AA Challenge: An interactive French-language educational program on the causes of AA amyloidosis - Analysis of 2,597 responses to 12 clinical quizzes

Abstract

Introduction: AA amyloidosis (inflammatory amyloidosis) is a rare but serious complication of chronic inflammatory diseases. Its etiological spectrum is broad, potentially contributing to delayed diagnosis, particularly when the underlying cause is rare or poorly recognized. We developed the AA Challenge, an interactive French-language online educational program based on clinical cases, to improve the recognition of the causes of AA amyloidosis among French-speaking physicians.

Methods: The AA Challenge was an international, year-long educational program for French-speaking physicians. It consisted of monthly interactive clinical case quizzes, each illustrating a different cause of AA amyloidosis or a relevant differential diagnosis. Participants were asked to identify the underlying etiology based on the clinical, biological, and/or imaging data provided. The program was disseminated via email, social media, and the digital platforms of organizations involved in amyloidosis. An international steering committee comprising physicians from ten French-speaking countries contributed to the promotion of the program. Participants also received a monthly literature review on AA amyloidosis. Quiz responses, available participant characteristics, and the results of the final satisfaction survey were analyzed.

Results: Twelve clinical cases were released between 2022 and 2023. A total of 2,968 responses were recorded on the Eval&Go® platform. After exclusion of duplicate submissions, 2,597 responses were included in the performance analysis. Information on medical specialty was available for 2,536 responses. Participants were primarily specialists in internal medicine (n=1,534; 59.1%), nephrology (n=470; 18.1%), and rheumatology (n=199; 7.7%). The most represented countries were Morocco (n=646; 24.9%), France (n=537; 20.7%), Romania (n=420; 16.2%), and Tunisia (n=273; 10.5%). Correct response rates varied by etiology, ranging from 29.9% for the AL amyloidosis quiz to 89.0% for the Crohn's disease quiz. The most accurately recognized etiologies were Crohn's disease, rheumatoid arthritis, and spondyloarthritis, whereas AL amyloidosis, tuberculosis-associated bronchiectasis, mevalonate kinase deficiency, cryopyrin-associated autoinflammatory syndromes (CAPS), and primary hyperoxaluria were less frequently identified. The overall correct response rate was 62.1%. The monthly literature review covered 25 publications on AA amyloidosis. The final satisfaction survey received 124 responses and demonstrated a high level of overall satisfaction, with a mean score of 8.61 ± 1.36 out of 10.

Conclusion: The AA Challenge demonstrates the feasibility and value of an interactive French-language online educational program based on clinical cases designed to increase physicians' awareness of the diverse causes of AA amyloidosis. This initiative highlights the potential of digital educational tools to improve knowledge of rare diseases and could be adapted to other conditions in which earlier or more accurate diagnosis is needed.