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First of all, congratulations on your innovative article about the effect of political events on the mood among young physicians in the United States(1). After reviewing the article during a critical reading group of Erasmus MC Rotterdam, several questions arose.
Firstly, in the methods section you described that you used a one-question measure of mood valence. With this, participants could respond daily on how their mood was on a scale from 1-10. According to the results, the highest recorded mean decline in mood after a political event was 0.32. Although statically significant, this effect seemed to rather small on a 1-10 scale and therefore hard to interpret. You compared this effect with the decline in mood recorded at the start of the internships, after assuming that this period is automatically correlated with increased stress and therefore mood decline. We wonder if the magnitude of the results would have been easier to interpret if you had put them in contrast to the systemic factors (heavy workloads, medical errors, sleep deprivation) which you mentioned in the introduction of the article.
Secondly, you found significant changes in mood following 66.7% of political events assessed. However, political events like these are difficult to avoid. What are the practical implications of this study for clinicians, does it impact their functioning? What measures could be taken to prevent or lessen this impact?
Thirdly, in the discussion it was unclear to us what the reason is that the non-political events, particularly the shootings, do not result in a significant reduction in mood. The discussion section suggests that emotionally arousing news can have psychological implications. Why do the shooting events, which are emotionally arousing and politically charged when it comes to the heavy-polarized gun-regulation discussion in the US, tend in no result of mood decline?
We hope the authors could clarify these points for us. Thank you in advance!
Marco van Santen, BSc
Lonneke Vos, BSc
Guido van Leeuwen, M.D.
Bart Koes, PhD
1. Frank E, Nallamothu BK, Zhao Z, Sen S. Political events and mood among young physicians: a prospective cohort study. BMJ. 2019;367:l6322.
No competing interests
18 January 2020
Anthon Marco van Santen
Lonneke E. Vos (Medical Student), Guido J. van Leeuwen (M.D.), Bart W. Koes (PhD)
Erasmus MC Rotterdam
Department of General Practice, Erasmus MC, 3000 CA Rotterdam, The Netherlands