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Q: How will my information be submitted to the ABIM for MOC credit?
A: For Part II credit for the MOC Module based on ASH-SAP, Fifth Edition: your answers will be submitted to the ABIM when you click the button at the end of module. You must have 80% correct in order to submit to the ABIM. Be sure that your name and date of birth match your ABIM records.

For Part IV credit for the MDS and Non-Hodgkin Lymphoma PIMs you will need to:
  • Complete an attestation of your participation in the ABIM program and answer the questions about your experience and observations. Click the "Submit" button when you have answered all the questions.
  • Once you have submitted to the ABIM, the ABIM verifies your participation with ASH through weekly reports. Once your participation has been confirmed the ABIM will post your credit on your ABIM Maintenance of Certification profile.
Q: What username and password do I use to access the ASH Academy?
A: ASH utilizes a Single Sign On system.  You can log in to the Academy using your regular ASH username and password.

SAP Testing Center

Q: Where do I get the CME certificate for completing ASH-SAP, Fifth Edition?
A: You can print a CME certificate from the "My Dashboard" page in the ASH Academy. This page has all the information on your progress and the modules and quizzes you have completed.
Q: Can I claim CME credit for completing the MOC Module based on ASH-SAP, Fifth Edition?
A: No, this module only carries ABIM Medical Knowledge credit.
Q: Which version of ASH-SAP, Fifth Edition should I purchase?
A: The only difference between the ASH-SAP, Fifth Edition and ASH-SAP, Fifth Edition with MOC Module is the additional 60-question module that comes with the MOC Module edition. Both versions include the 232-question CME test.
 
If you are enrolled in the American Board of Internal Medicine's Maintenance of Certification program, you should purchase the MOC Module version to access the additional test.
Q: Why is this MOC Module only worth 20 points when the ASH-SAP, Fourth Edition test was worth 70 points?
A: In light of the changes in the ABIM MOC structure, which are effective January 2014, a decision was made by ASH to create a MOC Module that is worth 20 points. We realize that previously many diplomates used the ASH-SAP to accrue 70 points while studying for the hematology examination in the later years of their 10-year certificate. Since the changes in the MOC system require accruing some points every two years, with a total of 100 points every five years, ASH made the decision to offer this smaller module.

Practice Improvement

Q: How long do I have to wait before I complete a PIM?
A: The first two phases of a practice improvement module (Assess and Improve) should only take a day or two (mostly depending on how accessible your charts are for the chart abstraction portion). Best practice for implementing changes and doing a second chart abstraction (the third phase, Evaluate) is at least three months.
Q: What are the Quality Indicators and Performance Measures for the Non-Hodgkin Lymphoma PIM?
A:

Quality Indicator

Performance Measure

What we are looking at/striving for

How we are measuring it

Pathologic Diagnosis

An accurate pathologic diagnosis is the most important first step in treating a patient with lymphoma.

Measure 1

The percent of patients with lymphoma whose initial lymphoma diagnosis was established by you (or confirmed by you) by one of the following:

· Incisional or excisional biopsy AND

· Immunohistochemical characterization

OR

· Core needle biopsy AND

· appropriate ancillary techniques employed (at least one of the following must have been done)

o PCR for IGHV and/or T-cell receptor (TCR) gene rearrangements

o FISH for major translocations (at least one of the following positive: (t(14;18), t(11:14, cMYC translocation, t(2;5)))

o immunophenotypic analysis

Staging

Appropriate staging is essential in diagnosis and for planning treatment.

Measure 2

The percent of lymphoma patients assigned a specific stage using Ann Arbor system including presence/absence of B symptoms AND having bone marrow biopsy or documentation why bone marrow biopsy was unnecessary or contraindicated.

Hepatitis B Testing

Hepatitis B testing (hepatitis B surface antigen and hepatitis B core antibody) is part of essential work-up prior to initiation of treatment in all patients who will receive anti CD20 monoclonal antibody-based regimens.

Measure 3

Patient treated with rituximab tested for hepatitis B prior to medication administration.

Prophylactic neutrophil growth factor (e.g. filgrastim)

Prophylactic neutrophil growth factor (e.g. filgrastim) for patients with diffuse aggressive lymphoma aged 65 and older treated with curative chemotherapy (CHOP or more aggressive regimens) should be given to reduce the incidence of FN [febrile neutropenia] and infections.

Measure 4

The percent of lymphoma patients that are 65 years old or older and receiving CHOP +/-R (or any regimen with the same or higher doses of cyclophosphamide and doxorubicin and, thus, with an equivalent or higher potential for neutropenia), prescribed prophylactic neutrophil growth factor (e.g. filgrastim)

Fertility Preservation

Physicians should address the possibility of infertility with patients treated during their reproductive years. Fertility preservation is often possible, but to preserve the full range of options, fertility preservation approaches should be considered as early as possible during treatment planning.

Measure 5

The percent of lymphoma patients of child bearing age who received treatment for lymphoma offered fertility counseling prior to starting treatment OR documentation in the medical record why such counseling was unnecessary.

Vaccinations

When feasible, clinicians should administer all indicated vaccines to all persons before initiation of chemotherapy, before treatment with other immunosuppressive drugs, and before radiation or splenectomy.

Measure 6

The percent of lymphoma patients recommended to receive immunization/vaccination aligned with CDC recommendations.

Q: How many charts do I need to complete one of the PIMs?
A: You will need 10 charts of appropriate nature from within the last 18 months of practice in order to complete the first chart abstraction.  You will need an additional 10 charts to complete the follow-up chart abstraction. ASH has received ABIM approval to administer chart abstraction with 10 charts - most other Practice Assessment activities require 25 appropriate charts.
Q: What are the Quality Indicators and Performance Measures for the MDS PIM?
A:

Quality Indicator

Performance Measure

What we are looking at/striving for

How we are measuring it

Quality Indicator - Cytogenetics

Cytogenetics for bone marrow samples (by standard karyotyping methods) should be obtained because they are of major importance for prognosis.

Measure 1

MDS patient whose baseline* diagnostic evaluation includes cytogenetic testing on bone marrow

Quality Indicator – Prognostic Scoring System

IPSS should be used or initial prognostic and planning purposes. The WHO classification-based prognostic scoring system (WPSS) permits dynamic estimation of prognosis at multiple time points during the course of MDS

Measure 2

MDS patient with an established pathologic classification/risk prognostication system (such as the World Health Organization (WHO) classification, WHO-based Prognostic Scoring System (WPSS), International Prognostic Scoring System (IPSS or IPSS-R), MD Anderson Risk Model or the French-American British (FAB) Cooperative Group classification) used to help plan therapeutic options

Quality Indicator -Iron

Iron repletion needs to be verified before instituting Epo or darbepoetin therapy.

Measure 3

MDS patient presenting with anemia (Hgb<10g/dL) had evidence of adequate iron stores within 60 days prior to receiving recombinant erythropoietin (epoetin or darbepoietin) therapy

Quality Indicator – EPO Level

A validated decision model has been developed for predicting erythroid responses to Epo plus G-CSF, based on the patient’s basal serum Epo level and number of previous RBC transfusions.

Measure 4

MDS patient presenting with anemia (Hgb<10 g/dL) had serum erythropoietin level <=500 mU/ml prior to receiving recombinant erythropoietin (epoetin or darbepoietin) therapy

Quality Indicator – Higher Risk Patients

Guidelines for MDS recommend the use of azacitidine (category 1) or decitabine (category 2A) within the algorithm for the treatment of higher-risk MDS patients

Measure 5

Higher-risk (intermediate-2, or high-risk using IPSS or high risk or very high-risk using IPSS-R, and/or with excess blasts) MDS patient receiving azacitidine or decitabine.

Quality Indicator – Irradiated Transfusion Products

All directed-donor products and transfused products for potential stem cell transplant patients should be irradiated.

Measure 6

MDS patient who is a candidate for allogeneic stem cell transplant receiving irradiated transfusion products

Quality Indicator – Clinical Trial Eligibility

Clinical trials…remain the hallmark of management for this disease. Progress toward improving management of MDS has occurred over the past few years and more such advances are anticipated using these guidelines as a framework for coordination of comparative clinical trials.

Measure 7

Diagnosis of MDS and eligibility for clinical trial checked at least once a year

Meeting Evaluations

Q: Can I claim my CME from the ASH Annual Meeting here?
A: No, CME from the ASH annual meeting is not available on this site. Complete information is here

Instructions for claiming CME credit for the ASH Annual Meeting are published in the Preliminary Program Brochures and in the Annual Meeting Program Books, and the links to the CME Credit site are featured on the ASH homepage for 4 months following each meeting.

Teaching Cases

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