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AA amyloidosis is a serious complication arising from chronic inflammatory conditions, yet its broad range of causes often leads to diagnostic delays. To address this, an interactive French-language online educational programme called the AA Challenge was created for physicians across multiple countries. Over a one-year period, twelve monthly clinical case quizzes were distributed alongside relevant literature reviews to test and enhance diagnostic recognition. Analysis of 2,597 responses showed that participants, predominantly specialists in internal medicine, nephrology, and rheumatology, achieved an overall correct response rate of 62.1 per cent. Diagnostic accuracy varied substantially depending on the underlying condition. Common causes such as Crohn's disease and rheumatoid arthritis were widely recognized, whereas rarer causes including AL amyloidosis, mevalonate kinase deficiency, and primary hyperoxaluria were frequently missed. Participants reported high satisfaction with this digital learning approach.
Delayed diagnosis of AA amyloidosis can lead to severe organ damage and poor health outcomes. By demonstrating where medical practitioners show diagnostic gaps, particularly regarding rarer underlying inflammatory diseases, this programme provides a clear model for using targeted digital quizzes and case reviews to strengthen clinical awareness and diagnostic competence among specialists internationally.
The initiative represents an applied and tested digital medical education tool. It could enable medical societies, continuing professional development providers, and healthcare training organisations to deliver interactive diagnostic training across distributed clinical networks. The abstract indicates the model is already deployed and validated in practice, with clear potential for adaptation to other complex or rare medical conditions requiring earlier and more accurate clinical diagnosis.
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Introduction: AA amyloidosis (inflammatory amyloidosis) is a rare but serious complication of chronic inflammatory diseases. Its etiological spectrum is broad, potentially contributing to delayed diagnosis, particularly when the underlying cause is rare or poorly recognized. We developed the AA Challenge, an interactive French-language online educational program based on clinical cases, to improve the recognition of the causes of AA amyloidosis among French-speaking physicians. Methods: The AA Challenge was an international, year-long educational program for French-speaking physicians. It consisted of monthly interactive clinical case quizzes, each illustrating a different cause of AA amyloidosis or a relevant differential diagnosis. Participants were asked to identify the underlying etiology based on the clinical, biological, and/or imaging data provided. The program was disseminated via email, social media, and the digital platforms of organizations involved in amyloidosis. An international steering committee comprising physicians from ten French-speaking countries contributed to the promotion of the program. Participants also received a monthly literature review on AA amyloidosis. Quiz responses, available participant characteristics, and the results of the final satisfaction survey were analyzed. Results: Twelve clinical cases were released between 2022 and 2023. A total of 2,968 responses were recorded on the Eval&Go® platform. After exclusion of duplicate submissions, 2,597 responses were included in the performance analysis. Information on medical specialty was available for 2,536 responses. Participants were primarily specialists in internal medicine (n=1,534; 59.1%), nephrology (n=470; 18.1%), and rheumatology (n=199; 7.7%). The most represented countries were Morocco (n=646; 24.9%), France (n=537; 20.7%), Romania (n=420; 16.2%), and Tunisia (n=273; 10.5%). Correct response rates varied by etiology, ranging from 29.9% for the AL amyloidosis quiz to 89.0% for the Crohn's disease quiz. The most accurately recognized etiologies were Crohn's disease, rheumatoid arthritis, and spondyloarthritis, whereas AL amyloidosis, tuberculosis-associated bronchiectasis, mevalonate kinase deficiency, cryopyrin-associated autoinflammatory syndromes (CAPS), and primary hyperoxaluria were less frequently identified. The overall correct response rate was 62.1%. The monthly literature review covered 25 publications on AA amyloidosis. The final satisfaction survey received 124 responses and demonstrated a high level of overall satisfaction, with a mean score of 8.61 ± 1.36 out of 10. Conclusion: The AA Challenge demonstrates the feasibility and value of an interactive French-language online educational program based on clinical cases designed to increase physicians' awareness of the diverse causes of AA amyloidosis. This initiative highlights the potential of digital educational tools to improve knowledge of rare diseases and could be adapted to other conditions in which earlier or more accurate diagnosis is needed.
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DOI: 10.1684/ndt.2026.196
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