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Interrupted time series (ITS) studies are frequently used to examine the impact of population-level interventions or exposures. Systematic reviews with meta-analyses including ITS designs may inform public health and policy decision-making. Re-analysis of ITS may be required for inclusion in meta-analysis. While publications of ITS rarely provide raw data for re-analysis, graphs are often included, from which time series data can be digitally extracted. However, the accuracy of effect estimates calculated from data digitally extracted from ITS graphs is currently unknown. Forty-three ITS with available datasets and time series graphs were included. Time series data from each graph was extracted by four researchers using digital data extraction software. Data extraction errors were analysed. Segmented linear regression models were fitted to the extracted and provided datasets, from which estimates of immediate level and slope change (and associated statistics) were calculated and compared across the datasets. Although there were some data extraction errors of time points, primarily due to complications in the original graphs, they did not translate into important differences in estimates of interruption effects (and associated statistics). Using digital data extraction to obtain data from ITS graphs should be considered in reviews including ITS. Including these studies in meta-analyses, even with slight inaccuracy, is likely to outweigh the loss of information from non-inclusion.

Interrupted time series (ITS) are often meta-analysed to inform public health and policy decisions but examination of the statistical methods for ITS analysis and meta-analysis in this context is limited. We simulated meta-analyses of ITS studies with continuous outcome data, analysed the studies using segmented linear regression with two estimation methods [ordinary least squares (OLS) and restricted maximum likelihood (REML)], and meta-analysed the immediate level- and slope-change effect estimates using fixed-effect and (multiple) random-effects meta-analysis methods. Simulation design parameters included varying series length; magnitude of lag-1 autocorrelation; magnitude of level- and slope-changes; number of included studies; and, effect size heterogeneity. All meta-analysis methods yielded unbiased estimates of the interruption effects. All random effects meta-analysis methods yielded coverage close to the nominal level, irrespective of the ITS analysis method used and other design parameters. However, heterogeneity was frequently overestimated in scenarios where the ITS study standard errors were underestimated, which occurred for short series or when the ITS analysis method did not appropriately account for autocorrelation. The performance of meta-analysis methods depends on the design and analysis of the included ITS studies. Although all random effects methods performed well in terms of coverage, irrespective of the ITS analysis method, we recommend the use of effect estimates calculated from ITS methods that adjust for autocorrelation when possible. Doing so will likely to lead to more accurate estimates of the heterogeneity variance.

To ensure equitable representation of women and BIPOC (Black, Indigenous, person of colour) individuals in surgical specialties, it is first necessary to understand the presence and extent of the disparities that exist. We explored the websites of the 17 Canadian faculties of medicine to examine sex and racial diversity in surgical specialties and in surgical leadership positions in Canada. We categorized faculty members of each department of surgery as either male or female and White or BIPOC. The relative percentage of female academic surgeons was very low compared with Canadian demographic data, and the relative percentage of BIPOC academic surgeons was similar to Canadian demographic data. Our observations suggest that actions must be taken to improve diversity and inclusion in surgery., Sex and racial diversity is becoming an increasingly important topic in today's society. American studies have reported a deficit of women and racial minorities among physicians, including those in leadership [...]

Background: The Continuing Professional Development (CPD) (Education) Committee of the Canadian Association of Thoracic Surgeons (CATS) has established a goal of describing the essential knowledge of thoracic surgery. We aimed to develop a national standardized set of undergraduate learning objectives for thoracic surgery. Methods: We obtained these learning objectives from 4 medical schools in Canada. These 4 institutions were selected to provide a broad geographical representation of medical schools of varying sizes and of both official languages. The resulting list of learning objectives underwent critical review by the CPD (Education) Committee, made up of 5 Canadian community and academic thoracic surgeons, 1 thoracic surgery fellow and 2 general surgery residents. A national survey was developed and circulated to all CATS members (n = 209). Respondents were asked to indicate on a 5-point Likert scale whether each objective should be a priority for all medical students. Results: Among 209 CATS members, 56 responded (response rate 27%). The mean length of experience in clinical practice among survey respondents was 10.6 (standard deviation 10.0) years. Respondents most commonly reported teaching or supervising medical students monthly (37.0%), followed by daily (29.6%). Eight of the 10 proposed objectives received a mean Likert score of 4/5 or higher and were selected for inclusion in the final list. A finalized list of 8 learning objectives was created, following a final review from the CATS Executive Committee. Conclusion: We developed a standardized set of learning objectives for medical students that was reflective of the core concepts within thoracic surgery. Contexte: Le comité de développement professionnel continu (DPC) (Formation) de l'Association canadienne de chirurgie thoracique (ACCT) a fixé l'objectif de décrire les connaissances essentielles à l'exercice de la chirurgie thoracique. Nous avions pour but d'établir un ensemble d'objectifs d'apprentissage normalisé à l'échelle nationale en chirurgie thoracique destiné aux étudiants de premier cycle. Méthodes: Quatre écoles de médecine canadiennes nous ont fourni ces objectifs d'apprentissage. Nous avons sélectionné les 4 établissements afin d'obtenir une large représentation géographique des écoles de médecine, de tailles différentes et ancrées dans les 2 langues officielles. La liste d'objectifs d'apprentissage que nous avons obtenue a fait l'objet d'une évaluation critique du comité de DPC (Formation), composé de 5 chirurgiens thoraciques canadiens provenant des milieux communautaires et universitaires, 1 stagiaire postdoctoral et 2 résidents en chirurgie générale. Nous avons élaboré une enquête nationale et l'avons soumise à l'ensemble des membres de l'ACCT (n = 209). Les personnes répondantes devaient indiquer sur une échelle de Likert en 5 points si chacun des objectifs devait constituer une priorité pour toutes les personnes étudiant en médecine. Résultats: Parmi les 209 membres de l'ACCT, 56 ont répondu (taux de réponse de 27%). L'étendue moyenne de l'expérience en pratique clinique des personnes ayant répondu à l'enquête était de 10,6 ans (écart-type de 10,0 ans). Les personnes répondantes ont plus souvent mentionné enseigner ou superviser des personnes étudiant en médecine sur une base mensuelle (37,0%), suivi d'une base quotidienne (29,6%). Huit des 10 objectifs proposés ont obtenu un score de Likert moyen d'au moins 4/5; nous les avons sélectionnés pour les intégrer à la liste finale. Nous avons créé une liste finale composée de 8 objectifs d'apprentissage à la suite d'une dernière révision par le comité de direction de l'ACCT. Conclusion: Nous avons élaboré un ensemble normalisé d'objectifs d'apprentissage destiné aux personnes étudiant en médecine qui se veut le reflet des concepts fondamentaux de la chirurgie thoracique., Medical students often have limited exposure to subspecialty surgery (including thoracic surgery) over the course of their education. At best, select students may have the opportunity to rotate through this [...]