Obesity Epidemic: US Temporal Trends

Although well known to most obesity researchers and epidemiologists, the public generally is not aware of the full magnitude of the obesity epidemic. Below is a classic report by the CDC of the emergence of the obesity epidemic in the United States from the early 1985 to 2004.

And finally - 2004

(Note the different color scheme)

[Click to enlarge]

A flash animated version of these maps is available here.

These slides are also available for download in Powerpoint format from the Centers of Disease Control and Prevention.

Journal Impact Factors for 2005

Impact Factors for leading medical and science journals in 2005 are listed below.
(Source: ISI Journal Citation Reports impact factors tabulated from each journal's public website)

Also visit the online H-index Calculator of Scientist Impact and Influence, powered by Google Scholar.

Additional journal impact factors:

--> Impact Factors of Genetics journals

--> Impact Factors of Cancer journals

--> Impact Factors of Cardiovascular disease journals

--> Impact Factors of Diabetes journals

--> Impact Factors of Epidemiology and Public Health journals

--> Impact Factors of Nutrition and Obesity journals

Journal Impact Factors
(note: review journals are not included)

General (internal) medicine

1. New England Journal of Medicine 44.0
2. Nature Medicine 28.9
3. The Lancet 23.4
4. Journal of the American Medical Association (JAMA) 23.3
5. Annals of Internal Medicine 13.3
6. British Medical Journal (BMJ) 9.0
7. Public Library of Science (PLOS) Medicine 8.4
8. Archives of Internal Medicine 8.0
9. Canadian Medical Association Journal (CMAJ) 7.4
10. Medicine 5.0
11. Am J Medicine 4.4
12. J Internal Medicine 4.0

Basic Science and Biology

1. Science 30.9
2. Cell 29.4
3. Nature 29.3
4. Nature Immunology 27.0
5. Nature Genetics 25.8
6. Nature Cell Biology 19.7
7. Nature Materials 15.9
8. Immunity 15.2
9. J Clinical Investigation 15.1
10. Molecular Cell 15.0
11. PLOS Biology 14.7
12. Developmental Cell 14.6
13. J Cell Biology 11.0
14. Proceedings of the National Academy of Science (PNAS) 10.3

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NIH Grant Success Rates and Change from 2004, by NIH institutes FY2005

The figure below shows a summary of NIH research grant application awards and success rates by NIH institutes in 2005, as well as change in awards and success rates from 2004.

Overall, results indicate that overall grant success rate dropping by 2.3%, or an absolute grant award decrease by 453 funded projects and -$171 million.

[Click to image to enlarge]

Impact Factors of Genetics Journals

Below are 2005 journal IMPACT FACTORS for genetics journals.

Visit here for general science and general clinical journal impact factors.

Genetics

Nature Genetics 25.8
Nature Rev Genetics 19.2
Genes Dev 15.6
Ann Rev Genetics 14.0
Am J Human Genetics 12.6
Trends Genetics 12.0
Ann Rev Genomics Human Genetics 10.1
Genome Res 10.1
Genome Biology 9.7
Curr Opin Genetics Dev 9.4
Human Mutation 7.9
Human Molecular Genetics 7.8
Oncogene 6.9
Molecular Biology Evol 6.2
Pharmacogenetics 5.9
Molecular Therapy 5.4
Mutation Res 5.3
Genetic Epidemiology 5.1
DNA Repair 5.0
Gene Therapy 4.8
J Mol Medicine (JMM) 4.7
BMC Evol Biology 4.4
Human Genetics 4.3
J Medical Genetics 4.3
Genetics 4.3
Am J Medical Genetics (Parts B and C) 4.3 and 3.5
Evolution 4.2
BMC Genomics 4.1
Human Gene Therapy 4.1
Pharmacogenomics J 4.0
DNA Res 3.9
Genes Immunity 3.8
J Gene Medicine 3.7
Human Heredity 3.6
Genes Cells 3.4
Clinical Genetics 3.3
Eur J Hum Genetics 3.3
Genetic in Medicine 3.1

Impact Factors of Nutrition and Obesity Journals

Below are 2005 journal IMPACT FACTORS for nutrition and obesity journals.

Visit here for general science and general clinical journal impact factors.

Nutition/Obesity

Ann Rev Nutrition 8.6
Am J Clinical Nutrition 5.9
Int J Obesity 4.5
Obesity Research 4.0
Crit Rev Food Science 3.9
Obesity Surgery 3.8
J Nutrition 3.7
Curr Opin Clinical Nutrition 3.3
British J Nutrition 3.0
Proc Nutrition Soc 2.6
Diabetes Obesity and Metabolism 2.5
Nutrition Rev 2.5
J Am Diet Assoc 2.4
Nutrition and Cancer 2.4
Clinical Nutrition 2.3
Eur J Nutrition 2.3
J Am Coll Nutrition 2.2
Eur J Clinical Nutrition 2.2
Nutrition 2.1
Nutrition Res Review 2.1
Public Health Nutrition 1.9

Impact Factors of Cancer Journals

Below are 2005 journal IMPACT FACTORS for cancer-related journals.

Visit here for general science and general clinical journal impact factors.

Cancer

Cancer Cell 18.7
J National Cancer Institute 15.2
J Clinical Oncology 11.8
Lancet Oncology 7.9
Cancer Research 7.6
Carcinogenesis 5.1
Cancer 4.8
Int J Cancer 4.7
Cancer Epidemiology Biomarkers and Prevention 4.5
Cancer Causes and Control 3.2
Biomedcentral (BMC) Cancer 2.0

Review Journals:
Ca-Cancer J Clin 49.8
Nature Rev Cancer 31.7
Cancer Metast Rev 8.0

Impact Factors of Diabetes Journals

Below are journal IMPACT FACTORS for diabetes-related journals.

Visit here for general science and general clinical journal impact factors.

Diabetes

Diabetes 8.0
Diabetes Care 7.8
Diabetologia 5.3
Diabetic Medicine 2.7
Diabetes Obesity Metab 2.5
Diabetic Metab Research 2.5
Nutrition Metab Cardiovascular Diseases 1.5

Impact Factors of Cardiovascular Journals

Below are 2005 journal IMPACT FACTORS for cardiovascular disease-related journals.

Visit here for general science and general clinical journal impact factors.

Cardiovascular Diseases

Circulation 11.6
Blood 10.1
Circulation Research 9.4
J American College Cardiology 9.2
European Heart J 7.3
ATVB 7.1
Hypertension 6.3
Stroke 5.9
Cardiovascular Research 5.3
J Hypertension 5.2
Atherosclerosis 3.8
Am Heart J 3.5
Am J Hypertension 3.5
Thromb Haemost 3.1
Am J Cardiology 3.0
Eur J Cardiov Prev R 2.3

Impact Factors for leading medical and science journals in 2005

Impact Factors for leading medical and science journals in 2005
(Source: ISI Journal Citation Reports impact factors tabulated from each journal's public website)

General (internal) medicine

1. New England Journal of Medicine 44.0
2. Nature Medicine 28.9
3. The Lancet 23.4
4. Journal of the American Medical Association (JAMA) 23.3
5. Annals of Internal Medicine 13.3
6. British Medical Journal (BMJ) 9.0
7. Public Library of Science (PLOS) Medicine 8.4
8. Archives of Internal Medicine 8.0
9. Can Medical Assoc J 7.4
10. Medicine 5.0
11. Am J Medicine 4.4
12. J Intern Medicine 4.0

Basic Science and Biology

1. Science 30.9
2. Cell 29.4
3. Nature 29.3
4. Nature Immunology 27.0
5. Nature Genetics 25.8
6. Nature Cell Biology 19.7
7. Nature Materials 15.9
8. Immunity 15.2
9. J Clinical Investigation 15.1
10. Molecular Cell 15.0
11. PLOS Biology 14.7
12. Developmental Cell 14.6
13. J Cell Biology 11.0
14. PNAS 10.3

(note: review journals are not included)

Additional journal impact factors:

--> Impact Factors of Genetics journals

--> Impact Factors of Cancer journals

--> Impact Factors of Cardiovascular disease journals

--> Impact Factors of Diabetes journals

--> Impact Factors of Epidemiology and Public Health journals

--> Impact Factors of Nutrition and Obesity journals

The Impact of Pre-Publication Presentation of Results: Epi Inquiry Accolade 03/20/2006

When is it a good idea, and when is it a bad idea to announce scientific results before formal publication? Does the medical community and the public quickly adopt pre-publication findings even though the results are not yet peer-reviewed? Such were the questions address by the recent article in JNCI by Giordano et al. and its accompanying editorial by Woloshin and Schwartz.

Giordano et al. investigated whether a new taxane treatment for lymph-node positive breast cancer significantly increased after its efficacy results were reported at the May 1998 meeting of the American Society of Clinical Oncology. Even though the taxane was not yet FDA approved and the formal publication was not to appear until 5 years later, the authors found that use of the newly reported treatment significantly increased >400% overall after the conference report. Furthermore, even though the treatment was shown only efficacious in lymph-node positive breast cancers (use increased 800%), results also showed that its use in patients with lymph-node negative breast cancers also increased 300%, which is in fact quite clinically disturbing as the drug was not even shown efficacious for such a disease.

The accompanying editorial by Woloshin and Schwartz summarized the risk and benefits of early adoption of pre-publication results, as well as noted examples in which early adoption has been clinically detrimental. Notably, the drug gefitinib (Iressa) had once been granted early FDA approval for increasing survival of patients with non-small-cell lung cancer who failed chemotherapy, even though the trial was unpublished, was a single uncontrolled trial, and subsequent issues were raised regarding adverse pneumonia deaths. Though over 200,000 people used the drug by 2004, a subsequent placebo-controlled trial shows no increased survival benefit. Such is an example in which adoption of pre-publication results did not benefit the public, and may have in fact caused more harm.

Woloshin and Schwartz summarize the following set of guideline regarding when to potentially adopt any pre-publication results:
1) large difference in all-cause mortality
2) no adverse effects
3) results are from a large randomized trial with long duration
4) confirms prior trial results, or presents first randomized trial evidence
5) no alternative treatments exist

For highlighting such important issues, the editors select as the dual-Epidemiologic Inquiry Accolade: Investigation of the Week...

Giordano SH, Duan Z, Kuo YF, Hortobagyi GN, Freeman J, Goodwin JS. Impact of a scientific presentation on community treatment patterns for primary breast cancer. J Natl Cancer Inst. 2006 Mar 15;98(6):382-8.

Woloshin S, Schwartz LM. What's the rush? The dissemination and adoption of preliminary research results. J Natl Cancer Inst. 2006 Mar 15;98(6):372-3.

~The Editors

Trusting Early Results Before Publication? Transition from Meetings to Journals

While doing a literature search, it is relatively common to find that either the results of a RCT presented at a scientific meeting were never published in a journal; or the results in the journal publication are discordant from those presented at the scientific meeting. Should we use the results from the scientific meeting, even if the results were never published later? Or should be just use the results from the peer-reviewed journal article, which might ensure completeness and proper interpretation of the data? This week's paper by Toma et al. in JAMA attempts to address these questions by examining the proportion of RCTs presented at American College of Cardiology (ACC) scientific meetings which were subsequently published as full-length journal articles; and the consistency between the data presented in the meeting abstract and the subsequent full-length publication.

The authors selected all RCTs presented at the scientific meetings of ACC between 1999 and 2002 and then searched the literature to see if these were ever published as full-length journal articles till the time of literature search. A distinction was made between the late- breaking clinical trials and the trials presented at other sessions of the ACC (oral or poster sessions). Significant results included the findings that the late-breaking clinical trials were more likely to be published as a full-length journal article subsequently (92% vs 69%); it was more likely that a design paper had been published prior to presentation of results for the late-breaking clinical trials (31% vs 13%); the late-breaking trials were likely to be larger (Median n=725 vs n=196); and the late-breaking trials were less likely to report a favorable effect of the intervention (OR of 0.46; 95% CI = 0.24, 0.90). The late-breaking trials also had higher quality scores and were more likely to be published in a journal with higher impact factor as compared to the RCTs presented at other sessions.

The authors believe that the differences between the late-breaking clinical trials and others can be explained to a certain extent by the process of selection of these RCTs. The application for presenting at the late-breaking session needs to be made at least 3 months in advance of the meeting and needs to be supported by details of the purpose, design, and methods of the trial. Also, since the results of these RCTs are not known at the time of application, it is more likely that they would report both favorable as well as negative results for the tested interventions.

Most importantly though, 41% of the RCTs (both late-breaking trials as well as others) which were subsequently published had a different estimate of primary outcome in the journal article as compared to what was presented at the scientific meetings. This suggests that we should not be over-eager in embracing the results from scientific meetings into clinical practice or in meta-analyses and we should wait for a peer-reviewed publication first. As the authors say - "As Shakespeare may have said in the 21st century, there are many slips betwixt podium and page".

~The Editors

Reference: Toma M, McAlister FA, Bialy L, Adams D, Vandermeer B, Armstrong PW. Transition From Meeting Abstract to Full-length Journal Article for Randomized Controlled Trials. JAMA 2006;295:1281-1287.

Sex Differences of Sex Hormones in Type 2 Diabetes: Implications for Sex-based Medicine

Recently, the theme of sex/gender-based medicine has been emerging as an ever more prevalent theme in clinical medicine. Thus, this also forces researchers to also ponder and consider sex-bas