S430 Gaps in Diagnosis and Treatment of EGIDs Revealed in Online CME Clinical Practice Assessment

Introduction: Eosinophilic gastrointestinal diseases (EGIDs) are a group of rare diseases characterized by increased presence of eosinophils in the GI tract. This study was designed to assess the current knowledge, competence, and practice barriers in the diagnosis and treatment of EGIDs. Methods: A 24-question CME clinical practice assessment survey consisting of multiple-choice knowledge- and case-based questions evaluating the pathophysiology, diagnosis, and treatment of EGIDs was made available online to gastroenterologists in the United States without monetary compensation or charge. The survey launched on a website dedicated to continuous professional development on January 7, 2021 and data were collected until April 5, 2021. Respondent confidentiality was maintained and responses were de-identified and aggregated prior to analyses. Results: 449 gastroenterologists completed all questions in the survey. The key findings include: Disease Awareness: Only 26% reported being mostly or very familiar with EGIDs. Only 12% knew the prevalence of EGIDs in the US. Pathophysiology of EGIDs: Only 51% recognized Th2 cells as implicated in EGID pathology. 88% knew Siglec-8 was present on eosinophils and mast cells. 71% recognized that mast cells were involved in GI symptoms of EGIDs. Diagnosis of EGIDs: Only 24% were mostly or very confident in their ability to diagnose patients with EGIDs. Only 56% recognized dysphagia as the most common symptom for EoE in adults. Only 56% knew that the diagnostic threshold for EoE was ≥15 eos/hpf. Only 50% knew that a normal appearance is the most common endoscopic finding for non-EoE EGIDs. 98% knew that endoscopy with multiple biopsies is recommended for EGID diagnosis. Treatment for EGIDs: Only 37% prescribed a swallowed topical steroid in the case of a patient with EoE who failed a PPI and elimination diet. Only 16% recognized the mechanism of action of Siglec-8 targeted agents. Only 14% knew the efficacy results of a study evaluating an elemental diet for EGIDs Conclusion: This research uncovered gaps regarding EGID disease awareness, its underlying pathology, diagnosis, and treatment approaches. These gaps will be used to inform future medical education for gastroenterologists and other clinicians who manage EGIDs.