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The changing face of our major meetings: Evolution or revolution?
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One morning in late July, I was poised over my laptop at exactly 9 a.m. Mountain time, ready for the ASH Annual Meeting and Exposition registration and housing website to go live. The system was slow and a little unstable — probably a result of several thousand people trying to access the site at once.
During the time it took to get myself signed up, I reflected on our major scientific meetings, why we still attach importance to them, what has changed over the past 20 to 30 years, and what the future might hold.
I should start with three disclaimers. First, I am an advocate for change, believe it to be positive and subscribe to the philosophy eloquently stated above by Thomas Jefferson. Second, what follows are my opinions and are only partly supported by data! Third, these observations relate to impressions of the meetings as a “consumer” (attendee/presenter) with no reference to the systems in place within each society for the structure of its meetings or the selection of abstracts.
Dramatic transformation
John Sweetenham
I attended my first large oncology conference as a fellow in 1987. I was left with three overwhelming impressions from that meeting: the scale, both in numbers of attendees and the size of the convention center; the excitement of hearing new data; and the approachability of many of the giants of oncology, who had been just names to me up to that point. I left the meeting with a buzz that carried me over to the following year.
Over subsequent years, as junior faculty, I was a little more successful at abstract preparation and submission. The meetings took on a new significance: to exchange and learn new scientific information, and to network with collaborators and colleagues.
The meetings grew in attendance and scale but were constant in character. The atmosphere was scholarly, and certain (written or unwritten) rules governed the content. It was generally accepted that any data presented at the meeting had not been presented before, the results of studies were generally only presented if they were complete, and the authorship was somewhat restricted.
The abstract submission process reinforced these rules. The abstract had to fit into a pre-drawn box, allowing it to be reproduced photographically. Space was limited, so there was no room for excess verbiage or excess authors. The submission process was slower, and abstracts that concluded with “Results will be presented at the conference” were usually — and appropriately — rejected.
Potential presenters needed to have a complete set of data when they prepared their abstract, and they needed to get to the point concisely. The result was a large, academically based meeting, with presentations of important new data (usually with no major surprises, as the abstract book was available several weeks in advance), informative educational sessions and ample opportunity to interact with colleagues.
The impact of industry sponsors was mostly evident in the exhibit halls. They made an essential contribution to the success of the meeting, both academically and financially, but outside of the elaborate exhibits, their presence was low key.
As the size of these meetings has exploded and the technology supporting them has improved, they have transformed from relatively simple (in format) academic meetings into major scientific, interactive, social and media events. If they seemed large in scale and scope in 1987, they are colossal now.
There are many clear and tangible changes. The meetings have become more glitzy in style and broader in scope. They welcome and cater to the press, the public, advocacy groups, patients and legislators, as well as the primary audience of oncology and hematology professionals.
In addition to disease-based tracks, sessions cover everything from clinical trial methodology and fellowship training to physician burnout. Through the late-breaking abstracts, “hot-off-the-press” data can be presented almost in real time, as virtual meeting technology makes the proceedings accessible to a global audience.
Further, the immediate impact of the meetings is reinforced by social media, as multiple attendees tweet the highlights of key sessions.
Consequences of change
Overall, these changes have been transformative. The scientific quality of the meetings has improved, and our professional organizations have increased their appeal and impact. Concerns for conflicts of interest have increased transparency and dampened some of the earlier excesses of the exhibit halls, which are now slightly quieter but probably more conducive to building meaningful and productive industry–academia relationships.
Are there unforeseen consequences of these changes? I think so.
As more organizations cluster their meetings to coincide with ASCO and ASH, many participants are pulled away from the main sessions into “fringe” meetings. This is inevitable given the presence of so many professionals in one city at the same time, but it challenges priorities and limits the value of the main meeting if many of the thought leaders are secreted away in other venues.
Having been involved in abstract development and submission for some recent meetings, the ground rules are clearly in evolution. I have been introduced to new strategies, partly driven by the enormous influence that favorable data presented at these meetings can have on the fortunes of products and companies. Gamesmanship over abstract presentation seems to have increased: Abstracts are submitted with a plan to withdraw them if not selected for oral presentation. They then can be resubmitted for another meeting or as a late-breaking abstract.
The “will be presented at the conference” conclusion appears to have gained new respectability. Now apparently known as “shell abstracts,” these contain basic demographic data regarding study populations, with no analysis of the trial results. The idea of presenting clinical trials in progress has been a positive trend, although I question whether these abstracts should be on equal footing with those reporting more complete work.
Most concerning for me has been the concept of “encore abstracts,” jargon for the practice of presenting the same data at more than one meeting. With the globalization and up-to-the-minute access afforded by the Internet and social media, I see no reason why we need to have results presented in exactly the same form at more than one major meeting.
Although just a personal observation, I have been struck at recent meetings by the number of oral presentations of new data given by very senior investigators. There seems to be a lot of gray hair on the podium. This is not to diminish their contribution and may be reflective of a desire for the key opinion leaders to give these talks for maximum impact, but it is concerning that we are limiting the opportunity for junior investigators to gain experience and exposure in an international forum.
The future of these major meetings seems to me to be secure. Despite all of the concerns about scale, accessibility and time crunches, they are still informative, exciting and enjoyable. Face-to-face interactions have a unique quality that can’t be reproduced by any interactive media, and the ability for trainees to see and meet leaders in our field has intangible but very real benefit. High-quality, novel data are still the biggest draw for many of us, and that should not change.
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John Sweetenham, MD, FRCP, FACP, is HemOnc Today’s Chief Medical Editor, Hematology. He can be reached at john.sweetenham@hci.utah.edu.
Disclosure: Sweetenham reports no relevant financial disclosures.