- Email: [email protected]
Equal Opportunity: The Trend in Women Authorship of Invited Articles in Four Major Gastroenterology Journals
Sa1129
physician-patient educational approach in SBS was effective in educating both healthcare provider and patient/care partner audiences who had knowledge gaps regarding the condition at baseline, and supported shared decision-making. Additional education using similar approaches may be useful in fostering further patient engagement and helping clinicians translate learnings into improved patient outcomes.
AGA Abstracts
EQUAL OPPORTUNITY: THE TREND IN WOMEN AUTHORSHIP OF INVITED ARTICLES IN FOUR MAJOR GASTROENTEROLOGY JOURNALS Nabila S. Azad, Michelle T. Long Background & Aims Prior work has shown an increase in women authorship of original research in gastroenterology over the past 2 decades - though a gender gap in authorship still exists. Being invited to write reviews or editorials for high impact journals is a sign of leadership and expertise in a given field. Thus authorship of invited articles may serve as a surrogate marker of perceived expertise in academic medicine. We set out to determine the proportion of women authors of invited articles in the field of gastroenterology. Methods: We conducted a retrospective review of articles published in four high impact gastroenterology journals: Gastroenterology, Journal of Hepatology, Gut and Gastrointestinal Endoscopy. The investigation was restricted to invited articles written by women authors, i.e. editorials, reviews, and commentaries. Eligible articles were selected after reviewing submission criteria for each journal. The sex of the first and senior (last listed) author for all invited articles published in the years 2000, 2005, 2010, and 2015 was determined by inspection of the author's name, review of the institutional website, or contacting the corresponding author. The Cochran-Armitage trend test was used to test for the trend over time. Results: The gender of authors was determined for >99% of the 1,189 invited articles identified. Overall the proportion of women first or senior authors increased from 11.6% in 2000 to 25.8% in 2015 (p<0.0001). Women first authorship significantly increased from 6.5% in 2000 to 18.4% in 2015 (p<0.0001). Notably the trend in overall women authorship (first or senior) or first authorship appears to plateau in the recent years, 26.8% in 2010 and 25.8% in 2015, 19.9% in 2010 and 18.4% in 2015 respectively. We did not observe a significant increase in women senior authorship from 2000 (12.9% women senior authors) to 2015 (14.7% women senior authors), (p=0.56). These trends were similar when comparing US based and non-US based authors. The individual journals had similar trends as above, except Journal of Hepatology did not have a significant trend for first, senior or overall (first or senior) women authorship in the years examined. Journal of Hepatology had >20% women authorship since 2005 and, therefore, had less room for improvement compared to other journals. Conclusions: Over the past 15 years, there has been an increase in women authors of invited articles in academic gastroenterology journals, mostly secondary to an increase in the number of women first authors. Interestingly this trend is not seen for women authors in senior (last) author position. Furthermore, it appears women remain a minority of authors for invited articles. Importantly the trend of increasing women representation appears to be plateauing.
Sa1131 HOW IS OIC DIAGNOSED AND MANAGED? INSIGHTS FROM A VIRTUAL PATIENT SIMULATION Jovana Lubarda, Martin Warters, Piyali Chatterjee, Brooks D. Cash, William D. Chey Study Objectives: Opioid induced constipation (OIC) is one of the most comon opioidrelated adverse effects, affecting up to 70% of patients on long-term therapy. With recent updates to the Rome IV criteria on OIC and the availability of therapies to manage OIC, clinicians need to be prepared to apply the latest evidence to clinical practice. The goal of this study was to determine physician performance in diagnosis and effective management of OIC, and to provide needed education, in a consequence free environment of a virtual patient simulation (VPS). Methods: A continuing medical education activity was delivered via an online VPS-based learning platform that offers a lifelike clinical care experience with complete freedom of choice in clinical decision-making, and expert personalized feedback to address the learner's practice gaps. Physicians (pain specialists and gastroenterologists) were presented with two patient cases of OIC, including electronic health records, which were designed to model the experience of actual practice. Following virtual interactions with patients, physicians were asked to make decisions regarding assessments, diagnoses, and pharmacologic therapies. The clinical decisions were analyzed using a sophisticated decision engine, and clinical guidance (CG), based on current evidence-based recommendations, was provided in response to learners' clinical decisions. Impact of the education was measured by comparing participant decisions pre- and post-CG using a 2-tailed, paired t-test; P<.05 was considered statistically significant. The activity was launched on Medscape Education on June 20, 2016, and data were collected through to August 17, 2016. Results: From preto post-CG in the simulation, pain specialists (n=168) were more likely to make evidencebased clinical decisions related to: -Ordering appropriate tests to determine side effects of opioids, such as ordering an amylase/lipase test (45% pre-CG to 58% post-CG, P<0.05). -Diagnosing OIC (39% pre-CG to 61% post-CG, P<0.001). -Selecting appropriate treatments for OIC (21% pre-CG to 52% post-CG, P<0.001). From pre- to post-CG in the simulation, gastroenterologists (n=105) were more likely to make evidence-based clinical decisions related to: -Diagnosing OIC (36% pre-CG to 60% post-CG, P<0.001). -Selecting appropriate treatments for OIC (30% pre-CG to 54% post-CG, P<0.001). Conclusions: Pain specialists and gastroenterologists who participated in VPS-based education significantly improved their clinical decision-making in OIC, particularly in diagnosis and selection of approved pharmacologic treatments. Given that VPS immerses and engages the physicians for an authentic practical learning experience matching the scope of clinical practice, this type of intervention can be used to support translation of knowledge into practice.
Sa1132 CAN CONTINUING MEDICAL EDUCATION IMPROVE EFFECTIVE MANAGEMENT OF IBS-D? Jovana Lubarda, Julia Muino, Piyali Chatterjee, Spencer D. Dorn Study objectives: Physicians vary widely in their knowledge of irritable bowel syndrome (IBS).[1] The aim of this study was to determine whether continuing medical education (CME) can improve physicians' knowledge of the pathophysiology of IBS with diarrhea (IBSD), diagnostic tests, and treatment options. Methods: The instructional method consisted of an online CME activity hosted on a medical education website, which was presented as a comprehensive 5000-word interactive monograph on pathophysiology, diagnosis, and management considerations for IBS-D. The effect of education on physician knowledge was assessed through an online survey that compared the same participant's responses to 4 identical pre- and post- assessment questions. A paired 2-tailed t-test was used to assess whether the mean post-assessment score was different from the mean pre-assessment score. McNemar's chi-squared statistic was used to determine statistical significance. Effect size of the education was calculated using Cramer's V by determining the change in proportion of participants who answered questions correctly from pre- to post- assessment. Survey data were collected from October 21, 2015 to 24th to December 18th, 2016. Results: Data were collected for 220 gastroenterologists and 701 primary care physicians (PCPs), each of whom answered all assessment questions during the study period. Gastroenterologists who participated in the CME activity demonstrated statistically significant improvements in knowledge (P<.05; V=0.132; small educational effect). While 42% answered 4 out of 4 questions correctly on pre-assessment, this improved to 63% on post-assessment. PCPs who participated in the CME activity demonstrated statistically significant improvements in knowledge (P<.05; V=0.135; small educational effect). While 37% answered 4 out of 4 questions correctly on preassessment, this improved to 60% on post-assessment. Statistically significant improvements (P<.05) were shown in recognition of appropriate testing for IBS-D diagnosis as well as the mechanisms of action of newer therapies for patients with IBS-D. Specifically, on postassessment, 16% of gastroenterologists and 49% of PCPs showed improved knowledge on the mechanism of action of eluxadoline. Conclusions: Online CME in the form of an interactive, text-based, clinically relevant monograph was effective in improving physicians' knowledge on both diagnosis and therapeutic approaches for IBS-D, which may be useful for improving the current state of care for this condition. References: 1. Longstreth GF and Burchette RJ. Family practitioners' attitudes and knowledge about irritable bowel syndrome. Effect of a trial of physician education. Family Practice 2003; 20: 670-674.
Trend in women authorship of invited articles in major gastroenterology journals.
Sa1130 IMPROVING PHYSICIANS' AND PATIENTS' KNOWLEDGE OF SHORT BOWEL SYNDROME THROUGH ALIGNED EDUCATION Jovana Lubarda, Julia Muino, Piyali Chatterjee, Donald F. Kirby Study objectives: The goal of this initiative was to determine if online, aligned physicianpatient education on short bowel syndrome (SBS) could improve physicians' and patients' knowledge of effective management strategies for SBS. Methods: Physician education was delivered via a continuing medical education (CME) activity hosted online on a medical education website, and targeted to gastroenterologists and surgeons managing SBS. The CME activity consisted of a 30-minute video-based exchange between two experts on physiology, intestinal function and adaptation, and patient education strategies for SBS. The CME activity was aligned with an educational activity for patients, with text and graphics, hosted on a website dedicated to patient education. Effect of the CME on physician participants was measured via a survey with 4 identical pre- and post-CME questions. Data from each participant's responses were assessed pre- and post-CME and analyzed using a paired 2tailed t-test. McNemar's chi-squared statistic to determine statistical significance. Effect size was calculated using Cramer's V to determine the change in proportion of participants who answered questions correctly from pre- to post- assessment. Effect of patient education activity was measured via 1 knowledge question administered both pre- and post- education. Both educational activities launched on November 30th, 2015, and data were collected through February 1st and July 27th for the CME activity and patient education activity, respectively. Results: Physicians: Post-CME 43% of gastroenterologists (n=140) and 43% of surgeons (n=339) answered all 4 questions correctly, compared with 13% and 10%, respectively, pre-CME (P<.05). 26% of gastroenterologists and 20% of surgeons improved understanding of SBS anatomy, 36% of gastroenterologists and 44% of surgeons improved understanding on the role of teduglutide in intestinal rehabilitation, and 46% of gastroenterologists and 45% of surgeons improved in knowledge of nutritional requirements of patients with SBS (P<.05). Patients/care partners: A total of 1,859 participants completed the patient education module, 55% of whom have SBS, 31% who are interested and 14% who are care partners of patients with SBS. After participating in the educational module, 55% of completers were able to recognize nutritional requirements for SBS such as the importance of oral rehydration solutions compared to 2.7% pre-education (P<.05). Conclusions: An aligned
AGA Abstracts
S-230
physician-patient educational approach in SBS was effective in educating both healthcare provider and patient/care partner audiences who had knowledge gaps regarding the condition at baseline, and supported shared decision-making. Additional education using similar approaches may be useful in fostering further patient engagement and helping clinicians translate learnings into improved patient outcomes.
AGA Abstracts
EQUAL OPPORTUNITY: THE TREND IN WOMEN AUTHORSHIP OF INVITED ARTICLES IN FOUR MAJOR GASTROENTEROLOGY JOURNALS Nabila S. Azad, Michelle T. Long Background & Aims Prior work has shown an increase in women authorship of original research in gastroenterology over the past 2 decades - though a gender gap in authorship still exists. Being invited to write reviews or editorials for high impact journals is a sign of leadership and expertise in a given field. Thus authorship of invited articles may serve as a surrogate marker of perceived expertise in academic medicine. We set out to determine the proportion of women authors of invited articles in the field of gastroenterology. Methods: We conducted a retrospective review of articles published in four high impact gastroenterology journals: Gastroenterology, Journal of Hepatology, Gut and Gastrointestinal Endoscopy. The investigation was restricted to invited articles written by women authors, i.e. editorials, reviews, and commentaries. Eligible articles were selected after reviewing submission criteria for each journal. The sex of the first and senior (last listed) author for all invited articles published in the years 2000, 2005, 2010, and 2015 was determined by inspection of the author's name, review of the institutional website, or contacting the corresponding author. The Cochran-Armitage trend test was used to test for the trend over time. Results: The gender of authors was determined for >99% of the 1,189 invited articles identified. Overall the proportion of women first or senior authors increased from 11.6% in 2000 to 25.8% in 2015 (p<0.0001). Women first authorship significantly increased from 6.5% in 2000 to 18.4% in 2015 (p<0.0001). Notably the trend in overall women authorship (first or senior) or first authorship appears to plateau in the recent years, 26.8% in 2010 and 25.8% in 2015, 19.9% in 2010 and 18.4% in 2015 respectively. We did not observe a significant increase in women senior authorship from 2000 (12.9% women senior authors) to 2015 (14.7% women senior authors), (p=0.56). These trends were similar when comparing US based and non-US based authors. The individual journals had similar trends as above, except Journal of Hepatology did not have a significant trend for first, senior or overall (first or senior) women authorship in the years examined. Journal of Hepatology had >20% women authorship since 2005 and, therefore, had less room for improvement compared to other journals. Conclusions: Over the past 15 years, there has been an increase in women authors of invited articles in academic gastroenterology journals, mostly secondary to an increase in the number of women first authors. Interestingly this trend is not seen for women authors in senior (last) author position. Furthermore, it appears women remain a minority of authors for invited articles. Importantly the trend of increasing women representation appears to be plateauing.
Sa1131 HOW IS OIC DIAGNOSED AND MANAGED? INSIGHTS FROM A VIRTUAL PATIENT SIMULATION Jovana Lubarda, Martin Warters, Piyali Chatterjee, Brooks D. Cash, William D. Chey Study Objectives: Opioid induced constipation (OIC) is one of the most comon opioidrelated adverse effects, affecting up to 70% of patients on long-term therapy. With recent updates to the Rome IV criteria on OIC and the availability of therapies to manage OIC, clinicians need to be prepared to apply the latest evidence to clinical practice. The goal of this study was to determine physician performance in diagnosis and effective management of OIC, and to provide needed education, in a consequence free environment of a virtual patient simulation (VPS). Methods: A continuing medical education activity was delivered via an online VPS-based learning platform that offers a lifelike clinical care experience with complete freedom of choice in clinical decision-making, and expert personalized feedback to address the learner's practice gaps. Physicians (pain specialists and gastroenterologists) were presented with two patient cases of OIC, including electronic health records, which were designed to model the experience of actual practice. Following virtual interactions with patients, physicians were asked to make decisions regarding assessments, diagnoses, and pharmacologic therapies. The clinical decisions were analyzed using a sophisticated decision engine, and clinical guidance (CG), based on current evidence-based recommendations, was provided in response to learners' clinical decisions. Impact of the education was measured by comparing participant decisions pre- and post-CG using a 2-tailed, paired t-test; P<.05 was considered statistically significant. The activity was launched on Medscape Education on June 20, 2016, and data were collected through to August 17, 2016. Results: From preto post-CG in the simulation, pain specialists (n=168) were more likely to make evidencebased clinical decisions related to: -Ordering appropriate tests to determine side effects of opioids, such as ordering an amylase/lipase test (45% pre-CG to 58% post-CG, P<0.05). -Diagnosing OIC (39% pre-CG to 61% post-CG, P<0.001). -Selecting appropriate treatments for OIC (21% pre-CG to 52% post-CG, P<0.001). From pre- to post-CG in the simulation, gastroenterologists (n=105) were more likely to make evidence-based clinical decisions related to: -Diagnosing OIC (36% pre-CG to 60% post-CG, P<0.001). -Selecting appropriate treatments for OIC (30% pre-CG to 54% post-CG, P<0.001). Conclusions: Pain specialists and gastroenterologists who participated in VPS-based education significantly improved their clinical decision-making in OIC, particularly in diagnosis and selection of approved pharmacologic treatments. Given that VPS immerses and engages the physicians for an authentic practical learning experience matching the scope of clinical practice, this type of intervention can be used to support translation of knowledge into practice.
Sa1132 CAN CONTINUING MEDICAL EDUCATION IMPROVE EFFECTIVE MANAGEMENT OF IBS-D? Jovana Lubarda, Julia Muino, Piyali Chatterjee, Spencer D. Dorn Study objectives: Physicians vary widely in their knowledge of irritable bowel syndrome (IBS).[1] The aim of this study was to determine whether continuing medical education (CME) can improve physicians' knowledge of the pathophysiology of IBS with diarrhea (IBSD), diagnostic tests, and treatment options. Methods: The instructional method consisted of an online CME activity hosted on a medical education website, which was presented as a comprehensive 5000-word interactive monograph on pathophysiology, diagnosis, and management considerations for IBS-D. The effect of education on physician knowledge was assessed through an online survey that compared the same participant's responses to 4 identical pre- and post- assessment questions. A paired 2-tailed t-test was used to assess whether the mean post-assessment score was different from the mean pre-assessment score. McNemar's chi-squared statistic was used to determine statistical significance. Effect size of the education was calculated using Cramer's V by determining the change in proportion of participants who answered questions correctly from pre- to post- assessment. Survey data were collected from October 21, 2015 to 24th to December 18th, 2016. Results: Data were collected for 220 gastroenterologists and 701 primary care physicians (PCPs), each of whom answered all assessment questions during the study period. Gastroenterologists who participated in the CME activity demonstrated statistically significant improvements in knowledge (P<.05; V=0.132; small educational effect). While 42% answered 4 out of 4 questions correctly on pre-assessment, this improved to 63% on post-assessment. PCPs who participated in the CME activity demonstrated statistically significant improvements in knowledge (P<.05; V=0.135; small educational effect). While 37% answered 4 out of 4 questions correctly on preassessment, this improved to 60% on post-assessment. Statistically significant improvements (P<.05) were shown in recognition of appropriate testing for IBS-D diagnosis as well as the mechanisms of action of newer therapies for patients with IBS-D. Specifically, on postassessment, 16% of gastroenterologists and 49% of PCPs showed improved knowledge on the mechanism of action of eluxadoline. Conclusions: Online CME in the form of an interactive, text-based, clinically relevant monograph was effective in improving physicians' knowledge on both diagnosis and therapeutic approaches for IBS-D, which may be useful for improving the current state of care for this condition. References: 1. Longstreth GF and Burchette RJ. Family practitioners' attitudes and knowledge about irritable bowel syndrome. Effect of a trial of physician education. Family Practice 2003; 20: 670-674.
Trend in women authorship of invited articles in major gastroenterology journals.
Sa1130 IMPROVING PHYSICIANS' AND PATIENTS' KNOWLEDGE OF SHORT BOWEL SYNDROME THROUGH ALIGNED EDUCATION Jovana Lubarda, Julia Muino, Piyali Chatterjee, Donald F. Kirby Study objectives: The goal of this initiative was to determine if online, aligned physicianpatient education on short bowel syndrome (SBS) could improve physicians' and patients' knowledge of effective management strategies for SBS. Methods: Physician education was delivered via a continuing medical education (CME) activity hosted online on a medical education website, and targeted to gastroenterologists and surgeons managing SBS. The CME activity consisted of a 30-minute video-based exchange between two experts on physiology, intestinal function and adaptation, and patient education strategies for SBS. The CME activity was aligned with an educational activity for patients, with text and graphics, hosted on a website dedicated to patient education. Effect of the CME on physician participants was measured via a survey with 4 identical pre- and post-CME questions. Data from each participant's responses were assessed pre- and post-CME and analyzed using a paired 2tailed t-test. McNemar's chi-squared statistic to determine statistical significance. Effect size was calculated using Cramer's V to determine the change in proportion of participants who answered questions correctly from pre- to post- assessment. Effect of patient education activity was measured via 1 knowledge question administered both pre- and post- education. Both educational activities launched on November 30th, 2015, and data were collected through February 1st and July 27th for the CME activity and patient education activity, respectively. Results: Physicians: Post-CME 43% of gastroenterologists (n=140) and 43% of surgeons (n=339) answered all 4 questions correctly, compared with 13% and 10%, respectively, pre-CME (P<.05). 26% of gastroenterologists and 20% of surgeons improved understanding of SBS anatomy, 36% of gastroenterologists and 44% of surgeons improved understanding on the role of teduglutide in intestinal rehabilitation, and 46% of gastroenterologists and 45% of surgeons improved in knowledge of nutritional requirements of patients with SBS (P<.05). Patients/care partners: A total of 1,859 participants completed the patient education module, 55% of whom have SBS, 31% who are interested and 14% who are care partners of patients with SBS. After participating in the educational module, 55% of completers were able to recognize nutritional requirements for SBS such as the importance of oral rehydration solutions compared to 2.7% pre-education (P<.05). Conclusions: An aligned
AGA Abstracts
S-230