First, list the names of any ineligible companies (defined in the “Glossary of Terms” below) with which you have, or have had, a financial relationship within the past 24 months.

Second, describe what you received (ex: salary, fee, research grant, etc). CME Outfitters does NOT want to know how much you received.

Third, describe your role.

Examples of financial interests or other relationships may include: receiving grants/research support, current or recent history of employment with, consultantship or advisory role to, or stockholder of a company, or being a member of a speakers bureau. Disclosing a relationship or affiliation with any commercial organization does not necessarily prevent a faculty member from making a presentation. However, if it is determined that the financial relationship may cause a conflict of interest, the faculty member has the option to alter the relationship so that a conflict no longer exists, or CME Outfitters will manage and attempt to mitigate the conflict in order to ensure activities are free of commercial bias. The policy is designed to place a higher priority on the health and well-being of the public than on individuals’ personal economic interests.

Glossary of Terms

Ineligible Companies (formerly known as 'Commercial Interest')
The Standards of Integrity and Independence define an “ineligible company” as any entity producing, marketing, re-selling, or distributing health care goods used on, or consumed by, patients. The Standards do not consider providers of clinical services directly to patients to be ineligible companies nor commercial interests. For more information, visit www.accme.org.

Financial relationships
Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria, ownership interest (e.g., stocks, stock options or other ownership interest, excluding diversified mutual funds), or other financial benefit. Financial benefits are usually associated with roles such as employment, management position, independent contractor (including contracted research), consulting, speaking and teaching, membership on advisory committees or review panels, board membership, and other activities from which remuneration is received, or expected. The Standards focus on all financial relationships with ineligible companies in the 24-month period preceding the time that the individual is being asked to assume a role controlling content of the CE activity. The Standards so not set a minimal dollar amount for relationships to be significant. Inherent in any amount is the incentive to maintain or increase the value of the relationship.

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CONTINUING EDUCATION PEER REVIEW FORM

Clinical Content Evaluation and Validation

Instructions to Peer Reviewer:
Please review the syllabus/course guide or presentation slides for the educational activity provided. As an independent reviewer for CME Outfitters, your role is to validate content, ensure the materials are fair, balanced, and free of commercial bias, and estimate applicability to the target audience. We ask that you scrutinize patient treatment recommendations to ensure they represent standard practice guidelines in the United States and conform to research principles generally accepted by the scientific community. The content or format of a CE activity or its related materials must promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest. Presentations must give a balanced view of therapeutic options. Use of generic names will contribute to this impartiality. If the CE educational material or content includes trade names, where available trade names from several companies should be used, not just trade names from a single company. We appreciate your candid feedback and thank you for contributing to high-quality CME/CE.

1. Review for Fair Balance and Bias

2. Scientific Validity

3. Patient Treatment Recommendations

4. Learning Objectives

5. Omission and Commission

6. General

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By clicking the Submit button below, you attest to understanding your role and responsibility as a content peer reviewer, and providing candid feedback in accordance with the following paragraph:

As an independent reviewer for CME Outfitters, your role is to validate content, ensure the materials are fair, balanced, and free of commercial bias, and applicability to the target audience. We ask that you scrutinize patient treatment recommendations to ensure they represent standard practice guidelines in the United States and conform to research principles generally accepted by the scientific community. The content or format of a CME activity or its related materials must promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest. Presentations must give a balanced view of therapeutic options. Use of generic names will contribute to this impartiality. If the CME educational material or content includes trade names, where available trade names from several companies should be used, not just trade names from a single company.

By clicking this button, I am affixing my signature to this document.