The Use of Caffeinated Substances by Surgeons for Cognitive Enhancement

Andreas G. Franke, MD, PhD, MA; Christiana Bagusat, Dipl-Soz; Carolyn McFarlane; Teresina Tassone-Steiger; Werner Kneist, MD; Klaus Lieb, MD

Disclosures

Annals of Surgery. 2015;261(6):1091-1095. 

In This Article

Methods

Participants

A total of 3306 German-speaking surgeons who attended 5 international conferences (Berlin, Bonn, Düsseldorf, Freiburg, and Munich) of the German Society of Surgery (Deutsche Gesellschaft für Chirurgie) were surveyed. After the first conference, potential participants were asked if they were assessed previously; those who previously filled out a questionnaire were excluded from participating again. Data from this sample about the use of prescription and illicit drugs among surgeons for CE were already published.[18]

Procedure

An anonymous paper-and-pencil questionnaire was designed to collect information about the use of coffee, caffeinated drinks, and caffeine tablets for the purpose of CE and to collect information about potential risk factors associated with its use (eg, sex, age at the time of the survey, age at first use, employer, satisfaction with professional situation, etc), and participants at the conferences were asked to fill in the questionnaire. In this study, we were only interested in healthy surgeons working in hospitals using caffeine specifically for CE; we thus excluded participants with self-reported psychiatric disorders (eg, depression, attention deficit/hyperactivity disorder) who have a physicians' prescription for any psychoactive drug and surgeons who worked in their private practice or industry were excluded. To achieve a high response rate, participants were asked to leave the completed questionnaire anonymously in black boxes.

Factors potentially associated with the use of coffee, caffeinated drinks, and caffeine tablets for CE (ie, age, sex, marital status, living with children, type of employer, employment status, hours of work, gross income, satisfaction with professional success, evaluation of career opportunities, pressure to perform at work, pressure to perform in private life, pressure to perform in a way that is perceived to be burdensome for the surgeon, pressure to perform in a way that is perceived to be harmful for the surgeon) were analyzed for all participants using logistic regression analysis. In addition, surgeons were asked for specific reasons for their use of caffeine. The study was approved by the local ethics committee, and all participants provided informed consent by returning the questionnaire.

Statistical Analysis

Statistical analyses were carried out using SPSS for Windows, version 17.0 (SPSS Inc, Chicago, IL). Values are reported as mean ± standard deviation and Clopper-Pearson confidence intervals (95% CIs). Differences between (sub)groups (sex, age, pressure to perform, etc) were compared using multiple logistic regression analysis and statistical tests according to the characteristics of the variables.

For the multiple logistic regression analysis, stepwise forward selection was performed with a selection level of 0.05. The following variables were analyzed as potential multivariable predictors of the use of caffeine for CE before forward selection: pressure to perform at work, pressure in private life, gross income, sex, age, marital status, living with children, type of employer, employment status, hours of work, satisfaction with professional success, evaluation of career opportunities, pressure to perform in a way that is perceived to be burdensome, and pressure to perform in a way that is perceived to be harmful to health. The main results are presented as odds ratio (ORs) with confidence limits and P values. Cases with missing values were excluded (complete case analysis).

processing....