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Association between medical academic genealogy and publication outcome: impact of unconscious bias on scientific objectivity

  • Original Article - Neurosurgery general
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Abstract

Background

Our previous studies suggest that the training history of an investigator, termed “medical academic genealogy”, influences the outcomes of that investigator’s research. Here, we use meta-analysis and quantitative statistical modeling to determine whether such effects contribute to systematic bias in published conclusions.

Methods

A total of 108 articles were identified through a comprehensive search of the high-grade glioma (HGG) surgical resection literature. Analysis was performed on the 70 articles with sufficient data for meta-analysis. Pooled estimates were generated for key academic genealogies. Monte Carlo simulations were performed to determine whether the effects attributed to genealogy alone can arise due to chance alone.

Results

Meta-analysis of the HGG literature without consideration for academic medical genealogy revealed that gross total resection (GTR) was associated with a significant decrease in the odds ratio (OR) for the hazard of death after surgery for both anaplastic astrocytoma (AA) and glioblastoma (AA: log [OR] = − 0.04, 95% CI [− 0.07 to − 0.01]; glioblastoma log [OR] = − 0.36, 95% CI [− 0.44 to − 0.29]). For the glioblastoma literature, meta-analysis of articles contributed by members of a genealogy consisting of mostly radiation oncologists revealed no reduction in the hazard of death after GTR [log [OR] = − 0.16, 95% CI [− 0.41 to 0.09]. In contrast, meta-analysis of published articles contributed by members of a genealogy consisting of mostly neurosurgeons revealed that GTR was associated with a significant reduction in the hazard of death [log [OR] = − 0.29, 95% CI [− 0.40 to 0.18]. Monte Carlo simulation revealed that the observed discrepancy between the articles contributed by the members of these two genealogies was unlikely to arise by chance alone (p < 0.006).

Conclusions

Meta-analysis of articles contributed by authors belonging to the different medical academic genealogies yielded distinct and contradictory pooled point-estimates, suggesting that genealogy contributes to systematic bias in the published literature.

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References

  1. Academic Genealogy Wiki (2014) Available at: http://phdtree.org/. Accessed 7 Oct 2015

  2. Barr AH Jr (1936) Cubism and abstract art. Belknap Press, Cambridge

    Google Scholar 

  3. Bloch O, Han SJ, Cha S, Sun MZ, Aghi MK, McDermott MW, Berger MS, Parsa AT (2012) Impact of extent of resection for recurrent glioblastoma on overall survival: clinical article. J Neurosurg 117(6):1032–1038. https://doi.org/10.3171/2012.9.JNS12504

    Article  PubMed  Google Scholar 

  4. Butowski N, Lamborn KR, Berger MS, Prados MD, Chang SM (2007) Historical controls for phase II surgically based trials requiring gross total resection of glioblastoma multiforme. J Neuro-Oncol 85(1):87–94

    Article  Google Scholar 

  5. Carico C, Nuño M, Mukherjee D, Elramsisy A, Dantis J, Hu J, Rudnick J, Yu JS, Black KL, Bannykh SI, Patil CG (2012) Loss of PTEN is not associated with poor survival in newly diagnosed glioblastoma patients of the temozolomide era. PLoS One 7(3):e33684. https://doi.org/10.1371/journal.pone.0033684

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Carley K (2003) Dynamic network analysis. In: Breiger R, Carley K, Pattison P (eds) Dynamic social network modeling and analysis: workshop summary and papers. National Academies Press, Washington, DC, pp 133–145

    Google Scholar 

  7. Chaichana K, Parker S, Olivi A, Quiñones-Hinojosa A (2010) A proposed classification system that projects outcomes based on preoperative variables for adult patients with glioblastoma multiforme. J Neurosurg 112(5):997–1004. https://doi.org/10.3171/2009.9.JNS09805

    Article  PubMed  Google Scholar 

  8. Chaichana KL, Martinez-Gutierrez JC, De la Garza-Ramos R, Weingart JD, Olivi A, Gallia GL, Lim M, Brem H, Quinones-Hinojosa A (2013) Factors associated with survival for patients with glioblastoma with poor pre-operative functional status. J Clin Neurosci 20(6):818–823. https://doi.org/10.1016/j.jocn.2012.07.016

    Article  PubMed  PubMed Central  Google Scholar 

  9. Chaichana KL, Cabrera-Aldana EE, Jusue-Torres I, Wijesekera O, Olivi A, Rahman M, Quinones-Hinojosa A (2014) When gross total resection of a glioblastoma is possible, how much resection should be achieved? World Neurosurg 82(1–2):e257–e265. https://doi.org/10.1016/j.wneu.2014.01.019

    Article  PubMed  Google Scholar 

  10. Chaichana KL, Jusue-Torres I, Navarro-Ramirez R, Raza SM, Pascual-Gallego M, Ibrahim A, Hernandez-Hermann M, Gomez L, Ye X, Weingart JD, Olivi A, Blakeley J, Gallia GL, Lim M, Brem H, Quinones-Hinojosa A (2014) Establishing percent resection and residual volume thresholds affecting survival and recurrence for patients with newly diagnosed intracranial glioblastoma. Neuro-Oncology 16(1):113–122. https://doi.org/10.1093/neuonc/not137

    Article  PubMed  Google Scholar 

  11. Fogh SE, Andrews DW, Glass J, Curran W, Glass C, Champ C, Evans JJ, Hyslop T, Pequignot E, Downes B, Comber E, Maltenfort M, Dicker AP, Werner-Wasik M (2010) Hypofractionated stereotactic radiation therapy: an effective therapy for recurrent high-grade gliomas. J Clin Oncol 28(18):3048–3053. https://doi.org/10.1200/JCO.2009.25.6941

    Article  PubMed  PubMed Central  Google Scholar 

  12. Gonda DD, Warnke P, Sanai N, Taich Z, Kasper EM, Chen CC (2013) The value of extended glioblastoma resection: Insights from randomized controlled trials. Surg Neurol Int 4. India. https://doi.org/10.4103/2152-7806.117173

  13. Hirshman BR, Jones LA, Tang JA, Proudfoot JA, Carley KM, Carter BS, Chen CC (2016) 'Journal Bias' in peer-reviewed literature: an analysis of the surgical high-grade glioma literature. J Neurol Neurosurg Psychiatry 87(11):1248–1250. https://doi.org/10.1136/jnnp-2015-312998

    Article  PubMed  Google Scholar 

  14. Hirshman BR, Tang JA, Jones LA, Proudfoot JA, Carley KM, Marshall L, Carter BS, Chen CC (2016) Impact of medical academic genealogy on publication patterns: an analysis of the literature for surgical resection in brain tumor patients. Ann Neurol 79:169–177

    Article  PubMed  Google Scholar 

  15. Jackson A (2007) A labor of love: the mathematics genealogy project. North Am Math Soc 54:1002–1003

    Google Scholar 

  16. Kaur G, Bloch O, Jian BJ, Kaur R, Sughrue ME, Aghi MK, McDermott MW, Berger MS, Chang SM, Parsa AT (2011) A critical evaluation of cystic features in primary glioblastoma as a prognostic factor for survival. J Neurosurg 115(4):754–759. https://doi.org/10.3171/2011.5.JNS11128

    Article  PubMed  Google Scholar 

  17. Keles GE, Anderson B, Berger MS (1999) The effect of extent of resection on time to tumor progression and survival in patients with glioblastoma multiforme of the cerebral hemisphere. Surg Neurol 52(4):371–379

    Article  CAS  PubMed  Google Scholar 

  18. Kolker JD, Halpern HJ, Krishnasamy S, Brown F, Dohrmann G, Ferguson L, Hekmatpanah J, Mullan J, Wollman R, Blough R et al (1990) "instant-mix" whole brain photon with neutron boost radiotherapy for malignant gliomas. Int J Radiat Oncol Biol Phys 19(2):409–414

    Article  CAS  PubMed  Google Scholar 

  19. Kowalczuk A, Macdonald RL, Amidei C, Dohrmann G 3rd, Erickson RK, Hekmatpanah J, Krauss S, Krishnasamy S, Masters G, Mullan SF, Mundt AJ, Sweeney P, Vokes EE, Weir BK, Wollman RL (1997) Quantitative imaging study of extent of surgical resection and prognosis of malignant astrocytomas. Neurosurgery 41(5):1028–1036

    Article  CAS  PubMed  Google Scholar 

  20. Kreth FW, Warnke PC, Scheremet R, Ostertag CB (1993) Surgical resection and radiation therapy versus biopsy and radiation therapy in the treatment of glioblastoma multiforme. J Neurosurg 78:762–766

    Article  CAS  PubMed  Google Scholar 

  21. Krishnasamy S, Vokes EE, Dohrmann GJ, Mick R, Garcia JC, Kolker JD, Wollmann RL, Hekmatpanah J, Weichselbaum RR (1995) Concomitant chemoradiotherapy, neutron boost, and adjuvant chemotherapy for anaplastic astrocytoma and glioblastoma multiforme. Cancer Investig 13(5):453–459

    Article  CAS  Google Scholar 

  22. Mathematics Genealogy Project (2014) Available at: http://genealogy.math.ndsu.nodak.edu/. Accessed 7 Oct 2015

  23. McGirt MJ, Chaichana KL, Gathinji M, Attenello FJ, Than K, Olivi A, Weingart JD, Brem H, Quiñones-Hinojosa AR (2009) Independent association of extent of resection with survival in patients with malignant brain astrocytoma. J Neurosurg 110(1):156–162. https://doi.org/10.3171/2008.4.17536

    Article  PubMed  Google Scholar 

  24. Oppenlander ME, Wolf AB, Snyder LA, Bina R, Wilson JR, Coons SW, Ashby LS, Brachman D, Nakaji P, Porter RW, Smith KA, Spetzler RF, Sanai N (2014) An extent of resection threshold for recurrent glioblastoma and its risk for neurological morbidity. J Neurosurg 120(4):846–853. https://doi.org/10.3171/2013.12.JNS13184

    Article  PubMed  Google Scholar 

  25. Patil CG, Yi A, Elramsisy A, Hu J, Mukherjee D, Irvin DK, Yu JS, Bannykh SI, Black KL, Nuño M (2012) Prognosis of patients with multifocal glioblastoma: a case-control study. J Neurosurg 117(4):705–711. https://doi.org/10.3171/2012.7.JNS12147

    Article  PubMed  Google Scholar 

  26. Patil CG, Nuño M, Elramsisy A, Mukherjee D, Carico C, Dantis J, Hu J, Yu JS, Fan X, Black KL, Bannykh SI (2013) High levels of phosphorylated MAP kinase are associated with poor survival among patients with glioblastoma during the temozolomide era. Neuro-Oncology 15(1):104–111. https://doi.org/10.1093/neuonc/nos272

    Article  CAS  PubMed  Google Scholar 

  27. Piano Genealogy Database (2015) http://www.pianogenealogy.com.au/. Accessed 5 May 2015

  28. R Core Team (2014) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna. http://www.R-project.org/. Accessed May 2018

  29. Ramakrishna R, Barber J, Kennedy G, Rizvi A, Goodkin R, Winn RH, Ojemann GA, Berger MS, Spence AM, Rostomily RC (2010) Imaging features of invasion and preoperative and postoperative tumor burden in previously untreated glioblastoma: correlation with survival. Surg Neurol Int 1. https://doi.org/10.4103/2152-7806.68337

  30. Robert CP, Elvira V, Tawn N, Wu C (2018) Accelerating MCMC algorithms. Wiley Interdiscip Rev Comput Stat 10(5):e1435. https://doi.org/10.1002/wics.1435

    Article  PubMed  PubMed Central  Google Scholar 

  31. Roberts PS, Nuño M, Sherman D, Asher A, Wertheimer J, Riggs RV, Patil CG (2014) The impact of inpatient rehabilitation on function and survival of newly diagnosed patients with glioblastoma. PM R 6(6):514–521. https://doi.org/10.1016/j.pmrj.2013.12.007

    Article  PubMed  Google Scholar 

  32. Sanai N, Polley MY, McDermott MW, Parsa AT, Berger MS (2011) An extent of resection threshold for newly diagnosed glioblastomas. J Neurosurg 115(1):3–8. https://doi.org/10.3171/2011.2.JNS10998

    Article  PubMed  Google Scholar 

  33. Sarmiento JM, Nuño M, Ortega A, Mukherjee D, Fan X, Black KL, Patil CG (2014) Cystic glioblastoma: an evaluation of IDH1 status and prognosis. Neurosurgery 74(1):71–75. https://doi.org/10.1227/NEU.0000000000000200

    Article  PubMed  Google Scholar 

  34. Scharp K (2014) History of Western Philosophy

  35. Scott J (2000) Social network analysis: a handbook, 2nd edn. Sage, London

    Google Scholar 

  36. Showalter TN, Andrel J, Andrews DW, Curran WJ Jr, Daskalakis C, Werner-Wasik M (2007) Multifocal glioblastoma multiforme: prognostic factors and patterns of progression. Int J Radiat Oncol Biol Phys 69(3):820–824

    Article  PubMed  Google Scholar 

  37. Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ et al (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352:987–996

    Article  CAS  PubMed  Google Scholar 

  38. The Academic Family Tree (2014) Available at: http://academictree.org/. Accessed 7 Oct 2015

  39. Wallner KE, Galicich JH, Malkin MG, Arbit E, Krol G, Rosenblum MK (1989) Inability of computed tomography appearance of recurrent malignant astrocytoma to predict survival following reoperation. J Clin Oncol 7(10):1492–1496

    Article  CAS  PubMed  Google Scholar 

  40. Wasserman S, Faust K (1994) Social network analysis. Cambridge University Press, Cambridge

    Book  Google Scholar 

  41. Westphal M, Hilt DC, Bortey E, Delavault P, Olivares R, Warnke PC et al (2003) A phase 3 trial of local chemotherapy with biodegradable carmustine (BCNU) wafers (Gliadel wafers) in patients with primary malignant glioma. Neuro-Oncology 5:79–88

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Woodworth GF, Garzon-Muvdi T, Ye X, Blakeley JO, Weingart JD, Burger PC (2013) Histopathological correlates with survival in reoperated glioblastomas. J Neuro-Oncol 113(3):485–493. https://doi.org/10.1007/s11060-013-1141-3

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, University of California San Diego, San Diego, CA, USA

    Brian R. Hirshman

  2. Center for Computational Analysis of Social and Organizational Systems, School of Computer Science, Carnegie Mellon University, Pittsburgh, PA, USA

    Brian R. Hirshman & Kathleen M. Carley

  3. Computation, Organizations and Society Program, School of Computer Science, Carnegie Mellon University, Pittsburgh, PA, USA

    Brian R. Hirshman & Kathleen M. Carley

  4. School of Medicine, University of California San Diego, San Diego, CA, USA

    Ali A. Alattar

  5. Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA

    Sanjay Dhawan & Clark C. Chen

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Correspondence to Clark C. Chen.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

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Hirshman, B.R., Alattar, A.A., Dhawan, S. et al. Association between medical academic genealogy and publication outcome: impact of unconscious bias on scientific objectivity. Acta Neurochir 161, 205–211 (2019). https://doi.org/10.1007/s00701-019-03804-9

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