Evidence map›Paper›PMID 34616977›Full record

ArticleAEM education and training2021

Images of dark skin in top emergency medicine journals: A cross-sectional analysis of images of emergent cutaneous disorders.

Geovonni Bell, Sherita Holmes, Scott Gillespie, Anna Wood, Brittany L Murray

Abstract read
In one paragraph

Article in AEM education and training, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Geovonni BellEmergency Medicine Emory University School of Medicine Atlanta Georgia USA.ORCID https://orcid.org/0000-0002-1132-1307
Sherita HolmesEmergency Medicine Emory University School of Medicine Atlanta Georgia USA.
Scott GillespieDepartment of Pediatrics Emory University School of Medicine Atlanta Georgia USA.
Anna WoodDepartment of Pediatrics Emory University School of Medicine Atlanta Georgia USA.
Brittany L MurrayEmergency Medicine Emory University School of Medicine Atlanta Georgia USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionEmergency medicine (EM) physicians must recognize emergent cutaneous disorders (CDs) in patients of all skin tones. In other medical specialties, images of CDs in light-skinned individuals (LSI) are published more frequently than images of CDs in dark-skinned individuals (DSI). This study aims to determine the representation of LSI versus DSI in images of emergent CDs published in top EM journals.

methodsThis is a cross-sectional analysis of CD images published from 2015 to 2020 in the six most influential EM journals as determined by Eigenfactor. The 2016 Model of the Clinical Practice of Emergency Medicine (EM Model) by the American Board of Emergency Medicine was used to classify CDs as "emergent," "nonemergent," or "not listed." The Fitzpatrick skin tone scale was used to classify skin tone as light, dark, or indeterminate. Two blinded reviewers classified each image; for disagreements, a third blinded reviewer determined the final classification. Descriptive statistics and chi-square were used to analyze the data. A kappa coefficient was used to determine reviewer agreement (LSI vs. DSI), and a weighted kappa coefficient was used for agreement between individual Fitzpatrick categories.

resultsThere were 314 images of CDs. Forty images were indeterminate, and one image was excluded, leaving 273. Of the 273 images analyzed, 44.0% were emergent, 8.0% were nonemergent, and 48.0% were not listed in the EM Model. DSI comprised 13.6% of images. For emergent CDs, 85.0% were LSI versus 15.0% DSI. For nonemergent CDs, 27.3% were DSI, and for CDs not listed in the EM Model, 9.9% were DSI. The kappa coefficient for reviewer agreement between LSI and DSI was 0.76 (95% confidence interval [CI] = 0.65 to 0.87) and the weighted kappa coefficient for agreement between Fitzpatrick categories was 0.70 (95% CI = 0.64 to 0.76), showing substantial agreement.

conclusionFor emergent and nonemergent CDs, images of LSI were published more than those of DSI in top EM journals.

Identifiers

PMID34616977
PMCPMC8480477

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.