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Abstract Details

Improving the Identification and Diagnosis of Autoimmune Encephalitis Patients: A Departmental Quality Improvement Project.
Autoimmune Neurology
P6 - Poster Session 6 (12:00 PM-1:00 PM)
15-010
While AIE prevalence and disease awareness have increased over the past years, this disease remains poorly diagnosed given the continuous advancement of knowledge of AIE syndromes and multiple AIE autoantibody panels available. We hypothesized that the implementation of targeted teaching interventions would improve AIE identification and diagnosis at our institution.

The purpose of this study was to improve the identification and diagnosis of patients with autoimmune encephalitis (AIE), among Neurology and Neuropsychiatry residents at the University of Massachusetts Medical School.

A prospective IRB-approved intervention study was conducted during AY 2018-2019. We administered a first questionnaire to residents (N=10) to evaluate their baseline knowledge on AIE. Subsequently, we implemented (1) formal training on how to identify and diagnose AIE patients; (2) a card with tips on AIE diagnosis; (3) individual feedback about suspected AIE cases. The training lecture was available for those unable to attend in-classroom session. Post-didactic questionnaires were administered at 3 months (N=21) and 6 months (N=16). Level of confidence in diagnosing AIE and in ordering the panels was assessed. We recorded the number of AIE diagnosis made as well as the number, correctness and results of panels sent.
We used Friedman’s and Dunn’s tests to evaluate the number of correct answers at baseline, 3 and 6 months. There were statistically significant differences among the score-matched groups (p<0.0012); specifically, residents’ knowledge increased in 0m vs 3m (p<0.05) and in 0m vs 6m (p<0.05). There was an improved confidence in diagnosing AIE (p=0.04) and in ordering panels. Increased number of diagnoses were made. More panels were ordered, with complete panel orders increasing from 14% to 59% (p=0.07), and increased number of positive panel results.
Our study suggests that targeted teaching on AIE clinical and diagnostic updates is feasible and effective and may aid trainees in the diagnosis of this disorder.
Authors/Disclosures
Raffaella Umeton, MD (University of Massachusetts Medical School)
PRESENTER
Dr. Umeton has nothing to disclose.
Joshua D. Claunch, MD No disclosure on file
Daniela Arantxa Pimentel Maldonado, MD, MSCR (U.S. Food and Drug Administration) Dr. Pimentel Maldonado has nothing to disclose.
Carolina Ionete, MD (UMass Memorial) Dr. Ionete has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanofi. Dr. Ionete has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BMS. The institution of Dr. Ionete has received research support from Genetech. The institution of Dr. Ionete has received research support from Biogen. The institution of Dr. Ionete has received research support from NIH.