Motorcycle helmet laws are perceived to infringe upon individual rights even though they reduce mortality and health care costs. We describe proposed helmet legislation that protects individual rights and provides incentives for helmet use through a differential motorcycle registration fee that requires higher fees for those who wish to ride without a helmet.

Introduction: Although statins represent the cornerstone of dyslipidemia treatment, certain statins may increase the incidence of new-onset diabetes mellitus (DM). This study was conducted to determine if online continuing medical education (CME) could improve knowledge/competence of diabetologists/endocrinologists (D/E) and primary care physicians (PCPs) in tailoring statin therapy to reduce the risk for DM. Methods: Physicians participated in at least one of two 30-minute video-based online CME activities. The activities addressed educational themes related to effects of statins on lipid metabolism and tailoring statin therapy to reduce the risk of DM. 6 matching pre-education/post-education questions associated with these themes were analyzed by comparing participant responses from pre- to post-education using a repeated-pairs design. For all questions combined, the McNemar’s chi-square test was used to assess differences from pre- to post-assessment. Results: Significant improvements (P < .05) were seen after education across both CME activities for D/E (N=438) and PCPs (N=1023). For all questions combined, average relative improvements in knowledge/competence were 44% for D/E and 73% for PCPs (P<.05). Pre-assessment, the average correct response rate was 43% for D/E and 48% for PCPs, while post-assessment average correct response rates were 62% and 83%, respectively. Significant improvements were observed (all P<.05): effect of statins on glucose metabolism: 49% relative improvement among D/E (43% vs. 64%) and 103% improvement among PCPs (37% vs. 75%). Tailoring statin therapy to reduce the risk of DM: 64% improvement among D/E (50% vs. 82%). Conclusions: This study demonstrates the success of online CME on improving knowledge/competence of D/E and PCPs regarding tailoring lipid-lowering strategies in high-risk patients. Properly implemented, this type of intervention can translate into improvements in guideline-based patient care and improve long-term outcomes for at-risk patients. Disclosure J. Spyropoulos: None. C.S. Healy: None.

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We assessed baseline knowledge of PCPs and diabetologists/endocrinologists (D/Es) and determine if an online continuing medical education (CME) could improve individualized treatment of patients with T2D. A 3-question knowledge and 1-question confidence linked pre-/post assessment study designed with McNemar’s chi-squared test (5% significance level P <.05) and Cramer’s V (<0.05 no effect; 0.06-0.15 small effect; 0.16-0.30 medium effect; >0.30 large effect) assessed educational effect. The activity launched December 19, 2017 and data collected through January 19, 2018. PCPs (N=585) demonstrated a lower baseline knowledge level compared to D/Es (N=118): • 29% of PCPs compared to 81% of D/Es correctly identified which basal insulin had a lower risk for hypoglycemia • 52% of PCPs compared to 75% of D/Es correctly identified the regimen needed to decrease the risk for hypoglycemia and maintain glucose control • 42% of PCPs compared to 62% of D/Es accurately distinguished between basal insulin and longer-acting basal insulin. Overall improvements were seen after participation in the CME activity for both PCPs (N=585, P<.0001, large effect V=0.343) and D/Es (N =118, P<.0001, medium effect V=0.290). • 48% of PCPS (P <.0001) and 15% of D/Es (P=.0008) improved related to risk of hypoglycemia with longer-acting basal insulin • 25% of PCPs (P<.0001) and 20% of D/Es (P=.0011) improved on selecting a regimen to minimize hypoglycemia risk • 40% of PCPs (P<.0001) and 35% of D/Es (P<.0001) improved related to differences in basal versus longer-acting basal insulin • 27% of PCPs and 15% of D/Es reported increased confidence in prescribing basal insulins for patients with T2D. This study demonstrates the success of CME online activity on improving clinical knowledge and confidence of PCPs and D/Es related to evidence-based use of basal insulin for T2D. PCPs especially would benefit from further education on differences between traditional and newer, longer-acting basal insulins. Disclosure A. Larkin: None. C.S. Healy: None. A. Le: None. Funding Novo Nordisk

Introduction: Mortality rates due to cardiovascular disease (CVD) are 2-4 times higher among people with diabetes than in those without. Glucose control reduces the risk of any CVD event by 42% and the risk of heart attack, stroke, or death from CVD by 57%. We assessed the hypothesis that continuing medical education (CME) improves knowledge and performance of cardiologists in managing glycemic control and other CV risk factors in patients with type 2 diabetes (T2D). Methods: Cardiologists who treat patients with coronary artery disease participated in at least 1 of 2 online CME activities within a curriculum on CV risks and outcomes in patients with T2D. Participant responses to a case-based survey after activity completion were compared with responses from demographically similar control groups of nonparticipants. Educational effect size was calculated using Cohen’s d formula, with a value of <0.4 representing a small effect, 0.4-0.8 a medium effect, and >0.8 a large effect. Results: Participating cardiologists (n = 151) were more likely to make evidence-based practice choices than were nonparticipating cardiologists. Activity 1: Improving CV Outcomes in Patients with T2D Multi-media format Increased Likelihood to Make Evidence-Based Practice Choices Post-Education: 33.5% Effect Size: 0.51 (N = 78) Activity 1: Assessing CV Risk in Patients with T2D Multi-media format Increased Likelihood to Make Evidence-Based Practice Choices Post-Education: 50.3% Effect Size: 0.87 (N = 73) Domain 1: Managing Glycemic Control and Other CV Risk Factors in Patients with CVD and T2D. Participating cardiologists significantly improved their consideration of comorbid conditions when deciding on a glucose management strategy (73% pre vs. 85% post) and selection of treatment for early intervention (85% pre vs. 96% post). Domain 2: Identification of Outcomes Data on Glucose-Lowering Agents in Patients with T2D and CVD. Participating cardiologists significantly improved in the recognition of antihyperglycemic agents shown in clinical trials to be safe for high risk CV patients (36% pre vs. 79% post) and in identification of the effect of saxagliptin on CV events in high risk CV patients with T2D (SAVOR TIMI 53 trial) (55% pre vs. 86% post). Domain 3: Application of Outcomes Data on Glucose-Lowering Agents in Patients with T2D and CVD. Participating cardiologists significantly improved in their selection of a DPP-4 inhibitor as the most appropriate antihyperglycemic agent for patients with T2D and CV risk factors or previous CV events (59% pre vs. 81% post and 53% pre vs. 73% post, respectively). Conclusion: This study demonstrated the success of a curriculum-style educational intervention using multimedia technology on improving knowledge and performance of cardiologists which can lead to enhanced management of CV risks and, thus, improved outcomes in patients with T2D and CVD.