Session Information
Date: Sunday, October 21, 2018
Title: Education Poster
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose: The diagnosis and management of patients who develop immune related adverse events (irAEs) from checkpoint inhibitor therapy (ICI) requires multidisciplinary care and rheumatologists play an important role in their management1. In September 2017 a new monthly conference was developed at our institution dedicated to the presentation and management of irAEs. This tumor board consists of clinicians from numerous departments with known interest and experience in irAEs. The goal is to discuss new and/or challenging cases of irAEs, review the extant literature and receive input on interprofessional management. On average, 6 cases are discussed at each conference. A survey was developed to assess its educational value to attendees and appraise its impact on confidence in managing irAEs.
Methods: In the 2nd quarter of 2018, an online survey was sent via e-mail to health care providers (HCPs) at the Cleveland Clinic. The survey population was made up of HCPs included on the monthly tumor board invitation. The survey questions aimed to assess the satisfaction with the educational value of this new conference, the perceived impact on irAE awareness, confidence level in diagnosing and management of irAEs, and perceived impact on patient care. Future educational needs were also assessed.
Results: The survey was sent to 37 HCPs with a response rate of 24/37 (65%). The majority of responders were oncologists followed by rheumatology HCPs (Table 1). 95.8% reported having seen a patient who developed an irAE from ICI with 29.2% seeing 1-2 patients per month. In terms of the clinical impact of this irAE tumor board, 66.7% reported a significant increase in their awareness of the scope and presentation of irAEs, and 41.7% reported significantly increased confidence in diagnosing and managing certain irAEs. Most (75%) felt that the conference format/content was superior to other conferences in terms of interest and practical content. When queried about what aspects they valued most, the most common response was the multidisciplinary nature of the conference.
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Table 1. Tumor Board survey responses (N = 24) |
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Which advanced degree do you have? |
DO/MD 83.3% NP 4.2% PA 0% RN 8.3% Other 4.2% |
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What type of medicine to you practice |
Oncology 66.7% Rheumatology 12.5% Pulmonology 0% Gastroenterology 4.2% Hepatology 0% Endocrinology 4.2% Ophthalmology 0% Dermatology4.2% Other 12.5% |
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How many years have you been practicing in your field? |
< 5 years 33.3% 5-10years 29.2% > 10 years 37.5% |
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Have you seen patients who are treated with ICI and develop irAEs? |
Yes 95.8% No 4.2% |
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Describe you primary role in irAEs from ICI |
Prescriber/manager of ICI therapy 4.2% Management of irAEs 29.2% Both 54.2% Neither 12.5% |
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How many tumor board conferences have you attended |
One 12.5% Two 16.7% Three or more 70.8% |
Conclusion: irAEs are a new area of medicine that require multidisciplinary collaboration for investigation and optimal management. The multisystem involvement and autoimmune, inflammatory mechanisms of these complications makes rheumatologists valued, if not central, partners in both patient management and research. Novel venues for educational interchange are needed to further this evolving field. A regular conference solely dedicated to irAEs appears to have educational value as assessed by learner satisfaction and may increase skill and confidence in patient management.
- Calabrese L, Mariette X The evolving role of the rheumatologist in the management of immune-related adverse events caused by cancer immunotherapy. Ann Rheum Dis 2017;77(3):317-8.
To cite this abstract in AMA style:
Calabrese C, Funchain P, Patil PD, Calabrese LH. The Impact of a Novel Immune Related Adverse Event Tumor Board on Interprofessional Clinical Confidence and Collaboration [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/the-impact-of-a-novel-immune-related-adverse-event-tumor-board-on-interprofessional-clinical-confidence-and-collaboration/. Accessed .« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-impact-of-a-novel-immune-related-adverse-event-tumor-board-on-interprofessional-clinical-confidence-and-collaboration/