Corrigendum: Editorial boards of dermatology journals and their potential financial conflict of interest.

The original article was published on August 15, 2018 and corrected on September 15, 2018. The revised version of the article removes a co-author, unintentionally retained during the editorial proofing process. This change appears in the revised online PDF copy of this article.

Editorial boards of dermatology journals and their potential financial conflict of interest.

BACKGROUND: Financial relationships between editorial board members of peer-reviewed journals and pharmaceutical and medical device manufacturing companies can potentially lead to biases and loss of objectivity of the medical literature. The purpose of this study was to evaluate the potential financial conflicts of interest that exist among editorial board members of dermatology journals. METHODS: Editorial board members for 36 dermatology journals were identified and searched using the Open Payments database on the Center for Medicare and Medicaid Services website. The total amount of general payments made to these physician editors were collected and stratified using a tier system: 1) nothing reported, 2) >$0 and <$10,000, 3) >$10,000 and <$100,000, and 4) >$100,000. RESULTS: We identified 551 editors from 36 dermatology journals for use in our analysis. Some form of general payment was made to 87% of these physicians (480 of 551). Four journals had >25% of their editorial staff receiving >$100,000. CONCLUSIONS: Financial relationships exist between editorial board members of dermatology journals and pharmaceutical/medical device manufacturing companies, which could lead to financial conflicts of interest. Publications coming from journals with highly paid physician editors have more potential to be biased.

The Interaction of Obesity and Metabolic Syndrome in Determining Risk of Complication Following Total Joint Arthroplasty.

BACKGROUND: The arthroplasty population is increasingly comorbid, and current quality improvement initiatives demand accurate risk stratification. Metabolic syndrome (MetS) has been identified as a risk factor for adverse events after arthroplasty; however, its interaction with obesity in contributing to risk is unclear. METHODS: A retrospective analysis of all Medicare patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA) at a single institution from 2009 to 2013 investigated the interaction between MetS, body mass index (BMI), and risk for Centers for Medicare and Medicaid Services (CMS)-reportable complications, readmission, and discharge disposition. RESULTS: A total of 1462 patients (942 TKA, 538 THA) were included, of which 16.2% had MetS. Regression analysis found that MetS was significantly related to risk of CMS complications (odds ratio [OR] = 1.96, 95% confidence interval [CI] 1.16-3.31, P = .012) and nonhome discharge (OR = 1.78, 95% CI 1.39-2.27, P < .001), but not readmission (OR = 1.23, 95% CI 0.7-2.18, P = .485). Within the MetS cohort, increasing BMI was not associated with increasing complications (P = .726) or readmissions (P = .206) but was associated with nonhome discharge (OR = 1.191 per unit increase in BMI, 95% CI 1.038-1.246, P = .001). CONCLUSION: MetS increases risk for CMS-reportable complications and nonhome discharge disposition after THA and TKA regardless of BMI. Obesity is of less value than MetS in assessing overall risk for complication after THA and TKA.

Prognostic implications of human papillomavirus status for patients with non-oropharyngeal head and neck squamous cell carcinomas.

PURPOSE: We examined overall survival in a large cohort of patients with human papillomavirus (HPV)-positive and HPV-negative non-oropharyngeal squamous cell carcinoma of the head and neck (non-OPSCC). METHODS: Patients diagnosed with non-OPSCC and known HPV status were identified in the National Cancer Database (NCDB). Multivariate logistic regression was applied to examine factors associated with HPV status. Multivariate analysis was utilized to determine factors correlated with overall survival. Propensity score-weighted Kaplan-Meier estimation was used to adjust for confounders in survival analyses. Multiple imputation method was used for sensitivity analysis. RESULTS: We identified 19,993 non-OPSCC patients with 5070 being positive for HPV in the NCDB. Median follow-up was 23.5 months. HPV-positive patients were more commonly male, white, with a lower comorbidity index score, presenting with T-stage <2, and N-stage ≥1. Unadjusted 3-year overall survival was 62% and 80% for HPV-negative and HPV-positive patients, respectively (p < 0.0001). On multivariate analysis, mortality was reduced for HPV-positive patients with early stage (HR = 0.68) and locally advanced disease (HR = 0.46). Adjusted 3-year overall survival was 65% for HPV-negative and 76% for HPV-positive patients (p < 0.0001). The survival advantage of HPV was maintained in all subsites and robust on sensitivity analysis. CONCLUSIONS: Patients with HPV-positive non-OPSCC exhibit similar characteristics as HPV-positive OPSCC. Overall survival was significantly higher for patients with HPV-positive versus HPV-negative non-OPSCC. These data reveal that HPV-positive non-OPSCC represent a favorable cohort that warrants recognition in the design of future clinical trial investigation.

Intensive Care Unit Outcomes Among Patients With Cancer After Palliative Radiation Therapy.

PURPOSE: To inform goals of care discussions at the time of palliative radiation therapy (RT) consultation, we sought to characterize intensive care unit (ICU) outcomes for patients treated with palliative RT compared to all other patients with metastatic cancer admitted to the ICU. METHODS AND MATERIALS: We conducted a retrospective cohort study of patients with metastatic cancer admitted to an ICU in a tertiary medical center from January 2010 to September 2015. We compared in-hospital mortality between patients who received palliative RT in the 12 months before admission and all other patients with metastatic cancer. We used multivariable logistic regression to evaluate the association between receipt of palliative RT and in-hospital mortality, adjusting for patient characteristics and acute illness severity. RESULTS: Among 1424 patients with metastatic cancer, 11.3% (n=161) received palliative RT before ICU admission. In-hospital mortality was 36.7% for palliative RT patients, compared with 16.6% for other patients with metastatic cancer (P<.001). Receipt of palliative RT was associated with increased in-hospital mortality (odds ratio 2.08, 95% confidence interval 1.34-3.21, P=.001), after adjusting for patient characteristics and severity of critical illness. Only 34 patients (21.1%) treated with palliative RT received additional cancer-directed treatment after ICU admission. CONCLUSIONS: For patients with metastatic cancer, prior treatment with palliative RT is associated with increased in-hospital mortality after ICU admission. Nearly half of patients previously treated with palliative RT either died during hospitalization or were discharged with hospice care, and few received further cancer-directed therapy. Palliative RT referral may represent an opportunity to discuss end-of-life treatment preferences with patients and families.