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This COVID-19 Practice: As the Pandemic Cancels Large In-Person Events, Neurology Conferences Go Virtual

In the setting of COVID-19, major neurology meetings have abandoned exhibit halls and conference hotels in favor of cyberspace safety. Instead of flying across the country to convene with colleagues, conference participants are—or soon will be—logging on to their computers to learn about research findings in a new meeting format.

Orchestrating a major conference takes at least a year of planning, so meeting organizers have had to toss their filled-out playbooks for 2020 and invent a virtual event on the fly, with little experience or best practices to draw from. Everything is an experiment this year, as association leaders seek to disseminate research findings expeditiously and make accessing that information as easy as possible for their members during this difficult time.

"We're not blindly going about business as usual," said Christine E. Phelps, deputy executive director of the American Academy of Neurology Institute.

In interviews with Neurology Today, conference planners said they are already seeing some advantages to virtual meetings. They allow attendees to access content at their own convenience at much less expense than attending a live event—and early indications suggest that they reach a much broader audience than in-person conferences. On the other hand, creating opportunities for real-time discussions about research findings and the social interaction that is an important part of neurology meetings is a challenge.

Here's what to expect from upcoming meetings:

2020 AAN Science Highlights, Available Now

Content for the AAN Annual Meeting, originally scheduled for April 25 through May 1 in Toronto, is being disseminated online, using multiple formats delivered in waves.

"Instead of just popping things up online, we are taking a very measured approach to move forward in an innovative way," Phelps said. "We're trying to be very cognizant that people are fatigued with Zoom and electronics."  

In mid-May, the 2020 AAN Science Highlights, a collection of up to 2,000 virtual posters and scientific presentations, were posted online. This includes original science abstracts and presentations by the 2020 Scientific Award recipients. All content is available for free to members and non-members, with no registration required. 

As of mid-June, the new site has been visited more than 35,000 times. Posters and presentations have been viewed more than 50,000 times.

 "We have actually had an overwhelming response," said Natalia S. Rost, MD, MPH, FAAN, chair of the AAN Science Committee that is responsible for planning the science program at each year's conference. "But this is only the tip of the iceberg."

The plenary sessions in which panels of prominent neurologists discuss important topics—contemporary clinical issues, hot topics, controversies, and so forth— that had been planned for the annual meeting will be presented this summer and fall in a format that allows meeting attendees to interact with presenters.

"What we're planning right now is how to bring back the audience participation, the active learning, the engagement, the scientific dialogue that occurs in a Q&A format," said Dr. Rost, chief of the stroke division at Massachusetts General Hospital department of neurology and professor of neurology at Harvard Medical School. "I think this is going to be a terrific experience."

AHS Annual Scientific Meeting, Launching June 13

When COVID-19 hit, the American Headache Society's Scientific Planning Committee was already excited about the abstracts that had been submitted. "Arguably, this is the most interesting time in headache medicine ever," Chief Executive Officer Howard Rosen said.

The Society's board of directors and scientific planning committee sought to create a virtual event that balances the urgency of disseminating new scientific knowledge with the demands that health care providers interested in headache are currently coping with. 

"This meeting is designed to  present  the latest  science  in such a way that our members and others can obtain this information even if they are not able to block off a certain day to view it," Rosen said.

The AHS Annual Scientific Meeting, which is launching as a virtual event on June 13, with a single day of pre-recorded presentations—the president's welcome, three talks about headache medicine in the COVID-19 era, and a few awards lectures—each of which was followed by a live question-and-answer session that allowed viewers to interact with presenters. On that same day, posters—with summaries narrated by the researchers—were posted online. All content will be available online for a year. Registration is required, but AHS members can view all of the content at no expense.

"The most common feedback (from members) we have received is that they value the ability to access the material at their convenience and that there is no need to travel this summer in order to learn more about the latest in headache medicine," Rosen said.

AAIC 2020, July 27-31 

The Alzheimer's Association International Conference pivoted from Amsterdam to online. Beyond that, however, the virtual event will retain much of its traditional schedule, with more than 50 live sessions over five days. Registration is required, but the conference is free.

The conference will also include more than 100 on-demand sessions and more than 3,000 posters. All recorded sessions will be available for viewing for 30 days after the conference.

"We're excited that the virtual format will have something for everyone, both in terms of the content, but also in how they access it," said Claire Sexton, DPhil, director of scientific programs and outreach for the Alzheimer's Association.

Viewers of live sessions will use a chat function to interact with presenters in real time. Those who view on-demand sessions or posters can leave comments or questions in chat rooms and authors will respond at their convenience.

Conference organizers are trying to schedule presentations to be convenient for both the presenters and the attendees they want to reach, Sexton said. "We are trying to make sure we have things scheduled at times that are accessible to the largest audience," she said. "We looked up the time zone for every single person who is presenting an abstract to see how we can tailor the schedule best for them."

That said, the virtual format may increase the viewership of presentations and posters beyond what it would be at an in-person meeting. Unlike in-person poster sessions, there will be no risk of missing the author because he or she is engaged with another viewer. "And there's less conflict of 'oh, there are two sessions at the same time that I'd like to go to,' because you can revisit the content at any time," Sexton said.  

Self-promotion is good. The meeting will feature more than 3,000 posters. In a webinar to coach presenters about designing their posters for online viewing, Sexton encouraged them to build their own audience. "There won't be the same kind of captive audience of people walking around during their lunch break to see posters," she said. "So it's important that the poster presenters go out on social media to encourage people to come and view them."

MSVirtual2020, September 9-12

Americas Committee for Treatment and Research in Multiple Sclerosis and its counterpart, European Committee for Treatment and Research in Multiple Sclerosis, intended to call their triennial joint meeting MSWashingtonDC2020 until the pandemic nixed that idea.

ACTRIMS President Jeffrey A. Cohen, MD, said the event, now known as MSVirtual2020, will try to keep some of the structure of a typical conference. "We don't want the whole thing to just be dumped online for people to watch at their leisure—we want to actually have a meeting," he said. "But how to do that in a way that is feasible has taken a lot of discussion."

The plan is for important scientific sessions to be presented online at scheduled times. Each talk will be pre-recorded to avoid connectivity glitches that might cause problems.

"At the end of each session, there will be time for interactions between the speakers and the session chairs and the audience in real time," said Dr. Cohen, director of experimental therapeutics in the Cleveland Clinic's Mellen Center for Multiple Sclerosis Treatment and Research.

Those sessions will be archived and available on demand along with some other scientific sessions and teaching courses that will be offered on-demand only. Viewers of on-demand content will be able to post questions through a chat function which the speakers can answer, but not in real-time. 

Scheduling online content that has a "live" component presents some special challenges. "Is it realistic that people are going to spend six or eight hours on the computer watching a meeting?" Dr. Cohen said. "And are they going to want to do that on a weekend?"

On the other hand, many neurologists are expecting to be busy catching up from the pandemic-induced disruption to their practice and may not be able to take time off during the workweek to participate in a virtual meeting. In an attempt to find the most palatable solution, ACTRIMS decided to schedule its live sessions on Friday, Saturday, and Sunday, running from mid-morning to mid-afternoon, Eastern time zone.

"People can pick and choose what they watch live and which things they watch on-demand," he said. "People are going to be watching from all around the world and it's unrealistic that someone in Asia is going to get up at 3 in the morning to watch a live session."

Poster innovation. Scientific posters will be posted for on-demand viewing at the beginning of the conference. Instead of the traditional poster format, researchers will submit slides that represent various components of the poster and a brief oral summary. "So when you call up the poster, you'll see the slides and the presenter will walk you through them," Dr. Cohen said.

Registration is required, but pricing had not been set as of June 8.

Let's just catch up. Conference attendees enjoy opportunities to hang out together, so the ACTRIMS staff will bring some social elements from the standard conference into cyberspace. "Not everything makes sense to carry over but we plan to create an engaging program with as much attendee interaction as possible," Amanda Safa, senior meetings manager, said by email.

A virtual concert will precede the opening plenary session, for example. And, instead of gathering in the exhibit hall lounge for casual conversations, attendees can sign up for virtual "brain dates" —group conversations around a topic of interest—scheduled during the conference.

 MDS Virtual Congress 2020, September 12-16

When the International Parkinson and Movement Disorder Society (MDS) had to scrap the plan for its International Congress in Philadelphia, conference planners originally considered putting a smaller version of the event online. 

"But after seeing the success of the European Academy of Neurology (EAN) meeting and seeing the potential of reaching such a large audience—the EAN had 41,000 attendees at one point—we decided to go the full Monty," said Oscar Gershanik, MD, chair of the Congress Oversight Committee. "One of the big decisions we had to make is how to translate this virtual meeting into something that resembles a live meeting." 

To that end, about 60 sessions will be presented in "mock live" fashion, meaning that pre-recorded presentations will be scheduled at a specific time, followed by live Q&A with the speakers. The first day of the Congress will be "launched" twice—once for the Eastern Hemisphere, once for the Western—so that participants will be able to participate in live Q&A with presenters during daytime hours in their own hemisphere.  

"For that one day, we're launching sessions twice so that people can interact," said Jenny Quebbeman, MDS director of meetings. "This day of sessions appeals to a broad audience—general neurologists, young neurologists, all different types—so we felt this was the best day to try this."

The Congress schedule is being adapted to accommodate the virtual format, said Vincenzo Bonifati, MD, PhD, chair of the scientific program committee. For example, more sessions will be scheduled on the weekend so that participants can attend without missing work. Also, each conference day will be shorter than in a live event.

"Normally when you are at the in-person meeting, you are there from 8 o'clock in the morning to 8 o'clock in the evening, but we cannot ask people to stay connected virtually for 12 hours," said Dr. Bonifati, a neurologist and professor of genetics at Erasmus University Medical Center in The Netherlands. "We also need to take into account the different time zones of the world."

Instead of presenting less content, more sessions will be presented in parallel time slots. All presentations will be archived online for viewing after the live session.

 "Even some of the plenary sessions, which are designed to appeal to a broad audience, will be run in parallel but I think this is not going to be a problem," he said.

Posters will be presented through "virtual guided tours" with live chat and discussion boards that allow viewers to interact with authors in real-time or asynchronous responses.

"Every year on the top of the scientific sessions, there is a lot of activity in terms of committees, study groups, task force meetings and this is going to be replicated for as much as possible virtually this year," Dr. Bonifati said.

Congress participation will be free for members and non-members alike, said Dr. Gershanik, professor of neurology and scientific director at the Institute of Neuroscience at Favaloro University in Buenos Aires. Content will be available on demand for free for a limited time; after that, the online content will be available for free to MDS members.

ANA 2020: October 4-9

The American Neurological Association virtual meeting will include plenary sessions broadcast live on Sunday, October 4, and Monday, October 5, followed by four days of presentations and workshops that feature live, interactive Q&A sessions. Participation is free for ANA members and offered at reduced rates for non-members. Registration is required for all participants.

Talks and posters will be presented live with opportunities for questions from the audience. Eighteen special interest groups—global neurology or traumatic brain injury, for example—will convene for live sessions, and interactive workshops will focus on advances in various neurologic subspecialties. All sessions will be recorded and available for viewing after the live event.

"We are looking forward to a meeting that represents even more countries and educational and research institutions and is more 'international' than ever," Conrad C. Weihl, MD, PhD, professor of neurology at Washington University School of Medicine and chair of the Association's Scientific Program Advisory Committee, said in an email.

ANA Executive Director Nadine Goldberg, PhD, MS, said association members have expressed appreciation that they will be able to present their work and receive feedback on it without risking their health at an in-person event. "Our team is working with exciting new technology that will allow the meeting to be more than a static presentation, but a truly interactive event on many levels," she said by email. 

Meet for a drink? Networking opportunities built into the program include a virtual reception for junior and early-career members that includes sharing their thoughts and recommendations on upcoming sessions and opportunities to interact with more senior members who will offer advice about the meeting.

Each special interest group—for example, epilepsy or neurogenetics—will have a networking session either before or after its sub-specialty session. 

The Future of Meetings?

As they re-imagine their 2020 events, many leaders wonder if they are creating the "new normal" for neurology meetings in the future.

Because of jet lag from international travel, meeting attendees sometimes are exhausted during the conference and for days after they return to work, ACTRIMS President Dr. Cohen said. "I'm ambivalent because I enjoy going to meetings," he said. "But once we have figured out how to (hold virtual conferences), perhaps this is the way we should have meetings in the future rather than everybody congregating in one city for five days."

Indeed, Dr. Gershanik plans to propose that the MDS Congress oversight committee consider "hybrid" meetings in which faculty members convene in person but content is delivered by virtual platform. "If this experience of a virtual meeting is successful, as we expect it to be, maybe this is the way to go in the near future," he said.

The AAN will conduct its remaining 2020 meetings—the Sports Concussion Conference, the AAN Fall Conference, and a new education series for advanced practice providers—in virtual format this year.

"While everybody is hoping that (the disruption caused by the pandemic) is just an aberration, we need to be realistic in our plans for the long run," Dr. Rost said. "This particular predicament may be an opportunity for us to develop the format for delivering science and education in the most advanced technological way."

As the Academy innovates, its goal will be to keep the community of neurologists together, centered on members' mutual interest in scientific and educational content, she said.

At the Alzheimer's Association, Sexton expects that, over time, a "hybrid" conference that includes both in-person and virtual elements will evolve. "We will be  learning a lot from this virtual event and we will want to incorporate what we learn in future conferences," she said. "I can't see that things will just revert completely back to how they were."