Robust Inference With Ghostknockoffs in Genome-Wide Association Studies With Sample Relatedness.

Participation in high-level college athletics is growing. Each year, >500,000 student-athletes compete across National Collegiate Athletic Association (NCAA) sports, many in contact or collision settings where acute injury and long-term sequelae are common. Physicians who care for collegiate athletes practice in a high-stakes environment defined by frequent injury and the pressures of competitive sport. They are responsible not only for the diagnosis and treatment of injuries but also for preparticipation clearance, injury prevention protocols, rehabilitation oversight, return-to-play determinations, and coordination with athletic trainers and consulting specialists. These responsibilities often arise within time-pressured environments where clinical decisions may directly influence athlete availability, team performance, and scholarship or roster status. As a result, clinicians may be required to balance short-term performance expectations against the long-term health of the athlete while ensuring delivery of appropriate medical care. Such circumstances may increase vulnerability to allegations of negligence when adverse outcomes occur, particularly in cases involving delayed diagnosis, premature clearance, or progression of injury. Despite long-standing concern regarding medicolegal risk in sports medicine, existing litigation scholarship has focused primarily on trends in professional athletics, including the National Football League (NFL) or sports orthopaedic procedures more broadly. In contrast, college athletics occupies a distinct medicolegal space, in which physicians (1) treat athletes who are neither fully amateur nor professional and (2) often practice within university-affiliated or institutional health care systems. In the wake of Name, Image, and Likeness (NIL) reforms and the settlement, malpractice exposure in college athletics may carry higher stakes because athletes can now frame delayed diagnoses or premature clearance as causes of lost NIL earnings and other endorsement-based opportunities. Such developments highlight the evolving medicolegal landscape in which physicians care for collegiate athletes. Recent high-profile lawsuits involving elite athletes have brought physician liability in college athletics into sharper focus. However, there remains no comprehensive analysis of negligence claims brought against physicians caring for college athletes. Defining baseline patterns of physician liability can help inform clinical practice and risk mitigation. The purpose of this study was to characterize litigation claims against physicians caring for collegiate athletes. We hypothesized that there would be an increase in cases against physicians caring for collegiate athletes in recent years.