scholarly journals Online CME As a Tool to Increase Clinicians' Ability to Identify and Diagnose Paroxysmal Nocturnal Hemoglobinuria

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 2988-2988
Author(s):  
Michelle Arielle Worst ◽  
Emily S. Van Laar ◽  
Lisa A Cockrell ◽  
Ilene C. Weitz
Keyword(s):  
Primary Care Physicians ◽  
Paroxysmal Nocturnal Hemoglobinuria ◽  
Clinical Manifestations ◽  
Diagnostic Methods ◽  
Healthcare Team ◽  
Hematopoietic Stem ◽  
Paired Samples ◽  
Cohen’S D ◽  
Cohen's D ◽  
Post Assessment

Abstract Background: Paroxysmal nocturnal hemoglobinuria (PNH) is an extremely rare clonal hematopoietic stem cell disorder characterized by episodes of hemolysis and a high risk of thrombosis [Hill A, et al. Nat Rev Dis Primers. 2017;3:17028.]. PNH has diverse clinical manifestations, which contribute to its particularly challenging diagnosis. As a result, diagnostic delays are common, and patients often experience complications of untreated PNH [Mancuso S, et al. Hematol Rep. 2018;10:7523.]. Due to the rarity and confounding presentation of PNH, many members of the healthcare team are challenged to accurately recognize signs and symptoms of the disease and implement appropriate diagnostic methods. The objective of this study was to determine if an online continuing medical education (CME) intervention could improve hematologists' and primary care physicians' (PCPs) ability in identifying and diagnosing patients with PNH. Methods: The activity consisted of an approximately 2,000-word text-based interview between a moderator and a single expert faculty [Weitz I. https://www.medscape.org/viewarticle/943900. 2021.]. Educational effect was assessed with a repeated pairs pre-/post-assessment study including a 3-item, multiple choice, knowledge/competence questionnaire and 1 confidence assessment question, with each participant serving as his/her own control. Pre- and post-assessment scores were compared to determine relative changes in the proportion of correct responses to knowledge/competence questions. A paired samples t-test was conducted for significance testing on overall average number of correct responses and for confidence rating, and McNemar's test was conducted at the learning objective level (5% significance level, P <.05). Cohen's d with correction for paired samples estimated the effect size of the education on number of correct responses (<.20 modest, .20-.49 small, .59-.79 moderate, ≥.80 large). The activity launched 15 January 2021; data were collected until 3 May 2021. Results: Overall, statistically significant improvements in knowledge/competence were seen after education consumption for hematologists (N=55, P <.001, Cohen's d=.59) and PCPs (N=332, P <.001, Cohen's d=.47). 5% of hematologists and 17% of PCPs improved (P <.317 and P <.001, respectively) and 78% and 57%, respectively, reinforced their knowledge regarding the clinical manifestations of PNH. 29% of hematologists and 40% of PCPs improved (P<.001) and 69% and 36%, respectively, reinforced their competence related to establishing a diagnosis of PNH. Following the activity, 38% of hematologists and 52% of PCPs had a measurable increase in confidence regarding their ability to evaluate patients with suspected PNH. Conclusions: Participation in a text-based CME-certified activity resulted in statistically significant improvements in knowledge/competence and measurable increases in confidence of hematologists and PCPs regarding the diagnosis of PNH. These results have the ability to translate to improvements in clinical care. The need for additional educational activities was also identified to address residual gaps and further increase clinicians' ability in this rare clinical setting. Disclosures Weitz: Apellis Pharmaceuticals: Consultancy, Honoraria; Alexion: Consultancy, Honoraria, Speakers Bureau; Biocryst: Consultancy, Honoraria; Novartis Corporation: Consultancy, Honoraria; Sanofi Genxyme: Consultancy, Honoraria.

scholarly journals Improving Competence in Diagnosis, Referral and Initial Management of Acquired Hemophilia a through Online Interactive Case-Based Education

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 2990-2990
Author(s):  
Christy Rohani-Montez ◽  
Deborah Middleton ◽  
Karen Reid ◽  
Alice Ma
Keyword(s):  
Correct Response ◽  
Response Rate ◽  
Initial Management ◽  
Paired Samples ◽  
Cohen’S D ◽  
Increased Risk ◽  
Cohen's D ◽  
Post Assessment ◽  
Correct Response Rate ◽  
Case Based

Abstract INTRODUCTION Diagnosing acquired haemophilia A (AHA) can be challenging due to a) it's rarity (~1.5 cases per million), and b) the range of nonspecific bleeding patterns that may present. Therefore, there is a substantial diagnostic delay and rate of misdiagnosis, leading to an increased risk of morbidity and mortality. This study was conducted to determine whether online interactive case-based independent medical education could improve clinicians' competence in identifying possible AHA, in appropriate referral to specialist centers and in initial management. METHODS Hematologists and emergency medicine (EM) physicians participated in a text, case-based activity and completed pre- and post-questions (Ma A. Active Bleeding in the ER and a Prolonged aPTT: What's Your Next Step? www.medscape.org/viewarticle/944112). Educational effect was assessed using a 3-question repeated-pair design with pre-/post-assessment. A paired samples t-test was conducted for significance testing on overall average number of correct responses and for confidence rating, and a McNemar's test was conducted at the learning objective level (5% significance level, P <.05). Cohen's d with correction for paired samples estimated the effect size of the education on number of correct responses (<.20 modest, .20-.49 small, .59-.79 moderate, ≥.80 large). Data were collected from 03/15/2021 to 06/14/2021. RESULTS Overall significant improvements at the aggregate level were seen after participation for hematologists (33% average correct response rate at pre-assessment vs 94% at post-assessment; P<.001, Cohen's d= 2.27, N=86), and EM physicians (24% average correct response rate at pre-assessment vs 80% at post-assessment; P<.001, Cohen's d= 1.30, N=102). Highly significant improvements were achieved with regards to recognizing symptoms of AHA, appropriate referral, and initial therapeutic management (figure). After participating, 37% of hematologists and 40% of pulmonologists had measurable improved confidence (both P<.001), resulting in 63% of hematologists and 46% of EM physicians who were mostly or very confident in identifying features consistent with a possible AHA diagnosis post-CME (vs 44% and 26% pre-CME respectively). CONCLUSIONS This study demonstrates the success of online, interactive case-based education in improving clinicians' competence in identifying patients with possible AHA, appropriate referral and initial treatment. Both improvement and reinforcement in the context of a linked learning assessment have been shown to positively correlate with increases in confidence as well as intention to make clinical practice changes (Lucero KS, Chen P. J Eur CME. 2020 Oct 12;9(1):1834759), suggesting that most clinicians who participated in this activity are likely to make improvements in their practice. This could lead to earlier appropriate treatment and improved overall outcomes for these patients. Figure 1 Figure 1. Disclosures Ma: Takeda: Honoraria, Research Funding; Accordant: Consultancy.

Education on reactive oxygen species to lay the foundation for understanding therapeutic advances in anticancer therapy.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 478-478
Author(s):  
Kinjal Parikh ◽  
Charlotte Warren ◽  
Richard Caracio
Keyword(s):  
Reactive Oxygen Species ◽  
Cell Death ◽  
Cancer Cell ◽  
Reactive Oxygen ◽  
Educational Activity ◽  
Oxygen Species ◽  
Ongoing Research ◽  
Cohen’S D ◽  
Cohen's D ◽  
Post Assessment

478 Background: The disruption of redox balance is increasingly thought to be one of the most important underlying factors contributing to the development, progression, and metastasis of cancers in human cells. This imbalance in redox homeostasis has been shown to be induced by the generation of free radicals, predominantly reactive oxygen species (ROS). Emerging data have established ROS as a new potential therapeutic target. Understanding the mechanisms associated with tumorigenesis is important to integrate novel potential therapeutic targets and understand which tumors or patient populations may benefit from ongoing research. Shortcomings in oncologists’ knowledge and confidence can hamper the integration of new treatments into the care of patients with cancer. Methods: An online continuing education (CME) activity consisted of a multi-media 30-minute video panel of two panelists discussing the mechanism, pathophysiology, and the premises for novel anti-cancer therapies. Educational effect was assessed using a repeated paired pre-/post-assessment study design. A McNemar’s test was used to identify differences between pre- and post-assessment responses. Effect size was calculated using Cohen’s d test by determining the strength of the association between the activity and the outcomes (d < .20 is modest and d ≥ .80 is large). P values were calculated and those < .05 were considered statistically significant. The activity launched 5/14/2020 and data are represented through 8/6/2020. Results: A total of 1,033 learners, of which there are 656 physicians, participated in the activity. Participating in education resulted in statistically significant improvements and noticeable educational effect and data for oncologists that answered all pre- and post-assessment questions are represented below (n = 45, p < .001, Cohen’s d = .454). Percentages represent relative rates of improvement The role of ROS on cancer cell proliferation, cancer cell toxicity, and the tumor microenvironment (67%, p < .05) The interplay of antioxidants to aid in the development of therapies to induce DNA-damaged cell death (100%; p < .001) The potential biomarkers to aid in the development of therapies to induce DNA-damaged cell death (34%; p < .05). Conclusions: This online, interactive, expert-led, CME-certified educational activity resulted in significant gains in oncologist knowledge and confidence regarding the ROS pathway and associated clinical pipeline developments Upon completion of the initiative, only 11% of oncologists were able to answer all 3 matched pre/post questions correctly, signifying the need for further education The novelty of the information to many learners demonstrate the need to continue highlighting clinical advances and molecular pathways that may have potential implications in cancer therapy progress.

New Insights into Paroxysmal Nocturnal Hemoglobinuria

Hematology ◽  
2006 ◽  
Vol 2006 (1) ◽  
pp. 24-28 ◽  
Author(s):  
Robert A. Brodsky
Keyword(s):  
Stem Cells ◽  
Hematopoietic Stem Cells ◽  
Paroxysmal Nocturnal Hemoglobinuria ◽  
Clinical Manifestations ◽  
Intravascular Hemolysis ◽  
Complement Protein ◽  
Hematopoietic Stem ◽  
Esophageal Spasm ◽  
Humanized Monoclonal Antibody ◽  
Healthy Control

Abstract Paroxysmal nocturnal hemoglobinuria (PNH) is an uncommon intravascular hemolytic anemia that results from the clonal expansion of hematopoietic stem cells harboring somatic mutations in an X-linked gene, termed PIG-A. PIG-A mutations block glycosylphosphatidylinositol (GPI) anchor biosynthesis, resulting in a deficiency or absence of all GPI-anchored proteins on the cell surface. CD55 and CD59 are GPI-anchored complement regulatory proteins. Their absence on PNH red cells is responsible for the complement-mediated intravascular hemolysis. Intravascular hemolysis leads to release of free hemoglobin, which contributes to many of the clinical manifestations of PNH including fatigue, pain, esophageal spasm, erectile dysfunction and possibly thrombosis. Interestingly, rare PIG-A mutations can be found in virtually all healthy control subjects, leading to speculation that PIG-A mutations in hematopoietic stem cells are common benign events. However, negative selection of PIG-A mutant colony-forming cells with proaerolysin, a toxin that targets GPI-anchored proteins, reveals that most of these mutations are not derived from stem cells. Recently, a humanized monoclonal antibody directed against the terminal complement protein C5 has been shown to reduce hemolysis and greatly improve symptoms and quality of life for PNH patients.

scholarly journals Paroxysmal Nocturnal Hemoglobinuria with a Distinct Molecular Signature Diagnosed Ten Years after Allogenic Bone Marrow Transplantation for Acute Myeloid Leukemia

2019 ◽  
Vol 2019 ◽  
pp. 1-3
Author(s):  
Alberto Santagostino ◽  
Laura Lombardi ◽  
Gerard Dine ◽  
Pierre Hirsch ◽  
Srimanta Chandra Misra
Keyword(s):  
Bone Marrow ◽  
Acute Myeloid Leukemia ◽  
Somatic Mutation ◽  
Myeloid Leukemia ◽  
Paroxysmal Nocturnal Hemoglobinuria ◽  
Clonal Selection ◽  
Bone Marrow Failure ◽  
Clinical Manifestations ◽  
Hematopoietic Stem ◽  
Acute Myeloid

Paroxysmal nocturnal hemoglobinurea (PNH) is a rare disorder of complement regulation due to somatic mutation of PIGA (phosphatidylinositol glycan anchor) gene. We herewith report a case who developed a symptomatic PNH long after an allogenic marrow transplant. Some reasonable arguments concerning the origin of PNH clone have been discussed. The molecular studies revealed presence of JAK2 and TET2 mutations without a BCOR mutation. The literature review has been performed to probe into the complex interplay of autoimmunity and clonal selection and expansion of PNH cells, which occurs early in hematopoietic differentiation. The consequent events such as hypoplastic and/or hemato-oncologic features could further be explained on the basis of next-generation sequencing (NGS) studies. Paroxysmal nocturnal hemoglobinuria (PNH) is a rare clonal disorder of hematopoietic stem cells, characterized by a somatic mutation of the phosphatidylinositol glycan-class A (PIGA). The PIGA gene products are crucial for biosynthesis of glycosylphosphatidylinositol (GPI) anchors, which attaches a number of proteins to the plasma membrane of the cell. Amongst these proteins, the CD55 and CD59 are complement regulatory proteins. The CD55 inhibits C3 convertase whereas the CD59 blocks the membrane attack complex (MAC) by inhibiting the incorporation of C9 to MAC. The loss of complement regulatory protein renders the red cell susceptible to complement-mediated lysis leading to intravascular and extravascular hemolysis. The intravascular hemolysis explains most of the morbid clinical manifestations of the disease. The clinical features of syndrome of PNH are recurrent hemolytic episodes, thrombosis, smooth muscle dystonia, and bone marrow failure; other important complications include renal failure, myelodysplastic syndrome (MDS), and acute myeloid leukemia (AML). The most used therapies were blood transfusions, immunosuppressive, and steroid. Allogeneic stem cell transplantation was also practiced. At present, the therapy of choice is eculizumab (Soliris, Alexion Pharmaceuticals), a humanized monoclonal antibody that blocks activation of the terminal complement at C5. The limiting factor for this therapy is breakthrough hemolysis and the frequent dosing schedule. Ravulizumab (ALXN1210) is the second generation terminal compliment inhibitor which seems to provide a sustained control of hemolysis without breakthrough hemolysis and with a longer dosing interval.

PIG-a Mutations in a Brazilian Cohort of Patients with Paroxysmal Nocturnal Hemoglobinuria

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 944-944
Author(s):  
Patricia Eiko Yamakawa ◽  
Ana Rita Da Fonseca ◽  
Caio Perez Gomes ◽  
Agatha Mendes ◽  
Fabiana Bettoni ◽  
...  
Keyword(s):  
Paroxysmal Nocturnal Hemoglobinuria ◽  
Conflicts Of Interest ◽  
Clinical Manifestations ◽  
Clonal Expansion ◽  
Reference Sequence ◽  
Base Substitution ◽  
Missense Mutations ◽  
Hematopoietic Stem ◽  
Single Base ◽  
Pathogenicity Prediction

Introduction: Paroxysmal nocturnal hemoglobinuria (PNH) is a disorder due to an acquired loss-of-function mutation in the phosphatidylinositol glycan class A (PIG-A) gene. A large spectrum of acquired PIG-A mutations has been described, like insertions or deletions involving a single base or several bases, and single base substitution that are the most common. Usually there are more than one PIGA mutations and one clone is predominant. The clinical manifestations of PNH are intrinsically related to clonal expansion of hematopoietic stem cell deficient in GPI-anchored proteins. Some hypothesis failed to explain alone this clonal expansion. Here we try to identify and to correlate PIG-A gene mutations with clinical manifestations in a series of patients with PNH. Methods: We analyzed 31 patients with classical PNH (n=23) or aplastic anemia and PNH clone (n=8). The sequencing of the PIG-A gene was performed using the Sanger technique. The electropherograms were aligned against the reference sequence of the PIG-A gene deposited in GenBank (Accession number NG_009786), and analyzed using the Geneious R10 software (Biomatters). After analysis, a search was performed in the Clinvar, dbSNP and HGMD databases to verify the pathogenicity of the mutations. For variants without description in the literature, a pathogenicity prediction analysis was performed using Mutation Taster, Polyphen 2 and Human Splicing Finder software. Results: We found 29 different variants of the PIG-A gene in 27 patients: 23 were new mutations, with no previous description in the literature, 3 were previously described mutations, and 3 were single nucleotide polymorphism (SNP). There was great variation in the type and location of somatic mutations. Mutations were predominantly small deletions and simple base changes; 42% of the mutations were described as frameshift mutations and 31% missense mutations. We did not find any specific correlation between the clinical characteristics of hemolytic PNH patients and their mutations, due to the wide variety of mutations. According the pathogenicity prediction programs, the majority (22 of 29) of the variants found were classified as probably pathogenic. Among the 23 patients with hemolytic PNH, 19 patients had at least one mutation classified as pathogenic. In patients with subclinical PNH, only SNPs were found. Fifteen patients with hemolytic PNH had more than one concomitant mutation, most of which were probably pathogenic mutations associated with a polymorphism. Conclusion: We described PIG-A mutations in a series of PNH patients in Brazil and observed no correlation exists between mutation types and clinical features in hemolytic patients. Among subclinical PNH patients, only SNPs were observed, probably because of small clone sizes. Disclosures No relevant conflicts of interest to declare.

scholarly journals Rheumatic polymyalgia: clinic, diagnosis, principles of therapy (to help the primary care physician)

2021 ◽  
pp. 164-169
Author(s):  
M. S. Svetlova
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Primary Care Physicians ◽  
Clinical Manifestations ◽  
The Elderly ◽  
Care Physician ◽  
Diagnostic Methods ◽  
Malignant Neoplasms ◽  
Adequate Treatment ◽  
Laboratory Activity

In recent decades, there has been an increase in the number of elderly people. Among the patients of the primary care physician, without a doubt, those who are over 60 years old predominate. A feature of the elderly is polymorbidity. Combined pathology, numerous complaints of patients make it difficult to diagnose diseases, require patience from the doctor, and, of course, knowledge. There are diseases that are peculiar only to the elderly, developing only after 50 years. These include rheumatic polymyalgia. This pathology is not frequent and, in this regard, is not very familiar to outpatient therapists. However, it is to them that elderly patients turn with complaints of pain and stiffness in the shoulder and/or pelvic girdle, in the neck, in the joints of the hands, fever, weight loss, sleep disorders, depression, general malaise (the main complaints of patients with rheumatic polymyalgia). The above-mentioned clinical manifestations, as well as the high laboratory activity inherent in this disease, make the doctor look for malignant neoplasms, infectious, systemic processes. This takes a long time, the diagnosis is delayed, the sufferings of the patient are prolonged. The article presents data on the prevalence, clinical features, methods of diagnosis of rheumatic polymyalgia and its differential diagnosis. The criteria of the disease, the principles of management of the patient at the outpatient stage  (step-by-step treatment with glucocorticoids, alternative approaches, prevention of side effects of therapy, which develop quite often) are also given. Awareness of primary care physicians about rheumatic polymyalgia, its manifestations and diagnostic methods will speed up the diagnosis, timely consultation of the patient with a rheumatologist, which will allow you to start adequate treatment, significantly improve the quality of life of an elderly patient, and prevent the destabilization of concomitant diseases.

scholarly journals Students’ Attitude Change: Virtual vs. In-Person Intergenerational, Arts-Based Courses

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 367-367
Author(s):  
Meghan Young ◽  
Elizabeth Lokon ◽  
Yue Li
Keyword(s):  
Service Learning ◽  
Attitude Change ◽  
Attitude Scale ◽  
Comfort Level ◽  
Effect Sizes ◽  
Face To Face ◽  
Paired Samples ◽  
Cohen’S D ◽  
Students Attitudes ◽  
Cohen's D

Abstract When higher education classes went virtual at the start of the COVID-19 pandemic, converting an in-person, arts-based, service-learning course into a meaningful, virtual experience seemed impossible. However, the Opening Minds through Art (OMA) program developed online courses where students met older adults weekly over Zoom to create and discuss art. Undergraduate and graduate students at Miami and Marian Universities (n=47) came from more than 20 different areas of study and had varying knowledge of gerontology and dementia. Pre- and post-assessments were administered at the start and end of the academic semester. Paired-samples t-tests were conducted to examine pre-post changes in students’ attitudes toward people living with dementia (PLWD) using the Dementia Attitude Scale (DAS) (O’Connor & McFadden, 2010) and the extent students actually like PLWD using the Allophilia scale (Pittinsky et al, 2011). Students in virtual OMA courses showed significant improvement in overall DAS and Allophilia scores and all subdomain scores (i.e., general knowledge about dementia, affection, social comfort level, kinship, and engagement and enthusiasm when interacting with PLWD), with moderate to high effect sizes (Cohen’s d range between 0.39 and 1.10). The magnitudes of these effect sizes for virtual OMA are comparable to previous studies examining students’ participation in face-to-face OMA sessions, where Cohen’s d on DAS and Allophilia scales ranged between 0.48 and 1.07 (Lokon et al, 2017, 2018). Overall, we found that it is possible to design virtual service-learning courses that improve students’ attitudes toward PLWD as effectively as face-to-face courses.

THE SYNDROME OF NEUROLOGICAL DISORDERS AS A PREDICTOR OF EARLY DIAGNOSIS AND A CRITERION FOR THE EFFECTIVENESS OF SURGICAL TREATMENT OF NONSPECIFIC PURULENT DISEASES OF THE SPINE

2020 ◽  
Vol 17 (2) ◽  
pp. 175-186
Author(s):  
M.Yu. Goncharov ◽  
◽  
D.D. Masyutina ◽  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Period ◽  
Neurological Disorders ◽  
Primary Care Physicians ◽  
High Risk Patient ◽  
Clinical Manifestations ◽  
Diagnostic Methods ◽  
Neurological Deficits ◽  
Neurosurgical Department

Nonspecific purulent diseases of the spine (NPDS) are a relatively rare pathology that is little known to a wide circle of doctors, as a result of which mistakes are often made in the tactics of patient management, the timing of diagnosis and the appointment of adequate therapy is delayed. Long-term «diagnostic trap» leads to the formation of persistent neurological deficits. Goal. The purpose is to study the structure of neurological manifestations in the diagnosis NPDS and the dynamics in assessing the quality of surgical treatment. Materials and methods. The article presents an analysis of a group of patients receiving treatment for NPDS in the neurosurgical department of State budgetary health institution in the Sverdlovsk region '‘Sverdlovsk Regional Clinical Hospital No. 1’' in Yekaterinburg for the period from 2005 to 2018 with an assessment of the dynamics of neurological disorders and vertebral pain syndrome in the early postoperative period. A significantly better result in assessing regression of neurological disorders and a decrease in the severity of pain in the postoperative period was observed in the group of patients who underwent decompression-sanitizing-stabilizing surgeries (DSS) in comparison with decompression-sanitizing (DS). Conclusions. The understanding by primary care physicians, neurologists, neurosurgeons of high-risk patient groups, the dynamics of clinical manifestations, and effective diagnostic methods contributes to the choice of the correct management tactics and timely surgical treatment, which significantly improves outcomes, reduces disability rates, and improves the quality of life of patients.

scholarly journals 971. Online Medical Education Improves Knowledge of Data on Appropriate and Timely Use of Influenza Antiviral Medications to Patients at High Risk for Influenza-Related Complications and Morbidity

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S577-S578
Author(s):  
Allison Armagan ◽  
Roderick Smith
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Online Education ◽  
Primary Care Physicians ◽  
Statistical Tests ◽  
Influenza B ◽  
Video Lecture ◽  
Cohen’S D ◽  
Cohen's D ◽  
Antiviral Medications

Abstract Background Many patients are at a higher risk of influenza complications because of age and comorbidities. We sought to assess whether online education, focused on appropriate and timely use of influenza antiviral medications to patients at high risk for influenza-related complications and morbidity, could improve knowledge, competence, and confidence of clinicians. Methods Primary care physicians (PCPs) and pediatricians participated in a 30-minute video lecture with synchronized slides. Educational effect was assessed using a repeated-pairs design with pre-/post-assessment. Three multiple choice questions assessed knowledge/competence, and 1 question assessed confidence. Statistical tests to assess significance: Paired samples t-test for overall average number of correct responses and for confidence rating; McNemar’s test for individual questions (5% significance level, P &lt; .05). Cohen’s d estimated the effect size impact on number of correct responses (&lt; .20 modest, .20-.49 small, .59-.79 moderate, ≥.80 large). Data were collected from 10/28/20 to 12/23/20. Results Average knowledge/competence improved from 29% to 43% (N=430, P&lt; .001, Cohen’s d = 0.46) among primary care physicians and from 31% to 43% (N=226, P&lt; .001, Cohen’s d = 0.38) among pediatricians. Post participation, 12% more PCPs and pediatricians answered all questions correctly. Relative improvements post-participation in specific areas were as follows (P&lt; .001): (i) 105% improvement among PCPs and 100% improvement among pediatricians in findings associated with the efficacy of treatment with antivirals for influenza in hospitalized patients. (ii) 117% improvement among PCPs and 104% improvement among pediatricians in identifying the antiviral with the greatest activity against influenza B viral strain as reported in a phase 3 clinical trial. (iii) 34% of PCPs and 46% of pediatricians had a measurable improvement in confidence after completing the program. Conclusion This study demonstrated the success of a video lecture with synchronized slides at improving PCPs and pediatricians knowledge, competence and confidence related to appropriate and timely use of influenza antiviral medications to patients at high risk for influenza-related complications and morbidity. Disclosures All Authors: No reported disclosures

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