Virginia Uhley PhD, RDN

uhley@oakland.edu

Oakland University William Beaumont School of Medicine

Guidelines for the Preparation of Abstracts

This slide presentation includes information presented by David M. Svinarich, Vice President of Research, St. John Providence Health System in 2017 and Ruth T. Moore, Director of Biomedical Investigation and Research, St John Providence Health System in 2015

To understand the purpose and process of writing an abstract that will:

a. Grab the attention of the reader

b. Conform to standard abstract writing principles

c. Be succinct and logical in organization

Research Workshop III: Objectives

•A very brief written summary of your research or findings

•An independent statement that briefly conveys the most salient and essential information of a manuscript, text, poster or presentation

What is an Abstract?

•Enables your work to be evaluated for presentation atscholarly meetings

•Helps readers decide if they should read an entire article,listen to a particular presentation or view a particular poster

• Helps readers remember key findings on a topic

• Helps readers better understand a manuscript, text,presentation or poster

Purpose of an Abstract

Basic Content of an Abstract

• Introduction Why?

• Materials and Methods How?

• Results What?

• Discussion So What?

• Research

• Clinical Vignette (Case Report)

• Patient Safety/Continuous Quality Improvement (CQI)

Challenge: Condensing months/years of work or a lengthy

clinical case into 250 to 300 words

Abstract Styles

•Regardless of abstract type it should be concise, clear and direct

•Readers do not expect the abstract to have the same sentence structure flow of a complete manuscript

•ACP website-link to writing a research or clinical vignetteabstracts:

https://www.acponline.org/membership/residents/competitionsawards/abstracts/preparing/writing

https://www.acponline.org/membership/residents/competitionsawards/abstracts/preparing/vignette

Abstract Styles

1. Title

2. Authors, Institution

3. Introduction

4. Methods

5. Results

6. Summary / Conclusions

7. References, Acknowledgements (Optional)

Research and CQI Abstract Organization

1. Title

2. Authors, Institution

3. Introduction

4. Case Description

5. Discussion

6. Summary / Conclusions

7. References, Acknowledgements (Optional)

Clinical Vignette Abstract Organization

1. Classic example of an unusual/rare disease

2. Unusual presentation of a common condition

3. New diagnostic strategy

4. New cost effective approach

5. Unusual pathobiology underlying a common or rare clinical finding

Clinical Vignette: A Case Worth Reporting

Title

A. Capitalized, bold face font

B. Indicate your findings in a clear concise way

C. Avoid use of abbreviations, acronyms or medical jargon

D. Grab the attention of the reader without being too cute or gimmicky

The Body of the Abstract

1. Clear

2. Indicates your findings

3. Written in active voice

4. Includes direction of changes

5. Grabs the reader

Title Characteristics

• Primary Aldosteronism Incidence in Diabetics

• BNP and NT-proBNP correlate with myocardial dysfunction in critically ill patients

Examples of Clear Titles

• Fireworks Stress Pregnant Mares

• Building Bridges: Connecting at Risk Women to Mammography via Emergency Department Visits

Active Verbs in Titles

Boring:

• A Case of Addison’s Disease

Better:

Cardiac tamponade preceding adrenal

insufficiency — an unusual presentation of

Addison’s Disease

Titles

• Does Giving Premature Infants Vitamin D Drops

Shorten Their NICU Time?

• Elevated Troponin-I — “Nonspecific” Marker of

Myocardial Damage?

Titles That Ask Questions Grab the Reader

A. Describes what the study sought to determine or the purpose of the study

B. States the research question or hypothesis

C. Provides relevant background information (your previous work orother’s work)

D. Indicates the importance, relevance or necessity of the work

E. Use present or past tense, 1-2 sentences

Introduction/Objectives/Background

A. Briefly describes the general design of the experiment or study

B. Describes the methodologies in chronological order of appearance

C. Includes the use of controls, inclusion/exclusion criteria, patient populations, numbers per group, type of model or cell line(s) used, how data was analyzed

D. Italicize organism names and Latin terminology such as E. coli, in vivo, in utero, etc.

Study Design/Methods

E. Avoid cluttering the design section with too much minutiae

F. The methods section should be a narrative not a numbered list of procedures

G. Indicate any trademarked devices, drugs or reagents used and use generic names for drugs. If you must use a proprietary name, identify the company

H. Convince reader that they can trust your results because the study design was appropriate and that you knew what you were doing

Study Design/Methods cont.

A. May be either in narrative, graphical or tabular

form

B. Be sure to adequately label the axes of all tables and graphs

C. Tables and Graphs should be interpretable

exclusive of the other sections

Results

D. Results should appear in a manner that ischronologically consistent with the study designand methods section

E. Include statistical support for any data that isstated as being either significant or non-significant(P values)

F. Include appropriate units for any numerical data

Results cont.

Reminder: Data as Graph Draws Attention

0

25

50

75

100

Reached at 1 month Obtained or scheduled

mammogram

Educational Intervention

Controls

%

p < .0005

0

25

50

75

100

Reached at 1 month Obtained or scheduled

mammogram

Educational Intervention

Controls

%

p < .0005

Building Bridges: Connecting at Risk Women to Mammography via Emergency

Department Visits

INTRODUCTION: Women presenting to the ED, who had not had a recent screening

mammogram, were given educational materials and referred to free mammography. We then

measured their rate of scheduling a mammogram within 1 month.

HYPOTHESIS: Providing at risk women with educational materials and referral for free

mammography will not improve their rate of obtaining a mammogram within 1 month of

discharge.

METHODS: In this prospective, controlled study, a survey regarding mammogram use, and

breast cancer awareness was verbally given to women over 40 in the ED, and 1 month later by

phone. The intervention group (n=200) received pamphlets about breast cancer prevention plus

phone numbers for a free mammogram at community health departments; awareness posters

were also placed in the ED waiting room. A similar group (n=200, controls) also responded to

the survey in the ED and 1 month later by phone, but without any intervention.

RESULTS: Of the 131 women needing mammograms enrolled in the educational intervention,

97 (74.0%) were reached by phone, and 21.6% had obtained or scheduled a mammogram in the

month after discharge. Of the

111 women needing

mammograms enrolled in the

control group, 88 (79.3%)

were reached by phone, only

3.4% had obtained a

mammogram in the month

after discharge (Fisher’s Exact

Test, p < .0005).

CONCLUSIONS: At risk women less likely to have access to reliable health care responded to

an educational intervention and awareness of free/reduced cost resources by complying with

ACS breast cancer screening guidelines. The ED provides a unique setting in which to promote

such preventative measures to women most in need.

A. Address each study objective described in the Objectives Section

B. Provide a sentence that synthesizes all the data presented and relates it to your hypothesis

C. Provide a summary sentence that relates this work to the “big picture” (optional)

D. Address any limitations or shortcomings of the experimental design or treatment of data

E. Indicate whether or not further work is needed

Conclusions/Summary

Indicate referenced statements with a number inparenthesis or superscript that correlates with thefull reference at the end of the text

Examples of how to cite literature

Article1. Faro S. Chlamydia trachomatis infection inwomen. J Reprod Med 1995;30:273-8.

References (optional)

Book/Edited Book

1. Sweet RL, Gibbs RS, eds. Infectious Diseases of the Female Genital Tract, 3rded. Baltimore,MD:Williams& Wilkins: 1998;1320.

Chapter in book

1. Washington AE, Johnson RE, Sanders LL. Incidence of Chlamydia trachomatis infections in the United States. In Oriel D, Ridgway G, Schachter J, et al., eds. Vaginal Surgery. New

References (optional) cont.

•Recognize a company for providing study drugs, reagents or devices

•Recognize a sponsor for funding or grant support

•Recognize individuals or who have served as a consultant or otherwise assisted in the work (e.g. Colleague, Pathologist, Research Associate, Statistician, etc.)

Acknowledgments (optional)

Abstracts intended for inclusion in manuscripts, medical conferences or scientific meetings will have specific restrictions on the number of authors, on font size, abstract size or word count, etc.

STRICTLY adhere to these guidelines or risk having the abstract returned or rejected outright.

The technical specifications for the abstract are defined in the “call for abstracts” section in most Professional Society meeting application booklets or in the “Instructions to Authors” section for a given journal.

Instructions to Authors

How Do We Shorten Abstracts?

1. Use active voice

Patients were saved by the treatment

Treatment saved patients

Enzyme levels were lowered…

Enzyme levels dropped

Abstract Size is Limited by Word or Character Count

2. Don’t use “empty” constructionsIn order to determine…

To determine…

There were 87 patients enrolled in…87 patients enrolled in…

Adapted from AMWA listserve postings by:tomlangcom@aol.comJoanmnewyork@aol.com

Find Plain Language Guidelines at: http://plainlanguage.gov/howto/

Ways to Shorten Abstracts

3. Choose stronger, shorter words

In addition Also

Not later than By

4. Remove phrases with prepositions

In the month of May In May

With the exception of Except for

Ways to Shorten Abstracts

5. Compare groups in parallel

Patients who received therapy had a median life expectancy of 7.0 years, compared to 2.3 years for those who did not receive therapy. (23words)

Median life expectancy was 7.0 years for treated patients and 2.3 years for untreated patients. (15words)

Ways to Shorten Abstracts

6. Start with “Of” or “Among” when reportingproportions

84 subjects were enrolled in the study and 58 completed it. (11 words)

Among 84 subjects enrolled, 58 completed it. (7 words)

Ways to Shorten Abstracts

•Use bold face fonts to highlight headings

•Ensure sufficient time to compose the abstract-at least 5 or 6 hours (it takes longer than you think!)

•Strictly adhere to abstract guidelines, format requirements and deadlines

•Use 12pt font or greater to facilitate reading andphotocopying (check meeting/journal guidelines)

Tips on Writing Good Abstracts

• Avoid large blocks of uninterrupted text (useparagraphs, indentions, spaces, bold font headings)

• Be clear, concise and brief

• If abbreviations are necessary, define them whenthey first appear within the text,(e.g.Lippopolysaccharide (LPS)

Tips on Writing Good Abstracts cont.

•The use of “I” and “we” are not preferable to the third person and the passive voice (“the Authors, it has been shown, etc.”)

•Describe the methods and results in the past tense

•Discuss the conclusions in the present tense

•Have several people independently evaluate the abstract for content, completeness, grammar, punctuation and spelling

Tips on Writing Good Abstracts cont.

•Uses one or more well developed paragraphs: these are unified, coherent, concise and able to function independently

•Avoids using unnecessary adverbs, adjectives

•Provides logical connections or transitions between the information included

•Follows the chronology of the work

Qualities of a Good Abstract

•Is complete and fully understandable when read separately from the corresponding manuscript, text, poster or presentation

•Is understandable to a wide audience from different disciplines-avoid specialty-specific acronyms, abbreviations or jargon

•Adds no additional information beyond that which is contained within the report

Qualities of a Good Abstract

a. Abstract was incomplete or did not conform toguidelines (word count, font size, organization)b. Significant flaws in study designc. Poorly powered study (e.g. not enough subjects)d. Statistical analysis not appropriatee. Abstract was not internally consistentf. Study was incomplete (e.g. no data)g. Abstract was poorly written in generalh. Study was not appropriate for intended audiencei. Abstract submitted past the submission deadline

Leading Reasons why Abstracts are Rejected

•The primary author is the individual who has contributed the greatest amount of work and intellectual effort to the project

•The primary author should be listed first and the name should appear in bold face font/underlined (in keeping with the indicated abstract format)

•Keep the number of authors to a minimum. The maximum number may be defined by the journal or society

•All authors appearing on the abstract are responsible for the content of the abstract and the veracity of the work it describes

Authors and Ethics

•Only individuals who have made a substantive contribution to the work should appear as an author-ghost authorships are not appropriate

•Decide in advance who will appear on the abstract and the order of their appearance

•Generally, only original abstracts not previously presented at other meetings or published will be accepted-check with the individual medical society for exceptions to this

•Beware of “cut and paste” plagiarism

Authors and Ethics cont.

1. Due date for abstract is ____________2. Number of copies needed ____________3. Presenting author is listed as first author4. Presenting author meets eligibility requirements for the meeting5. Author affiliations are listed6. Abstract clearly organized into Introduction, Methods, Results, and Conclusion7. The conclusions are supported by data presented in the abstract8. Completed abstract meets word limit requirements or fits into formatting box9. Abstract printed with correct font size and style (if stipulated)10. Abstract has been reviewed by others for content, style, grammar, and spelling

Reference: Shamelessly lifted from the ACP website

Scientific Abstract Checklist

FIREWORKS STRESS PREGNANT MARES

To examine whether the stress of fireworks noise could disrupt

reproductive function, Prolactin (PRL), epinephrine (EPI) and progesterone (P)

were measured acutely in the plasma of pregnant mares at intervals prior to and

following the annual fireworks celebration in Philadelphia. Blood samples were

drawn from an indwelling catheter placed in the jugular vein by 4 pm July 4th

and shielded with a protective collar. At -2 hr, an extension was attached to each

catheter and led out of the stall. Blood was drawn from 6 Arabian mares early

in pregnancy (4-6 weeks). They were housed within 2 miles of the fireworks site

and bled at -30, 0, +2, +5, +10, +20 and +60 minutes in relation to the scheduled

initial fireworks (10 pm). All horses were agitated throughout the 15 minute

fireworks. Hormonal values (mean SE) are shown below.

Time from Fireworks Start (mins) Hormone

(ng/ml)

-30

0

+2

+5

+10

+15

+60

PRL 0.2 0.1 0.3 0.1 2.0 0.5 15.3 2.4 18.7 2.9 14.1 3.3 4.2 2.3

EPI 0.5 0.2 0.4 0.1 9.9 0.6 58.7 5.9 54.1 6.8 50.6 2.3 3.8 1.6

P 6.0 0.3 5.6 0.5 5.8 0.6 7.6 0.5 9.7 0.9 10.6 1.3 6.8 1.6

As expected, EPI and PRL surged in response to the fireworks, although

EPI peaked earlier and remained more elevated than PRL. P increased

moderately, most probably due to adrenal release.

We conclude that the stress of the fireworks’ noise increased circulating

E and PRL. While all mares delivered healthy foals at the expected times, the

long term effects of such transient stress hormonal alterations on dam and foal

are unclear.

Which Would You Read First?Comparison of Allogenic Bone Screws with Bioabsorbable and Stainless

Steel Screws

Abstract O8.

Newly developed allogenic bone screws have yet to be compared to stainless steel and

bioabsorbable screws for their resistance tos breaking and bending, important factors in

fixating osteotomies and fractures. We tested the hypothesis that allogenic bone screws exhibit

greater stiffness and torque than established screws. Using an Instron™ device, in vitro studies

in shear resistance and bending were performed. Twelve allogenic bone and 12 bioabsorbable

3.5mm screws were tested against equal length stainless steel screws.

Bending Shear

Seconds to Failure Load (N) at Failure Seconds to Failure Load (N) at Failure

Allogenic Bone 53.45 4.81* 4.73 0.03* 14.73 0.09* 310.66 9.91**

Bioabsorbable 201.94 11.11** 11.00 0.09** 50.42 2.46** 617.29 24.63*

Stainless Steel 123.45 21.30*** 63.06 9.12*** 26.57 8.18* 710.62 195.96*

within the same column, different superscripts (such as * and **) are different (p < .03, ANOVA)

In the bending test, allogenic bone screws failed faster and at markedly smaller loads. In the

shear test, allogenic bone failed at approximately half the load of stainless steel or

bioabsorbable screws (see graphs). Thus, allogenic bone screws do not exhibit greater stiffness

and torque than stainless steel and bioabsorbable screws. This determination of relative

resistance to binding and shear will help podiatric surgeons select the best screw for the

osteotomy or fracture being repaired.

S h e a r T e s t - A l lo g e n ic B o n e

0

1 0 0

2 0 0

3 0 0

4 0 0

1

15

29

43

57

71

85

99

11

3

12

7

14

1

15

5

16

9

18

3

19

7

Lo

ad

(N

)

S h e a r T e s t - B i o a b s o r b a b l e

0 . 0 0

2 0 0 . 0 0

4 0 0 . 0 0

6 0 0 . 0 0

8 0 0 . 0 0

1

38

75

11

2

14

9

18

6

22

3

26

0

29

7

33

4

37

1

40

8

Lo

ad

(N)

Cryogenic Denervation for the Treatment of Lower Extremity Neuromas

Foot pain from neuromas can become debilitating, limiting patients’

activities. When conservative treatment fails, the neuroma is excised. However,

the failure rate of surgical neurectomies exceeds 20%. To examine whether

cryogenic denervation blocks neuroma pain, 20 surgical candidates consented to

experimental treatment by cryoprobe denervation.

Thirty-one neuromas were denervated using a Westco cryoneedle insterted

percu-taneously. The activated cyroprobe damages endoneural capillaries

initiating demyelinization and axonal degeneration. Neuromas were subjected to

two three-minute freeze cycles at –70 C with a 30 second thaw in between.

Post-operatively, all patients resumed normal activity immediately. However, 2

weeks after intervention, patients fell into 3 groups: pain free (n = 11); partial

pain (15) or full pain (5). Pain ratings for these groups differed (partial vs. full,

p < .002; pain free vs. partial and full pain, p < .04). Thus cryoprobe treatment

was completely effective for 35.5% of these patients while it failed totally for

16.1%.

0.0

2.0

4.0

6.0

8.0

10.0

-1 0 1 7

14

28

56

72

16

8

33

6

Time (Days)

Pa

in R

ati

ng

Pain Free

Partial Pain

Full Pain

While direct comparison to surgery will require a randomized clinical trial,

these results suggest that cryosurgery has a failure rate similar to surgery but

provides at least temporary respite from neuroma pain and can be totally

effective for some patients.

Associations between cigarette smoking and each of 21 types of cancer: a multi-

site case-control study.

BACKGROUND. Although the effects of cigarette smoking on cancer risk have been

well documented, several outstanding issues remain to be clarified, including which

types of cancer are associated with smoking and estimating the magnitude of the

effect of smoking on different types of cancer. A further issue is whether the effects

seen elsewhere can be demonstrated in Canada, where tobacco products differ

somewhat from those in other countries. METHODS. A case-control study was

undertaken in Montreal to investigate the associations between environmental and

occupational exposure and several types of cancer. Between 1979 and 1985, male

patients with 21 types of cancer, including 15 anatomical sites, were interviewed to

obtain detailed information on smoking histories, job histories, and other potential

confounders. A total of 3730 cancer patients and 533 population controls were

interviewed. For each type of cancer, two groups acted as controls: population and

cancer controls (from other cancer patients). The purpose of our analysis is to

estimate the relative risk of each selected cancer in relation to smoking and to

estimate the % of cancer cases attributable to cigarette smoking. RESULTS.

Separate analyses conducted with the two control groups produced similar results. Of

the sites examined, colon, rectum, liver, prostate, kidney and skin (melanoma)\ were

not associated with cigarette smoking. There was no excess risk of Hodgkin's

lymphoma.. The following were clearly associated with smoking: lung (odds ratio

[OR] 12.1), bladder (OR 2.4), oesophagus (OR 2.4), stomach (OR 1.7), and pancreas

(OR 1.6). Population attributable risk percentages due to smoking were 90% for

lung, 53% for bladder, 54% for oesophagus, 35% for stomach, and 33% for

pancreas. CONCLUSIONS. Of the 21 types of cancer examined, lung, bladder,

oesophagus, stomach and pancreas were associated with smoking among men in

Montreal. Smoking likely accounts for a large proportion of cancers occurring at

these sites.

Transforming Growth Factor Beta (TGF1) and Insulin-like Growth Factor I (IGF-

1) Stimulate Collagen Synthesis In Rat Intestinal Smooth Muscle

TGF1 is a growth factor with immunomodulatory and fibrogenic effects in many

tissues including intestinal smooth muscle. Rats with peptidoglycan-polysaccharide

(PG-PS)-induced chronic enterocolitis have marked fibrosis in the distal ileum and

ceacum. The fibrogenic peptide IGF-1 is highly expressed in this model, but TGF-1

has not been studied. We ran a series of in vitro experiments to study the expression

of TGF- mRNA in PG-PS enterocolitis and the effect of TGF-1 with and without

IGF-1 on type α1 collagen synthesis in isolated rat intestinal smooth muscle cells.

Methods: PG-PS or control solution was injected intramurally into the caecum and

distal colon of Lewis rats. Intestinal smooth muscle cells were isolated from sacrificed

animals and cultured. Cells were washed to remove serum proteins and then exposed

in triplicate to IGF-1 (1.25-25 nM), TGF-1 (1-1000 pM) or both peptides together.

Procollagen α1 mRNA was detected by northern analysis of total cellular RNA and

type α1 collagen protein was evaluated by western immunoblot.

Results: A dose response increase of 2.4 + 0.6 fold (n=5; p=0.04) in TGF-1 mRNA

was observed in PG-PS treated intestinal cells compared with control tissue at 24 h,

with an increase detected at 50pM and maximal effect observed at 100pM. At 12 h,

250 pM TGF-1 stimulated a 2.1 + 0.4x increase in TGF-1 mRNA (n=4; p?0.05) and

a 4.0 + 1.6 fold increase in type α1 collagen protein. In parallel experiments, at 12 h

12.5 nM IGF-1 stimulated a 3.1x increase in IGF-1 mRNA. A similar increase in type

α1 collagen protein occurred after 12.5 nM IGF-1. There was no detectable synergy

between the peptides.

Conclusions: TGF-1 and IGF-1 stimulate collagen synthesis to a similar extent, but

TGF-1 is more potent than IGF-1 on a molar basis. Contrary to findings in other

systems, no synergy was detected. These data suggest that both TGF-1 and IGF-1

contribute to collagen synthesis during the response to PG-PS in rat intestinal smooth

muscle cells.

ACUTE CYSTITIS PATHWAY: A PHONE TRIAGE SUCCESS

Some physicians treat simple problems such as uncomplicated UTI in ambulatory clinics through

phone triage while others do not. The choice of and length of therapy also vary. In this study, we

evaluated the effectiveness of trained personnel using an acute cystitis pathway to establish the

diagnosis of uncomplicated UTI, to discuss the details with a physician, and to call in a low-cost,

effective prescription.

All patients calling our ambulatory clinic with symptoms suspicious of a UTI spoke with the triage

nurse. The nurse went through a specific checklist establishing a UTI diagnosis and excluding

complicating factors that might prevent treatment over the phone. As soon as possible, the results

were discussed with a physician. With physician endorsement, the nurse phoned the patient with

instructions, then called a prescription into the pharmacy. Forty-three patients were triaged; 3

were asked to be seen and one did not have a UTI. Of the 39 patients treated over the phone,

none had any complications. The time lapse from the patient’s initial call to the nurse’s call to the

pharmacy ranged from 30 minutes to 4 hours. We estimated the total savings in this trial at

$5,088, based on physician and clinic time, lost work time, and lowered prescription costs. Since we

see an average of 25 UTI’s/month, the potential savings in our clinic could reach $42,000/year. We

conclude that when an acute cystitis pathway is applied to low risk patients, with proper screening

tools and back up, there is a very significant savings. Based on this experience, we recommend a

phone triage trial for UTI treatments to other ambulatory clinics.

PENICILLIN ALLERGY: WHAT DO WE KNOW?

While 5-20% of the United States population report penicillin allergy, 80-

90% of those individuals are not truly allergic when assessed by skin testing.

Falsely reported penicillin allergy has far-reaching consequences including

antibiotic resistance, unnecessary or harmful avoidance of appropriate antibiotics,

and rising health care costs. There are significant deficits in knowledge of

penicillin allergy among community and academic physicians practicing internal

medicine and pediatrics. Improved physician knowledge is one way to combat

falsely reported penicillin allergy, but education on this topic is not currently a part

of most residency curricula.

The objective of this study was to assess resident physicians’ knowledge on

penicillin allergy and to determine whether a simple educational tool would

improve this knowledge. Participants were St. John Hospital & Medical Center

resident physicians in the departments of Family Practice, Internal Medicine,

Pediatrics, or Medicine-Pediatrics. Transitional residents, Emergency Department

residents, and medical students who were rotating in these departments were also

included. A one-hour session was scheduled during which the same ten-question

test was administered at the beginning (pre-test) and end (post-test) of the session.

After the pre-test, participants were given a thirty minute Power Point®

presentation on clinically relevant aspects of penicillin allergy.

The effect of the educational intervention was measured using a paired t-test

to compare the pre- and post-test scores, and the proportions of correct answers to

each question. Scores were compared by post-graduate year (PGY) level and by

department of origin.

Of 57 total participants, 54 completed both pre- and post-tests. 14 Family

Practice, 21 Internal Medicine, 2 Medicine-Pediatrics, 9 Pediatrics, 3 Transitional

or ER residents, and 8 medical students comprised the test population. Scores

improved significantly after the educational intervention [pre-test 54.8% 5.8%

(mean S.E); post-test 82.7% 5.5%; p = .007]. This benefit was seen among all

PGY levels and departments, except for medical students and Medicine-Pediatrics

residents (among the smallest in sample size). We conclude that a simple

educational presentation can improve resident’s knowledge of penicillin allergy in

the short term, and plan to test retention at specific intervals after this intervention.

Evidence-based Therapy Post-Coronary Artery Bypass Graft Surgery (CABG) and Potential Impact on Readmission While clinical trials have validated the use of aspirin (ASA), statins and smoking

cessation for secondary prevention after CABG, current adherence with these

therapies has not been studied. Furthermore, the cardioprotective value of beta-

blockers (BB) and ACE-I’s in pts undergoing CABG after AMI or with left

ventricular dysfunction (LVD), respectively, is uncertain. The purpose of this study

was to determine the utilization of these therapies in pts undergoing CABG and the

impact of readmission. Medical records of 113 consecutive CABG pts during Oct-

Nov, 1999 were reviewed for demographics, risk factors, medical history and

comorbidities. Therapies prescribed at discharge based on eligibility:

CABG PROFILE THERAPEUTIC INTERVENTIONS

(N) (N) (%) (readmits %)

CABG 113 ASPIRIN 96 85.0 82.0

CABG, AMI 63 BETA BLOCKER 46 73.0 57.0

CABG, LVEF <40 52 ACE-I 21 40.4 20.0

CABG, Smoking 20 Cessation Counseling 5 25.0 50.0

CABG, Hyperlipid 75 Statins 9 12.0 0.0

Eleven (9.1%) pts were readmitted within 6 months after discharge for cardiac

reasons. Using logistic regression, a model was constructed that predicted non-

readmission with a 93% specificity. Variables contributing to the probability of

readmission (in order of contribution) were: AMI 24 hours prior to surgery; no

statins at discharge; no smoking cessation education; AMI within 6 hours of

surgery; and not discharged on ACE-I (EF<40%) or BB (post MI). Therapeutic

adherence is suboptimal., and failure to prescribe these therapies may contribute to

cardiac readmission.

A B C D

E F G H

Thank You For Your Attention!

Any Questions?