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Abstract: SA-PO918

Success of CME at Improving Physicians’ Knowledge of Diagnosis and Treatment of Hepatorenal Syndrome

Session Information

  • Educational Research
    November 04, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Nephrology Education

  • 1301 Educational Research


  • Gitzinger, Susan, Medscape, Lexington, Kentucky, United States
  • Blatherwick, Donald, Medscape, Lexington, Kentucky, United States
  • Muino, Julia A., Medscape, LLC, New York, New York, United States

Timely diagnosis and intervention are critical for improving outcomes for patients with hepatorenal syndrome (HRS), yet most specialists are not fully confident in their ability to identify and classify HRS, or to select appropriate pretransplant therapies. We sought to determine if continuing medical education (CME) improves physician knowledge of the diagnosis and treatment of HRS.


The CME activity consisted of an online video roundtable discussion among leading experts in HRS. Participants completed a 4-question survey before and after the activity to identify changes to knowledge, competence or confidence in relation to a specific clinical situation. A repeated pairs pre-assessment/post-assessment study design was used. The analysis included:
- A paired, 2-tailed t-test to assess differences between mean pre- to post-assessment scores
- McNemar’s chi-square test assessed differences from pre- to post-assessment; P values <.05 are statistically significant
- Cramer’s V to determine effect size

Survey data were collected from March 29, 2017 through May 2, 2017.


In total, nephrologists (n=127) and gastroenterologists (n=139) improved their understanding and competence in several specific topic areas including (data expressed as % correct pre-assessment vs % correct post-assessment; all P<.001):
- The link between HRS and ascites (88% vs 99% of nephrologists and 85% vs 96% of gastroenterologists)
- Characteristics of type 1 HRS (72% vs 98% of nephrologists and 69% vs 93% of gastroenterologists)
- Appropriate first-line therapies for patients with type 1 HRS awaiting liver transplantation (52% vs 80% of nephrologists and 60% vs 84% of gastroenterologists)

Overall, the educational effect size was medium, indicating a noticeable effect on participants' ability to choose correct responses (nephrologists: V=0.285; gastroenterologists: V=0.251). In addition to these gains in clinical knowledge. 46% of nephrologists and 52% of gastroenterologists indicated that they felt more confident in their ability to properly diagnose HRS after participation in this education.


This study demonstrates that a well-designed online CME initiative can have a positive effect on both nephrologists and gastroenterologists, resulting in significant improvements (P<.05) in clinical knowledge and competence seen in both audiences on all topics presented.


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