Years: 2010-2011

* required

To comply with CME accreditation guidelines, please supply a one sentence objective that pertains to your presentation:*

ABSTRACT (Minimum of 100 words/Maximum of 150 words):*

REFERENCES (Maximum of 3 recent, clinically oriented references):*

Please indicate whether this is an invited paper or free paper :
This is an invited paper (asked to speak by moderator).
This is a free paper for consideration.

If your talk involves a PowerPoint presentation, would you be willing to give NEOS a copy of this? *
(We may use it for our members to reference in the future.)
Yes, my talk uses a PowerPoint presentation and I would be willing to allow NEOS to use it on its website.
No, I do not want my presentation used in any way.

Financial Interest Disclosure*

Conflict of Interest Disclosure for CME Activities
It is important to assure the public that education received by physicians and other health care professionals through whom patient care decisions are made is conducted with the highest integrity, scientific objectivity and in the absence of bias. A conflict of interest exists when individuals have both a financial relationship with a commercial interest and the opportunity to affect the content of CME about the product or services of that commercial interest. The Accreditation Council for Continuing Medical Education (ACCME) holds providers of CME responsible for collecting information from speakers, planners, moderators, and panel participants, and resolving any conflicts prior to the activity. The intent of the conflict of interest resolution process is to assure that any financial relationships with commercial interests and resultant loyalties do not supersede the public interest in the design and delivery of continuing medical education activities for the profession.

Criteria for disclosure of conflicts of interest
Since you have the ability to affect the content of a CME activity, you are required to disclose to NEOS any relevant financial relationships you have with commercial interests in any amount over the past 12 months ONLY. A "commercial interest" is defined as a maker or owner of FDA-regulated drugs or devices.  

Of special note
• Relationships with governmental agencies (e.g., the NIH) and organizations that do not make or own FDA-regulated drugs or devices do not have to be disclosed.
• Honoraria (fee-for-service) or consulting funds from a CME provider, even though those funds may have been provided through an educational grant from a commercial interest, do not have to be disclosed.
• Significant financial relationships your spouse or life partner has with commercial interests must be disclosed. (i.e. holder of a patent, employed by or provides marketing advice to a relevant commercial interest)

In accordance with ACCME requirements, failure to provide disclosure information in a timely manner will result in the disqualification of the potential speaker, planner, panel member or moderator from this activity.

I submit the following information to share with participants of this program:

Will your presentation include discussion of any commercial products or services?
Yes
No

If Yes, will your discussion include the off-label use of any commercial product?
Yes
No

If Yes, explain:

If Yes, do you have a significant financial interest or other relationship with the manufacturers(s) of any of the products or providers(s) of any of the services you intend to discuss?
Yes
No

If Yes, please list the manufacturer(s) or provider(s) and describe the nature of the relationship(s).

In addition to the above information, please disclose all financial interests and/or relationships you have with commercial manufacturer(s):

If you reported relationships in the chart above, will any of these relationships impact your ability to present an unbiased presentation or impact your ability to be impartial during the planning process?    
Yes
No

I have no financial interests or relationships to disclose.

If you have any questions or problems regarding your abstract, please contact David Lawlor, MD