Western Occupational & Environmental Medical Association
Leading Occupational & Environmental Medicine

CME Webinars Calendar

WOEMA’s Education Committee offers CME Webinars on topics relevant to the practice of occupational and environmental medicine. These webinars can be accessed by calling a toll-free 800 number and viewing the Powerpoint presentation using your Internet browser from your own computer. WOEMA members will be notified in advance of the dial-in phone number and the URL link to access the slides. When the CME Webinar is offered live, members will have the opportunity to send questions to the presenter and have those answered in real-time on the live broadcast.

WOEMA CME Webinar Registration Fees
WOEMA/ACOEM Member – Free
Non-Member Physician – $20
Non-Member, Non-Physician – $15

Click here to listen/view past webinar presentations.

TOPIC: The California DWC Formulary: An Introduction

Aired on December 21, 2016 at 12:00 pm PT

Speaker: Robert L. Goldberg, MD, FACOEM

The 2017 implementation of the California DWC drug formulary will impact care for hundreds of thousands of injured workers. Thus great attention has been turned to the current draft regulations, which add an important layer of clinical context to guide drug therapy. The formulary is notably linked to the California Medical Treatment Utilization Schedule (MTUS) and driven by the American College of Occupational and Environmental Medicine (ACOEM) treatment guidelines. The DWC adoption of a closed drug formulary grounded in such high-quality evidence-based guidelines will place drug therapy decisions within the context of the injury or condition being treated, rather than the availability of the medication alone. Dr. Robert Goldberg will speak to the development of the DWC formulary, its potential clinical and cost benefits, provide insight into its functionality and application, and discuss important considerations for implementation.

Learning Objectives – Participants will be able to:

  • Summarize the development of the formulary from evidence-based occupational medical treatment guidelines
  • Explain the potential clinical and cost benefits of a closed drug formulary supported by evidence-based guidelines
  • Describe the considerations that are important to the successful implementation and adoption of a state-based formulary
  • Describe the functionality of the formulary and the supporting tools to make prescribing decisions for injured workers

Dr. Robert Goldberg is the Chief Medical Officer of Healthesystems and the developer of the ACOEM/Reed formulary. Board -certified in Occupational Medicine and a former Vice-Chair, Occupational Medicine of the American Board of Preventive Medicine, he is a nationally-recognized expert in the prevention and treatment of work-related injuries. He is also a Past-President of ACOEM and WOEMA and was a Professor of Medicine and the Residency Director in the Division of Occupational and Environmental Medicine at UCSF.

CREDIT: WOEMA is accredited by the Institute of Medical Quality/California Medical Association to provide continuing medical education for physicians. WOEMA takes responsibility for the content, quality, and scientific integrity of this CME activity.

WOEMA designates this live internet activity, when combined with completion and submission of the on-line questionnaire, for a maximum of 1.0 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

This credit may also be applied to the CMA Certification in Continuing Medical Education.

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TOPIC: Work-Related Elbow Injuries – Diagnosis and Management

Aired on October 27, 2016

Speaker: James Van den Bogaerde, MD

This webinar will focus on common work related elbow injuries – both traumatic and degenerative. I will discuss the clinical presentation of a variety of elbow conditions and review evidence-based management strategies. The presentation should improve your ability diagnose and treat common elbow injuries and be aware of less common elbow conditions, as well.

Learning Objectives – Participants will be able to:

  • Become familiar with the most common elbow injuries
  • Be aware of less common sources of elbow pathology
  • Appropriately diagnose elbow injuries
  • Recall how age, gender and occupation may affect the differential diagnosis
  • Review evidence-based treatment options

Dr. Van den Bogaerde (pronounced ‘van den bogard’) is a sports medicine specialist and director of the Sports Medicine Fellowship at UC Davis Orthopaedics and Sports Medicine. His practice focuses on shoulder and elbow arthroscopy and reconstruction. He provides medical coverage for the US Ski Team, Sacramento Republic FC (soccer), and local university and junior college football teams.

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TOPIC: Maintaining Board Certification in Occupational Medicine

Aired on August 31, 2016

Speaker: Eric Wood, MD, MPH

The American Board of Preventive Medicine (ABPM) administers the Maintenance of Certification (MOC) program for Diplomates Board Certified in Occupational Medicine. MOC consists of four parts: I) Professionalism and Professional Standing, II) Lifelong Learning and Self-Assessment, III) Assessment of Knowledge, Judgment, and Skills, and IV) Improvement in Medical Practice. This webinar is designed to help Occupational Medicine physicians understand the requirements for maintaining ABPM Board Certification, important timelines, and assistance in finding resources to meet those requirements.

Learning Objectives – Participants will be able to:

  • Review the origins and evolving nature of Maintenance of Certification (MOC)
  • Describe and define the Four Parts of Continuous Certification
  • Identify timelines to meet MOC requirements
  • Provide resources for achieving MOC requirements

Dr. Eric Wood is Director of Occupational Medicine at the Rocky Mountain Center for Occupational and Environmental Health (RMCOEH), University of Utah. He also serves as the Director of the Occupational and Environmental Medicine Residency program at the University of Utah. He completed residency training in Family Medicine and Occupational Medicine and is Board-Certified in both disciplines. He has broad training and experience in occupational health having begun his career as an Industrial Hygienist working for both OSHA and private consulting to address and mitigate a wide spectrum of occupational health risks among workers. His current academic responsibilities include education and training of occupational medicine residents, graduate students, medical students, and other health professionals; research with a focus on Occupational Health and Wellness among Commercial Truck Drivers, and Work-Related Musculoskeletal Disorders; and consultation and clinical practice of occupational medicine.   He is Co-Chair of the NIOSH NORA Transportation, Warehousing and Utility (TWU) Sector Council. Dr. Wood is a Director of the American Board of Preventive Medicine (ABPM), and he serves as Chair of the ABPM Maintenance of Certification Committee.

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TOPIC: Workplace Violence Prevention – Healthcare and Elsewhere

Aired on June 29, 2016

Speaker: Paul Papanek, MD, MPH, FACOEM

The webinar will review the epidemiologic sources of our data on workplace violence as an occupational health problem, and will focus particularly on violence in healthcare settings with a discussion of the upheavals caused by changes in both prison policy and forensic mental health practices. Using a recent Federal OSHA guidance document and experience from new standard setting in California, the talk will suggest strategies for prevention.

Learning Objectives – Participants will be able to:

  • Identify the mental health diagnoses associated with the highest risk of violent injuries to health care staff
  • Identify at least two authoritative resources for learning more about workplace violence prevention
  • State at least two strategies for decreasing episodes of workplace violence in healthcare settings

Dr. Paul Papanek is a graduate of UCSD Medical School, and took both his Family Medicine Residency and his MPH degree at UCLA. He is Board Certified in Occupational Medicine, and served as a Public Health Chief for LA County Health Department for 9 years, and as Chief of Occupational Medicine at the Kaiser Hospital in Los Angeles for about 15 years. He is currently a Public Health Medical Officer with Cal/OSHA, and has served on the WOEMA and ACOEM Boards.   He lives in Southern California, but has accumulated quite a few Frequent Flier miles.

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TOPIC: Coping with Medical Errors: Mistakes Happen

Aired on  April 27, 2016 

Speaker: CAPT Lisa Arnold, MSN, BSN, NP

Acknowledging medical errors and discussing unanticipated outcomes with patients is an essential skill for every healthcare provider.  It is also mandated by the Joint Commission on Accreditation of Healthcare Organizations.  After the apology, there is another issue to address:  How do we as physicians cope with our own guilt and doubt?  Medical errors have two victims:  patient and provider.  Join Captain Lisa Arnold for a live webinar presentation on Disclosure Training and Providers as Second Victims.

Learning Objectives – Participants will be able to:

  • Describe the impact of adverse events on the healthcare “system”
  • Summarize the history of the Department of Defense’s healthcare resolution program
  • Describe the legal considerations of disclosures and the “provider as a second victim” phenomenon

CAPT Lisa Arnold served twenty-four years in the Navy as a Pediatric Nurse Practitioner and is currently the Special Assistant to the Commander, Navy Medicine West, for Healthcare Resolutions.  CAPT Arnold is responsible for implementing the Healthcare Resolutions Program, a non-legal venue that attempts to resolve healthcare issues following unexpected outcomes of care, poor quality of care and in cases of medical error.  The process promotes organizational transparency and integrity with full disclosure, recognition of system vulnerabilities, and a commitment to process improvements.  Her previous positions leading to her selection for this program include:  role as a licensed independent practitioner, Head Patient Relations Naval Medical Center San Diego; DOD/VA Federal Recovery Coordinator.  CAPT Arnold lives in San Diego and is adjunct faculty, Masters Entry to Nursing Program, University of San Diego and National University.

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TOPIC: Comprehensive Pain Management

Aired on February 24, 2016

Speaker: Thuong D. Vo, MD

As Occupational Medicine specialists and primary care providers, we receive a steadily increasing number of referrals of patients already taking narcotics, and/or with significant injuries that may necessitate the initiation of same. How can we ensure that we are appropriately applying the Guidelines? Learn more by joining us for Comprehensive Pain Management Webinar provided by Dr T. Vo.

Learning Objectives – Participants will be able to:

  • Further understanding of the mechanisms of chronic non-malignant pain
  • Assessment prior to initiation of opioid therapy
  • Multidisciplinary approaches to the management of chronic pain
  • Common medications used to treat chronic pain

Dr. T. Vo is board certified in Pain Medicine, Anesthesiology, Age Management Medicine and is also certified in Aesthetic Medicine. He received his MD from the University of Rochester School of Medicine & Dentistry, his BS in Biochemistry, and his BA in Chemistry, both from the University of Rochester. Dr. Vo completed his fellowship in Pain Management from UCLA, and residency programs in Anesthesiology and General Surgery from University of Rochester Strong Memorial Hospital.

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TOPIC: Metabolic Syndrome & Workplace Wellness: A Total Worker Health(TM) Approach to Designing Healthy Workplaces

Aired on October 21, 2015

Speaker: Suzanne Nobrega, MS

Obesity is a major public health issue, and is a growing concern for employers. Participants will learn how our work organization can act as risk factors for obesity by influencing our individual behaviors or lifestyles. The presentation will discuss specific work environment factors that can contribute to overweight/obesity, and how to create a work environment conducive to health with worksite wellness activities and interventions.

Learning Objectives – Participants will be able to:

  • Recognize pathways between work environment and obesity/overweight
  • Identify factors relevant to low wage workforce
  • Describe strategies for addressing work-related risk factors for obesity/overweight

Suzanne Nobrega is the Outreach Director at the Center for the Promotion of Health in the New England Workplace (CPH-NEW) at the University of Massachusetts Lowell. She is Co-Principal Investigator of the Healthy and Safe@Work Project. In this role, she provides training and technical assistance to employer organizations looking to implement Total Worker Health programs in the workplace. Suzanne is an experienced program manager, program evaluator, and research coordinator. Her research interests focus on interventions to address job stress, organizational change, and obesity. She holds a master’s degree in nutrition from Cornell University, and has completed graduate coursework in Work Environment at the University of Massachusetts Lowell.

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TOPIC: Early Management of Occupational Low Back Pain

Aired on August 26, 2015

Speaker: Dallin DeMordaunt, MD

Low back pain is the most common occupational medical complaint that occupational health providers and primary care physicians encounter. These injuries can be challenging to manage in the acute and subacute stages. Health care providers will learn the key elements of evaluating and treating early low back injuries including typical occupational activity modifications. They also will learn what symptoms and signs suggest additional diagnostic work up. This presentation will help providers be more effective in managing this frequent medical issue in the future.

Learning Objectives – Participants will be able to:

  • Recognize the prevalence and expense of occupational low back injuries
  • Describe the steps for performing a history and examination for low back pain
  • Recognize the “red flags” of low back pain that require further diagnostic work up
  • Recall when and what imaging/tests are indicated early on in low back pain
  • Describe what treatments are usually indicated for most acute and subacute low back injuries
  • Recommend what occupational activity modifications are usually indicated for acute and subacute low back injuries

Dr. Dallin DeMordaunt is a Physiatrist — Board Certified in Physical Medicine and Rehabilitation, Sports Medicine, and Electrodiagnostic Medicine. He has worked in Reno, Nevada for 10 years at Sierra Regional Spine Institute and at Concentra Occupational Centers, and serves as assistant clinical professor for the University of Nevada School of Medicine. Dr. DeMordaunt specializes in the diagnosis and non-surgical treatment of musculoskeletal, nerve injuries and pain syndromes. He coordinates and directs appropriate therapies for work and non-work related injuries, and utilizes peripheral, interventional spine injections and electrodiagnostic testing. Dr. DeMordaunt resides in Reno, Nevada with his wife and four kids and spends his free time enjoying the outdoors around Lake Tahoe and the Sierra Mountains.

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TOPIC: Vaccines for International Travel: Special Focus on the Pacific Region

Aired on June 24, 2015

Speaker: Margaret Ryan, MD, MPH

Many professionals travel to the Pacific region as part of an increasingly world-connected workforce. Understanding infectious disease risks specific to these regions is important in occupational medicine. This webinar will address specific, current recommendations for the prevention of Hepatitis A and B, Influenza, Japanese Encephalitis, Polio, Rabies, and Typhoid. General recommendations for travel safety and addressing contemporary worker concerns, before and after Pacific region travel, will also be discussed.

Learning Objectives – Participants will be able to:

  • Describe vaccine-preventable infectious disease risks of importance in the Pacific region, including Hepatitis A and B, Influenza, Japanese Encephalitis, Polio, Rabies, and Typhoid
  • Summarize current recommendations for vaccination in preparation for travel to the Pacific region
  • Apply an understanding of vaccine information, including precautions and contraindications, to appropriately protect workers who travel to the Pacific region

Dr. Margaret Ryan is an occupational and preventive medicine physician who lives in San Diego, California. She completed her education at Johns Hopkins University, George Washington University, and the Uniformed Services University. Dr. Ryan served in the US military for more than 25 years, retiring as a Navy Captain in 2011. While in the military, she led several large epidemiologic projects focused on recruit health, vaccine-preventable infectious disease, and reproductive health. She has authored or co-authored more than 130 contributions to the peer-reviewed literature. Dr. Ryan is currently the Medical Director of the Defense Health Agency Immunization Regional Office in San Diego. She is also an adjunct Professor at the University of California San Diego, where she supports the preventive medicine residency and teaches occupational and environmental health to undergraduate students.

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TOPIC: Can Your Shortness of Breath Patient Work? Evaluation of Respiratory Impairment & Disability

Aired on April 29, 2015

Speaker: John R. Balmes, MD

Chronic respiratory disease due to cigarette smoke and occupational or environmental exposures is a leading cause of disability worldwide. Physicians thus are not uncommonly asked to evaluate the impact of a respiratory disease on a patient’s daily activities, including the ability to work. Despite the prevalence of chronic respiratory disease and the need to evaluate resulting disability, many physicians feel ill equipped to assess functional respiratory impairment. This webinar presentation will provide information about the concepts of impairment, disability and handicap; the impairment evaluation schemes required by different agencies; the default AMA impairment classification scheme; and some specific case examples of application of the AMA respiratory impairment guidelines. The information presented will enhance physician knowledge about why, when, and how to perform a respiratory impairment evaluation.

Learning Objectives – Participants will be able to:

  • Differentiate impairment from disability and handicap
  • Understand the physician’s role in disability assessment
  • Apply the AMA guidelines for respiratory impairment evaluation

Dr. Balmes is Professor of Medicine at UCSF and Professor of Environmental Health Sciences in the School of Public Health at UC Berkeley.  He is an Attending Physician in the UCSF Division of Occupational and Environmental Medicine and the Division of Pulmonary and Critical Care Medicine at San Francisco General Hospital.  He was recently named Acting Director of the UC Berkeley-UCSF Joint Medical Program.  He was appointed Physician Member of the California Air Resources Board in 2008.  Dr. Balmes has been studying the effects of occupational and environmental agents on respiratory and cardiovascular health for 35 years.

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TOPIC: Radiation Dose Assessment of the US DOD Population Following the Fukushima Daiichi Release

Aired on February 25, 2015

Speaker: Paul K. Blake, PhD, CHP

On March 11, 2011, the most powerful earthquake ever recorded near Japan occurred followed by a devastating tsunami.  The tsunami led to station blackout conditions at the Fukushima Daiichi Nuclear Power Station resulting in reactor core meltdowns for Units 1, 2, and 3 with subsequent loss of containment and releases of radioactive materials to the environment.  At the request of the Government of Japan, the U.S. Department of Defense (DOD) launched a humanitarian assistance and disaster relief operation.  This operation was unique in in that nearly 75,000 DOD-affiliated individuals were potentially exposed to this radiation source.  Webinar participants will learn how DOD determined the health risk to its population, via a radiation dose assessment, and how this information was effectively communicated.

Learning Objectives – Participants will be able to:

  • Describe how a radiation dose assessment may lead to a population health determination
  • Identify radiological data suitable for performing an individual’s dose assessment following a nuclear reactor meltdown
  • Recall which radionuclides released from a nuclear reactor meltdown are of greatest concern to potentially exposed populations
  • Describe how radiation doses from a reactor release may effectively be communicated to the public

Paul Blake manages the Nuclear Test Personnel Review Program, Defense Threat Reduction Agency (DTRA), Fort Belvoir, VA.  DTRA safeguards America and its allies from weapons of mass destruction by providing capabilities to reduce, eliminate, and counter the threat, and mitigate its effects.  He leads the Department of Defense (DOD)’s efforts to confirm participation and reconstruct radiation doses for atomic veterans in support of Department of Veterans Affairs and the Department of Justice radiogenic disease compensation claims. He also led DOD’s radiation dose assessment of its affiliated population following the radiological release of the Fukushima Daiichi Nuclear Power Station in 2011.

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TOPIC: Ebola: From the Basis of Origin & Disease Amplification Through Healthcare Worker Protection

Aired on December 17, 2014

Speaker: Christian Sandrock, MD, MPH, FCCP

Ebola is a longstanding disease  with periodic outbreaks.  Most outbreaks are relatively contained within smaller countries and geographic regions.  However, the most recent outbreak in West Africa is unprecedented in scope and magnitude, with direct impacts across the globe.  Thousands have died, and even under standard protections in developed, resource-rich hospitals, disease transmission has occurred to healthcare workers.  This webinar will examine the origins of Ebola, particularly at the animal-human interface, the anatomy of this recent outbreak, and some initial solutions and protections for healthcare workers and other individuals traveling to infected regions.

Learning Objectives – Participants will be able to:

  • Determine the initial origin and disease amplification factors of the current outbreak in West Africa
  • Identify the origins of Ebola and other filoviridae, including animal reservoirs
  • Summarize basic and advanced PPE measures for healthcare workers
  • Describe the risks and protective mechanisms for transmission for travelers to outbreak regions

Dr. Christian Sandrock graduated from Georgetown University School of Medicine and earned a Masters of Public Health degree from Lund University in Lund, Sweden. Dr. Sandrock completed his Fellowship in both Infectious Diseases and Pulmonary & Critical Care Medicine at the University of California, Davis. Currently, Dr. Sandrock is an Associate Professor of Clinical Medicine in the Division of Pulmonary/Critical Care Medicine, the Division of Infectious Diseases and the Department of Internal Medicine at the University of California, Davis School of Medicine.  Dr. Sandrock has clinical interests in respiratory infections, community-acquired and viral pneumonia, and ICU-acquired infections. His research interests include emerging infectious diseases at the animal and human interface, particularly respiratory infections such as avian influenza, SARS, and other diseases acquired by humans.

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TOPIC: Climate Change and Public Health
Aired on October 29, 2014

Speaker: Kent E. Pinkerton, PhD

There is an increasing concern of how a changing world environment is affecting global public health. Climate change is contributing to increased population exposure to aeroallergens and secondary pollutants associated with adverse cardiorespiratory health effects. This presentation is designed for physicians, scientists and health care providers to gain a better understanding of the public health effects of climate change and to support evidence-based global health policy.

Learning Objectives – Participants will be able to:

  • Understand the global issues surrounding environmental and climate changes that impact on respiratory and public health
  • Understand how physicians and basic scientists may become more involved in addressing environmental issues associated with climate change
  • Implement the tools to address climate change in the treatment of patients

Kent E. Pinkerton is Professor of Pediatrics in the School of Medicine and Professor of Anatomy, Physiology and Cell Biology in the School of Veterinary Medicine at the University of California, Davis.  He serves as Director of the Center for Health and the Environment at UC Davis.  Dr. Pinkerton has authored more than 200 articles and book chapters on the health effects of ambient air pollutants (ozone and particles), combustion-generated particles, environmental tobacco smoke and engineered nanomaterials.  He has served as Chair of the Environmental and Occupational Health Assembly and the Environmental Health Policy Committee for the American Thoracic Society.  He co-chaired the ATS Workshop on Climate Change and Human Health (2012) and is co-editor of the book, Global Climate Change and Public Health (Humana Press, 2014).

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TOPIC: Occupational Neurology Fitness for Duty in Safety Sensitive Workers
Aired on August 27, 2014

Speaker: Jonathan Rutchik, MD, MPH, FACOEM

Occupational Medicine practitioners are often faced with challenging decisions when a patient with nonindustrial neurological conditions requests a return to work. Many of these are commercial drivers, police officers, fire fighters, hazardous waste workers, or aviation pilots where there is a potential safety risk to self or others.  In fact the newest FMCSA, NFPA and FAA regulations require clearance from a “neurologist who understands the functions and demands of commercial driving.”  In this presentation, Dr. Jonathan Rutchik, an ACOEM fellow, Associate Professor in Occupational Medicine at UCSF and physician board certified in both Neurology and Occupational Medicine will discuss neurological conditions such as head trauma, stroke and seizure, multiple sclerosis, tremor and medication use in patients with safety sensitive positions.   The participant will become familiar with the algorithms necessary when evaluating these patients and when a neurologist consultation is necessary.

Learning Objectives – Participants will be able to:

  • Define safety sensitive positions in the workplace, the American Disabilities Act (ADA) and which neurological conditions are commonly of concern in this arena
  • Define the most important issues regarding neurological conditions and an employee’s risk to self or others
  • Interpret how neuroepidemiology can help with predicting risk in neurological patients so as to appropriately judge their fitness in an era of the ADA

Dr. Jonathan Rutchik is a physician board certified in both neurology and occupational and environmental medicine.  An ACOEM fellow and Associate Professor at UCSF, he evaluates and treats injured workers and those exposed to industrial or environmental agents in his private practice in 5 locations in the San Francisco bay area.  Dr. Rutchik also provides expert consulting on various topics related to Occupational and Environmental Neurology and Clinical Neurotoxicology including fitness for duty in commercial drivers, firefighters, police and aviators as well as disability and chronic pain and neurological trauma.

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TOPIC: Hypertension Update: New JNC8 Guidelines vs. Old Federal Motor Carrier Safety Regulations (49 CFR 391.41 (b)(6))
Aired on June 25, 2014

Speaker: Joel Handler, MD

Hypertension recommendations have changed with the new Joint National Committee on High Blood Pressure (JNC8) evidence-based guideline, and are finding their way into general practice.  It is important for primary care practitioners to understand the rationale for the new guideline.  Delivery of care is dependent upon accurate blood pressure measurement, and participants will learn to avoid common errors.

Learning Objectives – Participants will be able to:

  • Recognize the JNC8 recommendations for the treatment of hypertension
  • Identify and avoid common errors in blood pressure measurement
  • Explain the elements of protocoled care that are associated with a high rate of hypertension control

Dr.  Joel Handler has been the national Kaiser Permanente Clinical Hypertension Lead since 2006, and since 2005 has been the southern California Kaiser Permanente region hypertension lead. In these roles he is responsible for the development and periodic review of hypertension treatment guidelines as well as their implementation. He created a referral clinic for resistant hypertension in 1992 and sees KP patients throughout southern California. Dr. Handler is currently certified in internal medicine, critical care medicine, geriatrics, and is an American Society of Hypertension Specialist in Clinical Hypertension. In 2011 he became a Fellow of the American Society of Hypertension. In his daily clinical practice, he sees intensive care unit patients in the mornings, as well as a primary care panel and hypertension referral patients in the afternoons.

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TOPIC: Latent TB diagnosis with the Quantiferon Assay- Providing Answers and Raising Questions
Aired on April 23, 2014 

Speaker: Madeline Slater, MD

Despite the all-time low incidence of tuberculosis (TB) in the United States, large numbers of U.S. healthcare workers (HCWs) are screened routinely for latent TB infection (LTBI). IFN-gamma release assays (IGRAs), such as the QuantiFERON-TB Gold In-Tube (Qiagen/Cellestis, Carnegie, Australia) test (QFT) and T-spot (Oxford Immunotec, UK) are increasingly replacing the tuberculin skin test (TST) for occupational screening. More than 70 U.S. medical institutions have adopted the QFT assay to serially test hundreds of thousands of hospital employees each year. In principle, IGRAs have equivalent sensitivity compared with the TST, with improved specificity in bacille Calmette-Guérin vaccinated individuals and individuals with nontuberculous mycobacterial infection. Additionally, IGRAs improve the logistics and economics of TB screening because, unlike the TST, they do not require trained readers, a return visit, or baseline two-step testing for annual screening. However, in practice, IGRA results have proved more dynamic in serial testing than anticipated. Early adopters of the QFT assay for occupational screening are now reporting major concerns with interpretation of the high conversion and reversion rates using the manufacturer’s recommended cutoff of simple negative to positive change.

Learning Objectives – Participants will be able to:

  • To define IGRAs and describe how they are performed
  • To define performance characteristics of IGRAs and compare to those of the TST
  • To review guidelines on the usage of IGRAs and discuss clinical scenarios
  • To describe the observed variability in serial testing; to list potential sources of variability; to describe quality assurance measures to minimize variability
  • To outline areas of clinical uncertainty

Dr. Slater is currently a senior postdoctoral fellow for the Infectious Diseases Division at Stanford University School of Medicine. She has focused the past years primarily on IGRA research and has published multiple highly regarded journal articles from studies conducted both domestically and abroad. Clinically, she works as a TB and STD physician for the San Mateo Department of Public Health. Additionally, she serves as a consultant to the CDC on a large-scale project in Thailand and Vietnam evaluating latent TB acquisition in health care workers.

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TOPIC: Opioid Prescribing: New FDA Labeling and New Guidelines
Aired on February 26, 2014

Speaker: Scott Fishman, MD

Description: This webinar will review current data and recommendations/guidelines from regulators and professional societies on the use of opioids and chronic pain. The risk vs. benefit analysis will be framed as an essential element of treatment decisions and thus emphasis will be placed on close attention to current data of risks compared with the benefits associated with chronic opioid prescribing. Recommendations from regulatory organizations including the recent labelling of chronic opioids by the FDA as well as recently revised model policy on opioid prescribing by the Federation of State Medical Boards will be reviewed.

Learning Objectives – Participants will be able to:

  • Understand the legal issues that relates to pain
  • Understand emerging legislation related to pain
  • Understand areas where law and practice may conflict

Dr. Scott M. Fishman is Professor and the Charles and Patricia Fullerton Endowed Chair of Pain Medicine, Chief of the Division of Pain Medicine, and Executive Vice Chair for the Department of Anesthesiology and Pain Medicine at the University of California, Davis. His medical degree is from the University of Massachusetts Medical School. Formal clinical training is in Internal Medicine (Greenwich/Yale University School of Medicine) and Psychiatry (Massachusetts General/Harvard Medical School).

Dr. Fishman lectures on all aspects of pain control including preventing prescription drug abuse. Dr. Fishman has authored many peer-reviewed articles in medical journals, book chapters, and other scholarly reviews. He is senior editor of the journal Pain Medicine and serves on the editorial boards of other medical journals.

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