The International Society of Extremity MRI in Rheumatology (ISEMIR) Inaugural Conference

Thursday, April 10, 2008
7:00 AM - 7:00 PM

Trump International Hotel & Tower
401 N. Wabash Avenue
Chicago, IL 60611

Click here to view the agenda for this CME program

CME INFORMATION

This activity is sponsored by The Foundation for Better Health Care

This activity is supported by educational grants from

Abbott Esaote Hologic PI ONI Amgen

Overview

This CME will address the role of imaging modalities, specifically MRI in rheumatoid arthritis (RA). It is shown that early diagnosis and aggressive treatment of RA improves patient outcomes. MRI may allow for an earlier diagnosis than that of traditional radiography, therefore optimizing the overall outcomes and quality of life for RA patients.

Intended Audience

This educational activity is designed for rheumatologists who manage patients with RA.

Content Validation

The Foundation for Better Health Care (FBHC) validates the content of its CME activities through a peer review process and by utilizing evidence-based medicine sources throughout the planning and implementation of its activities. Adopting the levels of evidence used by the American Academy of Family Physicians1 and the principles of evidence-based medicine outlined by Straus et al,2 the FBHC rates the level of evidence of the literature used to determine needs and learning objectives, as well as all data cited and presented.

All recommendations involving clinical medicine are based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. Further, all scientific research referred to, reported, or used in support or justification of a patient care recommendation conforms to the generally accepted standards of experimental design, data collection, and analysis.

Levels of Evidence1

  • Level A (randomized controlled trial [RCT]/meta-analysis)
  • Level B (other evidence): A well-designed, nonrandomized clinical trial. A nonquantitative systematic review with appropriate search strategies and well-substantiated conclusions. Includes lower-quality RCTs, clinical cohort studies, and case-controlled studies with nonbiased selection of study participants and consistent findings. High-quality, historical, uncontrolled studies or well-designed epidemiologic studies with compelling findings are also included
  • Level C (consensus/expert opinion)
  1. Siwek J, Gourlay ML, Slawson DC, Shaughnessy AF. How to write an evidence-based clinical review article. Am Fam Physician. 2002;65:251-258.
  2. Straus SE, Richardson WS, Glasziou P, Haynes RB. Evidence-Based Medicine. 3rd ed. Edinburgh, Scotland: Churchill Livingstone; 2005.

Learning Objectives

The learning objectives for this activity have been designed to address clinician competence, performance or patient outcomes. Upon completion of this activity, participants should be able to:

1. Recognize the importance of early diagnosis and aggressive treatment in Rheumatoid Arthritis (RA) (competence) in order to delay radiographic progression and improve patient outcomes (performance/patient outcomes)

  • Lindqvist E, et al. Course of radiographic damage over 10 years in a cohort with early rheumatoid arthritis. Ann Rheum Dis. 2003;62:611-616. [Evidence Level B]
  • Schumacher HR, Pessler F, Chen LX. Diagnosing early rheumatoid arthritis (RA). What are the problems and opportunities? Clin Exp Rheumatol. 2003;21(Suppl 31):S15-S19. [Evidence Level C]

2. Cite the technical limitations of radiography (competence) and discuss some of the advantages of MRI in order to detect erosions and synovitis earlier (performance/patient outcomes)

  • Crues JV, Shellock FG, Dardashti S, James TW, Troum OM. Identification of wrist and metacarpophalangeal joint erosions using a portable magnetic resonance imaging system compared to conventional radiographs. J Rheumatol. 2004;31:676-685. [Evidence Level B]
  • Ejbjerg BJ, Narvestad E, Jacobsen S, Thomsen HS, Ostergaard M. Optimised, low cost, low field dedicated extremity MRI is highly specific and sensitive for synovitis and bone erosions in rheumatoid arthritis wrist and finger joints: comparison with conventional high field MRI and radiography. Ann Rheum Dis. 2005;64(9):1280-1287. [Evidence Level B]

3. Review the evidence for using specific imaging techniques in the management of RA (competence) and recognize practical issues in providing these services to patients in order to maximize the benefits of treatment (performance/patient outcomes)

  • Peterfy CG, Roberts T, Genant HK. Dedicated extremity MR imaging. An emerging technology. Radiol Clin North Am. 1997;35(1):1-20. [Evidence Level B]
  • McQueen F, Benton N, Crabbe J, Robinson E, Yeoman S, McLean L, Stewart N. What is the fate of erosions in early rheumatoid arthritis? Tracking individual lesions using x rays and magnetic resonance imaging over the first two years of disease. Ann Rheum Dis. 2001;60:859-868. [Evidence Level B]

Needs Assessment

The FBHC has incorporated into this CME activity the relevant educational needs concerning knowledge, competence, or performance that underlie the professional practice gaps of our participants.

Accreditation

The FBHC is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The FBHC takes responsibility for the content, quality, and scientific integrity of this CME activity.

Credit Designation

The FBHC designates this educational activity for a maximum of 6.0 AMA PRA Category 1 Credit(s)TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Identifying and Resolving Conflicts of Interest

The FBHC requires all planning committee members, faculty, teachers, authors, and staff of a CME activity to identify all relevant financial relationships that benefit the individual and his or her spouse or partner in any financial amount within the past 12 months. Such relationships may affect the content of CME regarding the products or services of the commercial interest.

The FBHC has created the FBHC Committee to Identify and Resolve Conflicts of Interest, which reviews Faculty and Staff Disclosure Statements, identifies and resolves conflicts of interest, and determines the level of participation of planning committee members, faculty members, teachers, and authors.

FBHC Disclosure Statement

The FBHC is an independent professional organization that does not endorse specific products of any pharmaceutical concern. This FBHC CME activity has been independently planned by the FBHC.

CME Planning Committee

Norman Gaylis, MD, FACP, FACR
Voluntary Clinical Associate Professor
University of Miami School of Medicine
President and Managing Partner
Arthritis and Rheumatic Disease Specialties
Aventura, FL

Judy Seraphine
Executive Vice President
The Foundation for Better Health Care

Sejal Patel
Director, Grantor Relations and Project Management
The Foundation for Better Health Care

LaTanya M. Brown
Project Director
The Foundation for Better Health Care

Eresso Aga, PhD
Scientific Director
The Foundation for Better Health Care

Faculty

Philip Conaghan, MD, PhD, FRACP, FRCP
Professor of Musculoskeletal Medicine
University of Leeds
United Kingdom

John Crues, MD
Medical Director
RADNET, Inc
Visiting Professor
University of California San Diego
Los Angeles, CA

Paul Emery, MA, MD, FRCP
Professor of Rheumatology
Head of Academic Unit of Musculoskeletal Disease
University of Leeds
United Kingdom

Norman Gaylis, MD, FACP, FACR
Voluntary Clinical Associate Professor
University of Miami School of Medicine
President and Managing Partner
Arthritis and Rheumatic Disease Specialties
Aventura, FL

Steven Needell, MD
Director, Musculoskeletal Imaging
Boca Radiology Group, PA
Boca Raton, FL

Ewa Olech, MD
Clinical Assistant Professor of Medicine
Oklahoma University Health Sciences Center
Clinical Assistant Member
Oklahoma Medical Research Foundation
Oklahoma City, OK

Charles Peterfy, MD, PhD
Chief Medical Officer
Executive Vice President
SYNARC, Inc
San Francisco, CA

Orrin Troum, MD
Clinical Professor of Medicine
Keck School of Medicine
University of Southern California
Santa Monica, CA

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