Specialty Board Research Articles

An overview of the medical specialties most relevant to chiropractic practice and education.

The purpose of this article is to present an overview of the key medical and surgical specialties most likely relevant to chiropractic practice in the United States. Understanding the similarities and differences in the training and typical practices of these medical providers may enhance a chiropractor's likelihood to collaborate and increase participation in team-based care. This was a descriptive analysis to develop preliminary content on US medical physician specialties. Selection was informed by the authors' clinical experience with medical collaboration, along with results of previously published work on medical specialties most commonly reported to be involved in referral patterns with US chiropractors. Data from the Accreditation Council for Graduate Medical Education and individual specialty boards were synthesized through an iterative process, and supplemented by qualitative input from subject matter experts. Data were entered into tabular format for review and analysis. We propose that the medical and surgical specialties most relevant to typical US chiropractic practice are internal medicine, family medicine, emergency medicine, physical medicine and rehabilitation, neurology, pain medicine, rheumatology, radiology, orthopedic surgery, and neurological surgery. There is overlap in scope of conditions and diagnostic and therapeutic tools utilized by various medical specialties. This work describes 8 medical and 2 surgical specialties proposed to be most relevant to general chiropractic practice in the United States. The results may have relevance to interprofessional education and collaboration.

Development of a surgical oncology training curriculum for accreditation.

In 2011, the American Board of Surgery announced a new specialty board certification for Complex General Surgical Oncology. The development of a 2-year fellowship training curriculum was based on the core values of multidisciplinary care, surgical management of oncologic disease, education in basic research and clinical trial design, community outreach, patient counseling, and leadership in oncology. This article highlights the elements necessary for developing a fellowship training program in the context of these core values.

Life satisfaction of Taiwanese dental graduates received residencies in the U.S.: a cross-sectional study

BackgroundEach year, more than 200 international dental graduates start U.S. specialty trainings to become specialists. It is unknown if their life satisfaction is associated with any dental career-related factor before residencies (e.g. dental school class rank, research experience, or private practice experience) and after residencies (e.g. staying in the U.S., teaching status, workplace, or board certification). This cross-sectional study aimed to identify these potential factors by surveying Taiwanese dental graduates who pursued U.S. residencies.MethodsLife satisfaction was measured with a structured questionnaire, Satisfaction With Life Scale (SWLS), which includes five statements on a 5-point Likert scale. Online surveys were sent out to 290 Taiwanese dental graduates who were known to pursue U.S. residencies. T-test, one way analysis of variance, and multivariable adjusted generalized linear model (GLM) were used to assess the differences of mean SWLS scores from different variables.ResultsSurveys were completed by 158 dentists. Mean SWLS score of 125 specialists was higher (p = 0.0007) than the score of 33 residents. For the 125 specialists, multivariable adjusted GLM demonstrated better life satisfaction was positively associated with multiple independent factors, such as having research experience, being ranked in the top 26 ~ 50% of the class in dental school, starting U.S. residency within 4 years after dental school, starting residency before year 1996, and specializing in endodontics (vs. periodontics). Life satisfaction was not associated with any factors after residency (e.g. staying in the U.S. afterwards, teaching status, or workplace), but better mean life satisfaction score was significantly associated with being American specialty board certified (p < 0.001) for the specialists in the 26 ~ 75% of their class in dental school. For the 33 residents, better mean life satisfaction score was associated with better dental school class rank in both bivariate (p = 0.020) and multivariable adjusted GLM (p = 0.004) analyses.ConclusionsThe life satisfaction of Taiwanese dental graduates pursuing U.S. residencies might be associated with some professional factors, such as research experience, dental school class rank, residency timing, specialty type, and specialty board certification. We hope our results may provide some objective information on making career decisions for international dental graduates/students who are preparing for U.S. residency.

New physician specialty training system impact on distribution of trainees in Japan

ObjectivesThe problem of uneven distribution of medical services and inequitable distribution of physicians is drawing much attention worldwide. Revealing how changes in the specialty training system in Japan have affected the distribution of doctors could help us understand this problem. In 2018, a new and standardized specialty training system was implemented by the Japanese Medical Specialty Board, which is recognized by the Ministry of Health, Labor and Welfare. The purpose of this study was to investigate how this new system has affected the geographical distribution of doctors commencing specialty training (trainees) and choice of specialty in Japan. Study designRetrospective observational study. MethodsThe change in the number of trainees between the control period (2012–2014) and 2018 was investigated, taking into account the prefecture and specialty selected. Population, the proportion of residents aged 65 years or older (aging rate), and the total number of overall doctors in each prefecture were considered as the background characteristics of each prefecture. We created a Lorenz curve and calculated the Gini coefficient for the distribution of trainees. ResultsIn 2018, the number of trainees per 100,000 population increased to 6.6 nationwide compared with 5.5 during the control period. The number of trainees per 100,000 population in 2018 increased in prefectures with a large population of ≧ 2,000,000, a low aging rate (<27%), and a high doctor density (≧ 250 doctors per 100,000 population). The Gini coefficient showed an increase to 0.226 in 2018 compared with only 0.160 during the control period. ConclusionsAfter the implementation of the new training system, there was an increase in the number of doctors enrolling in specialty programs, and the specialties other than internal medicine and surgery have attracted more trainees. Inequality in the distribution of doctors between urban and rural prefectures worsened. This indicates the need to explore new ways of balancing distribution while maintaining optimal opportunities for specialist training.

Vascular surgery's identity

Vascular surgery's identity

救急科専攻医の都道府県分布に関する検討(Prefectural distribution of trainees for a specialty board of emergency medicine)

要旨【目的】新専門医制度は2018年度から開始されたものの，医師偏在を助長するとの懸念から専攻医の都道府県分布が議論されている。本研究の目的は，救急科専攻医が多く採用された都道府県の特徴を明らかにすることである。【対象】2018年度研修開始予定で採用された専攻医の都道府県別人数と医療や人口構成に関わる公的データを単位人口当りにして計11項目を因子分析（主因子法・バリマックス回転）に投入した。さらに因子分析で関係が強いと考えられる項目についての相関を観察した。【結果】因子分析は3つの潜在因子を抽出した（累積寄与度72.6%）。救急科専攻医数（第1因子：−0.07，第2因子：0.18，第3因子：0.69）には第3因子が強く影響し，救急科医師数（−0.08，0.19，0.72）と相関した（r=0.57，P&lt;0.01）。都市化や人口構成の高齢者割合を反映した第1因子の影響は乏しく，都市化率との間に有意な相関を認めなかった（r=0.13, P=0.39）。一方，基本領域専攻医数（−0.12，0.88，0.26）は第2因子が強く影響し，医育機関病院医師数（0.02，0.89，0.18）と相関した（r=0.80，P&lt;0.01）。因子分析上，救急科専攻医数と基本領域専攻医数の潜在因子の影響は異なり，都道府県分布は同様ではなかった。【結語】救急科専攻医が多い都道府県は救急科医師の多い都道府県であった。救急科専攻医は都市化の進行した都道府県に集中してはいなかった。

The Role of Gender in the Experience and Impact of Recertification Exam Preparation: A Qualitative Study of Primary Care Physicians.

Background: Little is known about how physicians experience preparing for board recertification examinations. As women make up a growing proportion of the primary care physician workforce, we aimed to explore how primary care physicians experience the personal and professional impacts of recertification examination preparation activities, and whether these impacts differ by gender. Materials and Methods: We conducted exploratory qualitative semistructured interviews with 80 primary care physicians, who had recently taken either the American Board of Family Medicine or American Board of Internal Medicine recertification examination and who practice outpatient care. We used an iterative recruitment approach to obtain a representative sample. We applied a team-based constant comparative analytic approach to identify and categorize themes related to how preparing for the recertification examination impacted their personal or professional lives, and then compared these themes by physician gender. Results: We interviewed 41 male and 39 female participants. Physicians most frequently described taking time from personal rather than professional activities to study, but often said this was "no big deal." Physicians described impacts on personal life such as missing out on family or leisure time, conflicts with parenting responsibilities, and an increased reliance on their spouse for domestic and childcare duties. Female physicians more frequently described parenting and leisure time impacts than males did. Conclusions: Recertification examination preparation impacts physicians' personal lives in a variety of ways and are sometimes experienced differently along gendered lines. These findings suggest opportunities for employers, payers, and specialty boards to help physicians ease potential burdens related to maintaining board certification.

Prevalence of Depression among Oman Medical Specialty Board (OMSB) Residents.

ObjectivesWe sought to estimate the prevalence of depression among Oman Medical Specialty Board (OMSB) residents and determine the relationship between depression and sociodemographic characteristics.MethodsWe conducted a cross-sectional survey from January to March 2017. A self-administered questionnaire was distributed to all residents enrolled under different OMSB training programs. Information was obtained on the sociodemographic characteristics. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for depressive symptoms.ResultsA total of 399 residents (158 males and 241 females) participated in the study. Overall, 115 residents had a PHQ-9 score of 5 or more, giving a prevalence of depression of 28.8%. Of those who were depressed, 85 (73.9%) had mild depression, 20 (17.4%) had moderate depression, and 10 (8.7%) had severe depression. There was a significant association between depression and participants’ gender (p = 0.030), level of residency (p = 0.006), sleep duration (p = 0.001), and exercise (p = 0.019). There was no significant association between depression with the other demographic characteristics such as marital status (p = 0.489), specialty (p = 0.370), smoking (p = 0.953), or drug use (p = 0.060).ConclusionsDepression is a common issue among medical residents. Health education on the harmful effects of depression needs to be addressed. Further research on the consequences of depression and its effects on quality of life and academic performance is needed.

The trustworthiness and transparency in clinical practice guidelines versus the ongoing damaging power of direct and indirect conflict of interest

With the increasing costs of health care, clinical practice guidelines (CPGs) have gained a crucial role in standardizing care, protecting health resources, and assuring their accurate distribution by improving health outcomes. Influencing the outcome of a guideline (by one of the authors, members of the specialty board, or an influential member of the specialty) could result in inappropriate expense to the health care system and profits to investors of the medications/tests/devices that were recommended. CPGs are statements based on a systematic review of the existing scientific evidence, developed by knowledgeable experts, that have the potential to reduce inappropriate practice variation, enhance research, and improve health care quality and safety.1

CATALYST: Piloting a Longitudinal Assessment and Learning Program for Board Recertification and Continuous Professional Development

Abstract Context As a proposed alternative to the traditional recertification examination, CATALYST is a longitudinal formative assessment platform created on cognitive learning principles. CATALYST was designed by the National Board of Osteopathic Medical Examiners to encourage more complex and durable practice-relevant learning and demonstration of ongoing competencies. Objective To investigate the value of the CATALYST platform using board diplomates’ subjective feedback and comparison of performance on CATALYST questions with performance on board examinations. Methods Diplomates from 3 osteopathic specialty boards (the American Osteopathic Board of Internal Medicine, the American Osteopathic Board of Pediatrics, and the American Osteopathic Board of Obstetricians and Gynecologists) participated in this pilot study. Over the course of 16 weeks, participants were provided 2 questions per week via the CATALYST platform. An evaluation survey was emailed at the end of the study period to collect participants’ feedback. Survey results and correlations of CATALYST performance with past or upcoming board examination scores were analyzed. Results A total of 196 diplomates completed the surveys, with 95% reporting that participation in the platform would help them stay current in their specialties and 91% reporting that participation would help them provide better care to their patients. For the AOBIM, a significant correlation was found between the number of CATALYST questions answered correctly and performance on the board examination (r=0.51, P&lt;.001). The correlations found for the AOBP and AOBOG were not significant (r=0.197, P=.296, and r=0.370, P=.075, respectively). Conclusion The CATALYST platform could offer valuable contributions to the board recertification process and to patient safety. Further investigations are being conducted on a new user-friendly platform.

CATALYST: Piloting a Longitudinal Assessment and Learning Program for Board Recertification and Continuous Professional Development.

As a proposed alternative to the traditional recertification examination, CATALYST is a longitudinal formative assessment platform created on cognitive learning principles. CATALYST was designed by the National Board of Osteopathic Medical Examiners to encourage more complex and durable practice-relevant learning and demonstration of ongoing competencies. To investigate the value of the CATALYST platform using board diplomates' subjective feedback and comparison of performance on CATALYST questions with performance on board examinations. Diplomates from 3 osteopathic specialty boards (the American Osteopathic Board of Internal Medicine, the American Osteopathic Board of Pediatrics, and the American Osteopathic Board of Obstetricians and Gynecologists) participated in this pilot study. Over the course of 16 weeks, participants were provided 2 questions per week via the CATALYST platform. An evaluation survey was emailed at the end of the study period to collect participants' feedback. Survey results and correlations of CATALYST performance with past or upcoming board examination scores were analyzed. A total of 196 diplomates completed the surveys, with 95% reporting that participation in the platform would help them stay current in their specialties and 91% reporting that participation would help them provide better care to their patients. For the AOBIM, a significant correlation was found between the number of CATALYST questions answered correctly and performance on the board examination (r=0.51, P<.001). The correlations found for the AOBP and AOBOG were not significant (r=0.197, P=.296, and r=0.370, P=.075, respectively). The CATALYST platform could offer valuable contributions to the board recertification process and to patient safety. Further investigations are being conducted on a new user-friendly platform.

Characteristics of physicians with dermatology board certification by the American Board of Physician Specialties

To the Editor: The American Board of Medical Specialties (ABMS) and American Osteopathic Association (AOA) are nationally recognized organizations that collaborate with member boards, including the American Board of Dermatology and the American Osteopathic Board of Dermatology, to offer specialty board certification. The American Board of Physician Specialties (ABPS) is another organization offering board certification to physicians in various specialties, including dermatology. Given little data exist, we evaluated the characteristics of physicians with ABPS dermatology board certifications (DBCs).

Growing Academic Physiatry: The Impact of the Baruch's Grants on Harvard Medical School and Columbia College of Physicians and Surgeons. Part II.

Growing Academic Physiatry: The Impact of the Baruch's Grants on Harvard Medical School and Columbia College of Physicians and Surgeons. Part II.

Closing the Gap on the Palliative Care Needs of Patients with Kidney Disease: Innovations from the Pathways Project (TH306)

•Summarize recent research findings on the unmet palliative care needs of patients with advanced chronic kidney disease and end-stage kidney disease.•Present the current state of early adopter dialysis center implementation of primary palliative care for their patients.•Describe three components of the dialysis facility improvement team processes to identify seriously ill patients with advanced CKD and ESKD and provide goal concordant care.•Present outcomes of implementation of communication principles to conduct shared decision-making and advance care planning with patients with advanced CKD and their families.•Describe the extent to which nephrologist/dialysis center medical director buy-in influenced the success of the implementation intervention. Among seriously ill patients, those with advanced chronic kidney disease (CKD) and end-stage kidney disease (ESKD) arguably receive among the worst end-of-life care. These patients frequently die in the hospital, often after an intensive procedure like cardiopulmonary resuscitation, and with a low referral rate to hospice. There is now a concerted effort in the nephrology and palliative care communities to integrate palliative care into the treatment of these seriously ill patients. The Pathways Project is a national demonstration, funded by the Gordon and Betty Moore Foundation, to develop scalable innovations in kidney supportive care. Fifteen dialysis centers and associated nephrology practices have been working together since early 2019. In this session, the interdisciplinary faculty (two nephrologists with palliative care specialty boards, a nephrology social worker, a nephrology nurse quality improvement advisor, and a palliative care policy analyst) will share lessons in implementing evidence-based best practices to improve supportive care delivery for patients with kidney disease. Presenters will 1) review the literature on unmet palliative care needs of this patient population, 2) describe the needs assessment survey results of dialysis personnel (nephrologists, nurse practitioners, social workers, and administrators) at early adopter dialysis centers, and 3) discuss the first-year results of implementation of the Pathways Project. The presenters will highlight both the successes and challenges of the Pathways Project implementation strategy including identification of seriously ill patients with advanced CKD and ESKD, conducting goals of care conversations with them, offering medical management without dialysis to older advanced CKD patients with multiple comorbidities, and tracking changes in healthcare utilization. They will comment on what worked and did not work to achieve buy-in from nephrologists, nephrology NPs, and other team members. This session will offer clear concepts for how to facilitate palliative care program development for patients with advanced CKD and ESRD.

Development of a Platform to Align Education and Practice: Bridging Academia and the Profession in Portugal.

Limited fitness for practice may result from a mismatch between education and practice. Aiming to meet the common interests of academics and practitioners, the Portuguese Pharmaceutical Society (PPS) developed the Education and Practice Platform (EPP). The EPP includes one representative from each pharmacy faculty, and all Councils of Speciality Boards of Practice. Brainstorming with involved parties enabled sharing of interests, concerns and identifying a common path. Aims, mission, vision and values were set. The EPP’s mission is to: act as an enabler to foster the quality and adequacy of education through sharing best practices, ultimately leading to facilitate professional integration, and to foster quality development in teaching practices with recognition for autonomy in freedom to teach and to learn. Its vision is an alignment of education and practice with the PPS’ statutes to ensure validation of the competences defined for each practice area, and compliance with international guidance. Key performance indicators (KPIs) were set. Activities developed include the creation of a national forum to discuss education and practice, development of workshops on teaching methods and pharmacy internships, enhanced representation in international events and response to global and national requests. Ongoing work focuses on the creation of a common training framework in hospital and community pharmacy practice adapted to Portugal. The EPP is a worldwide case study, encouraging the development of discussion contributing to an open climate of sharing best practices, indirectly leading to foster a better alignment between education and practice. Many of these results are so far intangible in scientific terms but worth describing.

Pain Medicine Board Certification Status Among Physicians Performing Interventional Pain Procedures in the State of Florida Between 2010 and 2016

The US Department of Health and Human Services has recommended that physicians performing interventional pain procedures be credentialed based on criteria based guidelines and minimum training requirements. To quantitatively assess gaps in certification related to pain medicine fellowship requirements, we studied the distribution of such procedures in Florida between 2010 and 2016. This research involved a retrospective analysis with a sample size of n = 1,885,442 interventional pain procedures. Data describing interventional pain procedures performed in Florida between January 2010 and December 2016 were obtained from the Florida Department of Health. The National Provider Identifier file and board certification lists from the American Board of Medical Specialties (ABMS), the American Board of Pain Medicine (ABPM), and the American Board of Interventional Pain Physicians (ABIPP) corresponding to this time frame were also obtained. The datasets were linked to determine the specialty of physicians performing interventional pain procedures, and whether or not they were pain medicine diplomates of the ABMS, the ABPM, or the ABIPP. The similarity index theta was calculated for the distribution of interventional pain procedure codes among medical specialty groups, and with respect to the practitioners' pain medicine board certification status. Of the interventional pain procedures, anesthesiologists performed 63.5%, physiatrists 19.1%, neurologists or psychiatrists 5.2%, and other practitioners 12.3%. Among procedures performed by anesthesiologists, physiatrists, and psychiatrists or neurologists, 66.2%, 50.3%, and 50.4% were by ABMS pain board-certified practitioners, respectively. Practitioners without ABMS pain medicine boards performed 45.8% of interventional pain procedures. Practitioners without such boards from either the ABMS, ABPM, or ABIPP performed 37.7%. There was very large similarity (theta > 0.9) in the distribution of procedures comparing ABMS pain medicine board-certified practitioners to non-ABMS pain medicine board-certified anesthesiologists, physiatrists, or all other specialties. In countries other than the United States, where pain medicine board certification is relatively recent, there may be a higher percentage of interventional pain procedures performed by individuals without certification than we report. In "opt-out" states, where nurse anesthetists can independently perform interventional pain procedures, the percentage of interventional pain procedures performed by individuals without physician pain medicine board certification may also be higher. The datasets we used do not contain information to allow assessment of outcomes or effectiveness resulting from pain medicine board certification. Approximately one-third of interventional pain procedures were performed by physicians without at least 1 of the 3 pain medicine board certifications. In addition, the practitioners performed very similar distributions of procedures (i.e., those without pain medicine board certification, overall, have not restricted their practice). These results suggest the need for additional accredited pain medicine fellowship training positions for newly graduated residents. The results also show that, for the recommendations of the Department of Health and Human Services to be satisfied, physicians without board certification performing intervention procedures would need to obtain ABPM or ABIPP certification, or ABMS certification after completion of a full-time Accreditation Council of Graduate Medical Education pain medicine fellowship. Chronic pain, education, medical, graduate, specialty boards.

RE: Prevalence of burnout of residents in oman medical specialty board: A cross-sectional study in Oman

RE: Prevalence of burnout of residents in oman medical specialty board: A cross-sectional study in Oman

Prevalence of burnout of residents in oman medical specialty board: A cross-sectional study in Oman

Objective: Burnout is a state of physical and emotional exhaustion and a sense of low personal accomplishment. Our aim was to study the prevalence of burnout among all residents of Oman Medical Specialty Board (OMSB), to increase awareness of burnout among trainers and trainees not only within Oman but also in other countries with similar residency programs. This would help residency directors to increase the performance of their residents. Methods: This is a cross-sectional study with residents of OMSB involved in 17 training programs from April 2018 to April 2019. The residents were invited to answer a validated burnout questionnaire (Maslach Burnout Inventory). Only exclusion criteria were programs with at least three residents. Results: A total of 343 of 555 residents (61.8% of the total OMSB residents) participated in the study. The response rate was 100% of those who got the survey. The overall burnout rate was 16.6%. From postgraduate years (PGY) 1–5, there was a sudden spike of burnout at PGY 2 and PGY 5 at 17.6% and 25%, respectively. Emergency residents had the highest incidence of burnout at 46.2%. Burnouts among surgical, medical, and diagnostic specialties were 13.9%, 19.0%, and 12.8%, respectively. Chi-squared test showed no significant association between burnout and marital status, gender, or number of children at 0.18, 0.88, and 0.55, respectively. The percentage of residents who reported emotional exhaustion was 61.2%, while the highest percentage of depersonalization was 42.6%. Conclusion: Emergency medicine program burnout is alarming. PGY 2 and 5 show higher burnout. The overall burnout in OMSB is low.

Anesthesiology Specialist System：From JSA Board to Japanese Medical Specialty Board

Anesthesiology Specialist System：From JSA Board to Japanese Medical Specialty Board

Management of CAR T-Cell Toxicities: Concordance and Divergence between Healthcare Providers and Expert Consensus Recommendations

Background: Chimeric antigen receptor (CAR) T-cell therapy has been a major innovative breakthrough for hematologic malignancies with 2 currently FDA approved CAR T-cell products (tisagenlecleucel and axicabtagene ciloleucel) and several others in different stages of clinical investigation. However, these therapies are associated with unique safety profiles and potentially serious toxicities, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity (ICANS), that require vigilant monitoring and prompt recognition and management to ensure patient safety and optimal therapeutic benefit. We developed an online interactive decision support tool at www.clinicaloptions.com/carttool to give healthcare providers (HCPs) case-specific, evidence-based guidance from experts on the management of adverse events (AEs) due to CAR T-cell therapy. Here, we report a comparison of CAR T-cell toxicity management among HCPs using the tool vs the expert consensus recommendations in the tool. Methods: In March 2019, a panel of 5 experts provided consensus guidance for the screening, prophylaxis, monitoring, and management of CRS and ICANS in patients for which CAR T-cell therapy was either planned or started. This information was used to build the interactive online tool. To use the online tool, HCPs enter the AE that the patient is experiencing, either CRS or ICANS; the grade or severity of the event, per the American Society for Transplantation and Cellular Therapy consensus grading for CRS and ICANS (Lee DW, et al. Biol Blood Marrow Transplant. 2019;25:625-638); and their planned management approach. The HCPs were then shown the expert management recommendation for that specific AE scenario. After viewing the expert management recommendation, HCPs were asked if it impacted their intended management approach. Results: Between May and July 2019, 115 HCPs entered 166 unique case scenarios into the tool. The majority of cases (58%) entered were for patients who were planned for CAR T-cell therapy or who had started therapy without yet experiencing an AE, for which users received expert recommendations on pretreatment screening along with AE prophylaxis and monitoring. Of the 69 cases entered for patients who had received CAR T-cell therapy and were experiencing an AE, 71% were CRS and 29% were neurotoxicity/ICANS. The majority of CRS cases (67%) were intermediate grade (2/3) whereas the ICANS cases were evenly distributed across all grades (1-4). Overall the planned toxicity management strategy of HCPs matched the expert recommendations in 45% of cases, with the greatest discordance for CRS management, where the rate of agreement was 37% (Figure). The proportion of cases in which the planned management strategies of HCPs matched expert recommendations also varied by syndrome grade/severity between US and non-US HCPs. There was no concordance (0%) among US HCPs compared with non-US HCPs (60%) for grade 1 AEs, whereas greater concordance was found in the management of grade 2 and grade 3 AEs among US HCPs (67% and 57%, respectively) compared with non-US HCPs (43% and 44%, respectively; Figure). Of the 15 grade 1 AEs entered by users, only 5 came from US HCPs. Among the 48% of HCPs who answered the optional survey on the impact of the tool on their intended management plan, 48% indicated that the expert recommendations changed their approach, and 80% reported practicing at a treatment center authorized to administer CAR T-cell therapy. Conclusions: These data suggest that many HCPs are challenged to optimally manage toxicities related to CAR T-cell therapy and are not managing their patients in concordance with expert recommendations. Use of an online tool providing easy access to evidence-based consensus expert recommendations may improve patient care and safety in patients treated with CAR T-cell therapy. A detailed analysis of the tool, including case entries and planned management vs expert consensus recommendations for each toxicity and grade, will be presented. Figure. Planned Management of HCPs Compared With Expert Recommendations Figure Disclosures Frigault: Novartis: Patents &amp; Royalties: Royalty; Arcellx, Celgene, Foundation Medicine, Kite/Gilead, Nkarta, Novartis, and Xenetic: Consultancy. DeAngelo:GlycoMimetics: Research Funding; Abbvie: Research Funding; Blue Print Medicines: Consultancy, Research Funding; Novartis: Consultancy, Patents &amp; Royalties: Royalty, Research Funding; Celgene: Consultancy; Amgen: Consultancy; Shire: Consultancy; Jazz Pharmaceuticals Inc: Consultancy; Incyte: Consultancy; Pfizer: Consultancy; Takeda Pharmaceuticals: Consultancy. Galinsky:Pfizer Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Merus Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; ABIM: Other: Member on specialty oncology board; AbbVie Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees. Paul:Agios: Consultancy; Pfizer: Consultancy. Park:Allogene: Consultancy; Amgen: Consultancy; AstraZeneca: Consultancy; Autolus: Consultancy; GSK: Consultancy; Incyte: Consultancy; Kite Pharma: Consultancy; Novartis: Consultancy; Takeda: Consultancy.