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cian teaching time was positively correlated with discussion of any test-ordering principle (P < .001).

between 1960 and 2015 in English language. Phase II, III or IV clinical trials with atleast one study arm assessing a treatment of interest were included. PRO studies (not limited to RCTs) reporting quality-of-life (QoL) data for these compounds were included. Additionally, information was extracted from product package inserts of molecules within FDA indication. Archives of 27 HTA bodies were searched for qualifying HTAs of these compounds as well. Patient characteristics, primary and secondary endpoints, safety, QoL and reimbursement decisions were extracted exhaustively from qualifying studies and HTAs. Results: So far, data are available for 15 cancers, including 90 agents in 487 studies. The interactive, user-friendly MS-Excel® based tool can be used to study any selected cancer, including conduct meta-analyses, generate summaries and reports of clinical, PRO and HTA data. The registry provides functionality for a user to make desired assessments via multiple variables such as line of treatment, tumor-stage, molecule, grade of adverse events and so on. ConClusions: OncoLitBank provides up-to-date data and a robust platform that can be easily used for systematic reviews, to conduct direct and indirect comparisons through meta-analyses, to inform economic models, perform landscape analyses, produce value dossiers,and to create target product profiles and value development plans. Expansion of searches to other literature databases and trial registries and inclusion of economic and epidemiology studies are underway.

The approach to clinical conundrums by an expert clinician is revealed through the presentation of an actual patient's case in an approach typical of a morning report. Similarly to patient care, sequential pieces of information are provided to the clinician, who is unfamiliar with the case. The focus is on the thought processes of both the clinical team caring for the patient and the discussant. A 66-year-old man presented to the Emergency Department (ED) with rash and malaise in early April. He was in his usual state of good health until the morning of presentation, when he awoke feeling lethargic. Over the course of the day, his hands and feet grew cold and numb, his nose became dark red, and he developed a diffuse, net-like red rash over his legs, hands, buttocks, and trunk. He had multiple maroon bowel movements. His wife noted that he became ''incoherent'' and brought him to the ED.This apparently previously healthy man presented with an acute episode of fatigue and altered mental status accompanied by a prominent cutaneous eruption. The differential diagnosis will ultimately be guided by the morphology of the rash. At this stage, infectious diseases, drug or toxin exposure, and allergic processes including anaphylaxis must all be considered in this patient with rash and acute illness. The maroon bowel movements likely represent a gastrointestinal bleed that may be part of a unifying diagnosis-a hematologic disorder, a vasculitis, or liver disease.In the ED, the patient was reportedly febrile (exact temperature not recorded) with a blood pressure of 96/54 mmHg. He had pulse oximetry of 88% on room air and a diffuse purpuric rash. The patient was noted to have a leukocytosis, thrombocytopenia, coagulopathy, and an elevation of his creatinine and cardiac enzymes. He was given fluids, fresh frozen plasma, and broad-spectrum antibiotics, and transferred directly to the intensive care unit of a tertiary medical center for further management.Upon arrival to the intensive care unit, he complained of fatigue, progression of his nonpruritic, nonpainful rash, and worsening numbness and tingling of his extremities. He denied headache, nuchal rigidity, photophobia, vision or hearing changes, chest pain, cough, abdominal pain, myalgias, or arthralgias. While being interviewed, he had dark brown emesis and a bloody bowel movement.The patient's past medical history included bacterial pericarditis as a teenager and remote hepatitis of unclear etiology. He rarely saw a physician, took no medications, and had no known medication allergies.

Background: Many internal medicine residency programs have incorporated ultrasonography into their curriculum; however, its integration with physical examination skills teaching at a graduate medical level is scarce. The program’s aim is to create a reproducible elective that combines physical exam and bedside ultrasound as a method for augmenting residents’ knowledge and competence in these techniques with the ultimate goal of improving patient care. Methods: We designed and implemented a two-week elective rotation for senior internal medicine residents, combining evidence-based physical examination with diagnostic bedside ultrasonography. The rotation took place in an inpatient setting at Denver Health Hospital. Program evaluation data was collected data between February 2016 to March 2019. IRB approval was waived. Results: Since its inception in 2016, 19 residents completed the rotation. Residents performed a pre-test and a post-test under direct observation by course faculty. Each resident was measured on the ability to perform pre-determined physical exam and point-of-care ultrasound (POCUS) skills. In the pre-test, participants correctly performed an average of 40% of expected physical exam maneuvers and 32% of expected POCUS skills. At elective conclusion, all participants were effectively able to demonstrate the highest yield physical exam and ultrasound maneuvers. Discussion and Conclusion: An elective designed specifically to integrate POCUS and physical exam modalities improves the ability of resident physicians to utilize both diagnostic modalities.