Acquisition of procedural skills in pre-registration physiotherapy education comparing mental practice against no mental practice: The Learning of Procedures in Physiotherapy Education Trial - a development of concept study

Kavi Jagadamma - ORCID 0000-0003-2011-0744 https://orcid.org/0000-0003-2011-0744Gillian Baer - ORCID 0000-0002-1528-2851 https://orcid.org/0000-0002-1528-2851Introduction: Procedural skills are a central element in the education of physiotherapists. Procedural skills relate to the execution of a practical task. An educational intervention, which can be used to support skill acquisition of procedural skills, is mental practice (MP). Several studies have investigated the use of MP or imaging in medical education. This pilot study evaluated the application of MP on the acquisition of procedural skills in physiotherapy education.Methods: This pilot randomised controlled study recruited a convenience sample of 37 BSc physiotherapy student participants. Two different complex task procedures (transfer and vestibular rehabilitation) were trained during this study. Participants in both the transfer (task procedure 1) and the vestibular rehabilitation (task procedure 2) arm of the study were randomly assigned to either MP or no MP.Results: For the transfer task, median performance at post-acquisition testing showed a moderate effect size in favour of the group using MP (r: −0.3), but the findings were not statistically significant (P: 0.2). Similar results were found for the vestibular rehabilitation task (r: 0.29; P: 0.21). In addition, the self-reported confidence was higher in the MP group.Conclusion: Moderate effect sizes were identified in favour of MP at post-acquisition testing. In addition, the between-group difference was higher than the minimally important difference. The feasibility of the study was high based on quantitative feasibility measures such as the recruitment rate. Both these findings suggest larger well-powered studies should be considered to confirm the findings of this pilot study.https://doi.org/10.1177/23821205209273827pubpu

The recovery of walking ability and subclassification of stroke.

BACKGROUND AND PURPOSE: The recovery of walking after a stroke is a key functional goal for many patients. Reports vary, but approximately 50-80% of patients will regain some degree of walking ability following stroke (Skilbeck et al., 1983). There are few data available to show whether different subclassifications of stroke have distinct patterns of gait recovery. The present paper describes the pattern of walking recovery in a population of stroke patients classified according to the Oxfordshire Community Stroke Project classification (Bamford et al., 1991). METHOD: A prospective observational study. Stroke patients (n = 238) admitted to the inpatient Stroke Rehabilitation Unit at the Western General Hospital, Edinburgh were initially included, with data for 185 patients ultimately available for analysis. Standardized measures of recovery of 10 steps and a 10-metre walk were used routinely to examine recovery time of walking ability. The main outcome measures consisted of days taken to achieve a 10-step walk, days to achieve a 10-metre walk, and initial and discharge gait velocity over 10 meters. RESULTS: Eighty-nine per cent of the sample (n = 164) achieved a 10-step walk in a median time of five days and a 10-metre walk in eight days. The median initial gait velocity was 0.45 m/s which improved by discharge to 0.55 m/s. Further analysis by subgroup revealed that subjects sustaining a partial anterior circulation infarct, lacunar infarct or posterior circulation infarct recovered significantly more quickly than those subjects with a total anterior circulation infarct (Kruskal Wallis test for days to achieve 10 steps (H = 22.524, N = 164, df = 3) p < 0.001; Kruskal Wallis test for days to achieve a 10-metre walk (H = 22.586, N = 164, df = 3) p < 0.001. CONCLUSIONS: An hierarchical pattern of recovery of gait was observed with definite variation between the subclassifications of stroke. It is suggested that further work needs to be undertaken to identify more accurately the factors that may influence the recovery of walking following stroke.sch_phy6pub1017pub

The assessment of procedural skills in physiotherapy education: A measurement study using the Rasch model

Gillian Baer - ORCID 0000-0002-1528-2851 https://orcid.org/0000-0002-1528-2851Replaced AM with VoR 2020-05-26Background: Procedural skills are a key element in the training of future physiotherapists. Procedural skills relate to the acquisition of appropriate motor skills, which allow the safe application of clinical procedures to patients. In order to evaluate procedural skills in physiotherapy education validated assessment instruments are required. Recently the assessment of procedural skills in physiotherapy education (APSPT) tool was developed. The overall aim of this study was to establish the structural validity of the APSPT. In order to do this the following objectives were examined: i) the fit of the items of APSPT to the Rasch-model, ii) the fit of the overall score to the Rasch model, iii) the difficulty of each test item and iv) whether the difficulty levels of the individual test items cover the whole capacity spectrum of students in pre-registration physiotherapy education.Methods: For this observational cross-sectional measurement properties study a convenience sample of 69 undergraduate pre-registration physiotherapy students of the HES-SO Valais-Wallis was recruited. Participants were instructed to perform a task procedure on a simulated patient. The performance was evaluated with the APSPT. A conditional maximum likelihood approach was used to estimate the parameters of a partial credit model for polytomous item responses. Item fit, ordering of thresholds, targeting and goodness of fit to the Rasch model was assessed.Results: Item fit statistics showed that 25 items of the APSPT showed adequate fit to the Rasch model. Disordering of item thresholds did not occur and the targeting of the APSPT was adequate to measure the abilities of the included participants. Undimensionality and subgroup homogeneity were confirmed.Conclusion: This study presented evidence for the structural validity of the APSPT. Undimensionality of the APSPT was confirmed and therefore presents evidence that the latent dimension of procedural skills in physiotherapy education consists of several subcategories. However, the results should be interpreted with caution given the small sample size.https://doi.org/10.1186/s40945-020-00080-010pubpu

Level of diagnostic agreement in musculoskeletal shoulder diagnosis between remote and face‐to‐face consultations: A retrospective service evaluation

From Wiley via Jisc Publications RouterHistory: received 2023-11-28, rev-recd 2024-03-22, ppub 2024-04-01, accepted 2024-04-03, epub 2024-04-21Article version: VoRPublication status: PublishedLouise Cockburn - ORCID: 0000-0002-2713-4645 https://orcid.org/0000-0002-2713-4645Gill Baer - ORCID: 0000-0002-1528-2851 https://orcid.org/0000-0002-1528-2851Background and Aims: To determine the level of diagnostic agreement between remote and face‐to‐face consultation in assessing shoulder complaints. Methods: A retrospective service evaluation with three groups of patient data; those assessed only face‐to‐face (group 1), remotely then face‐to‐face (group 2), remotely only (group 3). Patient data were extracted from 6 secondary care shoulder Advanced Physiotherapy Practitioner's (APPs) records, covering six sites. Three‐hundred‐and‐fifty‐nine sets of patient data were included in the final evaluation. The main outcome measure was the percentage of agreement between diagnosis at initial and follow‐up consultation, when assessed by APPs across the three groups. A Pearson χ2 test was used to assess the relationship between the method of consultation and the level of diagnostic agreement. Diagnoses were categorized as either the same, similar, or different by an independent APP. Secondary outcome measures investigated whether age or the length of time between appointments had any effect in determining the level of diagnostic concordance. Results: There was exact agreement of 77.05% and 85.52% for groups 1 and 3, respectively, compared with 34.93% for patient data in group 2. Similar clinical impressions across both initial and follow‐up were seen 16.39% of the time in group 1, 7.24% of the time in group 3, and 36.99% in group 2. Lastly, the percentage of times a diagnosis was changed between initial and review appointments occurred in only 6.56% of group 1 contacts, 7.24% of group 3 contacts, but 28.08% of the time in group 2. Conclusion: There was a large mismatch in the diagnosis of musculoskeletal shoulder complaints, when patients are initially assessed remotely and then followed‐up in‐person. This has implications for the future provision of shoulder assessment in physiotherapy.pubpu

Assessment von prozeduralen Fähigkeiten in der physiotherapeutischen Ausbildung: Ein systematischer Review

Introduction: Learning of procedural skills is important in the education of physiotherapists. It is the aim of physiotherapy degree programmes that graduates are able to practice selected procedures safely and efficiently. Procedural competency is threatened by an increasing and diverse amount of procedures that are incorporated in university curricula. As a consequence, less time is available for the learning of each specific procedure. Incorrectly performed procedures in physiotherapy might be ineffective and may result in injuries to patients and physiotherapists. The aim of this review was to synthesise relevant literature systematically to appraise current knowledge relating to assessments for procedural skills in physiotherapy education. Method: A systematic search strategy was developed to screen five relevant databases (CINAHL, Cochrane Central, SportDISCUS, ERIC and MEDLINE) for eligible studies. The included assessments were evaluated for evidence of their reliability and validity. Results: The search of electronic databases identified 560 potential records. Seven studies were included into this systematic review. The studies reported eight assessments of procedural skills. Six of the assessments were designed for a specific procedure and two assessments were considered for the evaluation of more than one procedure. Evidence to support the measurement properties of the assessment was not available for all categories. Discussion: It was not possible to recommend a single assessment of procedural skills in physiotherapy education following this systematic review. There is a need for further development of new assessments to allow valid and reliable assessments of the broad spectrum of physiotherapeutic practice.https://doi.org/10.1515/ijhp-2017-0008sch_phy4pub4685pub

A systematic review and meta-analysis of selected motor learning principles in physiotherapy and medical education

Background Learning of procedural skills is an essential component in the education of future health professionals. There is little evidence on how procedural skills are best learnt and practiced in education. There is a need for educators to know what specific interventions could be used to increase learning of these skills. However, there is growing evidence from rehabilitation science, sport science and psychology that learning can be promoted with the application of motor learning principles. The aim of this review was to systematically evaluate the evidence for selected motor learning principles in physiotherapy and medical education. The selected principles were: whole or part practice, random or blocked practice, mental or no additional mental practice and terminal or concurrent feedback. Methods CINAHL, Cochrane Central, Embase, Eric and Medline were systematically searched for eligible studies using pre-defined keywords. Included studies were evaluated on their risk of bias with the Cochrane Collaboration's risk of bias tool. Results The search resulted in 740 records, following screening for relevance 15 randomised controlled trials including 695 participants were included in this systematic review. Most procedural skills in this review related to surgical procedures. Mental practice significantly improved performance on a post-acquisition test (SMD: 0.43, 95 % CI 0.01 to 0.85). Terminal feedback significantly improved learning on a transfer test (SMD: 0.94, 95 % CI 0.18 to 1.70). There were indications that whole practice had some advantages over part practice and random practice was superior to blocked practice on post-acquisition tests. All studies were evaluated as having a high risk of bias. Next to a possible performance bias in all included studies the method of sequence generation was often poorly reported. Conclusions There is some evidence to recommend the use of mental practice for procedural learning in medical education. There is limited evidence to conclude that terminal feedback is more effective than concurrent feedback on a transfer test. For the remaining parameters that were reviewed there was insufficient evidence to make definitive recommendations.Britain has a serious shortage of nurses, as well as problems in recruiting and retaining them It is not simply that there are too few nurses; some key skills shortages also exist, with increasing demand for more qualified staff in some areas Much better planning of the workforce is required, and this needs to be more integrated with the planning for other groups in healthcare A change in the pay system may help, but the creation of better work environments may be part of the solution The rapid pace of change in the nursing profession has produced a challenge that the NHS needs to addresssch_phy16pub4254pub1

Treadmill Training to improve mobility for people with sub-acute Stroke: A Phase II Feasibility Randomised Controlled Trial

Objective: This phase II study investigated the feasibility and potential effectiveness of treadmill training versus normal gait re-education for ambulant and non-ambulant people with sub-acute stroke delivered as part of normal clinical practice. Design: A single-blind, feasibility randomised controlled trial. Setting: Four hospital-based Stroke units Subjects: Participants within three months of stroke onset. Interventions: Participants were randomised to treadmill training (minimum twice weekly) plus normal gait re-education or normal gait re-education only (control) for up to eight weeks. Main Measures: Measures were taken at baseline, after eight weeks intervention and at six months follow up. The primary outcome was the Rivermead Mobility Index. Other measures included the Functional Ambulation Category, 10 metre walk, six minute walk, Barthel Index, Motor Assessment Scale, Stroke Impact Scale and a measure of confidence in walking. Results: Seventy seven patients were randomised, 39 to treadmill and 38 to control. It was feasible to deliver treadmill training to people with sub-acute stroke. Only two adverse events occurred. No statistically significant differences were found between groups. For example, Rivermead Mobility Index, median (IQR): after eight weeks treadmill 5 (4-9), control 6 (4-11) p = 0.33; or six months follow-up treadmill 8.5 (3 -12), control 8 (6 - 12.5) p = 0.42. The frequency and intensity of intervention was low. Conclusions: Treadmill training in sub-acute stroke patients was feasible but showed no significant difference in outcomes when compared to normal gait re-education. A large definitive randomised trial is now required to explore treadmill training in normal clinical practice.sch_phy1. Lord S, McPherson KM, McNaughton HK, et al. How feasible is the attainment of community ambulation after stroke? A pilot randomized controlled trial to evaluate community-based physiotherapy in subacute stroke. Clin Rehab 2008; 22(3): 215-225 2. Mehrholz J, Pohl M and Elsner B. Treadmill training and body weight support for walking after stroke. Cochrane Database of Systematic Reviews 2014, Issue 1. Art. No.: CD002840. DOI: 10.1002/14651858.CD002840.pub3. 3. Wade DT, Wood VA, Heller A, et al. Walking after stroke. Measurement of recovery over the first three months. Scan J Rehab Med 1987; 19: 25-30. 4. Jrgensen HS, Nakayama H, Raaschou HO, et al. Recovery of walking function in stroke patients: the Copenhagen Stroke Study. Arch Phys Med Rehabil, 1995; 76 (1): 27-32 5. Francheschini M, Carda S, Agosti M, et al. Walking after stroke: What does treadmill training with body weight support add to overground gait training in patients early after stroke? A single blind randomised controlled trial. Stroke 2009; 40 (6): 3079 - 3085. 6. Hyer E, Jahnsen R, Stanghelle JK, et al. Body weight supported treadmill training versus traditional training in patients dependent on walking assistance after stroke: a randomized controlled trial. Disabil Rehabil 2012; 34 (3):. 210-9. 7. Ada L, Dean CM and Lindley R. Randomized trial of treadmill training to improve walking in community-dwelling people after stroke: the AMBULATE trial. Int J Stroke 2013; 8 (6):436-44. 8. Macko RF, Ivey FM, Forrester LW, et al. Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke: a randomised controlled trial. Stroke 2005; 36 (10): 2206-11. 9. Globas C, Becker C, Cerny J, et al. Chronic stroke survivors benefit from high-intensity aerobic treadmill exercise: a randomized control trial. Neurorehabil Neural Repair 2011; 26 (1): 85-95. 10. Mackay-Lyons M, McDonald A, Matheson J, et al. Dual effects of body-weight supported treadmill training on cardiovascular fitness and walking ability early after stroke: a randomized controlled trial. Neurorehabil Neural Repair 2013; 27 (7): 644-53. 11. WHO MONICA Project Investigators. The World Health Organization MONICA Project (Monitoring trends and determinants in cardiovascular disease). J Clin Epidemiol 1988; 41:105-114. 12. Altman DG and Bland JM. Treatment allocation by minimisation. BMJ 2005; 330: 843. 13. Holden MK, Gill KM and Magliozzi MR. Gait Assessment for Neurologically Impaired Patients: Standards for Outcome Assessment. Phys Ther 1986; 66(10): 1530-1539. 14. Collen FM, Wade DT, Robb GF, et al, The Rivermead Mobility Index: a further development of the Rivermead Motor Assessment. Int Disabil Studies 1991; 1 (3): 50-54. 15. Podsiadlo D and Richardson S. The timed Up & Go-: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc. 1991; 39: 142-148. 16. Guyatt GH, Sullivan MJ, Thompson PJ, et al. The 6-minute walk: a new measure of exercise capacity in patients with chronic heart failure. Can Med Assoc J 1985;132: 919-23. 17. Duncan P, Richards L, Wallace D, et al. Randomized, Controlled Pilot Study of a Home-Based Exercise Program for Individuals With Mild and Moderate Stroke. Stroke 1998; 29: 2055-2060. 18. Carr J, Shepherd R, Nordholm L, et al. Investigation of a new motor assessment scale for stroke patients. Phys Ther 1985; 65 (2): 175-80. 19. Mahoney FI and Barthel DW. Functional evaluation: the Barthel Index. Maryland State Med J 1965; 14( 2): 56-61 20. Duncan P, Bode R, Min Lai S, et al. Rasch analysis of a new stroke-specific outcome scale: The Stroke Impact Scale. Arch Phys Med Rehabil 2003; 84(7): 950-63. 21. Siddiqui O, and Ali MW. A comparison of the random-effects pattern mixture model with last-observation-carried-forward (LOCF) analysis in longitudinal clinical trials with dropouts. J Biopharm Stat 1998; 8(4): 545-63. 22. Visintin M, Barbeau H, Korner-Bitensky N et al. A new approach to retrain gait in stroke patients through body weight support and treadmill stimulation. Stroke 1998; 29 (6): 1122-8. 23. McCain KJ, Pollo FE, Baum BS, et al. Locomotor treadmill training with partial body-weight support before overground gait in adults with acute stroke: a pilot study. Arch Phys Med Rehabil 2008; 89 (4): 684-91. 24. da Cunha IT, Lim PA, Qureshy H, et al. Gait outcomes after acute stroke rehabilitation with supported treadmill ambulation training: a randomized controlled pilot study. Arch Phys Med Rehabil. 2002; 83 (9): 1258-65. 25. NHS Scotland. Scottish Stroke Care Audit. 2015 National Report. Edinburgh: ISD Scotland http://www.strokeaudit.scot.nhs.uk/Downloads/2015_report/SSCA-report-2015-web.pdf32pub4752pub

Forum: Feminism in German Studies

From Professor Wallach\u27s contribution entitled Jews and Gender : To consider Jews and gender within German Studies is to explore the evolution of German‐Jewish Studies with respect to feminist and gender studies. At times this involves looking beyond German Studies to other scholarship in Jewish gender studies, an interdisciplinary subfield in its own right. Over the past few decades, the focus on gender within German‐Jewish Studies has experienced several shifts in line with broader trends: an initial focus on the history of Jewish women and feminist movements gradually expanded to encompass the study of gender identity, masculinity, and sexuality. Historical and literary scholarly approaches now operate alongside and in dialogue with interdisciplinary scholarship in cultural studies, film and visual studies, performance studies, and other fields. [excerpt

Computer-Assisted versus Oral-and-Written History Taking for the Prevention and Management of Cardiovascular Disease: a Systematic Review of the Literature

Background and objectives: CVD is an important global healthcare issue; it is the leading cause of global mortality, with an increasing incidence identified in both developed and developing countries. It is also an extremely costly disease for healthcare systems unless managed effectively. In this review we aimed to: – Assess the effect of computer-assisted versus oral-and-written history taking on the quality of collected information for the prevention and management of CVD. – Assess the effect of computer-assisted versus oral-and-written history taking on the prevention and management of CVD. Methods: Randomised controlled trials that included participants of 16 years or older at the beginning of the study, who were at risk of CVD (prevention) or were either previously diagnosed with CVD (management). We searched all major databases. We assessed risk of bias using the Cochrane Collaboration tool. Results: We identified two studies. One comparing the two methods of history-taking for the prevention of cardiovascular disease n = 75. The study shows that generally the patients in the experimental group underwent more laboratory procedures, had more biomarker readings recorded and/or were given (or had reviewed), more dietary changes than the control group. The other study compares the two methods of history-taking for the management of cardiovascular disease (n = 479). The study showed that the computerized decision aid appears to increase the proportion of patients who responded to invitations to discuss CVD prevention with their doctor. The Computer-Assisted History Taking Systems (CAHTS) increased the proportion of patients who discussed CHD risk reduction with their doctor from 24% to 40% and increased the proportion who had a specific plan to reduce their risk from 24% to 37%. Discussion: With only one study meeting the inclusion criteria, for prevention of CVD and one study for management of CVD we did not gather sufficient evidence to address all of the objectives of the review. We were unable to report on most of the secondary patient outcomes in our protocol. Conclusions: We tentatively conclude that CAHTS can provide individually-tailored information about CVD prevention. However, further primary studies are needed to confirm these findings. We cannot draw any conclusions in relation to any other clinical outcomes at this stage. There is a need to develop an evidence base to support the effective development and use of CAHTS in this area of practice. In the absence of evidence on effectiveness, the implementation of computer-assisted history taking may only rely on the clinicians’ tacit knowledge, published monographs and viewpoint articles

Selective inhibition of FLT3 by gilteritinib in relapsed or refractory acute myeloid leukaemia: a multicentre, first-in-human, open-label, phase 1-2 study.

BackgroundInternal tandem duplication mutations in FLT3 are common in acute myeloid leukaemia and are associated with rapid relapse and short overall survival. The clinical benefit of FLT3 inhibitors in patients with acute myeloid leukaemia has been limited by rapid generation of resistance mutations, particularly in codon Asp835 (D835). We aimed to assess the highly selective oral FLT3 inhibitor gilteritinib in patients with relapsed or refractory acute myeloid leukaemia.MethodsIn this phase 1-2 trial, we enrolled patients aged 18 years or older with acute myeloid leukaemia who either were refractory to induction therapy or had relapsed after achieving remission with previous treatment. Patients were enrolled into one of seven dose-escalation or dose-expansion cohorts assigned to receive once-daily doses of oral gilteritinib (20 mg, 40 mg, 80 mg, 120 mg, 200 mg, 300 mg, or 450 mg). Cohort expansion was based on safety and tolerability, FLT3 inhibition in correlative assays, and antileukaemic activity. Although the presence of an FLT3 mutation was not an inclusion criterion, we required ten or more patients with locally confirmed FLT3 mutations (FLT3mut+) to be enrolled in expansion cohorts at each dose level. On the basis of emerging findings, we further expanded the 120 mg and 200 mg dose cohorts to include FLT3mut+ patients only. The primary endpoints were the safety, tolerability, and pharmacokinetics of gilteritinib. Safety and tolerability were assessed in the safety analysis set (all patients who received at least one dose of gilteritinib). Responses were assessed in the full analysis set (all patients who received at least one dose of study drug and who had at least one datapoint post-treatment). Pharmacokinetics were assessed in a subset of the safety analysis set for which sufficient data for concentrations of gilteritinib in plasma were available to enable derivation of one or more pharmacokinetic variables. This study is registered with ClinicalTrials.gov, number NCT02014558, and is ongoing.FindingsBetween Oct 15, 2013, and Aug 27, 2015, 252 adults with relapsed or refractory acute myeloid leukaemia received oral gilteritinib once daily in one of seven dose-escalation (n=23) or dose-expansion (n=229) cohorts. Gilteritinib was well tolerated; the maximum tolerated dose was established as 300 mg/day when two of three patients enrolled in the 450 mg dose-escalation cohort had two dose-limiting toxicities (grade 3 diarrhoea and grade 3 elevated aspartate aminotransferase). The most common grade 3-4 adverse events irrespective of relation to treatment were febrile neutropenia (97 [39%] of 252), anaemia (61 [24%]), thrombocytopenia (33 [13%]), sepsis (28 [11%]), and pneumonia (27 [11%]). Commonly reported treatment-related adverse events were diarrhoea (92 [37%] of 252]), anaemia (86 [34%]), fatigue (83 [33%]), elevated aspartate aminotransferase (65 [26%]), and increased alanine aminotransferase (47 [19%]). Serious adverse events occurring in 5% or more of patients were febrile neutropenia (98 [39%] of 252; five related to treatment), progressive disease (43 [17%]), sepsis (36 [14%]; two related to treatment), pneumonia (27 [11%]), acute renal failure (25 [10%]; five related to treatment), pyrexia (21 [8%]; three related to treatment), bacteraemia (14 [6%]; one related to treatment), and respiratory failure (14 [6%]). 95 people died in the safety analysis set, of which seven deaths were judged possibly or probably related to treatment (pulmonary embolism [200 mg/day], respiratory failure [120 mg/day], haemoptysis [80 mg/day], intracranial haemorrhage [20 mg/day], ventricular fibrillation [120 mg/day], septic shock [80 mg/day], and neutropenia [120 mg/day]). An exposure-related increase in inhibition of FLT3 phosphorylation was noted with increasing concentrations in plasma of gilteritinib. In-vivo inhibition of FLT3 phosphorylation occurred at all dose levels. At least 90% of FLT3 phosphorylation inhibition was seen by day 8 in most patients receiving a daily dose of 80 mg or higher. 100 (40%) of 249 patients in the full analysis set achieved a response, with 19 (8%) achieving complete remission, ten (4%) complete remission with incomplete platelet recovery, 46 (18%) complete remission with incomplete haematological recovery, and 25 (10%) partial remission INTERPRETATION: Gilteritinib had a favourable safety profile and showed consistent FLT3 inhibition in patients with relapsed or refractory acute myeloid leukaemia. These findings confirm that FLT3 is a high-value target for treatment of relapsed or refractory acute myeloid leukaemia; based on activity data, gilteritinib at 120 mg/day is being tested in phase 3 trials.FundingAstellas Pharma, National Cancer Institute (Leukemia Specialized Program of Research Excellence grant), Associazione Italiana Ricerca sul Cancro