Target Audience

This program is intended for health care providers of primary care services, including physicians, nurses and physician assistants.

Learning Objectives

After participating in this activity, participants will be able to:

• Evaluate a patient who presents with thyroid or adrenal disease and determine the best course of treatment
• Discuss the importance of risk assessment with respect to new lipid guidelines and primary prevention
• Recognize the conditions of cateracts, glaucoma, macular degeneration or diabetic retinopathy and available treatment options
• Discuss value based propositions for colorectal cancer prevention, gastroesophageal reflux testing, and hepatitis C virus screening, and recognize examples of low value decision making  
• Identify when to initiate or continue opioids for chronic pain, and how to select, dose, follow up and discontinue opioids
• Apply conservative care and create a nonsurgical plan for management of patients with spine issues
• Recognize acupuncture’s suggested mechanism of action, the evidence base for its effectiveness and the clinical applications for which acupuncture can be considered

Accreditation Statement 

Case Western Reserve University School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Case Western Reserve University School of Medicine designates this enduring material for a maximum of 3.25 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Planning Committee

Roy Buchinsky, MD

Dr. Buchinsky reports no financial relationship with a commercial interest relevant to this activity.

George Topalsky, MD

Dr. Topalsky reports no financial relationship with a commercial interest relevant to this activity.

Todd Zeiger, MD

Dr. Zeiger reports no financial relationship with a commercial interest relevant to this activity.

Disclosure Statement

The policy of Case Western Reserve University School of Medicine CME Program (CWRU CME) requires that the Activity Director, planning committee members and all activity faculty (that is, anyone in a position to control the content of the education activity) disclose to the activity participants all relevant financial relationships with commercial interests.  Where disclosures have been made, conflicts of interest, real or apparent, must be resolved.  Disclosure will be made to activity participants prior to the commencement of the activity.  CWRU CME also requires that faculty make clinical recommendations based on the best available scientific evidence and that faculty identify any discussion of "off-label" or investigational use of pharmaceutical products or medical devices.

Instructions

To receive statements of credit for up to 3.25 AMA PRA Category 1 Credits™ you must:

1. Review the full content of the recorded sessions.
2. Review any supplementary materials referenced under Resources.
3. Reflect on the content.
4. Successfully complete the post-test. A score of 75% is required for passage.
5. Complete the evaluation.

Your credits will be recorded by the CWRU School of Medicine CME Program and made a part of your cumulative transcript. Credits are awarded on a per-talk basis.

Fee

There is no fee for this program.

To contact the CME Provider: E-mail Case Western Reserve University School of Medicine CME at medcme@case.edu

Medical Disclaimer

Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required.  The author has checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication.

Although every effort is made to ensure that this material is accurate and up-to-date, it is provided for the convenience of the user and should not be considered definitive.  Neither the author nor the Case School of Medicine nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from the use of such information.

Learners are encouraged to confirm the information contained herein with other sources.  This information should not be construed as personal medical advice and is not intended to replace medical advice offered by physicians.  The Case School of Medicine will not be liable for any direct, indirect, consequential, special, exemplary, or other damages arising here from.

Resources

1. Haugen et al., 2015 ATA Management Guidelines for Adult Patients with Thyroid Nodules and Differentiated Thyroid Cancer.  Thyroid (2016) 26:  1-133.
2. Jonklaas J et al.  Guidelines for the treatment of hypothyroidism.  Thyroid (2014) 24:  1670-1751.
3. Al-Kindi SG, DeCicco A, Longenecker CT, Dalton J, Simon DI, Zidar DA. Rate of Statin Prescription in Younger Patients With Severe Dyslipidemia. JAMA Cardiol 2017.
4. Knowles JW, Stone NJ, Ballantyne CM. Familial Hypercholesterolemia and the 2013 American College of Cardiology/American Heart Association Guidelines: Myths, Oversimplification, and Misinterpretation Versus Facts. The American Journal of Cardiology 2015;116:481-4.
5. Quigley, Harry A., and Aimee T. Broman. "The number of people with glaucoma worldwide in 2010 and 2020." British journal of ophthalmology 90.3 (2006): 262-267.
6. Klein, Robert J., et al. "Complement factor H polymorphism in age-related macular degeneration." Science 308.5720 (2005): 385-389.
7. http://www.cdc.gov/hepatitis/Statistics/2013Surveillance/Commentary.htm
8. Shaukat, Aasma, et al. "Long-term mortality after screening for colorectal cancer." New England Journal of Medicine 369.12 (2013): 1106-1114.
9. https://www.cdc.gov/drugoverdose/prescribing/guideline.html
10. https://www.samhsa.gov/sbirt
11. Ishak, Nor Azizah, Zarina Zahari, and Maria Justine. "Effectiveness of Strengthening Exercises for the Elderly with Low Back Pain to Improve Symptoms and Functions: A Systematic Review." Scientifica 2016 (2016). 
12. Nahin RL, Boineau R, Khalsa PS, Stussman BJ, Weber WJ. Evidence-based evaluation of complementary health approaches for pain management in the United States. Mayo Clinic Proceedings. 2016;91(9):1292–1306.
13. MacPherson H, Vertosick EA, Foster NE, Lewith G, Linde K, Sherman KJ, Witt CM, Vickers AJ. The persistence of the effects of acupuncture after a course of treatment: a meta-analysis of patients with chronic pain. Pain. 2016 Oct 17.