Rare Lymphoma Cases: Online Education Significantly Improves Hematologist/Oncologist Ability to Personalize Treatment
Authors: Willis Lauren , Abair Tristin , Fagerlie Sara R. 
Published: February 2021

Background: Mantle cell lymphoma (MCL) and marginal zone lymphoma (MZL) are rare types of non-Hodgkin lymphoma (NHL). While MZL is generally indolent, MCL often has a more aggressive clinical course and many patients progress after initial treatment. This study was conducted to determine if an online, case-based continuing medical education (CME) intervention could improve skills of hematologists/oncologists (hem/oncs) to personalize treatment for patients with relapsed/refractory (R/R) MCL or R/R MZL.
Methods: The format was an online CME-certified text-based activity composed of 2 patient cases with interactive questions on the diagnosis and treatment of rare types of NHL. Evidence-based educational feedback was provided following each response. Three case-based questions were repeated immediately after activity participation and learners had to select treatment for patients based on prior treatment history, imaging results, and lab values. Question 1, 2, and 3 tested hem/oncs ability to select treatment for a patient with R/R MZL, R/R MCL, and R/R MCL, respectively. Additionally, 1 self-efficacy question was also repeated immediately after activity participation. These questions assessed the impact of the education in the form of a repeated pairs pre-assessment/post-assessment study design in which each participant served as his/her own control. Using data from the assessment completers, percentages of correct responses to pre- and post-assessment questions were compared. A chi-square test was used to assess statistical significance of the educational impact, where P &lt; .05 was considered statistically significant. Cramer's V was used to estimate the magnitude of change in the total number of correct responses between the compared test scores, where V &gt;0.26 indicates an extensive educational impact. The activity launched online on January 9, 2020 and data reported were collected through July 9, 2020.
Results: At the time of data collection 203 hem/oncs had completed the activity. Of these 104 (57%) were community-based practitioners. Education had an extensive impact (V =.424) and significantly improved hem/oncs competence to select personalized treatment for patients with these rare types of NHL (Figure 1). Table 1 shows the case summary, questions, and answer choices.
Conclusions: This online, interactive, case-based CME-certified educational activity led to statistically significant improvements in the clinical competence of hematologists/oncologists regarding personalizing treatment selection for patients with R/R mantle cell or marginal zone lymphoma. The results indicate that unique educational methodologies and platforms, which are available on-demand, can be effective tools for advancing clinical decision making. Additional studies are needed to assess whether improved aptitude translates to improved performance during clinical practice.
Acknowledgements: This CME activity was supported by an independent educational grant from Celgene Corporation and Pharmacyclics, Inc.
Reference: https://www.medscape.org/viewarticle/923424
Figure 1

Disclosures
No relevant conflicts of interest to declare.