Brian C. Martinson

Background/Objective: InFLUenza Patient-reported Outcome (FLU-PRO Plus) is a 34-item patient-reported outcome instrument designed to capture the intensity and frequency of viral respiratory symptoms. This study evaluates whether FLU-PRO Plus responses could discriminate between symptoms of coronavirus disease 2019 (COVID-19) and influenza-like illness (ILI) with no COVID diagnosis, as well as forecast disease progression. Methods: FLU-PRO Plus was administered daily for 14 days. Exploratory factor analysis was used to reduce the FLU-PRO Plus responses on the first day to 3 factors interpreted as “symptom clusters.” The 3 clusters were used to predict COVID-19 versus ILI diagnosis in logistic regression. Correlation between the clusters and quality of life (QoL) measures was used to assess concurrent validity. The timing of self-reported return to usual health in the 14-day period was estimated as a function of the clusters within COVID-19 and ILI groups. Results: Three hundred fourteen patients completed day 1 FLU-PRO Plus, of which 65% had a COVID-19 diagnosis. Exploratory factor analysis identified 3 symptom clusters: (1)general Body, (2) tracheal/bronchial, and (3) nasopharyngeal. Higher nasopharyngeal scores were associated with higher odds of COVID-19 compared with ILI diagnosis [adjusted odds ratio = 1.61 (1.21, 2.12)]. Higher tracheal/bronchial scores were associated with lower odds of COVID-19 [0.58 (0.44, 0.77)]. The 3 symptom clusters were correlated with multiple QoL measures (r = 0.14–0.56). Higher scores on the general body and tracheal/bronchial symptom clusters were associated with prolonged time to return to usual health [adjusted hazard ratios: 0.76 (0.64, 0.91), 0.80 (0.67, 0.96)]. Conclusion: Three symptom clusters identified from FLU-PRO Plus responses successfully discriminated patients with COVID-19 from non-COVID ILI and were associated with QoL and predicted symptom duration.

Background: Concerns about research misbehavior in academic science have sparked interest in the factors that may explain research misbehavior. Often three clusters of factors are distinguished: individual factors, climate factors and publication factors. Our research question was: to what extent can individual, climate and publication factors explain the variance in frequently perceived research misbehaviors? Methods: From May 2017 until July 2017, we conducted a survey study among academic researchers in Amsterdam. The survey included three measurement instruments that we previously reported individual results of and here we integrate these findings. Results: One thousand two hundred ninety-eight researchers completed the survey (response rate: 17%). Results showed that individual, climate and publication factors combined explained 34% of variance in perceived frequency of research misbehavior. Individual factors explained 7%, climate factors explained 22% and publication factors 16%. Conclusions: Our results suggest that the perceptions of the research climate play a substantial role in explaining variance in research misbehavior. This suggests that efforts to improve departmental norms might have a salutary effect on behavior.

Background Cardiovascular disease (CVD) risks are of concern among immigrants and refugees settling in affluent host countries. The prevalence of CVD and risk factors among Somali African immigrants to the U.S. has not been systematically studied. Methods In 2015–2016, we surveyed 1156 adult Somalis in a Midwestern metropolitan area using respondent-driven sampling to obtain anthropometric, interview, and laboratory data about CVD and associated risk factors, demographics, and social factors. Results The prevalence of diabetes and low physical activity among men and women was high. Overweight, obesity, and dyslipidemia were also particularly prevalent. Levels of calculated CVD risk across the community were greater for men than women. Conclusion Though CVD risk is lower among Somalis than the general U.S. population, our results suggest significant prevalence of risk factors among Somali immigrants. Comparison with prior research suggests that CVD risks may be increasing, necessitating thoughtful intervention to prevent adverse population outcomes.

In the United States (US), long-term opioid therapy has been commonly prescribed for chronic pain. Since recognition of the opioid overdose epidemic, clinical practice guidelines have recommended tapering long-term opioids to reduced doses or discontinuation. The Effects of Prescription Opioid Changes for veterans (EPOCH) study is a national population-based prospective observational study of US Veterans Health Administration primary care patients designed to assess effects of evolving opioid prescribing practice on patients treated with long-term opioids for chronic pain. A stratified random sampling design was used to identify a survey sample from the target population of patients treated with opioid analgesics for ≥ 6 months. Demographic, diagnostic, visit, and pharmacy dispensing data were extracted from existing datasets. A 2016 mixed-mode mail and telephone survey collected patient-reported data, including the main patient-reported outcomes of pain-related function (Brief Pain Inventory interference; BPI-I scores 0–10, higher scores = worse) and health-related quality of life. Data on survey participants and non-participants were analyzed to assess potential nonresponse bias. Weights were used to account for design. Linear regression models were used to assess cross-sectional associations of opioid treatment with patient-reported measures. Of 14,160 patients contacted, 9253 (65.4%) completed the survey. Participants were older than non-participants (63.9 ± 10.6 vs. 59.6 ± 13.0 years). The mean number of bothersome pain locations was 6.8 (SE 0.04). Effectiveness of pain treatment and quality of pain care were rated fair or poor by 56.1% and 45.3%, respectively. The opioid daily dosage range was 1.6 to 1038.2 mg, with mean = 50.6 mg (SE 1.1) and median = 30.9 mg (IQR 40.7). Among the 73.2% of patients who did not receive long-acting opioids, the mean daily dosage was 30.4 mg (SE 0.6) and mean BPI-I was 6.4 (SE 00.4). Among patients who received long-acting opioids, the mean daily dosage was 106.2 mg (SE 2.8) and mean BPI-I was 6.8 (SE 0.07). Higher daily dosage was associated with worse pain-related function and quality of life among patients without long-acting opioids, but not among patients with long-acting opioids. Future analyses will use follow-up data to examine effects of opioid dose reduction and discontinuation on patient outcomes.

Breaches of research integrity have shocked the academic community. Initially explanations were sought at the level of individual researchers but over time increased recognition emerged of the important role that the research integrity climate may play in influencing researchers’ (mis)behavior. In this study we aim to assess whether researchers from different academic ranks and disciplinary fields experience the research integrity climate differently. We sent an online questionnaire to academic researchers in Amsterdam using the Survey of Organizational Research Climate. Bonferroni corrected mean differences showed that junior researchers (PhD students, postdocs and assistant professors) perceive the research integrity climate more negatively than senior researchers (associate and full professors). Junior researchers note that their supervisors are less committed to talk about key research integrity principles compared to senior researchers (MD = -.39, CI = -.55, -.24). PhD students perceive more competition and suspicion among colleagues (MD = -.19, CI = -.35, -.05) than associate and full professors. We found that researchers from the natural sciences overall express a more positive perception of the research integrity climate. Researchers from social sciences as well as from the humanities perceive less fairness of their departments’ expectations in terms of publishing and acquiring funding compared to natural sciences and biomedical sciences (MD = -.44, CI = -.74, -.15; MD = -.36, CI = -.61, -.11). Results suggest that department leaders in the humanities and social sciences should do more to set fairer expectations for their researchers and that senior scientists should ensure junior researchers are socialized into research integrity practices and foster a climate in their group where suspicion among colleagues has no place.

(2018). Expanding the Scope of Research Ethics Consultation Services in Safeguarding Research Integrity: Moving Beyond the Ethics of Human Subjects Research. The American Journal of Bioethics: Vol. 18, No. 1, pp. 55-57.

Assessing the integrity of research climates and sharing such information with research leaders may support research best practices. We report here results of a pilot trial testing the effectiveness of a reporting and feedback intervention using the Survey of Organizational Research Climate (SOuRCe). We randomized 41 Veterans Health Administration (VA) facilities to a phone-based intervention designed to help research leaders understand their survey results (enhanced arm) or to an intervention in which results were simply distributed to research leaders (basic arm). Primary outcomes were (1) whether leaders took action, (2) whether actions taken were consistent with the feedback received, and (3) whether responses differed by receptivity to quality improvement input. Research leaders from 25 of 42 (59%) VA facilities consented to participate in the study intervention and follow-up, of which 14 were at facilities randomized to the enhanced arm. We completed follow-up interviews with 21 of the 25 leaders (88%), 12 from enhanced arm facilities. While not statistically significant, the proportion of leaders reporting taking some action in response to the feedback was twice as high in the enhanced arm than in the basic arm (67% vs. 33%, p = .20). While also not statistically significant, a higher proportion of actions taken among facilities in the enhanced arm were responsive to the survey results than in the basic arm (42% vs. 22%, p = .64). Enhanced feedback of survey results appears to be a promising intervention that may increase the likelihood of responsive action to improve organizational climates. Due to the small sample size of this pilot study, even large percentage-point differences between study arms are not statistically distinguishable. This hypothesis should be tested in a larger trial.

We read with great interest the recent article by Redman and Caplan “Improving research misconduct policies”. While we generally agree with the authors’ main premise that most regulatory policies aimed at addressing research misconduct are not sufficiently informed by empirical evidence, we would like to respond to their critique on two particular points. First, we wholeheartedly concur with their argument that policies related to research integrity need to be more grounded in social psychological theory and data. Unfortunately, in making their argument, they seem themselves to overlook a great deal of existing evidence. For many years, researchers focused on research integrity, including members of our own team, have been applying concepts, …

Background. Researchers theorize that interventions increase physical activity by influencing key theory-based mediators (e.g., behavioral processes).