SummaryGenetic and epigenetic alterations contribute to the biological and clinical characteristics of myelodysplastic syndromes (MDS), but a role for socioeconomic environment remains unclear. Here, socioeconomic status (SES) for 283 MDS patients was estimated using the Scottish Index of Multiple Deprivation tool. Indices were assigned to quintile categorical indicators ranked from SES1 (lowest) to SES5 (highest). Clinicopathological features and outcomes between SES quintiles containing 15%, 20%, 19%, 30% and 16% of patients were compared. Prognostic scores identified lower-risk MDS in 82% of patients, with higher-risk disease in 18%.SES quintiles did not associate with age, gender, cytogenetics, IPSS, or in subanalysis (n=95), driver mutations. The odds ratio of a diagnosis of RA was greater than other MDS sub-types in SES5 (OR 1.9, p=0.024). Most patients (91%) exclusively received supportive care. SES did not associate with leukaemictransformation or the cause of death. Cox regression models confirmed male gender (p<0.05), disease-risk (p<0.0001) and age (p<0.01) as independent predictors of leukaemia-free survival, with leukaemic-transformation an additional determinant of overall survival (p=0.07). Thus, if access to healthcare is equitable, SES does not determine disease biology or survival in MDS patients receiving supportive treatment; whether outcomes following disease-modifying therapies are influenced by SES requires additional studies.

hospital, particularly its role in managing patients concerns and avoiding hospital admission. Methods A retrospective audit of 1000 IBD patient calls between August 2019 and October 2019 was conducted. The help line covered patients across all Imperial Trust sites-Charing Cross, St Mary's and Hammersmith Hospitals. The data collected included the following-Time of call, diagnosis, mode of contact, when the call was answered, number of attempts, advice given by whom, call reason and outcome. Results The divide between UC and Crohn's was approximately equal (46.3% vs 48.5%). Out of the 1000 the majority (809) were direct patient contact. Voicemail was the most common mode of contact (577) followed closely by email (435). 84% of patients were answered on the same day, 12% the next day and 4% on another day. 84% of patients got through on the first attempt while 11% needed a second attempt and 5% required three attempts. Majority of the advice was given via telephone (70%), the second most common was email (24%). Most calls (25%) were regarding investigation/treatment, 21% regarding flares, 12% results, 11% admin, 11% advice, 7% homecare, 4% earlier appointment and 4% side effects. Regarding outcomes-28% involved investigation/treatment, 13% repeat prescriptions, 13% results, 12% advice, 7% appointments, 5% admin, 3% dose escalation, 3% home care, 3% contacted the consultant, 2% biologics switch, 2% A&E/ urgent care referrals and 1% support. Conclusions The service was highly efficient; 85% of calls were answered < 24 hours while the clear majority could get through on the first attempt. A significant amount of patient contact was via emailallowing flexibility of contact between IBD Specialist nurses, patients and medical team. The majority of calls and outcomes related to investigation, treatment and disease flare-updemonstrating that the service is being used appropriately. Only 2% of patients required A&E/urgent care referrals, demonstrating that access to specialist advice can reduce or avoid costly hospital admissions. These data are in keeping with systematic reviews that have all shown advice lines to be safe and cost-effective. Medication advice and monitoring was a common use of the advice linethis remote service helps provide a robust platform for toxicity surveillance. In order to maintain the high quality of the service, ongoing IBD Nurse education and prescribing, can help maintain high levels of efficiency, good patient care and a high level of patient satisfaction.