Lucero Katie, Finnegan Thomas, Borson Soo
Medscape, 283-299 Market Street, 2 Gateway Center - 4th Floor, Newark, NJ, 07102, United States, 1 2123016700.
Keck School of Medicine, University of Southern California, Los Angeles, CA, United States.
JMIR Med Educ. 2025 May 22;11:e72000. doi: 10.2196/72000.
Alzheimer disease (AD) presents significant challenges to health care systems worldwide. Early and accurate diagnosis of AD is crucial for effective management and care to enable timely treatment interventions that can preserve cognitive function and improve patient quality of life. However, there are often significant delays in diagnosis. Continuing medical education (CME) has enhanced physician knowledge and confidence in various medical fields, including AD. Notably, web-based CME has been shown to positively influence physician confidence, which can lead to changes in practice and increased adoption of evidence-based treatment selection.
This study investigated the impact of a targeted, web-based CME intervention on health care providers' confidence, competence, and real-world outcomes in diagnosing early AD.
The study employed a 2-phase design. Phase I used a pre-post assessment to evaluate immediate changes in knowledge and confidence before and after CME participation. Phase II involved a retrospective, matched case-control study to examine the impact of CME on AD diagnoses in claims data.
A 1-way ANOVA showed a significant effect of CME regarding change in the volume of AD diagnoses (F1900=5.50; P=.02). Compared to controls, CME learners were 1.6 times more likely to diagnose AD, resulting in an estimated net increase of 7939 new diagnoses annually. Post-CME confidence was associated with a greater likelihood of diagnosing AD (odds ratio 1.64; 95% CI 0.92-2.92; P=.09; n=219).
Web-based CME participation is associated with increased real-world AD diagnoses. Findings offer a mechanism to explain the changes in clinical practice seen as a result of the CME intervention, which improves skills and confidence.
阿尔茨海默病(AD)给全球医疗保健系统带来了重大挑战。AD的早期准确诊断对于有效管理和护理至关重要,以便能够及时进行治疗干预,从而保留认知功能并提高患者生活质量。然而,诊断往往会出现显著延迟。继续医学教育(CME)增强了医生在包括AD在内的各个医学领域的知识和信心。值得注意的是,基于网络的CME已被证明对医生信心有积极影响,这可能导致实践的改变和循证治疗选择的更多采用。
本研究调查了有针对性的基于网络的CME干预对医疗保健提供者在早期AD诊断方面的信心、能力和实际效果的影响。
该研究采用两阶段设计。第一阶段使用前后评估来评估参加CME前后知识和信心的即时变化。第二阶段涉及一项回顾性匹配病例对照研究,以检查CME对索赔数据中AD诊断的影响。
单因素方差分析显示CME对AD诊断数量的变化有显著影响(F1900=5.50;P=.02)。与对照组相比,参加CME的学习者诊断AD的可能性高1.6倍,估计每年新增诊断净增7939例。CME后的信心与诊断AD的可能性更大相关(优势比1.64;95%CI 0.92-2.92;P=.09;n=219)。
参与基于网络的CME与实际AD诊断增加相关。研究结果提供了一种机制来解释CME干预导致的临床实践变化,这种变化提高了技能和信心。