Introduction: Despite current therapies, many physicians are currently not optimizing treatment of patients with heart failure (HF), resulting in more than 1 million hospitalizations per year. Hypothesis: A video-based, online medical education (CME) activity can improve knowledge and competence of cardiologists and primary care physicians (PCPs) related to management of HF. Methods: An online CME activity was developed as a 25-minute roundtable discussion with 3 leading experts. The activity included a transcript of the discussion and a downloadable slide deck to highlight and reinforce key data. The effects of education were assessed using a linked pre-assessment/post-assessment study design. For all questions combined, the McNemar's chi-square test was used to assess differences from pre-to postassessment. P values are shown as a measure of significance; P values <.05 are statistically significant. Cohen's d was used to calculate the effect size (>0.8 are large, 0.8-0.4 are medium, and <0.4 are small). Results: Comparison of individually linked pre-assessment question responses to the respective post-assessment question responses demonstrates statistically significant improvements with large effect sizes for both cardiologists (n = 55; P < .0001; d = 1.93) and PCPs (n = 74; P = .001; d = 1.60). Both cardiologists and PCPs had a low baseline level of knowledge pre-education, with 36% and 28% average correct response rates, respectively. Significant improvements were observed post-compared to pre-education (all P < .05): 1) A 68% relative improvement for cardiologists (40% vs 67%) and a 92% improvement (24% vs 46%) for PCPs in knowledge of the role of the "funny" channel; 2) A 75% relative improvement for cardiologists (24% vs 42%) and a 58% improvement (19% vs 30%) for PCPs in recognition of the results of the SHIFT trial; 3) A 45% relative improvement for cardiologists (40% vs 58%) and a 34% improvement (35% vs 47%) for PCPs in understanding of clinical factors contributing to an HF patient's elevated HR. Conclusion: The statistically significant improvements observed as a result of participation in this online CME intervention demonstrate that effective internetbased education can improve knowledge and competence of physicians related to management of HF. However, both cardiologists and PCPs continued to demonstrate a need for further education on understanding the functions of the funny channel, the underlying pathophysiology and implications of persistent elevated heart rate, and the benefits of addressing elevated HR in patients with HF.
Key Points
Spontaneous coronary artery dissection and Takotsubo syndrome are less common cardiovascular diseases that share similar clinical features.
The current study offers a promising association and mechanistic etiology between the disorders, but is limited by a small sample size.
Further research with a larger patient population is warranted.
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