Resident Spotlights Journal Costs, AI and Patient Materials

She and colleagues conducted research on the associated costs to publish in various orthopaedic journals and on use of artificial intelligence (AI) to rewrite orthopaedic trauma educational materials for patients.

Both research projects were designated as top 10 poster presentations at the conference. The AI educational materials study was further selected as a podium research presentation, Lutnick says, ranking in the top four conference abstracts.

The study exploring publication costs is titled “Publish or Perish: The Cost of Publication in Orthopaedic Journals.”

Lutnick says the team grew frustrated after having to repeatedly pay high prices to publish, prompting the research topic.

To conduct the research, Lutnick and colleagues looked at 300 orthopaedic journals that ranged in size and influence and visited the journals’ websites to find and record publication costs.

They found that about 52 percent of the orthopaedic journals analyzed have costs to publish and the average cost is around $2,000.

Compared to other medical subspecialties, more orthopaedic journals charge publication fees, and these costs tend to be comparatively high, Lutnick says.

Further, Lutnick notes that while open access journals, which don’t charge to view content, can be beneficial to the scientific community, such journals often charge higher publication costs.

The research team also analyzed the orthopaedic journals’ impact metrics to see if paying more to publish results in higher visibility or a higher h-index, which measures research influence based on citations — they found no correlation.

“You’re paying to publish in the journal, but that cost doesn’t necessarily guarantee you’re getting more visibility or that the journal that you’re publishing in actually has better metrics,” Lutnick says.

Building a research portfolio of papers and abstracts can be critical to success at all stages, from medical student to resident to faculty member, Lutnick says. Yet high publication costs can hamper small research teams and limit funds for attending conferences and other activities critical to development, she adds.

“We need clinician-scientists to produce this research and try to make advances in the field to take care of people better and to practice medicine better,” Lutnick says. “But it’s also very expensive for that same team and those same people to be doing all of this work.”

Orthopaedic trauma surgery, a field that Lutnick hopes to pursue, often involves performing emergency operations, such as fixing broken bones, on injured patients.

Patients frequently receive literature and handouts about their injuries and needed surgical procedures. Yet Lutnick says these materials aren't always written at a sixth-grade reading level, which is the American Medical Association standard.

“I’m pretty passionate about social determinants of health,” Lutnick says, and that includes providing medical information that’s accessible to all patients.

Lutnick and her colleagues conducted a feasibility study to explore using AI to rewrite orthopaedic trauma patient materials to a sixth-grade reading level. The study is titled “Readability of Orthopaedic Patient Educational Material: An Artificial Intelligence Application.”

After collecting 32 publicly available written materials from various Level 1 U.S. trauma hospitals, the team wrote and applied a code used to format the materials for readability scoring. They then asked several different AI platforms to rewrite the materials to a sixth-grade level.

They found that the AI model Chat GPT-4o mini performed best. “This version of AI managed to simplify the reading to a lower reading level without losing the relevant information,” Lutnick says. “And it did a better job of actually rewriting the article rather than just summarizing it.”

When screening the rewritten materials, the team did not find any medical inaccuracies.

“Health care literacy is hugely important to patient outcomes,” Lutnick says. “The more people can understand what you’re doing, the goals, and what your expectations are, the more they trust you and the more they buy into their own care.”

The next step is to apply this methodology to a larger collection of patient materials, Lutnick adds. 

The study on AI and patient educational materials was recently published in the Journal of Clinical Orthopaedics and Trauma, Lutnick’s first paper as senior author.

Given her affinity for research and mentoring, Lutnick was named resident research coordinator as a PGY-2, helping connect orthopaedic residents to research projects and facilitating departmental research.

She credits the freedom and ability to explore such wide-ranging and unique topics in orthopaedic medicine to the flexibility and supportiveness of her residency program.

“I wanted to come to UB for residency, after being here my whole life, on purpose, not because it was convenient. I knew that this was a program where I could make my education what I wanted it to be,” she says.

Additional authors on the publication costs study include Benjamin Mazur; Sophia Puertas; Matthew Alben, DO; and Evgeny Dyskin, MD, PhD, all of the Jacobs School Department of Orthopaedics.

Additional authors on the AI and patient materials study include Miles LaNicca of the Jacobs School and Ellis Wright of Case Western Reserve University.