A multicenter retrospective evaluation of Chronic Myeloid Leukemia (CML) therapy in Austria assessing the impact of early treatment response on patient outcomes in a real-life setting : R-EFECT study.

BACKGROUND: Several clinical trials in chronic phase (CP) chronic myeloid leukemia (CML) showed that early response to tyrosine kinase inhibitor (TKI) treatment results in an improved long-term survival and progression-free survival. This study assessed whether patients achieving early treatment response (ETR; partial cytogenetic response or BCR-ABL1 mRNA ≤10% at 3 months) in daily practice also have a long-term survival benefit. METHODS: The Retrospective Evaluation of Early response in CML for long-term Treatment outcome (R-EFECT), a multicenter, retrospective chart review, documented patients with newly diagnosed CML-CP starting first-line TKI therapy in routine clinical practice. The primary aim was to assess the 5­year overall survival rate. RESULTS: Of the 211 patients from 12 centers across Austria (January 2004-May 2010), 176 (median age, 56 years) were included in the analysis. All patients received first-line therapy with imatinib. Overall, 136 patients (77.3%) achieved ETR (ETR+ group), whereas 40 (22.7%) did not reach ETR (ETR- group). The ETR+ group had higher 5­year overall survival (92.5% vs. 77.5%, P = 0.018) and progression-free survival (95.6% vs. 87.5%, P = 0.06) rates compared with the ETR- group. As expected, more patients in the ETR- group were switched to another TKI. At the last contact, 120 patients were still on imatinib and 44 had switched to another TKI (25 to nilotinib, 15 to dasatinib, and 4 to bosutinib). CONCLUSION: The data are in line with randomized trials demonstrating that ETR is associated with improved survival and thus confirmed these results in patients treated in daily clinical routine.

[Quality and Satisfaction with the Surgical Medical Clerkship from a Student Perspective]. / Qualität und Zufriedenheit mit der chirurgischen Famulatur aus studentischer Sicht.

PREFACE: The surgical medical clerkship is of special importance, as the student is given the opportunity to get in touch with medical colleagues and patients for the first time, and the interest in a certain field of specialisation can be consolidated. The present study will clarify how students perceived their medical clerkship in the field of surgery. METHODS: A nationwide online survey carried out in 2012 was able to recruit 9079 participants, and contained questions about the completed curricular internships. The present evaluation contains the data of those respondents who had completed at least four weeks of internship in surgery. The following main groups were of particular interest: overall assessment, satisfaction, structure and quality of teaching, of the teachers, and the acquisition of practical skills, which were divided into 35 items. Statistical evaluation was carried out using SPSS 22.0 (IBM Corp., Armonk, USA). In addition to the descriptive statistics, the Chi² test was performed for frequencies, and univariate ANOVAs with the sub-subject factor group (satisfied, neutral, dissatisfied) were performed for the individual items. RESULTS: Overall, the data of 526 participants could be analysed. The female proportion of students was 56.7%; the average age at the time of the survey was 25 years. In all evaluated items, there were significant differences between the groups satisfied and dissatisfied. The participants of the survey who were satisfied with the overall qualification (p = 0.000), reported that they benefited with regard to the technical and didactic quality of teaching (p = 0.000), the acquisition of practical competences (p = 0.000), as well as the didactic and professional quality of teaching (p = 0.000). DISCUSSION: Little is published about the internships for students, including the medical clerkship "Famulatur". However, this information seems to be important, as the students can freely choose the subject in which the Famulatur can be completed. Thus, in this early phase of training, it is possible to recruit young academics for the department by optimising existing structures and improving the range of courses.