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Background: Research is an important mandate for academic surgical divisions. However, there is widespread concern that the current health care climate is leading to a decline in research activity. A University of British Columbia (UBC) academic surgical division attempted to address this concern by strategically recruiting PhD research scientists to prioritize research and develop collaborative research programs. The objective of our study was to determine whether this strategy resulted in in creased research productivity. Methods: We reviewed the UBC Department of Surgery database to assess research funding obtained by the Division of General Surgery for the years 1994-2004. We searched MEDLINE for peer-reviewed publications by faculty members during this period. Results: Research funding increased from a mean of Can$417 292 per year in the 5 years (1994/95-1998/99) before the recruitment of dedicated PhD scientists to a mean of Can$1.3 million per year in the 5 years following the recruitment strategy (1999/2000- 2003/04; p = 0.012). Funding for the initial 5 years was Can$2.1 million, including 1 Canadian Institutes of Health Research (CIHR) grant. Funding increased to Can$6.8 million, including 22 CIHR grants over the subsequent 5 years (p < 0.001). Collaborative research led to the awarding of multidisciplinary grants exceeding Can$4 million with divisional members as principle or coprinciple investigators. From 1994/05 to 1998/99, the total number of peer-reviewed publications was 116 (mean 23.2, standard deviation [SD] 7 per year), increasing to 144 from 1999/2000 to 2003/04 (mean 28.8, SD 13 per year). The trend was for publications in journals with higher impact factors in the latter 5-year period. Conclusion: Strategic recruitment resulted in increased and sustained research productivity. Interactions between research scientists and clinicians resulted in successful program grant funding support. These results have implications for sustaining the research mission within academic departments of surgery. Contexte : La recherche est un des importants mandats impartis aux departements de chirurgie universitaires. Un peu partout, toutefois, on s&apos;inquiete du climat qui regne actuellement dans le milieu de la sante car il semble peu propice aux activites de recherche. A l&apos;Universite de la Colombie-Britannique, le departement de chirurgie a tente de contrer cette inquietude en adoptant une strategie axee sur le recrutement de chercheurs de niveau doctoral pour prioriser la recherche et elaborer des programmes de recherche en collaboration. L&apos;objectif de notre etude etait de verifier si cette strategie a contribue a l&apos;accroissement de la productivite en recherche. Methodes : Nous avons passe en revue la base de donnees du departement de chirurgie de l&apos;Universite de la Colombie-Britannique afin de retracer les subventions versees a la division de chirurgie generale pour la periode allant de 1994 a 2004. Nous avons interroge la base MEDLINE pour y recenser les publications soumises a l&apos;examen des pairs produites par des membres du corps professoral au cours de cette periode. Resultats : Le financement de la recherche est passe d&apos;une moyenne annuelle de 417 292 $Can par annee pendant les 5 annees de 1994/95 a 1998/99, soit avant le recrutement des chercheurs de niveau doctoral, a une moyenne annuelle de 1,3 million $Can au cours des 5 annees suivant l&apos;application de la strategie de recrutement (soit de 1999/2000 a 2003/04; p = 0,012). Pour les 5 premieres annees, le financement global a ete de 2,1 millions $Can, incluant une subvention des Instituts de recherche en sante du Canada (IRSC). Au cours des 5 annees suivantes, le financement est passe a 6,8 millions $Can, dont 22 bourses des IRSC (p < 0,001). La recherche en collaboration a mene a l&apos;attribution de bourses multidisciplinaires d&apos;une valeur de plus de 4 millions $Can pour des etudes dont les membres divisionnaires etaient les chercheurs ou co-chercheurs principaux. On a denombre en tout 116 publications soumises a l&apos;examen des pairs (moyenne annuelle, 23,2; ecart-type [ET], 7) de 1994/95 a 1998/99; ce nombre est passe a 144 pour la periode de 1999/2000 a 2003/04 (moyenne annuelle, 28,8; ET 13). Au cours de cette derniere periode de 5 annees, la tendance favorisait les publications dans des revues ayant un facteur d&apos;impact plus eleve. Conclusion : Le recrutement strategique a donne lieu a une augmentation soutenue de la productivite en recherche. Les interactions entre les chercheurs et les cliniciens ont permis l&apos;obtention de subventions de soutien aux programmes. Ces resultats ont des repercussions sur la realisation de la mission de recherche des departements universitaires de chirurgie., Research is an important component of the mission statement of an academic surgical division. Through research, patient care is improved, and the process of research methodology leads to better-informed surgical [...]

Objective: Our primary objective was to evaluate demographic and causal factors of inhospital mortality for significant firearm-related injuries (i.e., those with an Injury Severity Score [ISS] > 12) in Canadian [...]

Objective: The purpose of this study was to determine the satisfaction of members of an academic department who are funded by a Clinical Academic Service Contract (CASC), compared with those [...]

Unpublished data should not be completely excluded from meta-analyses but should be subject to the same methodological review as published data before inclusion. Meta-analyses combine data from several studies and have become an increasingly important tool for summarizing and assessing scientific findings. Publication bias refers to the differential selection or submission of studies based on the strength or direction of the findings. Meta-analyses that exclude unpublished data could thus be seen as misleading. Of 150 meta-analyses, 46 included unpublished data. Of the meta-analysts and methodologists surveyed, 77.7% felt that unpublished studies should be included as did 46.9% of journal editors surveyed. One possible solution would be for meta-analysts to analyse data both with and without unpublished studies. If the analyses came to a similar conclusion, the meta-analysis would be that much stronger and vice versa. All studies included should be rigorously evaluated because even publication in a peer-reviewed is no guarantee of scientific quality., Objective.--To identify the extent to which meta-analyses currently include unpublished data and whether editors, meta-analysts, and methodologists believe unpublished material should be included. Design.--This article describes two related studies: a literature review and a cross-sectional survey. Sample Selection.--For the literature review, we identified all articles indexed by the key word meta-analysis from January 1989 to February 1991 and determined whether unpublished material had been searched for, obtained, and included in the meta-analyses. For the cross-sectional survey, we surveyed authors of these meta-analyses, authors of articles addressing methodological issues in meta-analysis published during the same period, and editors of journals in which both types of articles were published. Intervention.--We asked the respondents about their attitudes concerning inclusion of unpublished data and publication of articles from which data had previously been included in a scientific overview. Main Outcome Measures.--Inclusion of unpublished data and opinions about whether unpublished material should be included in overviews and whether prior inclusion of data in an overview should bear on publication. Results.---Of 150 meta-analyses, 46 (30.7%) included unpublished data in their primary analysis. Of authors surveyed, 85% responded. Of the meta-analysts and methodologists, 77.7% felt that unpublished material should definitely or probably be included in scientific overviews; this was true of 46.9% of the editors. A total of 86.4% of the meta-analysts and methodologists and 53.2% of the editors felt that inclusion of data in a prior overview should have no bearing on full publication of original research. Conclusion.--While inclusion of unpublished data in scientific overviews remains controversial, most investigators directly involved in meta-analysis believe that unpublished data should not be systematically excluded. The most valid synthesis of available information will result when meta-analysts subject published and unpublished material to the same rigorous methodological evaluation and present results with and without unpublished sources of data. (JAMA. 1993;269:27492753)

Byline: Sami. AlNassar, Waseem. Hajjar, Salah. Rahal, Joanne. Clifton, Richard. Finley, Ravi. Sidhu Aim: To develop a video-based educational tool designed for teaching thoracic anatomy and to examine whether this [...]

Objectives: We sought to test the safety and efficacy of fluoroscopically guided, video-assisted, thoracoscopic resection after computed tomography (CT)-guided localization using platinum microcoils., Summary Background Data: Video-assisted thoracoscopic (VATS) resection of small pulmonary nodules >5 mm deep to the visceral pleura fails to locate the nodule and requires conversion to open thoracotomy in two thirds of cases. Therefore, we developed a new technique for intraoperative localization of these nodules using CT-guided placement of platinum microcoils. This study tests the safety and efficacy of this technique in a Phase I human study., Methods: Twelve patients with undiagnosed growing pulmonary nodules <20 mm were marked preoperatively using percutaneously placed CT-guided platinum microcoils. The coil was deployed adjacent to the nodule with the distal end of the coil placed deep to the nodule and the superficial end coiled on the pleural surface. The nodule and coil were excised using endostaplers guided by VATS and fluoroscopy. Histopathologic diagnosis was performed immediately after resection., Results: CT-guided microcoil localization was successful in all patients. A small hemothorax and a pneumothorax requiring a chest tube occurred in 2 patients. Mean distance from visceral pleura to the deep edge of the nodule was 30.9 +/- 15.4 mm. VATS resection of the nodules (size = 11.8 +/- 3.2 mm) was successful in all patients. Mean microcoil localization, fluoroscopy, and operative times were 42 +/- 14, 3.1 +/- 2.0, and 67 +/- 27 minutes. A diagnosis of primary nonsmall cell bronchogenic carcinoma was made in 6 patients who then received a completion lobectomy. Six patients (hamartoma: 2, reactive lymph node: 1, bronchoalveolar cell carcinoma: 2, metastatic sarcoma: 1) did not receive further resections., Conclusions: Preoperative localization of pulmonary nodules using percutaneous CT-guided platinum microcoil insertion combined with operative fluoroscopic visualization is a safe, effective technique that increases the success rate of VATS excision.