations per retracted publication was determined. Spearman's rho was used for statistical analysis. RESULTS: 192 retractions, originally published between 1984 and 2021, were included. Most retractions originated from China (31.3%), the United States (12.5%), Japan (7.3%), and South Korea (6.3%). The number of retractions increased over the years, especially since 2000 (Spearman's rho=0.764, p <0.001). Delay between original publication and retraction ranged from 0 days to 14 years and 3 months (median of 11 months). Most common reasons for retraction were duplication of article (7.1%), plagiarism of article (6.8%), concerns/issues about data (5.4%), investigation by company/institution (4.5%), and forged authorship (4.0%). Scientific misconduct was deemed present in 107 of 192 retracted articles (55.7%). Retracted articles (of which 138 were listed in Web of Science) received a median of 2 citations (range 0-148, IQR 5). CONCLUSION: The number of retracted medical imaging publications continues to increase over time, which could indicate that more compromised research has either been published or discovered. Scientific misconduct was the main cause for retraction.

Scientific Fraud, Publication Bias, and Honorary Authorship in Nuclear Medicine.

Our objective was to investigate nuclear medicine scientists' experience with scientific fraud, publication bias, and honorary authorship. Methods: Corresponding authors who published an article in one of the 15 general nuclear medicine journals (according to Journal Citation Reports) in 2021 received an invitation to participate in a survey on scientific integrity. Results: In total, 254 (12.4%) of 1,897 corresponding authors completed the survey, of whom 11 (4.3%) admitted to having committed scientific fraud and 54 (21.3%) reported having witnessed or suspected scientific fraud by someone in their department in the past 5 y. Publication bias was considered present by 222 (87.4%) respondents, and honorary authorship practices were experienced by 100 (39.4%) respondents. Respondents assigned a median score of 8 (range, 2-10) on a 1- to 10-point scale for their overall confidence in the integrity of published work. On multivariate analysis, researchers in Asia had significantly more confidence in the integrity of published work, with a ß-coefficient of 0.983 (95% CI, 0.512-1.454; P < 0.001). A subset of 22 respondents raised additional concerns, mainly about authorship criteria and assignments, the generally poor quality of published studies, and perverse incentives of journals and publishers. Conclusion: Scientific fraud, publication bias, and honorary authorship appear to be nonnegligible practices in nuclear medicine. Overall confidence in the integrity of published work is high, particularly among researchers in Asia.

Scientific integrity and fraud in radiology research.

PURPOSE: To investigate the view of radiologists on the integrity of their own and their colleagues' scientific work. MATERIALS AND METHODS: Corresponding authors of articles that were published in 12 general radiology journals in 2021 were invited to participate in a survey on scientific integrity. RESULTS: A total of 219 (6.2 %) of 3,511 invited corresponding authors participated. Thirteen (5.9 %) respondents reported having committed scientific fraud, and 60 (27.4 %) witnessed or suspect scientific fraud among their departmental members in the past 5 years. Misleading reporting (32.2 %), duplicate/redundant publication (26.3 %), plagiarism (15.3 %), and data manipulation/falsification (13.6 %) were the most commonly reported types of scientific fraud. Publication bias exists according to 184 (84.5 %) respondents, and 89 (40.6 %) respondents had honorary authors on their publications in the past 5 years. General confidence in the integrity of scientific publications ranged between 2 and 10 (median: 8) on a 0-10 point scale. Common topics of interest and concern among respondents were authorship criteria and assignments, perverse incentives (including the influence of money, funding, and academic promotions on the practice of research), and poorly performed research without intentional fraud. CONCLUSION: Radiology researchers reported that scientific fraud and other undesirable practices such as publication bias and honorary authorship are relatively common. Their general confidence in the scientific integrity of published work was relatively high, but far from perfect. These data may trigger stakeholders in the radiology community to place scientific integrity higher on the agenda, and to initiate cultural and policy reforms to remove perverse research incentives.

Mapping the cancer imaging research landscape: which cancers are more and which cancers are less frequently investigated?

OBJECTIVE: To investigate the proportion of published imaging studies relative to incidence and mortality rate per cancer type. METHODS: From a random sample of 2500 articles published in 2019 by the top 25 imaging-related journals, we included cancer imaging studies. The publication-to-incidence and publication-to-mortality ratios (defined as the publication rate divided by the proportional incidence and mortality rate, respectively) were calculated per cancer type. Ratios >1 indicate a higher publication rate compared to the relative incidence or mortality rate of a specific cancer. Ratios <1 indicate a lower publication rate compared to the relative incidence or mortality rate of a specific cancer. RESULTS: 620 original cancer imaging studies were included. Female breast cancer (20.2%), prostate cancer (13.0%), liver cancer (12.9%), lung cancer (8.8%), and cancers in the central nervous system (8.1%) comprised the top 5 of cancers investigated. Cancers in the central nervous system and liver had publication-to-incidence ratios >2, whereas nonmelanoma of the skin, leukemia, stomach cancer, and laryngeal cancer had publication-to-incidence ratios <0.2. Cancers in the prostate, central nervous system, female breast, and kidney had publication-to-mortality ratios >2, whereas esophageal cancer, stomach cancer, laryngeal cancer, and leukemia had publication-to-mortality ratios <0.2. CONCLUSION: This overview of published cancer imaging research may be informative and useful to all stakeholders in the field of cancer imaging. The potential causes of disproportionality between the publication rate vs. incidence and mortality rates of some cancer types are multifactorial and need to be further elucidated.

Artificial intelligence software for diagnosing intracranial arterial occlusion in patients with acute ischemic stroke.

PURPOSE: To evaluate the diagnostic performance of AI software in diagnosing intracranial arterial occlusions in the proximal anterior circulation at CT angiography (CTA) and to compare it to manual reading performed in clinical practice. METHODS: Patients with acute ischemic stroke underwent CTA to detect arterial occlusion in the proximal anterior circulation. Retrospective review of CTA scans by two neuroradiologists served as reference standard. Sensitivity and specificity of AI software (StrokeViewer) were compared to those of manual reading using the McNemar test. The proportions of correctly detected occlusions in the distal internal carotid artery and/or M1 segment of the middle cerebral artery (large vessel occlusion [LVO]) and in the M2 segment of the middle cerebral artery (medium vessel occlusion [MeVO]) were calculated. RESULTS: Of the 474 patients, 75 (15.8%) had an arterial occlusion in the proximal anterior circulation according to the reference standard. Sensitivity of StrokeViewer software was not significantly different compared to that of manual reading (77.3% vs. 78.7%, P = 1.000). Specificity of StrokeViewer software was significantly lower than that of manual reading (88.5% vs. 100%, P < 0.001). StrokeViewer software correctly identified 40 of 42 LVOs (95.2%) and 18 of 33 MeVOs (54.5%). StrokeViewer software detected 8 of 16 (50%) intracranial arterial occlusions which were missed by manual reading. CONCLUSION: The current AI software detected intracranial arterial occlusion with moderate sensitivity and fairly high specificity. The AI software may detect additional occlusions which are missed by manual reading. As such, the use of AI software may be of value in clinical stroke care.

Health Care Industry Payments to Editorial Board Members of Imaging-related Journals.

Background Editorial board members may be biased due to conflicts of interest (COIs). Purpose To investigate the frequency and amount of payments from industry to editorial board members of imaging-related journals and whether they are in agreement with the disclosure status as provided by the journal. Materials and Methods Editorial board members of 15 U.S.-based imaging-related journals who were listed in the Open Payments database (OPD) were included. Payments from industry to editorial board members in the year 2020 were extracted from the OPD and compared with publicly available COI disclosure data as provided by the journals. The Kruskal-Wallis test was used for statistical analysis. Results A total of 519 editorial board members were included, of whom 214 (41%) received industry payment and 305 (59%) did not. Payments to editorial board members by the industry ranged from $12.63 to $404 625.47 (median, $2397.48). Most payments from industry (59%) were ascribed to consulting. Editorial board members of the journals JACC: Cardiovascular Imaging and Journal of Vascular and Interventional Radiology received significantly higher amounts of individual payments from industry than editorial board members of most other journals. Financial COI disclosures were not publicly listed for 413 of the 519 (80%) editorial board members, 169 of whom received payments from industry according to the OPD. Of the 106 editorial board members whose financial COI disclosures were publicly listed, 36 (34%) were discordant with the OPD. Conclusion Payments from industry to Open Payments database-listed editorial board members of imaging-related journals are prevalent. Imaging-related journals often do not report or do not accurately report payments from industry to their editorial board members © RSNA, 2022.