Relación de las calificaciones en la prueba ECOE de la administración catalana con el expediente académico y los resultados en la prueba MIR en estudiantes de Medicina de la UPF-UAB

In the Medicine studies of the Campus Mar in Barcelona (UPF-UAB) the OSCE test recommended by the Conference of Deans of Spain has not yet been implemented, but all the students take an OSCE designed by the Catalan health administration during their final year. We plan to carry out a study to establish the possible relationship between the results in the external ECOE test and those obtained in our Medical School. We also tried to establish the relationship between the results in the ECOE and in the MIR test. The study was carried out with all the graduates of the first four promotions of the UPF-UAB degree in Medicine who had taken the ECOE test and the MIR test. No differences between sexes were found in the OSCE achievement. In both men and women, there was a positive and significant relationship between the results of the OSCE and those of the final score and those of the MIR test. The results are positively valued since the final score is in line with the performance in a test where presumably the most relevant competencies that graduates in Medicine should have are adequately evaluated. The positive relationship between OSCE and MIR allows some peace of mind until at some point an exam can be implemented that assesses clinical and communication skills for access to specialized training.En los estudios de Medicina del Campus Mar de Barcelona (UPF-UAB, aunque todavía no se ha implementado la prueba ECOE recomendada por la Conferencia Nacional de Decanos de Facultades de Medicina (CNDFM), todos los estudiantes realizan durante su último año una ECOE diseñada por la administración sanitaria catalana. Nos planteamos realizar un estudio para establecer la posible concordancia entre los resultados en la prueba ECOE externa y los obtenidos en nuestro centro. También se pretendió establecer la relación entre los resultados en la ECOE y en la prueba MIR. El estudio se realizó con todos los graduados de las cuatro primeras promociones del grado en Medicina de la UPF-UAB que habían realizado la prueba ECOE y la prueba MIR. No se encontraron diferencias entre sexos en los resultados de la ECOE. Tanto en hombres como en mujeres, existió una relación positiva y significativa entre los resultados de la ECOE y los del expediente final y los de la prueba MIR.  Los resultados son valorados positivamente  ya que el expediente final está en consonancia con el rendimiento en una prueba donde presuntamente se evalúan de forma adecuada las competencias más relevantes que tendrían que tener los  graduados en Medicina. La relación positiva entre ECOE y MIR permite cierta tranquilidad hasta que en algún momento pueda implementarse una prueba no exclusivamente cognitiva para el acceso a la formación especializada

Titin Missense Variants as a Cause of Familial Dilated Cardiomyopathy.

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Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry.

BACKGROUND: The Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. METHODS AND RESULTS: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012-2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P < 0.001). Diabetes and coronary artery disease (CAD) were prevalent in 36.2% and 28.1% of patients as compared with global prevalence of 22.2% and 21.6%, respectively (P < 0.001 for both). Antiplatelet therapy was the most common antithrombotic treatment in India. With increasing stroke risk, however, patients were more likely to receive oral anticoagulant therapy [mainly vitamin K antagonist (VKA)], but average international normalized ratio (INR) was lower among Indian patients [median INR value 1.6 (interquartile range {IQR}: 1.3-2.3) versus 2.3 (IQR 1.8-2.8) (P < 0.001)]. Compared with other countries, patients from India had markedly higher rates of all-cause mortality [7.68 per 100 person-years (95% confidence interval 6.32-9.35) vs 4.34 (4.16-4.53), P < 0.0001], while rates of stroke/systemic embolism and major bleeding were lower after 1 year of follow-up. CONCLUSION: Compared to previously published registries from India, the GARFIELD-AF registry describes clinical profiles and outcomes in Indian patients with AF of a different etiology. The registry data show that compared to the rest of the world, Indian AF patients are younger in age and have more diabetes and CAD. Patients with a higher stroke risk are more likely to receive anticoagulation therapy with VKA but are underdosed compared with the global average in the GARFIELD-AF. CLINICAL TRIAL REGISTRATION-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01090362

Relationship of the scores in the OSCE test ofthe Catalan administration with the academicrecord and the results in the MIR exam in UPF-UAB Medical students.

En los estudios de Medicina del Campus del Mar de Barcelona (UPF-UAB), aunque todavía no se ha implementado la prueba ECOE recomendada por la Conferencia Nacional de Decanos de Facultades de Medicina (CNDFM), todos los estudiantes realizan durante su último año una ECOE diseñada por la administración sanitaria catalana con características similares a la de la CNDFM. Nos planteamos realizar un estudio para establecer la posible concordancia entre los resultados en laprueba ECOE externa y los obtenidos en nuestro centro. También se pretendióestablecer la relación entre los resultados en la ECOE y en la prueba MIR. El estudiose realizó con todos los graduados de las cuatro primeras promociones del grado enMedicina de la UPF-UAB que habían realizado la prueba ECOE y la prueba MIR. Nose encontraron diferencias entre sexos en los resultados de la ECOE. Tanto enhombres como en mujeres, existió una relación positiva y significativa entre losresultados de la ECOE y los del expediente final y los de la prueba MIR. Los resultados son valorados positivamente ya que el expediente final está en consonancia con el rendimiento en una prueba donde presuntamente se evalúan deforma adecuada las competencias más relevantes que tendrían que tener losgraduados en Medicina. La relación positiva entre ECOE y MIR permite cierta tranquilidad hasta que en algún momento pueda implementarse una prueba no exclusivamente cognitiva para el acceso a la formación especializada.Abstract: In the Medicine studies of the Campus Mar in Barcelona (UPF-UAB) theOSCE test recommended by the Conference of Deans of Spain (CNDFM) has not yetbeen implemented, but during their final year, all the students take an OSCEdesigned by the Catalan health administration with similar characteristics to that ofthe CNDFM. We plan to carry out a study to establish the possible relationshipbetween the results in the external ECOE test and those obtained in our MedicalSchool. We also tried to establish the relationship between the results in the ECOEand in the MIR test. The study was carried out with all the graduates of the first fourpromotions of the UPF-UAB degree in Medicine who had taken the ECOE test andthe MIR test. No differences between sexes were found in the OSCE achievement. Inboth men and women, there was a positive and significant relationship between theresults of the OSCE and those of the final score and those of the MIR test. Theresults are positively valued since the final score is in line with the performance in atest where presumably the most relevant competencies that graduates in Medicineshould have are adequately evaluated. The positive relationship between OSCE andMIR allows some peace of mind until at some point an exam can be implemented thatassesses clinical and communication skills for access to specialized training

Comparison of international normalized ratio audit parameters in patients enrolled in GARFIELD-AF and treated with vitamin K antagonists

Vitamin K antagonist (VKA) therapy for stroke prevention in atrial fibrillation (AF) requires monitoring of the international normalized ratio (INR). We evaluated the agreement between two INR audit parameters, frequency in range (FIR) and proportion of time in the therapeutic range (TTR), using data from a global population of patients with newly diagnosed non-valvular AF, the Global Anticoagulant Registry in the FIELD\u2013Atrial Fibrillation (GARFIELD-AF). Among 17\ua0168 patients with 1-year follow-up data available at the time of the analysis, 8445 received VKA therapy (\ub1antiplatelet therapy) at enrolment, and of these patients, 5066 with 653 INR readings and for whom both FIR and TTR could be calculated were included in the analysis. In total, 70\ua0905 INRs were analysed. At the patient level, TTR showed higher values than FIR (mean, 56\ub70% vs 49\ub78%; median, 59\ub77% vs 50\ub70%). Although patient-level FIR and TTR values were highly correlated (Pearson correlation coefficient [95% confidence interval; CI], 0\ub7860 [0\ub7852\u20130\ub7867]), estimates from individuals showed widespread disagreement and variability (Lin's concordance coefficient [95% CI], 0\ub7829 [0\ub7821\u20130\ub7837]). The difference between FIR and TTR explained 17\ub74% of the total variability of measurements. These results suggest that FIR and TTR are not equivalent and cannot be used interchangeably