BackgroundWe studied the scientific yield of the medical PhD program at all Danish Universities.MethodsWe undertook a retrospective observational study. Three PhD schools in Denmark were included in order to evaluate the postdoctoral research production over more than 18 years through individual publications accessed by PubMed.ResultsA total of 2686 PhD-graduates (1995–2013) with a medical background were included according to registries from all PhD schools in Denmark. They had a median age of 35 years (interquartile range (IQR), 32–38) and 53 % were women at the time of graduation. Scientific activity over time was assessed independently of author-rank and inactivity was measured relative to the date of graduation. Factors associated with inactivity were identified using multivariable logistic regression. 88.6 % of the PhD theses were conducted in internal medicine vs. 11.4 % in surgery. During follow-up (median 6.9 years, IQR 3.0–11.7), PubMed data searches identified that 87 (3.4 %) of the PhD graduates had no publication after they graduated from the PhD program, 40 % had 5 or less, and 90 % had 30 or less. The median number of publications per year after PhD graduation was 1.12 (IQR 0.61–1.99) papers per year. About 2/3 of the graduates became inactive after 1 year and approximately 21 % of the graduates remained active during the whole follow-up. Female gender was associated with inactivity: adjusted odds ratio 1.59 (95 % confidence interval 1.24–2.05).ConclusionsThe scientific production of Danish medic PhD-graduates was mainly produced around the time of PhD-graduation. After obtaining the PhD-degree the scientific production declines suggesting that scientific advance fails and resources are not harnessed.
To examine the performance of Leibovich score versus GRade, Age, Nodes, and Tumor score in predicting disease recurrence in renal cell carcinoma. Methods: In total, 7653 patients diagnosed with renal cell carcinoma from 2010 to 2018 were captured in the nationwide DaRenCa database; 2652 underwent radical or partial nephrectomy and had full datasets regarding the GRade, Age, Nodes, and Tumor score and Leibovich score. Discrimination was assessed with a Cox regression model. The results were evaluated with concordance index analysis. Results: Median follow-up was 40 months (interquartile range 24-56). Recurrence occurred in 17%, and 15% died. A significant proportion of patients (36%) had missing data for the calculation of the Leibovich score. Among 1957 clear cell renal cell carcinoma patients the distribution of GRade, Age, Nodes, and Tumor score of 0, 1, 2, or 3/4 was 21%, 56%, 21% and 1.4%, respectively, and for Leibovich score of low/ intermediate/high this was 47%, 36% and 18%, respectively. A similar distribution was seen in 655 non-clear cell patients. Both Leibovich and GRade, Age, Nodes, and Tumor scores performed well in predicting outcomes for the favorable patient risk groups. The Leibovich score was better at predicting recurrence-free survival (concordance index 0.736 versus 0.643), but not overall survival (concordance index 0.657 versus 0.648). Similar results were obtained in non-clear cell renal cell carcinoma. Conclusion: GRade, Age, Nodes, and Tumor and Leibovich scores were validated in clear cell and non-clear cell renal cell carcinoma. Leibovich score outperformed the GRade, Age, Nodes, and Tumor score in predicting recurrence-free survival and should remain the standard approach to risk stratify patients during follow-up when all data are available.
INTRODUCTION AND OBJECTIVE: Leibovich score has been a standard method to predict recurrences in renal cell carcinoma (RCC). Recently, GRade, Age, Nodes, and Tumor (GRANT) score was proposed as an alternative. The objective was to examine the performance of Leibovich score versus GRANT score in predicting disease recurrence.METHODS: In total, 7,653 patients diagnosed with RCC from 2010 to 2018 were captured in the nationwide DaRenCa database; 2,652 underwent radical or partial nephrectomy and had full datasets regarding the GRANT score and Leibovich score. Discrimination was assessed with a Cox regression model. The results were evaluated with concordance index (C-index) analysis.RESULTS: Median follow-up was 40 months (IQR 24e56). Recurrence occurred in 17%, and 15% died. Among 1,957 clear cell (cc) RCC patients the distribution of GRANT grant score of 0,1,2, or 3/4 was 21%, 56%, 21% and 1.4%, respectively, and for Leibovich score of low/intermediate/high this was 47%, 36% and 18%, respectively. A similar distribution was seen in 655 non-cc patients.Both Leibovich and GRANT scores performed well in predicting outcomes for the favorable patient risk groups. The Leibovich score was better at predicting RFS (C-index 0.736 vs 0.643), but not OS (C-index 0.657 vs 0.648). Median follow-up was 40 months (IQR 24e56). Recurrence occurred in 17%, and 15% died. Among 1,957 clear cell (cc) RCC patients the distribution of GRANT grant score of 0,1,2, or 3/4 was 21%, 56%, 21% and 1.4%, respectively, and for Leibovich score of low/intermediate/high this was 47%, 36% and 18%, respectively. A similar distribution was seen in 655 non-cc patients.Both Leibovich and GRANT scores performed well in predicting outcomes for the favorable patient risk groups. The Leibovich score was better at predicting RFS (C-index 0.736 vs 0.643), but not OS (C-index 0.657 vs 0.648).CONCLUSIONS: GRANT and Leibovich score were validated in clear cell and non-clear cell RCC. Leibovich score outperformed the GRANT score in predicting RFS and should remain the standard approach to risk stratify patients during follow-up.
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