DIAGNOSIS, PROGNOSIS AND RISK ASSESSMENT OF MULTIPLE MYELOMA: IDENTIFYING GAPS AND ADDRESSING EDUCATION NEEDS FOR HEMATOLOGISTS AND ONCOLOGISTS
(Abstract release date: 05/19/16)
EHA Library. Van Laar E. 06/09/16; 134897; PB1997
Mrs. Emily Van Laar
Contributions
Contributions
Abstract
Abstract: PB1997
Type: Publication Only
Background
The diagnostic and prognostic criteria for multiple myeloma (MM) have rapidly evolved as the therapeutic landscaped has advanced. Furthermore, in 2014, the MM diagnostic criteria were revised to incorporate biochemical parameters in addition to traditional symptomatic criteria. These emerging changes require that the clinician interpret and integrate this new information into clinical practice.
Aims
A 2-part study was conducted with the first part focused on identifying clinical gaps in prognosis and diagnosis of patients with MM and the second part focused on determining the effect of educational intervention designed to address the identified clinical gaps.
Methods
Education interventions for hematologists/oncologists were developed and posted online (http://www.medscape.org/sites/advances/multiple-myeloma). Two of the interventions used a 25-question self-assessment focused on identifying clinical practice gaps in MM while the third comprised a 20-minute video of a two MM expert discussion designed to narrow the knowledge and competence gaps of hematologists and oncologists. Learning in the video-based intervention was assessed by comparing each learner’s responses to pre-education questions with responses to the same questions posed after education. The McNemar’s chi-square test was used to assess whether the mean pre-assessment score was different from the mean post-assessment score. Activities were posted online July 2015 and data were collected through September 2015.
Results
Responses of 434 hematologist/oncologists who completed all assessment questions in at least one intervention during the study period were analyzed. At baseline, identified clinical gaps included: the inability to recognize clinical features of high-risk disease (82% incorrect), inability to identify tools for assessing prognosis (73% incorrect), inability to distinguish unfavorable (44- 56% incorrect) or favorable (47% incorrect) cytogenetics, inability to assign the International staging system (ISS) score (26% incorrect), inability to detect clinical relapse (49% incorrect), and inability to interpret the IMWG diagnosis criteria (40-79% incorrect). For the second phase of the study, the education intervention focused on IMWG guidelines in newly diagnosed MM and utilized a study group of matched hematologist/oncologist learners (N=58). After participation in educational intervention, 84-95% of hematologist/oncologists selected the correct answer regarding diagnostic criteria (Table 1).Table 1. Post-education Outcomes
Conclusion
Despite the publication and dissemination of recent guideline updates, clinician show gaps in knowledge of clinical diagnostic and prognostic criteria for MM. This study identified specific education needs of physicians treating patients with MM regarding diagnostic, prognostic and risk stratification and demonstrated increased knowledge after participation in a targeted online intervention. Learners showed a mean improvement of 49% (range: 38-55%) in knowledge of IMWG diagnostic criteria in post assessments. Future education is warranted on practical application of diagnosis criteria, laboratory thresholds, prognostic, and monitoring tools, and proper risk assessment in order to enhance prompt diagnosis and effective disease management.
Session topic: E-poster
Keyword(s): Diagnosis, Myeloma, Prognosis
Type: Publication Only
Background
The diagnostic and prognostic criteria for multiple myeloma (MM) have rapidly evolved as the therapeutic landscaped has advanced. Furthermore, in 2014, the MM diagnostic criteria were revised to incorporate biochemical parameters in addition to traditional symptomatic criteria. These emerging changes require that the clinician interpret and integrate this new information into clinical practice.
Aims
A 2-part study was conducted with the first part focused on identifying clinical gaps in prognosis and diagnosis of patients with MM and the second part focused on determining the effect of educational intervention designed to address the identified clinical gaps.
Methods
Education interventions for hematologists/oncologists were developed and posted online (http://www.medscape.org/sites/advances/multiple-myeloma). Two of the interventions used a 25-question self-assessment focused on identifying clinical practice gaps in MM while the third comprised a 20-minute video of a two MM expert discussion designed to narrow the knowledge and competence gaps of hematologists and oncologists. Learning in the video-based intervention was assessed by comparing each learner’s responses to pre-education questions with responses to the same questions posed after education. The McNemar’s chi-square test was used to assess whether the mean pre-assessment score was different from the mean post-assessment score. Activities were posted online July 2015 and data were collected through September 2015.
Results
Responses of 434 hematologist/oncologists who completed all assessment questions in at least one intervention during the study period were analyzed. At baseline, identified clinical gaps included: the inability to recognize clinical features of high-risk disease (82% incorrect), inability to identify tools for assessing prognosis (73% incorrect), inability to distinguish unfavorable (44- 56% incorrect) or favorable (47% incorrect) cytogenetics, inability to assign the International staging system (ISS) score (26% incorrect), inability to detect clinical relapse (49% incorrect), and inability to interpret the IMWG diagnosis criteria (40-79% incorrect). For the second phase of the study, the education intervention focused on IMWG guidelines in newly diagnosed MM and utilized a study group of matched hematologist/oncologist learners (N=58). After participation in educational intervention, 84-95% of hematologist/oncologists selected the correct answer regarding diagnostic criteria (Table 1).Table 1. Post-education Outcomes
| IMWG Diagnosis Criteria Topic | Pre-education % Correct | Post-education % Correct | % Improved Learners | P-value |
| Abnormal Bone Marrow Plasma Cells | 41% | 95% | 53% | P<.05 |
| Serum Free Light Chain Ratio | 60% | 95% | 38% | P<.05 |
| Number of Lesions as Detected by MRI | 31% | 84% | 55% | P<.05 |
Conclusion
Despite the publication and dissemination of recent guideline updates, clinician show gaps in knowledge of clinical diagnostic and prognostic criteria for MM. This study identified specific education needs of physicians treating patients with MM regarding diagnostic, prognostic and risk stratification and demonstrated increased knowledge after participation in a targeted online intervention. Learners showed a mean improvement of 49% (range: 38-55%) in knowledge of IMWG diagnostic criteria in post assessments. Future education is warranted on practical application of diagnosis criteria, laboratory thresholds, prognostic, and monitoring tools, and proper risk assessment in order to enhance prompt diagnosis and effective disease management.
Session topic: E-poster
Keyword(s): Diagnosis, Myeloma, Prognosis
Abstract: PB1997
Type: Publication Only
Background
The diagnostic and prognostic criteria for multiple myeloma (MM) have rapidly evolved as the therapeutic landscaped has advanced. Furthermore, in 2014, the MM diagnostic criteria were revised to incorporate biochemical parameters in addition to traditional symptomatic criteria. These emerging changes require that the clinician interpret and integrate this new information into clinical practice.
Aims
A 2-part study was conducted with the first part focused on identifying clinical gaps in prognosis and diagnosis of patients with MM and the second part focused on determining the effect of educational intervention designed to address the identified clinical gaps.
Methods
Education interventions for hematologists/oncologists were developed and posted online (http://www.medscape.org/sites/advances/multiple-myeloma). Two of the interventions used a 25-question self-assessment focused on identifying clinical practice gaps in MM while the third comprised a 20-minute video of a two MM expert discussion designed to narrow the knowledge and competence gaps of hematologists and oncologists. Learning in the video-based intervention was assessed by comparing each learner’s responses to pre-education questions with responses to the same questions posed after education. The McNemar’s chi-square test was used to assess whether the mean pre-assessment score was different from the mean post-assessment score. Activities were posted online July 2015 and data were collected through September 2015.
Results
Responses of 434 hematologist/oncologists who completed all assessment questions in at least one intervention during the study period were analyzed. At baseline, identified clinical gaps included: the inability to recognize clinical features of high-risk disease (82% incorrect), inability to identify tools for assessing prognosis (73% incorrect), inability to distinguish unfavorable (44- 56% incorrect) or favorable (47% incorrect) cytogenetics, inability to assign the International staging system (ISS) score (26% incorrect), inability to detect clinical relapse (49% incorrect), and inability to interpret the IMWG diagnosis criteria (40-79% incorrect). For the second phase of the study, the education intervention focused on IMWG guidelines in newly diagnosed MM and utilized a study group of matched hematologist/oncologist learners (N=58). After participation in educational intervention, 84-95% of hematologist/oncologists selected the correct answer regarding diagnostic criteria (Table 1).Table 1. Post-education Outcomes
Conclusion
Despite the publication and dissemination of recent guideline updates, clinician show gaps in knowledge of clinical diagnostic and prognostic criteria for MM. This study identified specific education needs of physicians treating patients with MM regarding diagnostic, prognostic and risk stratification and demonstrated increased knowledge after participation in a targeted online intervention. Learners showed a mean improvement of 49% (range: 38-55%) in knowledge of IMWG diagnostic criteria in post assessments. Future education is warranted on practical application of diagnosis criteria, laboratory thresholds, prognostic, and monitoring tools, and proper risk assessment in order to enhance prompt diagnosis and effective disease management.
Session topic: E-poster
Keyword(s): Diagnosis, Myeloma, Prognosis
Type: Publication Only
Background
The diagnostic and prognostic criteria for multiple myeloma (MM) have rapidly evolved as the therapeutic landscaped has advanced. Furthermore, in 2014, the MM diagnostic criteria were revised to incorporate biochemical parameters in addition to traditional symptomatic criteria. These emerging changes require that the clinician interpret and integrate this new information into clinical practice.
Aims
A 2-part study was conducted with the first part focused on identifying clinical gaps in prognosis and diagnosis of patients with MM and the second part focused on determining the effect of educational intervention designed to address the identified clinical gaps.
Methods
Education interventions for hematologists/oncologists were developed and posted online (http://www.medscape.org/sites/advances/multiple-myeloma). Two of the interventions used a 25-question self-assessment focused on identifying clinical practice gaps in MM while the third comprised a 20-minute video of a two MM expert discussion designed to narrow the knowledge and competence gaps of hematologists and oncologists. Learning in the video-based intervention was assessed by comparing each learner’s responses to pre-education questions with responses to the same questions posed after education. The McNemar’s chi-square test was used to assess whether the mean pre-assessment score was different from the mean post-assessment score. Activities were posted online July 2015 and data were collected through September 2015.
Results
Responses of 434 hematologist/oncologists who completed all assessment questions in at least one intervention during the study period were analyzed. At baseline, identified clinical gaps included: the inability to recognize clinical features of high-risk disease (82% incorrect), inability to identify tools for assessing prognosis (73% incorrect), inability to distinguish unfavorable (44- 56% incorrect) or favorable (47% incorrect) cytogenetics, inability to assign the International staging system (ISS) score (26% incorrect), inability to detect clinical relapse (49% incorrect), and inability to interpret the IMWG diagnosis criteria (40-79% incorrect). For the second phase of the study, the education intervention focused on IMWG guidelines in newly diagnosed MM and utilized a study group of matched hematologist/oncologist learners (N=58). After participation in educational intervention, 84-95% of hematologist/oncologists selected the correct answer regarding diagnostic criteria (Table 1).Table 1. Post-education Outcomes
| IMWG Diagnosis Criteria Topic | Pre-education % Correct | Post-education % Correct | % Improved Learners | P-value |
| Abnormal Bone Marrow Plasma Cells | 41% | 95% | 53% | P<.05 |
| Serum Free Light Chain Ratio | 60% | 95% | 38% | P<.05 |
| Number of Lesions as Detected by MRI | 31% | 84% | 55% | P<.05 |
Conclusion
Despite the publication and dissemination of recent guideline updates, clinician show gaps in knowledge of clinical diagnostic and prognostic criteria for MM. This study identified specific education needs of physicians treating patients with MM regarding diagnostic, prognostic and risk stratification and demonstrated increased knowledge after participation in a targeted online intervention. Learners showed a mean improvement of 49% (range: 38-55%) in knowledge of IMWG diagnostic criteria in post assessments. Future education is warranted on practical application of diagnosis criteria, laboratory thresholds, prognostic, and monitoring tools, and proper risk assessment in order to enhance prompt diagnosis and effective disease management.
Session topic: E-poster
Keyword(s): Diagnosis, Myeloma, Prognosis
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