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Evidence-Based Diagnosis: Advanced Workshop on Evaluating & Using Medical Tests for Clinicians, Educators & Policy Makers
Presented by the Division of Clinical Epidemiology of the Department of Epidemiology and Biostatistics, University of California, San Francisco, School of Medicine University of California San FranciscoEVIDENCE-BASED Advanced Workshop onDIAGNOSIS: Evaluating and Using Medical Tests for Clinicians, Educators, and Policy Makers June 28 -29, 2012THURS DAY - FRIDAY China Basin Landing COURSE CHAIR 185 Berry Street Michael A. Kohn, MD, MPP Lobby 3, Room 6702 Associate Professor of San Francisco, CA Epidemiology & Biostatistics; University of California, San Francisco; Attending Emergency Physician, Mills-Peninsula Medical Center COURSE CO-CHAIR Thomas B. Newman, MD, MPH Chief, Division of Clinical Epidemiology; Professor, Departments of Epidemiology & Biostatistics and Pediatrics Attending Physician, Department of Pediatrics; University of California, San Francisco
EVIDENCE-BASED DIAGNOSIS: China Basin Landing 185 Berry StreetAdvanced Workshop on Evaluating Lobby 3, Room 6702 San Francisco, CAand Using Medical Tests for Clinicians,Educators, and Policy Makers June 28-29, 2012Today’s clinicians rely increasingly on diagnostic, prognostic, and ACCREDITATIONscreening tests. We spend vast resources on testing, and new The University oftests are being developed and marketed all the time. Medical California, San Franciscoprofessionals, educators, and policy makers need to know how to: School of Medicine• critically appraise a journal article about a new test; (UCSF) is accredited by the Accreditation Council• determine if the new test is superior to an existing test; for Continuing Medical• determine if the new test adds anything to the history, Education to provide physical exam, and other tests; continuing medical• use the new test in clinical practice and interpret its results. education for physicians.This hands-on workshop uses real examples from the medical UCSF designates this liveliterature and clinical practice to teach practitioners, teachers, activity for a maximum ofand policy makers how to evaluate medical tests and use them 15.25 AMA PRA Categoryin clinical practice. 1 Credit(s)TM. Physicians should only claim creditThese skills are hard to learn just by reading articles and books commensurate with theor by listening to lectures. The course faculty has found that the extent of their participationbest (and the most fun) way to learn this material is by working in the activity.through problems in small groups. We are clinicians whopractice in different specialties. Like you, we struggle to keep This CME activity meetsup with the rapid advances in diagnostic technology and stay the requirements underabreast of changes in testing strategies. California Assembly Bill 1195, continuing educationWhile most of the course will cover diagnostic and prognostic and cultural and linguistictests, the Friday afternoon session will focus on controversies competency.in breast, cervical, prostate and lung cancer screening.The course venue is located in the UCSF Department of Nurses: For the purposeEpidemiology and Biostatistics at China Basin Landing, 1 block of recertification, thefrom the San Francisco CalTrain station and Muni lines N, T, 30, American Nurses45, and 47. It is also right across 3rd Street from AT&T Park, Credentialing Centerwhere the San Francisco Giants will be playing the Cincinnati accepts AMA PRA Category 1 CreditTMReds on the Thursday evening between the first and second days issued by organizationsof the course. We have reserved a block of tickets on the Club accredited by the ACCME.Level, which includes deluxe indoor and outdoor seating andexclusive food and beverage service. Physician Assistants:This course is presented by the Division of Clinical Epidemiology AAPA accepts category 1of the Department of Epidemiology and Biostatistics, UCSF School credit from AOACCME,of Medicine, through the Office of Continuing Medical Education. Prescribed credit fromAll registrants will receive a copy of the textbook “Evidence-Based AAFP, and AMA Category 1 Credit for the PRA forDiagnosis” by Drs. Newman and Kohn (Cambridge University organizations accreditedPress, 2009). The course accepts no funding from for-profit by the ACCME.corporations.INTENDED AUDIENCEThe course is aimed primarily at physicians, particularly thosein policy making or teaching positions who are involved inapproving tests for clinical use, deciding how to report results, andtraining other clinicians to interpret results. However, it will bevaluable for anyone who wishes to critically evaluate and applyclinical research about medical tests. For a preview of the coursematerial, take the online pre-test at http://ebd.studysites.netOBJECTIVESAfter completing this course, participants should be able to:• Describe and apply the principles of diagnostic test assessment;• Calculate and use interval likelihood ratios;• Explain the relationship between interval likelihood ratios and the ROC curve;• Go beyond the area under the curve to get the most out of published ROC curves;• Identify and correct underappreciated flaws, biases, and limitations in studies of diagnostic tests;• Understand how to use prognostic tests, including genetic tests;• Account for special issues related to screening, especially cancer screening.
EVIDENCE-BASED DIAGNOSIS: AdvanUsing Medical Tests for Clinicians, Educa June 28-29, 2012THURSDAY, JUNE 28, 20128:30 am Continental Breakfast and Registration9:00 Introduction to the Course and Michael A. Kohn, MD, MPP Evidence-Based Diagnosis9:15 Dichotomous Tests Thomas B. Newman, MD, MPH9:55 Multi-level and Continuous Tests Michael A. Kohn, MD, MPP10:35 Break10:45 SMALL GROUPS • Influenza and Pertussis Testing • BNP, D-Dimer, and Lactate • Brain CT and MRI12:30 pm Lunch (Provided)1:30 Studies and Systematic Reviews of Thomas B. Newman, MD, MPH Diagnostic Tests2:15 Prognostic and Genetic Tests Mark J. Pletcher, MD, MPH3:00 Combining Tests Michael A. Kohn, MD, MPP3:45 Break4:00 SMALL GROUPS • Ultrasound for Intussusception, Ectopic Pregnancy, and DVT • Stroke Scores • Coronary Artery Calcium • Tumor Markers6:00 Adjourn for the day, but join the faculty at AT&T Park across the street for an informal reception prior to the ballgame (optional event with additional fee).7:15 pm San Francisco Giants vs. Cincinnati RedsFRIDAY, JUNE 29, 20128:30 am Continental Breakfast9:00 Welcome Back Michael A. Kohn, MD, MPP9:15 Quantifying Treatment Effects Mark J. Pletcher, MD, MPH10:00 Weighing Benefits, Harms, and Costs George F. Sawaya, MD10:45 Break11:00 SMALL GROUPS • Antivirals for Influenza and Antibiotics for Pertussis • Warfarin for Venous Thromboembolism • Early Goal Directed Therapy for Sepsis • Treatment of Angina, MI, TIA, and CVA • Treatment of Breast/Prostate/Lung Cancer12:30 pm Boxed Lunch1:15 Biases in Studies of Screening Programs Thomas B. Newman, MD, MPH2:00 Controversies in Screening George F. Sawaya, MD Recommendations2:45 Break3:00 SMALL GROUPS • CT for Lung Cancer • Mammography • Prostate-Specific Antigen • Colonoscopy • PAP Smear/HPV4:30 Post-Test and Discussion with the Faculty6:00 pm Adjourn
ced Workshop on Evaluating andators, and Policy Makers China Basin Landing • 185 Berry Street San Francisco, CA GENERAL INFORMATION REFUND POLICY Workshop pre-test available online at Cancellations received in writing before the first http://ebd.studysites.net day of the course will be refunded, less a $75 This no-obligation, 12-question pre-test will give administrative fee. No refunds will be made on you an idea of the material covered in our workshop. cancellations received after that date. No refunds If you enroll in the workshop, we will use your will be given for cancellation to the baseball game score on this pre-test and your responses to the and reception. pre-course survey to place you in a small group CONFERENCE LOCATION with others who have similar backgrounds and China Basin Landing at 185 Berry Street is located interests. You will receive the answer key to this just one block from the Caltrain Depot and the pre-test in your course materials. Muni metro J and T lines and the 10, 30, 45, and 47 Pre-registration is recommended to guarantee your bus lines. space in the course. Parking is available in “Lot A”, located at 3rd Street HOW TO ENROLL and Channel Street. The daily rate for parking at Tuition: $500 Physicians/Nurses/Allied Health Lot A is $9; there is a machine that takes cash or a Professionals/Pharmacists/ credit card, gives you a ticket for your dashboard Residents/Fellows after you enter the number of the parking slot you choose. On Giants game days, the current “event” $750 Pharmaceutical and Medical Device rate is in effect (which is several times higher than Industry Rate the usual daily rate in Lot A). $60 Optional Reception and Baseball Parking is also available at an underground lot at Game China Basin Landing for $3/20 minutes, $19 Payment may be made by Visa, MasterCard, maximum. The entrance is on 3rd Street across AmEx or check. from AT&T Park. Note that this garage also charges REGISTRATION “event” rates on Giants game days and is subject to Online: www.cme.ucsf.edu availability. Mail: Complete course registration form To reach the classrooms, enter the building at and send with payment to: Lobby 3 next to Foccacia Market and take the UCSF Office of CME elevator to the 6th Floor. Turn left as you get off the P.O. Box 45368 elevator and walk almost to the end of the hall–the San Francisco, CA classrooms are on your right. 94145-0368 ADDITIONAL TRAVEL INFORMATION Phone: To register by phone or to inquire For additional reservations information, rental car about registration status, please call and air transportation options please visit our UCSF’s CME Registration Office at website: www.cme.ucsf.edu. (415) 476-5808. Fax: Fax completed registration form to: (415) 502-1795 (be sure to include your credit card number) Some comments from a prior version of this course: “Asaclinicalteacher,IknowIwillabletotranslate “Aninformativeandfun,interactiveapproach theknowledgeIgainedhereintobetterteachingto toEBMthatwillappealtoawiderangeof theresidentsandstudents.Ihighlyrecommendthis EBMlearners.” coursetoanyoneseeingpatients!” “Imusuallyverycritical–cantthinkof “Ihadbeentaughtmuchofthecoursematerial anotherconference(ever)whereIgavesuch previously,butitwasnotuntilItookthiscourse unqualifiedpraise.” thatIdevelopedanunderstandingofandacomfort levelwithEBM.” “Itwillhelpmetreatmypatientsbetter,aswellas helpusmoveourorganizationtoincorporateEBM intoourpractice.”
Cover photo courtesy of SFCVB - Doug Peebles CME at (415) 476-4251 You may also reach us by calling the Office of University of California, firstname.lastname@example.org. For more information www.cme.ucsf.edu. or to register online Office of Continuing visit our website at San Francisco, CA Medical Education UCSF Box 0742 San Francisco 94143-0742 or email 0569COURSE CHAIR SPEAKERS S M A L L G RO U P L E A D E R SMichael A. Kohn, MD, MPP Mark J. Pletcher, MD, MPH Christopher R. Carpenter, MDAssociate Professor of Associate Professor, Assistant Professor, EmergencyEpidemiology Biostatistics; Departments of Epidemiology Medicine; Director, EvidenceUniversity of California, Biostatistics and Medicine Based Medicine; WashingtonSan Francisco; Attending Attending Physician, Department University School of Medicine,Emergency Physician, of Medicine; University of St. LouisMills-Peninsula Medical Center California, San Francisco Joshua M. Galanter, MDCOURSE CO-CHAIR George F. Sawaya, MD Assistant Professor, DepartmentsThomas B. Newman, MD, MPH Professor, Departments of of Bioengineering andChief, Division of Clinical Obstetrics, Gynecology Therapeutic Sciences andEpidemiology; Professor, Reproductive Sciences and Medicine; Attending Physician,Departments of Epidemiology Epidemiology Biostatistics; Department of Medicine; Biostatistics and Pediatrics University of California, University of California,Attending Physician, Department San Francisco; Director, San Francisco and San Franciscoof Pediatrics; University of Colposcopy and Cervical VA Medical CenterCalifornia, San Francisco Dysplasia Clinic, San Francisco Michael G. Shlipak, MD, MPH General Hospital, Former Chief, Division of General Internal member of US Preventive Medicine; San Francisco VA Services Task Force Medical Center; Professor, Departments of Medicine, Epidemiology Biostatistics University of California, San Francisco; Attending Physician, San Francisco VA Medical Center