Study design Cross-sectional analysis of patient educational materials from top pediatric orthopedic hospital websites. Objective To assess the readability of online educational materials of top pediatric orthopedic hospital websites for pediatric spinal deformity. Summary of background data The internet has become an increasingly popular source of health information for patients and their families. Healthcare experts recommend that the readability of online education materials be at or below a 6th-grade reading level. However, previous studies have demonstrated that the readability of online education materials on various orthopedic topics is too advanced for the average patient. To date, the readability of online education materials for pediatric spinal deformity has not been analyzed. Methods Online patient education materials from the top 25 pediatric orthopedic institutions, as ranked by the U.S. News and World Report hospitals for pediatric orthopedics, were accessed utilizing the following readability assessments: Flesch–Kincaid (FK), Flesch Reading Ease, Gunning Fog Index, Coleman–Liau Index, Simple Measure of the Gobbledygook Index (SMOG), Automated Readability Index, FORCAST, and the New Dale and Chall Readability. Correlations between academic institutional ranking, geographic location, and the use of concomitant multi-media modalities with FK scores were evaluated using a Spearman regression. Results Only 48% (12 of 25) of top pediatric orthopedic hospitals provided online information regarding pediatric spinal deformity at or below a 6th-grade reading level. The mean FK score was 9.0 ± 2.7, Flesch Reading Ease 50.8 ± 15.6, Gunning Fog Score 10.6 ± 3.1, Coleman–Liau Index 11.6 ± 2.6, SMOG index 11.7 ± 2.0, Automated Readability Index 8.6 ± 2.8, and Dale–Chall Readability Score 6.4 ± 1.4. There was no significant correlation between institutional ranking, geographic location, or use of multimedia with FK scores. Conclusion Online educational material for pediatric spinal deformity from top pediatric orthopedic institutional websites are associated with poor readability.

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Background : Publication metrics such as article citation count and the Hirsch index (h-index) are used to evaluate research productivity among academic faculty. However, these bibliometric indices are not field-normalized and yield inaccurate cross-specialty comparisons. We evaluate the use of the relative citation ratio (RCR), a new field-normalized article-level metric developed by the National Institutes of Health (NIH), among academic orthopedic hand surgeons and analyze physician factors associated with RCR values. Methods: A retrospective analysis was performed using the iCite database. Fellowship-trained orthopedic hand surgeons affiliated with accredited orthopedic surgery residency programs were included. Mean RCR, weighted RCR, and publication count were compared by sex, career duration, academic rank, and presence of additional degrees. Mean RCR represents the total number of citations per year of a publication divided by the average number of citations per year received by NIH-funded papers in the same field. Mean RCR serves as a measure of overall research impact. A value of 1.0 is the NIH-funded field-normalized standard. Weighted RCR is the sum of all article-level RCR scores and represents overall research productivity. Results : A total of 620 academic orthopedic hand surgeons from 164 programs were included. These physicians produced highly impactful research with a median RCR of 1.27 (interquartile range [IQR] 0.86-1.66). Weighted RCR was associated with advanced degree, advanced academic rank, and longer career duration. Conclusions : Fellowship-trained academic orthopedic hand surgeons produce highly impactful research. Our benchmark data can be used to assess grant outcomes, promotion, and continued evaluation of research productivity within the hand surgery community.

Background: The Internet has become a popular source of health information for patients and their families. Healthcare experts recommend that the readability of online education materials be at or below a sixth grade reading level. This translates to a standardized Flesch Reading Ease Score between 81 and 90, which is equivalent to conversational English. However, previous studies have demonstrated that the readability of online education materials of various orthopedic topics is too advanced for the average patient. To date, the readability of online education materials for pediatric spinal conditions has not been analyzed. The objective of this study was to assess the readability of online educational materials of top pediatric orthopedic hospital websites for pediatric spinal conditions. Methods: Online patient education materials from the top 25 pediatric orthopedic institutions, as ranked by the U.S. News and World Report hospitals for pediatric orthopedics, were assessed utilizing multiple readability assessment metrics including Flesch–Kincaid, Flesch Reading Ease, Gunning Fog Index, and others. Correlations between academic institutional ranking, geographic location, and the use of concomitant multimedia modalities with Flesch–Kincaid scores were evaluated using a Spearman regression. Results: Only 32% (8 of 25) of top pediatric orthopedic hospitals provided online health information at or below a sixth grade reading level. The mean Flesch–Kincaid score was 9.3 ± 2.5, Flesch Reading Ease 48.3 ± 16.2, Gunning Fog Score 10.7 ± 3.0, Coleman–Liau Index 12.1 ± 2.8, Simple Measure of the Gobbledygook Index 11.7 ± 2.1, Automated Readability Index 9.0 ± 2.7, FORCAST 11.3 ± 1.2, and Dale–Chall Readability Index 6.7 ± 1.4. There was no significant correlation between institutional ranking, geographic location, or use of video material with Flesch–Kincaid scores (p = 0.1042, p = 0.7776, p = 0.3275, respectively). Conclusion: Online educational material for pediatric spinal conditions from top pediatric orthopedic institutional websites is associated with excessively complex language which may limit comprehension for the majority of the US population. Type of study/Level of evidence: Economic and Decision Analysis/level III.

Background: Objective measures of research influence are being increasingly utilized to evaluate and compare academic faculty. However, traditional bibliometrics, such as the Hirsch index and article citation count, are biased by time-dependent factors and are limited by a lack of field normalization. The relative citation ratio (RCR) is a new field- and time-normalized article-level metric developed by the National Institutes of Health (NIH). Purpose/Hypothesis: The purpose of this study was to evaluate the RCR among fellowship-trained academic sports medicine surgeons and to analyze physician factors associated with RCR values. We hypothesized that the mean RCR score for fellowship-trained academic sports medicine surgery faculty will fall above the NIH standard. Study Design: Cross-sectional study. Methods: A retrospective data analysis was performed using the iCite database for all fellowship-trained sports medicine surgery faculty associated with Accreditation Council for Graduate Medical Education–accredited orthopaedic surgery residency programs in December 2021. In eligible faculty, the mean RCR, weighted RCR, and total publication count were compared by sex, career duration, academic rank, and presence of additional degrees. A mean RCR value of 1.0 is the NIH-funded field-normalized standard. The data herein are presented as the median and interquartile range, in addition to the mean and standard deviation, to account for outliers of the mean and weighted RCR scores. Results: A total of 624 fellowship-trained sports medicine surgery faculty members from 160 orthopaedic surgery residency programs were included in the analysis. Overall, faculty produced impactful research, with a median RCR of 1.6 (interquartile range, 1.0-2.2) and a median weighted RCR of 19.3 (interquartile range, 5.1-69.3). Advanced academic rank and career longevity were associated with increased weighted RCR and total publication count. All subgroups analyzed had an RCR value >1.0. Conclusion: Study findings indicate that fellowship-trained academic sports medicine surgery faculty are highly productive and produce impactful research, as evidenced by the high median RCR value relative to the benchmark NIH RCR value of 1.0.