Embedded Files
Page 10
The experimental hypothesis that there is a statistical difference was tested against the null hypothesis that plastic surgery patients do not differ from the general population for psychoactive drug use and reconstructive plastic surgery patients have similar drug use to cosmetic surgery patients. METHODS We conducted a review of 830 urban private plastic practice patients who underwent surgery performed by a single board-certified plastic surgeon. Patients who had multiple staged surgeries were counted only once. Seventy men were excluded from the cosmetic cohort due to minimal cohort number and no comparative national data. The data collected were divided into 2 groups: 1 of 405 female cosmetic surgery patients from 2013 to 2016 comparable with a group of 322 reconstructive breast patients from 2009 to 2016 (Table 1). Reconstructive patients were defined as any patient undergoing breast reconstruction regardless if they had any cosmetic surgery procedures included in the duration of their treatment. The groups were analyzed for age, race, procedure, psychoactive medications, and whether or not they stated a mental health diagnosis on their medical history forms. To avoid patient-reporting bias objective, Surescripts, a pharmacy database, and outside records were reviewed. Summary of Psychoactive Drug Categories and Their Effects and Interactions in Surgery We further divided the 2 groups into binary categories by positive or negative psychoactive drug use. Positive use was defined as any psychoactive medication found on their medical history or Surescripts history during the period of time in which they were treated as a patient at our practice. A Student’s t test was conducted to determine the statistical significance of sample data as compared with population data from national averages. The t test was further divided into categorical classes of each class of psychotropic drugs: antidepressants, stimulants, anxiolytics and antipsychotics, and mood stabilizers, and further tested for statistical significance using a t test at an alpha 0.5. RESULTS Sample testing showed that 33.6% of cosmetic surgery patients are on psychoactive drugs compared with the 26% national expected average.1 Using the national data available, the 7.6% difference between the cosmetic patient sample (n = 405) and national population data is statistically significant (P = 0.0006); thus, we reject the null hypothesis. The difference between cosmetic surgery patients’ psychoactive drug usage and that of the national population was statistically significant, with 95% certainty A summary of the Statistical Data Collected from Private Practice Cosmetic and Reconstructive Patients Regarding Taking Psychoactive Drug Reconstructive patients showed a stronger correlation with 46.27% of the sample patients on psychoactive drugs, compared with the 26% national average. These results were significant (P = 0.0001). We reject the null hypothesis. It was concluded with 95% certainty that there is a difference between reconstructive surgery patient’s psychoactive drug usage and national population psychoactive drug usage. Patrick DL, Erickson P: Health status and health policy: Quality of life in health care evaluation and resource allocation. Oxford Univ Press: NY, 1993 3. Piccirillo JF, Stewart MG, Gliklich RE, Yueh B: Outcomes research primer. Otolaryngol Head Neck Surg 117(4):380, 1997 4. Alsarraf R, Jung CJ, Perkins J, Crowley C, Gates GA: Otitis media health status evaluation: A pilot study for the investigation of cost-effective outcomes of recurrent acute otitis media treatment. Ann Otol Rhin Laryngol 107(2):120, 1998 5. Hassan SJ, Weymuller EA: Assessment of quality of life in head and neck cancer patients. Head Neck 15(6):485, 1993 6. Deleyiannis FW, Weymuller EA, Coltrera MD, Futran N: Quality of life after laryngectomy: Are functional disabilities important? Head Neck 21(4):319, 1999 7. Rosenfeld RM: Pilot study of outcomes in pediatric rhinosinusitis. Arch Otolaryngol Head Neck Surg 121:729, 1995 8. Piccirillo JF, Gates GA, White DL, Schectman KB: Obstructive sleep apnea treatment outcomes pilot study. Otolaryngol Head Neck Surg 118(6):833, 1998 9. Isenberg SF, Rosenfeld The National Resident Matching Program® (NRMP®) is a private, not-for-profit corporation established in 1952 to optimize the rank-ordered choices of applicants and program directors for clinical training in the United States. The NRMP is not an application processing service; rather, it provides an impartial venue for matching applicants' and programs' preferences for each other using an internationally recognized mathematical algorithm. The first Main Residency Match® ("the Match") was conducted in 1952 when 10,400 internship positions were available for 6,000 graduating U.S. medical school seniors. By 1973, there were 19,000 positions for just over 10,000 graduating U.S. seniors. Following the demise of internships in 1975, the number of first-year post-graduate (PGY-1) positions declined to 15,700; however, the number of PGY-1 positions gradually increased through 1994 before declining slowly until 1998. Since that time, the number of PGY-1 positions has only increased. This year, an all-time high 35,194 PGY-1 positions were offered (Figure 1), the nineteenth consecutive annual increase. The total number of positions, at 38,106, also was an all-time high. The trend in the total number of applicants is more dramatic, rising from 6,000 in 1952 to 36,056 in 1999. After a decline of 5,052 applicants from 1999 to 2003, the number has risen each year since the 2004 Match. In 2021, the number of registrants reached an all-time high of 48,700, an increase of 3,741 over 2020. For more information about the NRMP, please visit: www.nrmp.org. Additional data and reports for the Main Residency Match and the Specialties Matching Service® (SMS®) are at: http://www.nrmp.org/main-residencymatch-data/ and http://www.nrmp.org/fellowship-matchdata/. Instructions on how to request NRMP data also are provided. Results and Data 2021 Main Residency Match® iv Definitions/Organizations ACGME Accreditation Council for Graduate Medical Education. Active Applicant An applicant who submits a certified rank order list of programs. All In Policy Any program registering for the Match must attempt to fill all positions through the Match or another national matching plan. Applicant Type The NRMP classifies applicants for the Main Residency Match into eight types: · A 4th-year medical student in a U.S. allopathic medical school accredited by the Liaison Committee on Medical Education (LCME) with a graduation date after July 1 in the year before the Match; also referred to as a U.S. MD senior. · A 4th-year medical student in a U.S. osteopathic medical school accredited by the Commission on Osteopathic College Accreditation (COCA) with a graduation date after July 1 in the year before the Match; also referred to as a U.S. DO senior. · Previous Graduate of U.S. MD Medical School (U.S. MD Grad): A graduate of a U.S. allopathic school of medicine accredited by the LCME with a graduation date before July 1 in the year before the Match. Previous U.S. graduates are not sponsored by their medical schools. · Previous Graduate of U.S. DO Medical School (U.S. DO Grad): A graduate of a U.S. osteopathic school of medicine accredited by the COCA with a graduation date before July 1 in the year before the Match. Previous U.S. DO graduates are not sponsored by their medical schools. · Student/Graduate of Canadian Medical School (Canadian): A senior student or graduate of a Canadian school of medicine accredited by the Committee on Accreditation of Canadian Medical Schools (CACMS). · Graduate of Fifth Pathway Program (5th Pathway): A graduate of a U.S. Fifth Pathway program. · U.S. Citizen Student/Graduate of International Medical School (U.S. IMG): A U.S. citizen who attended an international medical school. · Non-U.S. Citizen Student/Graduate of International Medical School (Non-U.S. IMG): A non-U.S. citizen who attended an international medical school. In this report, applicant types are sometimes combined into a smaller number of groups. · Foreign-Trained Physicians: U.S. citizen and non-U.S. citizen students and graduates of international medical schools. · Others: Includes previous graduates of MD and DO, Canadian and Fifth Pathway applicants. Couple Any two applicants who register as a couple in the Match. The NRMP allows
Google Sites
Report abuse