Evidence Relating Health Care Provider Burnout and Quality of Care
Authors: Maya B. Mathur, Tyler J. VanderWeele
Journal: Annals of Internal Medicine (2020)

Letters17 March 2020Evidence Relating Health Care Provider Burnout and Quality of CareMaya B. Mathur, PhD and Tyler J. VanderWeele, PhDMaya B. Mathur, PhDStanford University, Palo Alto, California (M.B.M.) and Tyler J. VanderWeele, PhDHarvard University, Boston, Massachusetts (T.J.V.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L19-0826 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Tawfik and colleagues' meta-analysis (1) employed the widely used excess significance test (EST) (2) to compare the observed number of statistically significant studies with the number of studies that would be expected to be significant if there were no publication bias. The authors thus reported a statistical excess of significant findings, suggesting publication bias. However, we caution that the EST can be misleading in meta-analyses with heterogeneous effects, such as that by Tawfik and colleagues (I2 = 99.3%) (1).To calculate the expected number of significant studies, the EST assumes that all studies in the meta-analysis have the ...References1. Tawfik DS, Scheid A, Profit J. Evidence relating health care provider burnout and quality of care. A systematic review and meta-analysis. Ann Intern Med. 2019;171:555-67. [PMID: 31590181]. doi:10.7326/M19-1152 LinkGoogle Scholar2. Ioannidis JP, Trikalinos TA. An exploratory test for an excess of significant findings. Clin Trials. 2007;4:245-53. [PMID: 17715249] CrossrefMedlineGoogle Scholar3. Johnson V, Yuan Y. Comments on 'An exploratory test for an excess of significant findings' by JPA loannidis and TA Trikalinos. Clin Trials. 2007;4:254-5. [PMID: 17715250] CrossrefMedlineGoogle Scholar4. Jin ZC, Zhou XH, He J. Statistical methods for dealing with publication bias in meta-analysis. Stat Med. 2015;34:343-60. [PMID: 25363575] doi:10.1002/sim.6342 CrossrefMedlineGoogle Scholar5. Ioannidis JP. Excess significance bias in the literature on brain volume abnormalities. Arch Gen Psychiatry. 2011;68:773-80. [PMID: 21464342] doi:10.1001/archgenpsychiatry.2011.28 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Stanford University, Palo Alto, California (M.B.M.)Harvard University, Boston, Massachusetts (T.J.V.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L19-0826. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEvidence Relating Health Care Provider Burnout and Quality of Care Daniel S. Tawfik , Annette Scheid , Jochen Profit , Tait Shanafelt , Mickey Trockel , Kathryn C. Adair , J. Bryan Sexton , and John P.A. Ioannidis Evidence Relating Health Care Provider Burnout and Quality of Care Daniel S. Tawfik and John P.A. Ioannidis Metrics Cited byHealth Care Worker Burnout During the COVID-19 Pandemic in HIV Clinics in Guangxi, China: A Cross-sectional Analysis of Risk and Protective FactorsMoral courage, moral sensitivity and safe nursing care in nurses caring of patients with COVID‐19Estimating publication bias in meta‐analyses of peer‐reviewed studies: A meta‐meta‐analysis across disciplines and journal tiers 17 March 2020Volume 172, Issue 6Page: 437-438KeywordsConflicts of interestDisclosureHealth care providersHealth care qualityMotivation ePublished: 17 March 2020 Issue Published: 17 March 2020 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...