SAT0693 ONLINE EDUCATION SIGNIFICANTLY IMPROVED RHEUMATOLOGISTS’ UNDERSTANDING AND INTERPRETATION OF COMPARATIVE TREATMENT DATA FOR AS
Authors: Adriana Stan, Elaine Bell, Peter Schoonheim, Xenofon Baraliakos
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> With multiple therapeutic options now available for patients with ankylosing spondylitis (AS), clinicians and payers require evidence to guide their decision-making. Head-to-head randomized controlled trials (RCTs) are considered to provide the best evidence to inform treatment decisions, but in the absence of such trials, physicians often rely on their own experience and clinical trial data from single RCTs. In the absence of head-to-head RCTs, data from comparative studies such as network meta-analysis and matching adjusted indirect comparisons can be useful to help inform treatment choices. <h3>Objectives</h3> This study assessed whether the online CME accredited round-table-discussion with title "Comparing Treatment Alternatives in Ankylosing Spondylitis" improves physicians' understanding and interpretation of comparative effectiveness data for AS. <h3>Methods</h3> Rheumatologists participated in an online CME activity<sup>1</sup> consisting of a 30-minute video roundtable discussion between 3 experts with accompanying slides. Educational effect was assessed using a 4-question repeated pairs, pre-/post-assessment. A chi-square test was used to determine if a statistically significant improvement (<i>P</i> &lt;.05 significance level) existed in the number of correct responses from the pretest and posttest scores. Cramer's V was used to estimate the level of impact of the education. The CME activity launched on December 20, 2017, and the data were collected through March 6, 2018. <h3>Results</h3> A total of 328 rheumatologists completed the pre- and post activity assessments. Overall the activity had a signficiant impact (<i>P</i> &lt;.001) on rheumatologists' understanding of comparative effectiveness data in AS with a Cramer's V value of 0.189 indicating a considerable effect of the education. The average perecentage of correct responses rose from 22% pre-activity to 39% post-activity. A linked learning assessment (each individual tracked pre and posteducation) showed that 24% of learners improved their knowledge and 15% reinforced their knowledge. The change in percentage of correct responses from pre- to post-assessment achieved statistical significance (<i>P</i> &lt;.05) for all 3 questions presented: (i) recommendations for biologic DMARD use in AS according to the ASAS-EULAR 2016 guidelines (34% at baseline rising to 67% post acivity; <i>P</i> &lt;0.001), (ii) understanding the impact of treatment with biologic DMARDS on radiographic progression in AS (17% at baseline rising to 26% post acivity; <i>P</i> &lt;.01), (iii) understanding comparative analysis of RCTs in AS (14% at baseline rising to 24% post acivity; <i>P</i> &lt;.001) and (iv) a quarter of rheumatologists gained confidence in their ability to select a biologic DMARD based on comparative data and individual patient needs, with an average confidence shift of 14%. <h3>Conclusion</h3> This online CME activity significantly improved rheumatologists' understanding of how to compare treatments and interpret comparative effectiveness data in AS which may lead to improved treatment selection and better patient outcomes. However, there is clearly room for further improving physicians' knowledge of treatments &amp; radiographic progression and comparative analysis of RCTs (since 75% of rheumatologists provided incorrect answers to questions 2 and 3 post-activity) which can be addressed in future education. <h3>Reference</h3> [1] Comparing Treatment Alternatives in Ankylosing Spondylitis http://www.medscape.org/viewarticle/887334 <h3>Disclosure of Interests</h3> Adriana Stan: None declared, Elaine Bell: None declared, Peter Schoonheim: None declared, Xenofon Baraliakos Grant/research support from: AbbVie, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Centocor, Chugai, Janssen, MSD, Novartis, Pfizer Inc, Roche and UCB, Grant/research support from: AbbVie, Pfizer, Merck Sharp &amp; Dohme, UCB Pharma, Novartis, Consultant for: AbbVie, Bristol-Myers Squibb, Boehringer Ingelheim, Celgene, Chugai, Janssen Biologics, Novartis, Pfizer, UCB Pharma, Galapagos, Speakers bureau: AbbVie, Chugai, Janssen, Novartis, Pfizer, UCB Pharma