COVID-19 remains dominant in our top ten most read papers for July, 2021, with six of the ten spots held by COVID-19-related papers and Li et al.’s protocol for a systematic review and meta-analysis on the impact of COVID-19 on female fertility reclaiming the top spot. But the two new entries in the top ten focus on other topics. 

Averbuch et al.’s systematic review on academic bullying in medical settings entered the most read chart at number 6. As detailed previously, the researchers from McMaster University (ON, Canada) analysed findings from 68 studies from various countries published between 1999 and 2021, representing data from 82 349 respondents (consultants and trainees). They found that the most commonly reported pattern of bullying was overwork as a form of punishing behaviour and the most common impact was psychological distress. Perpetrators were most often consultants, and men were identified as the most common perpetrators, while women were the most common victims. Notably, less than a third of victims reported the bullying. Poor enforcement of anti-bullying policies, hierarchical power structures, and normalisation of bullying were identified as facilitators of bullying behaviours in academic medical settings. In commenting on the study to Medscape Medical News, lead investigator Harriette Van Spall explained how the research was inspired by her own personal experience. “Some behaviours were excruciating to deal with, protesting against them would bring more on, and every day was filled with dread. It took sheer will to show up at work to care for patients, to complete research I was leading, and to have hope and my academic output, income, and personal well-being dropped during those years.”

Also new in the top ten, Axson et al.’s article on clinical trial transparency and data sharing among biopharmaceutical companies entered the chart at number 9. The study, which follows on from earlier work from the same group, used the established Good Pharma Scorecard (GPS) transparency measures to appraise novel drugs and biologics that received approval from the US Food and Drug Administration (FDA) in 2016–17 and their company sponsors. The researchers found that there was no apparent difference in transparency between US-based and non-US companies and no difference between the transparency of reporting for biologics and non-biologic drugs. However, large companies (those in the top 20 largest companies by market capitalisation) were found to be significantly more transparent than smaller companies, with generally better data sharing procedures and superior implementation of FDA Amendments Act trial reporting requirements.

Here is the full list of most read papers in BMJ Open during July, 2021: