Background: Competency in electrocardiogram (ECG) interpretation is central to undergraduate and postgraduate clinical training. Studies have demonstrated ECGs are interpreted sub-optimally. Our study compares the effectiveness of two learning strategies to improve competence and confidence.
Introduction: It remains unclear what percentage of abstracts proceed to manuscript publication and the characteristics that predict successful publication. This study aimed to determine factors associated with successful peer-reviewed publications following oral presentation at the American Society of Hematology (ASH) annual meeting. Methods: All oral abstract presentations (n=621) in the hematological malignancy category from 2016 ASH annual meeting were included in the study. Abstract publication was confirmed by searching for the publicly listed abstract on PubMed by title, first, and last author names, and institutional matching. We recorded time to online publication, US versus foreign journal publication, and journal impact factor by 3.5 years from 2016 ASH annual meeting. Abstracts characteristics that were analyzed also included number of authors, gender of first author, gender of last author, and single vs multi-institution studies. Gender of the first and last author was confirmed by looking at their biography details on their institutional website. Descriptive analysis was performed and an association between presenter's or last author's gender and publication matrix was analyzed using Chi-square tests. Results: Of the 621 abstracts, 350 (56%) were published in full text by three and a half years since the 2016 ASH annual meeting. The abstracts' average time to journal publication was 17.46 months (SD +/- 11.32) (Table 1). Of the published articles, 64% (223/350) were published in U.S. journals; mean impact factor for all publications was 14.46 (SD+/- 11.47).The median number of authors for published and unpublished abstracts were similar. Females presented 37% (228/621) of the abstracts and 35% (123/350) of the journal publications had female first author and 22% (77/350) had female last author. A total of 53.9% (123/228) abstracts presented by a female author were published versus 57.7% (227/393) abstracts presented by a male author (p=<0.001). Males were more often involved in multi-institutional trials (p=0.045) and were more likely to have senior authorship (p=0.005). There was no correlation between the gender of the first author to journal impact factor (p=0.109) or time to publication (p=0.091). Conclusion: More than half of the oral abstracts were successfully published regardless of gender and number of authors. The rate of successful publication is higher for male authors even though there was no correlation between the gender of the first author to journal impact factor or time to publication. Our study highlights gender disparity in senior authorship, however this difference is not as wide in first authorship. Disclosures Jamshed: Takeda, Amgen and Celgene: Honoraria.
e19079 Background: Primary myelofibrosis (PMF) carries a poorer prognosis compared to other BCR-ABL-negative myeloproliferative diseases (MPD), and there is increased risk of early mortality due to blast transformation, thrombosis, bleeding complications, and progression of disease. Prior studies report greater incidence of second primary malignancy (SPM) among MPD patients, although the true risk in PMF has not been elucidated. We performed a large database study to evaluate the risk of SPM in PMF patients and analyzed the effects of sociodemographic factors on the risk of SPM. Methods: We used the Surveillance, Epidemiology, and End Results (SEER) database to identify all patients with a histologic diagnosis of PMF from 2009 to 2018. SPM was defined as any subsequent malignancy that developed at least 1 year after the diagnosis of PMF. Using multiple primary standardized incidence ratio (SIR) session of the SEER*Stat software (version 8.3.9), we calculated SIR and absolute excess risk (AER) of SPM for the entire cohort of PMF and also stratified based on age, sex, race, marital status, receipt of chemotherapy, follow-up duration, and year of diagnosis. We generated the 95% confidence intervals (CI) and p-values assuming Poisson distribution of the observed incidences of SPM. Results: A total of 5,273 patients with PMF were included in the analysis, of which 342 patients (6.4%) developed SPM. SPM occurred at SIR of 1.97 (95% CI 1.77-2.18, p<0.05) and AER of 151.87 per 10,000 population. A significantly higher incidence of melanoma (SIR 1.96, 95% CI 1.14-3.14, p<0.05), lymphoma (SIR 3.45, 95% CI 2.31-4.96, p<0.05), and leukemia (SIR 26.87, 95% CI 22.69-31.59, p<0.05) was observed. There was no statistically significant difference in SIR based on sex, race, marital status, follow-up duration, and receipt of chemotherapy. The risk was significantly higher in patients ≤60 years vs patients >60 years (SIR 2.34, 95% CI 1.89-2.86 vs SIR 1.86, 95% CI 1.65-2.10, p 0.01) and for PMF diagnosed after 2009 vs ≤2009 (SIR 2.64, 95% CI 2.26-3.07 vs SIR 1.61, 95% CI 1.40-1.85, p<0.001). Conclusions: Patients with PMF are at a high risk of developing SPM, especially leukemia and lymphoma. Data suggests higher incidence of SPM in patients aged ≤60 years and in the decade after 2009. The impact of ruxolitinib, which was approved in 2011, on the incidence of SPM deserves further study. [Table: see text]
Introduction The Electrocardiogram (ECG) is the most commonly used diagnostic test in modern medicine.1Competency in ECG interpretation is central to undergraduate and postgraduate clinical training and minimising potential adverse consequences on patient care. Several studies have demonstrated postgraduates interpret ECG’s sub-optimally.2,3 Our study compares the effectiveness of two cost neutral learning strategies to improve competence and confidence in this core clinical skill. Method A prospective randomised study was carried out over a one-month period comparing the learning strategies in two cohorts: undergraduate 3rd year medical students and postgraduate foundation year one (FY1) doctors.Both had blinded randomisation to one of these strategies; focused teaching program (FTP) and self-directed learning (SDL). All volunteers completed a confidence questionnaire on ECG interpretation before and after completing the intervention. Additionally, all undertook an ECG recognition multiple choice question (MCQ) paper at the end of the learning period to assess competence. Results A total of 21 FY1’s and 25 3rd year medical students participated. The undergraduates in the FTP group demonstrated a significant difference in successfully interpreting ‘Ventricular Tachycardia’ (p = 0.046) and ‘Narrow Complex Tachycardia’ (p = 0.009) than the SDL group. Overall, participant confidence increased in both groups in each cohort. The FTP group demonstrated a greater improvement in confidence compared to SDL in both cohorts. Conclusion A dedicated teaching program can improve trainee confidence and competence in ECG interpretation. A larger benefit is observed in those undertaking a focused teaching program. ECG interpretation can be improved at any training level, especially undergraduates with a dedicated teaching program. Abstract 4 Table 1 Confidence ratings before and after learning strategy Confidence rating% 3rd Year students Foundation year one doctors Before (25) After: FTP (13) After: SDL (12) Before (21) After: FTP (10) After: SDL (11) Very poor 60 (15) 0 (0) 16.7 (2) 0 (0) 0 (0) 0(0) Poor 36 (9) 38.5 (5) 75 (9) 19.1(4) 10(1) 27.3 (3) Satisfactory 4 (1) 46.2 (6) 8.3 (1) 66.6 (14) 60 (6) 72.7 (8) Good 0 (0) 7.7 (1) 0 (0) 4.8 (1) 30 (3) 0 (0) No response 0 (0) 7.7 (1) 0 (0) 9.5 (2) 0 (0) 0 (0) References Rubinstein J, Dhole A, Ferenchick G. Puzzle based teaching versus traditional instruction in electrocardiogram interpretation for medical students – a pilot study. BMC Medical Education 2009; 9(4):1–7 Sur D, Kaye L, Mikus M, Goad J, Morena A. Accuracy of electrocardiogram reading by family practice residents. Fam Med 2000; 32(5): 315–9 Jensen MSA, Thomasen JL, Jensen SE, Lauritzen T, Engberg M. Electrocardiogram interpretation in general practice. Family Practice 2005; 22:109–113
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