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INTRODUCTION: Health care professionals rely on annual general meetings (AGMs) to obtain up-to-date information and practice guidelines relevant to their specialty. The majority of such information at meetings is presented through abstract sessions. However, the quality of the evidence presented during such abstract sessions is unclear. Standardized measures were applied to assess the quality of evidence of abstracts presented at the Canadian Society of Nephrology AGM over a 5-year period. METHODS: Two authors independently reviewed all CSN AGM abstracts presented from 2012 to 2016. Using a schema published in 2011 by the Oxford Centre for Evidence-Based Medicine (OCEBM), each abstract was subsequently ranked based on the quality of evidence. Schema categories ranged from level I, representing the highest evidence quality, to level V, representing the lowest. The number of authors and the authors' institution affiliations were also collected from the abstracts, where available, or if affiliations were unclear, an internet search of the author was performed. RESULTS: Six hundred forty-two articles were screened. In total, 70% (n = 450) met the inclusion criteria. When assessed, 15% of articles were level I (highest quality), 17% level II, 53% level III, 12% level IV, and 3% level V (lowest quality). A Jonckheere-Terpstra test demonstrated a significant trend of increasing quality of evidence (P < .05) and collaboration (P < .005) over the 5-year study period. There was a significant correlation between level of evidence and collaboration across years reviewed in the study, rs(98) = -0.226, P < .001. DISCUSSION: The results indicate a consistent increase in quality of evidence and collaborative submissions over time. To the authors' knowledge, this is the first assessment and analysis of AGM presentation quality within internal medicine and its subspecialties. Documenting and monitoring changes in the quality of evidence with a standardized framework may offer valuable insight pertaining to the medical field and the research community.

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BACKGROUND: Arthroscopic surgery of the shoulder joint has become increasingly more common given its advantages over open surgery; however, one rare but potentially life-threatening complication is fluid extravasation into the surrounding tissues, causing edema, respiratory compromise, abnormal results on laboratory blood tests, and possibly death. Currently, no systematic review exists that summarizes the existing clinical research on this topic. PURPOSE: To perform a systematic review on fluid extravasation as a complication of shoulder arthroscopic surgery, specifically assessing clinical presentation, risk factors, management, and outcomes. STUDY DESIGN: Systematic review; Level of evidence, 4. METHODS: Two reviewers independently searched 3 databases (PubMed, Ovid [MEDLINE], and Embase) from database inception until July 1, 2017. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist guided the reporting and data abstraction. The methodological quality of these studies was assessed using the Methodological Index for Non-Randomized Studies (MINORS) checklist. The results are presented in a narrative summary fashion using descriptive statistics including ranges and agreement statistics. RESULTS: A total of 26 studies (20 case reports, 4 case series, and 2 prospective comparative studies) encompassing 205 patients (mean age, 50.8 years [range, 15-83 years]) were included. The most common signs of fluid extravasation included chest wall swelling (n = 86) and neck swelling (n = 116). In 32 patients, observation alone was sufficient. Other patients required airway intubation (n = 16), diuretics (n = 7), steroids (n = 1), and percutaneous drainage of fluid (n = 1). Clinical edema resolved after 2 to 48 hours, and patients were discharged 1 to 20 days postoperatively. Serious complications included transfer to the intensive care unit (n = 14), anterior interosseous nerve palsy (n = 4), rhabdomyolysis (n = 1), and death (n = 1). CONCLUSION: Fluid extravasation has the potential to be a life-threatening complication of shoulder arthroscopic surgery; however, it is most commonly managed nonoperatively, and symptoms typically resolve with no evidence of long-term complications. Intraoperative surgical decisions, such as minimizing the surgical time and volume of irrigation fluid used, may limit fluid extravasation, while careful intraoperative monitoring may facilitate prompt diagnosis and management to optimize patient outcomes.

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BACKGROUND: Evaluation of research productivity among plastic surgeons can be complex. The Hirsch index (h-index) was recently introduced to evaluate both the quality and quantity of one's research activity. It has been proposed to be valuable in assessing promotions and grant funding within academic medicine, including plastic surgery. Our objective is to evaluate research productivity among Canadian academic plastic surgeons using the h-index. METHODS: A list of Canadian academic plastic surgeons was obtained from websites of academic training programs. The h-index was retrieved using the Scopus database. Relevant demographic and academic factors were collected and their effects on the h-index were analyzed using the t test and Wilcoxon Mann-Whitney U test. Nominal and categorical variables were analyzed using χ2 test and 1-way analysis of variance. Univariate and multivariate models were built a priori. All P values were 2 sided, and P < .05 was considered to be significant. RESULTS: Our study on Canadian plastic surgeons involved 175 surgeons with an average h-index of 7.6. Over 80% of the surgeons were male. Both univariable and multivariable analysis showed that graduate degree (P < .0001), academic rank (P = .03), and years in practice (P < .0001) were positively correlated with h-index. Limitations of the study include that the Scopus database and the websites of training programs were not always up-to-date. CONCLUSION: The h-index is a novel tool for evaluating research productivity in academic medicine, and this study shows that the h-index can also serve as a useful metric for measuring research productivity in the Canadian plastic surgery community. Plastic surgeons would be wise to familiarize themselves with the h-index concept and should consider using it as an adjunct to existing metrics such as total publication number.

HISTORIQUE: Il peut être complexe d'évaluer la productivité des plasticiens en recherche. L'indice de Hirsch (indice h) a récemment été présenté pour évaluer la qualité et la quantité des activités de recherche personnelles. Cet outil serait précieux pour évaluer les promotions et les subventions en médecine universitaire, y compris la chirurgie plastique. Les auteurs se sont donné l'objectif d'évaluer la productivité en recherche des plasticiens universitaires canadiens au moyen de l'indice h. MÉTHODOLOGIE: Les auteurs ont colligé la liste des plasticiens canadiens dans les sites Web des programmes de formation universitaire. Ils ont extrait l'indice h à l'aide de la base de données Scopus. Ils ont recueilli les facteurs démographiques et universitaires et en ont analysé l'effet sur l'indice h au moyen du test de Student et du test de Wilcoxon Mann-Whitney. Ils ont analysé les variables nominales et catégorielles au moyen du test du chi carré et de l'analyse de variance unidirectionnelle. Ils ont construit des modèles univarié et multivarié a priori. Toutes les valeurs p étaient bilatérales, et le P < 0,05 était considéré comme significatif. RÉSULTATS: La présente étude sur les plasticiens canadiens a porté sur 175 chirurgiens ayant un indice h moyen de 7,6. Plus de 80 % des chirurgiens étaient de sexe masculin. L'analyse univariée et l'analyse multivariée ont toutes deux révélé que le diplôme d'études supérieures (P < 0,0001), la catégorie professorale (P = 0,03) et les années de pratique (P < 0,0001) présentaient une corrélation positive avec l'indice h. L'étude était limitée par le fait que la base de données Scopus et les sites Web des programmes de formation n'étaient pas toujours à jour. CONCLUSION: L'indice h est un nouvel outil pour évaluer la productivité de la médecine universitaire en recherche. La présente étude démontre que l'indice h peut également être une mesure utile pour évaluer la productivité des plasticiens canadiens en recherche. Il serait judicieux que ceux-ci se familiarisent avec le concept de l'indice h et envisagent de l'ajouter aux mesures en place, telles que le nombre total de publications.