Aaron E. Carroll's Blog, page 26

How Can We Fix the Culture of Science? A Podcast

Healthcare Triage has a podcast, and that podcast recently dropped a special limited series. We’ve spent a lot of time thinking about the culture of science and how researchers can improve the reproducibility of research. We also talked to a lot of really smart people who think a lot about this stuff, and we made eight amazing podcast episodes investigating the situation.

 



The post How Can We Fix the Culture of Science? A Podcast first appeared on The Incidental Economist.

The Healthcare Triage Podcast: How We Solve the Reproducibility Crisis – Incentives in Academia

In this eight-episode podcast series, we interview several experts about “the reproducibility crisis” and how they think the culture of science plays into that. Now that we’ve talked about all the things in science culture that contribute to reproducibility problems, let’s talk about how we can fix them, In this eighth and final episode, we focus mainly on practices that need changing within academia.

 

The post The Healthcare Triage Podcast: How We Solve the Reproducibility Crisis – Incentives in Academia first appeared on The Incidental Economist.

The Healthcare Triage Podcast: How We Solve the Reproducibility Crisis – Publishing, Funding, and the Media

In this eight-episode podcast series, we interview several experts about “the reproducibility crisis” and how they think the culture of science plays into that. Now that we’ve talked about all the things in science culture that contribute to reproducibility problems, let’s talk about how we can fix them. In this seventh episode, we focus mainly on publishing, funding, and the media.

 

The post The Healthcare Triage Podcast: How We Solve the Reproducibility Crisis – Publishing, Funding, and the Media first appeared on The Incidental Economist.

The Healthcare Triage Podcast: The Role of Mentorship and Authority in the Reproducibility Crisis

Academia relies on a model of mentorship. In this sixth episode of our special series on science culture and reproducibility, we take a look at what happens when mentors take liberties with their authority that affect the way trainees handle data.

 

The post The Healthcare Triage Podcast: The Role of Mentorship and Authority in the Reproducibility Crisis first appeared on The Incidental Economist.

The Healthcare Triage Podcast: The Role of the Media in the Reproducibility Crisis

The media loves a good headline about an exciting study. In this fifth episode of our special series on science culture and reproducibility, we talk about the role of the media in the reproducibility crisis. Can the way science media covers studies affect the science itself?

 

The post The Healthcare Triage Podcast: The Role of the Media in the Reproducibility Crisis first appeared on The Incidental Economist.

False Positives in Prenatal Screenings

Prenatal testing can provide valuable information for anyone with a baby on the way. However, a recent report suggests that for some syndromes, these tests are wrong a majority of the time. It’s not because the tests are “bad”, though, it’s because the syndromes they test for are so rare.

 



The post False Positives in Prenatal Screenings first appeared on The Incidental Economist.

Sexual Assault Evidence Collection Kits: The Many Barriers to Access

Content Warning: Sensitive topics are heavily discussed throughout this post, including those of sexual violence. 

Sexual violence and abuse are traumatic experiences for victims and survivors, with short- and long-term psychological, emotional, and physical impacts. When deciding whether to report an assault, a sexual assault forensic exam can be performed. This exam includes using a sexual assault evidence collection (SAEC) kit, commonly known as a “rape kit”, to collect all physical evidence. However, victims and survivors who want to have a SAEC kit completed can face multiple barriers to access.  

In a Public Health Post piece, I address these access barriers which include shortages of staff trained in providing a SAEC kit, concerns about the timing of when an exam can be given, and the need for specialized care. Most importantly, I discuss the impact of these barriers on those seeking to have an exam done, especially for cases involved in the justice system. 

Check out the full article here. 

Research for this piece was supported by Arnold Ventures. 

The post Sexual Assault Evidence Collection Kits: The Many Barriers to Access first appeared on The Incidental Economist.

Are tobacco sales bans legal, effective, or ethical?

Last fall, Brookline, Massachusetts implemented a tobacco sales bans that restricts sales of all tobacco and vaping products from individuals born on or after January 1, 2000. Essentially, the bylaw will “age out” tobacco sales incrementally. While lauded by anti-tobacco advocates, some are wrestling with the ethics and unintended consequences.

In this post I explore whether tobacco sales bans are legal, effective, or ethical. In short, it’s all still quite vague.

Though tobacco sales bans aren’t very common, Brookline isn’t the only jurisdiction implementing one. Beverly Hills and Manhattan Beach banned all tobacco products at the beginning of 2021. Internationally, New Zealand just announced a new law that will ban sales to those who are now 14 or younger, with the minimum age increasing each year. There is also considerable public interest for Australia to follow suit.

Are they legal?

Generally speaking, these types of bans do seem legal. However, there are some concerns. For one, local tobacco sales bans are automatically stricter than federal law. Some suing against Brookline’s ban argue that that dissonance isn’t fair, especially because there is no built-in exception for those who were once eligible to purchase products and are now suddenly ineligible.

Another important consideration is ageism. The Brookline ban is based on birth date. An argument made by those opposed is that a birth date doesn’t change. Thus, the ban discriminates against a permanent characteristic, and in a very permanent way. This is in contrast to age-based bans — such as federal restrictions on those under 21 — that allow individuals to eventually purchase tobacco once they age in.

Are they effective?

The obvious goal of tobacco sales bans is to reduce use and improve health. The evidence that they do that, however, is unclear, perhaps because these bans are not very common and those wishing to circumvent them by purchasing products elsewhere can often do so.

As proxy, I looked at the impact of smoking bans. (I chose not to compare to tobacco taxes because those don’t explicitly deny the right to buy a product.) Smoking bans are very effective. The research shows that they reduce both smoking and secondhand smoke exposure, and improve health. They also improve air quality and do not have negative impacts on businesses (e.g., lost revenue, closures, etc.).

This suggests that local tobacco sales bans may have similar effects, but we just don’t know.

One concern raised by opponents is that tobacco sales bans can include vaping products. Some argue this is counterproductive. After all, vaping products can be effective harm reduction tools for those who already use tobacco products. Limiting access to them could do more harm than good.

But vaping products also hook those who don’t already smoke, especially young people. So, it could be public health-promoting to include vaping products in certain sales bans, depending on the target population. For example, it was wise for the federal government to include vaping products in the minimum purchase age increase in 2019.

Are they ethical?

The final question is whether tobacco sales bans are ethical. I propose a few possible concerns below.

First, restricting purchase power courts paternalism. Singling out specific groups suggests the government thinks they are unfit to make certain decisions for themselves. It makes sense to have stricter rules for children because their brains are still developing, but many tobacco sales bans impact adults, too. In fact, many will impact older and older individuals over time.

Second, restricting purchase power infringes on personal freedom. The United States prides itself on this. Restricting tobacco sales limits individuals’ freedom to make their own choices. One could argue that if adults want to intentionally harm themselves by smoking, we should let them. On the other hand,  harmful products also have negative externalities, like higher health care costs for everyone.

Lastly, as with all public health interventions, equity must be considered. Low-income communities use tobacco products at higher rates than affluent ones and stores that sell tobacco products are often minority-owned and/or small businesses. Thus, any new bans or regulations may have disproportionate impacts on already marginalized populations.

Conclusion

Tobacco sales bans are complicated. We need to study the legality, effectiveness, and ethics of them further. But what we do know is that tobacco use is detrimental to health and there’s more work to be done to reduce its grip on our communities.

The post Are tobacco sales bans legal, effective, or ethical? first appeared on The Incidental Economist.

HSR Author Instructions Part 4 (and final): All the rest

This post is part of a series explaining aspects of the author instructions (see also the checklist) for Health Services Research (HSR) as they existed circa March 2022. Each post quotes portions of the instructions and explains their import. Neither these posts nor the checklist are a substitute for reading and following the full set of instructions, which is expected of all authors for all submissions. 

This post focuses on portions of Sections 6-9, all pertaining to post-acceptance issues and opportunities.

Section 6.1: “HSR is a subscription journal that offers an open access option. … Check if your funders mandate use of a particular type of CC license. If so, Wiley has information on compliance with specific Funder Open Access Policies. Your country or institution may have an agreement with Wiley to help with open access. See details and check eligibility on the Wiley website…”

Long story short, before deciding whether or not to make your article open access and before paying for it, check the links above. In addition, typically articles in special issues of HSR are open access, with the open access fee paid by the sponsors of those issues. So, if you’re submitting to a special issue, don’t pay the open access fee until you’ve checked with or heard from the editors whether the sponsor will cover it.

Section 7.2: “HSR offers Wiley’s Accepted Articles service for all manuscripts. Manuscripts accepted ‘in press’ are published online shortly after acceptance, before copyediting or typesetting … Accepted Articles will be indexed by PubMed … HSR offers rapid publication [of typeset articles] via Wiley’s Early View service, [which is the] Online Version of Record [and appears] before inclusion in a print or online issue. … The Early View article is fully citable and carries an online publication date and the same DOI as the Accepted Article version.”

In other words, we get your accepted article online within days* in the final form you submitted it. This is so you can start referring colleagues, journalists, policymakers, your parents, etc. to it just after acceptance. Then, we go through the typesetting/proofs process to make a “pretty” version, which goes online as soon as that’s ready (typically a few weeks after acceptance*). Only later (possibly months) is your article added to an issue; it won’t differ in appearance from the previously posted online version except that when printed in the bound, paper issue, all figures will be black & white. The DOI is already set in the Accepted Article stage and remains constant.

Section 8.4: “Send Twitter account information for authors, funders, and authors’ affiliation to hsr@social.aha.org to help us promote your work @HSR_HRET.”

Please do this! While we will independently promote your work, our resources to do so are modest. Every bit more you can do helps. To the email address above, you can also send any other promotional information, like press releases, blog posts, Twitter threads, webinar announcements, or anything else related to your paper. We want to help you get the word out about your work.

That’s the end of this selective tour through the HSR author instructions.

* Sometimes it takes longer if we don’t have the necessary meta-data to go along with your article (e.g., copyright forms and the like). You’ll be contacted to provide this and the pace at which we can get your article processed depends on how quickly you respond.

The post HSR Author Instructions Part 4 (and final): All the rest first appeared on The Incidental Economist.

HSR Author Instructions Part 3: Editorial Policies and Ethical Considerations

This post is part of a series explaining aspects of the author instructions (see also the checklist) for Health Services Research (HSR) as they existed circa March 2022. Each post quotes portions of the instructions and explains their import. Neither these posts nor the checklist are a substitute for reading and following the full set of instructions, which is expected of all authors for all submissions. 

This post focuses on portions of Subection 3.2, the Review portion of the Editorial Policies and Ethical Considerations section.

Section 3.2: “…Manuscripts will be sent to external review only if the Senior Managing Editor, Editor(s)-in-Chief, and Senior Associate Editors determine that they meet quality and relevance requirements….”

Manuscripts are assessed by the managing editors to check for compliance with author instructions. Many manuscripts are sent back to authors for corrections for failure to follow the instructions. I know this seems annoying to authors. They may think, “Can’t they assess my manuscript on scientific merit before making me [include funding information in my Acknowledgements | explain why my data are all older than 5 years | structuring my abstract in HSR style | etc.]?”

Actually, no. These things are expected by us and reviewers, and it’s in your interest to do them. When editors and reviewers have to do extra work, or make inferences, to fill in the gaps they’re going to be less pleased with your contribution. We send manuscripts back to fix these things so that you have the best possible review experience and are not at a disadvantage relative to other manuscripts with which you are competing for space in the journal.

Once the manuscript has all required elements, the Senior Managing Editor checks it for broad themes of scientific contribution and looks for similar work in HSR and elsewhere, among other things. It may be desk rejected at this point if it’s an obvious bad fit for HSR. Otherwise, then the Editor-in-Chief (EIC; that’s me) considers your manuscript. Desk rejection is possible at this stage as well. If not, it is assigned to a Senior Associate Editor (SAE) for consideration and possible assignment to reviewers. The SAE, with reviewer input as warranted, makes a recommendation to the EIC (reject, accept, revise).

Section 3.2: “… The acceptance criteria for all papers [includes the] clarity and organization of writing…”

Yes, we expect manuscripts to be well written. We have asked authors to revise manuscripts for writing. This is a challenging ask, but we must make it from time to time. What’s challenging is that we cannot tell the author all the ways in which the writing is not acceptable. To do so would be tantamount to doing the editing for them, which would make us co-authors! When we request that an author improve their writing, they will have to find a way to get feedback, perhaps from a colleague or a professional, scientific editing organization.

Section 3.2: “… Submissions authored by researchers with whom a particular editor has close relationships (for example mentor/mentee, recent coauthor, academic department member) or prior personal or professional conflicts will not be handled by that editor…”

We take this very seriously. Just because you’re buddies with an HSR editor doesn’t mean you’ll get (unfairly) favorable treatment. Just because you’ve had a conflict with an HSR editor doesn’t meant you’ll get (unfairly) unfavorable treatment. This is as it should be.

I will skip over the very short Sections 4 and 5 (Article Preparation Support and Assistance Upon Rejection, respectively). Though not unimportant, they’re so brief you can go read them in full in a moment yourself. In the next post I’ll cover a few post-acceptance topics in Sections 6-9, wrapping up this series.

The post HSR Author Instructions Part 3: Editorial Policies and Ethical Considerations first appeared on The Incidental Economist.