AOA/PIM Disclosure Form 62nd Annual Spring Meeting - 2022April 28-30, 2022Virtual - On Demand • Carlsbad, CA DISCLOSURE FORM FOR: Matthew Koepplinger, DO, FAOAOIf you are not Matthew Koepplinger, DO, FAOAO click here | Return to Faculty Forms. It is the policy of the AOAO to ensure balance, independence, objectivity, and scientific rigor in all its individually sponsored or jointly sponsored educational activities. All faculty participating in any AOAO sponsored programs are expected to disclose to the activity audience any real or apparent conflict(s) of interest that may have a direct bearing on the subject matter of the continuing education activity. This pertains to relationships with pharmaceutical companies, biomedical device manufacturers, or other corporations whose products or services are related to the subject matter of the presentation topic. The intent of this policy is not to prevent a speaker with a potential conflict of interest from making a presentation. It is merely intended that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It remains for the audience to determine whether the speaker's outside interests may reflect a possible bias in either the exposition or the conclusions presented. Financial Relationships for Planners, Faculty, and Others in Control of Activity Content Please disclose all financial relationships you have had in the past 24 months with ineligible entities. Financial relationships are those relationships in which the individual benefits by receiving a salary, royalty, intellectual property rights, consulting fee, honoraria for promotional speakers' bureau, 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. Contracted research includes research funding where the institution gets the grant and manages the fund's and the person is the principal or named investigator on the grant. There is no minimum dollar amount for relationships.An ineligible entity is any entity whose primary business is producing, marketing, selling, re-selling, or distributing health care products used by or on patients. For specific examples, visit accme.org/standards Activity: 62nd Annual Spring Meeting - 2022Date: Fri, Apr 29, 2022 - Presentation Title: Hand with Question and Answer In the past 24 months, have you had a financial relationships with any ineligible company? Yes No If yes, please complete the fields below by entering the company name and checking the appropriate boxes. Consultant/Advisory Board Employee/Owner Grant/Research Support Other financial or material support Patent Holder/Royalties paid to you Private Stock Shareholder Public Stock Shareholder Speakers Bureau/ Honoraria for non-CME Explain Relationship if Other financial or material support has been checked above: All speakers must attest to the following: Statement 1I will not accept payments or reimbursements from an ineligible company (any entity producing, marketing, re-selling, or distributing health care goods or services consumed by, or used on, patients) for my role in the planning and delivery of this CME activity. If I am approached by an ineligible company in this regard, I will immediately notify AOAO. I Agree Statement 2Continuing medical education consists of educational activities which serve to maintain, develop, or increase the knowledge, skills, and professional performance and relationships that a physician uses to provide services for patients, the public, or the profession. The content of CME is that body of knowledge and skills generally recognized and accepted by the profession as within the basic medical sciences, the discipline of clinical medicine, and the provision of health care to the public. As a presenter, my presentation will meet these standards. If I am a session moderator and/or an abstract discussant, any contribution I make to the discussion, will meet these standards. I Agree Statement 3Presentations that promote recommendations, treatment, or manners of practicing medicine that are not within the definition of CME or known to have risks or dangers that outweigh the benefits or known to be ineffective in the treatment of patients, are prohibited. Presentations devoted to advocacy of unscientific modalities of diagnosis or therapy are prohibited. As a presenter, my presentation will meet these standards. If I am a session moderator and/or an abstract discussant, any contribution I make to the discussion, will meet these standards. I Agree Statement 4All recommendations involving clinical medicine in a CME activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported or used in CME in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection and analysis. As a presenter, my presentation will meet these standards. If I am a session moderator and/or an abstract discussant, any contribution I make to the discussion, will meet these standards. I Agree Statement 5Presentations 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. As a presenter, my presentation will meet this standard. If I am a session moderator and/or an abstract discussant, any contribution I make to the discussion, will meet this standard. I Agree Statement 6Educational materials that are a part of this activity, such as slides, abstracts, and handouts, cannot contain any advertising, trade names, product-group messages, or ineligible company logos. As a presenter, my presentation will meet this standard. If I am a session moderator and/or an abstract discussant, any contribution I make to the discussion, will meet this standard. I Agree Statement 7The 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 an ineligible company. As a presenter, my presentation will meet this standard. If I am a session moderator and/or an abstract discussant, any contribution I make to the discussion, will meet this standard. I Agree Statement 8The content of the CME activity must not be influenced by any ineligible company. As a presenter, my presentation will meet this standard. I Agree This represents my signature and affirmation this information is current and accurate.
