I have just returned from the annual European Rheumatology EULAR 2013 meeting in Madrid. This massive conference was attended by about 14,000 delegates, with over 500 ‘posters’ per day and over 230 invited speakers. There were 10 concurrent oral sessions in the programme 4 or 5 times a day, often with very little time in between. I can remember many conferences in the past where I felt that I hadn’t get much out of the conference, but I think that this one was better than most. Over the years I have learned that it takes a lot of preparation and focus to make the most of the experience. For what it’s worth, I’m going to share with you how a I went about my preparation this year.
Physician, Know Thyself
Most of you will already know what your special interests are in clinical and/or research areas. One of your goals will be to keep up to date in these areas and to meet other researchers in the field. This could be the start of a very valuable collaboration in the future, and for younger trainees it might give you an idea as to which unit you would like to do research in. Experts in the field are more likely to be able to provide knowledgeable advice and insights.
First, I wrote out a list of my main interest areas and searched the abstracts before the conference using the EULAR app. This was a lot easier than trawling through the abstract book on the first evening of the conference, but it is difficult to keep focused!
Second, I starred the sessions and posters that I needed to visit. The EULAR app puts this into your ‘programme’ although I didn’t find this worked as well as the paper method when moving between sessions. I tried to keep the number of posters to visit down to 20-30 in one session. If there are really important posters where you need to speak to the lead author, make a beeline for those posters at the official poster viewing time. Looking at 20-30 interesting posters will probably take at least an hour and a half, but if pushed for time the paper handouts at some posters are very useful for later reference. These handouts (usually in colour) are expensive to produce and usually used by pharmaceutical or commercial companies. I saw a lot of people taking photographs of the posters and EULAR is more relaxed about this practice compared to the ACR meeting. If you do take photos I think you should certainly avoid posting them publicly. Some presenters are very happy for their work to be publicised others less so. I overheard a couple of presenters commenting (with pride) that everyone wanted to take a photo of their poster. Perhaps next year EULAR will have a release clause to indicate if the authors of posters are happy for photos to be taken/shared. It always seems a shame for people to put a lot of work into producing their posters and inevitably some people will not be able to see the result of their hard work until it is published in a journal. On Saturday I couldn’t get around half the posters I wanted to see as most of them were taken down early.
Third, I created themed notes with abstract collections. If there were any particularly important abstracts (such as those relating to the CONCERTO or AMPLE trials) I copied the text in the EULAR app and pasted them into a note in Evernote (which will make it easy to create themed notes and search for them in the future). It would be nice to be able do this direct from the EULAR app. Photographs on mobile phones can now be sent directly to Evernote – shared between devices etc. Another thing on my wish list – a 3 minute summary of the poster that people can download and listen to via the app or an internet site. For the first time this year I used the ‘share’ function in Evernote where an entire note can be shared over twitter. This may sound like an advert for Evernote, but I don’t know of any other easy way to do it. There are plenty of other note taking apps, including several that allow you to scribble your notes freehand. I used a Logitech keypad with my iPad (Courtesy of advice from Paul Sufka @TheRheumatologyPodcast). The only snag is that if you drop off to sleep your iPad will drop off as well!
Many of us make out a ‘personal development plan’ every year as part of our appraisal. We are encouraged to think of areas of weakness that need to be strengthened, and it is important not to ignore these areas completely. EULAR has ‘what’s new in…’ WIN sessions which are essentially summaries of the new developments in that field. There are also a series of HOT ‘How to treat’ sessions also arranged topically but focused more on therapeutics than research. This year I chose to go to sessions on myositis, systemic sclerosis and psoriatic arthritis. I also looked out for developments in early RA clinic treatment protocols and databases such as METEOR. There are practical sessions as well, but I didn’t focus on them this year.
I think it is also important to take a ‘patient-focused‘ approach. So for my next step I chose about 3 or 4 really difficult clinical situations I have faced in the last year, including a patient with severe RA and an unusual peripheral neuropathy, a patient with a severe case of polymyositis/IBM and another with severe MPA vasculitis. I try to discuss it with another experienced clinician with expertise in that area and choose some posters/sessions to visit. I went to an excellent session on peripheral neuropathy which led me to consider a small fibre neuropathy as a possible diagnosis. I also picked out a poster tour on myositis and a couple of posters which were relevant. I had discussions with colleagues as to how we can get access to some of the newer antibody tests for myositis. I found a poster on prognosis in lung/cardiac MPA which was very useful, so I think ‘job done’ on that goal. Of course, most doctors will use conferences to update their knowledge on patient safety issues, and there is always a lot of information on drug safety e.g. new biologic drugs compared to older ones.
The Social Side of Conferences
Of course, one of the most rewarding things about conferences is the ability to network with colleagues and ‘digest’ the new information we are hearing about. This allows us to assess if the new information will change what we actually do when we get back to the clinic, or plan how we can try and change the system we work in. A lot of doctors in the UK and elsewhere are finding it very difficult to deliver monthly ‘treat to target’ clinics in RA, but we had discussions about how we are moving toward this goal. I sought out some information to use to persuade the politicians/commissioners to invest in early arthritis (such as reductions in work disability).
There are useful opportunities to meet with patient representatives at the various organisation booths or at the PARE sessions. I attended my first PARE (patient association) session which gave a useful insight into the need to involve patients in the preparation of research proposals.
— Andrew Spong (@andrewspong) June 15, 2013
Of course, there are opportunities to visit the commercial stands – some of the ultrasound companies have educational sessions which demonstrate how to use the equipment. I took the opportunity to talk to a new company which uses a fluorescent dye imaging scanner to assess disease activity in the hands. This year I didn’t have much time for the pharmaceutical stands, but there were some great graphic displays to illustrate some of the newer pathways such as those involving Il-17.
If you are new to conferences, try to get someone with similar interests to go with you to a few sessions or at least meet up in between. Conferences can be very lonely places to be if you don’t manage to link up with the people you know.
Those with a strong academic or political bent will find that their meeting is full of intense research/EULAR meetings with their co-workers or potential collaborators. I once shared a taxi with a couple of well known professors – who held a pretty intense business meeting in the 15 minutes on the way to the conference center. I did manage to have some very useful meetings during the conference, including one which I hope will lead to a research collaboration in the future.
Social Media and the EULAR conference
One of the highlights of EULAR 2013 for me was the ‘Tweetup’ dinner with 6 rheumatology ‘tweeps’. We do know each other a little through tweeting but most of us had never met before in person. It was actually good ‘craic’ as the Irish would say, and Jose Campos our tweep from Madrid proved himself an excellent host. There was a social media session at 8:30 am on Saturday morning but this was in the smallest room in the conference centre which only holds 40 or 50 people. I might be a bit biased, but I think we did a better job of it at the Social Media session at the BSR!
There were over 3000 tweets from the conference using the tag #EULAR2013 – more than double the number last year. Rheumatologists who were not at the conference were able to join in the conversation and retweet the best tweets to a wider audience. It was no surprise to hear that EULAR was the top ‘trending’ conference on Twitter last week (the BSR achieved the same honour back in May). Patients and patient organisations are dying to hear the latest news as well, so bear in mind that they are listening in as well. Every informative tweet directed at the general public is likely to be appreciated. It is better if this comes from clinicians ‘with a pinch of salt’ rather than direct from pharma/commercial companies.
- Sharing new knowledge with colleagues and patients
- Extending knowledge by referring to the >3000 tweets with the EULAR2013 hashtag
- Extending knowledge by using the promised access to meetings you’ve missed (perhaps using the twitter feeds to work out which of the sessions were the best)
- Reviewing blogs written by our Rheumatology Tweeps (hoping to link to these soon)
- Looking up some of the references that the speakers have referred to in their talks. It is so much easier to do now that it often doesn’t matter if you didn’t quite get the whole reference down in your notes.
- Remember to file your certificate and record it as ‘CPD’ – you’ve definitely earned it!