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Exam 1: Effect of the Antidepressant Venlafaxine in Functional Dyspepsia: a Randomized, Double-Blind, Placebo-Controlled Trial
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY 2008;6:717–719
CME Activities–Exams 1 and 2 C. Mel Wilcox, MD, Editor, CME Section
CME Credits: The American Gastroenterological Association (AGA) Institute is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AGA Institute designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Faculty Disclosure: In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support of Continuing Medical Education, all faculty and planning partners must disclose any relevant financial relationship(s) or other relationship(s) held within the past 12 months. The AGA Institute implements a mechanism to identify and resolve all conflicts of interest prior to delivering the educational activity to learners.
Instructions: Category 1 credit can be earned by reading the relevant articles and taking these CME examinations online at http://www.cghjournal. org/content/cme. Answers can be obtained online after completing the exam(s).
Objectives: Upon completion of these activities, participants should be able to demonstrate an increase in or affirmation of their knowledge of clinical medicine and evaluate the appropriateness of the clinical information as it applies to the provision of patient care.
718
CME ACTIVITIES
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY Vol. 6, No. 7
Exam 1: Effect of the Antidepressant Venlafaxine in Functional Dyspepsia: a Randomized, Double-Blind, PlaceboControlled Trial van Kerkhoven LAS, et al, Authors Test ID No.: 0061
Contact hours: 1.0
Expiration Date: July 31, 2009
Question 1: Upper abdominal pain is a common symptom prompting referral to gastroenterologists. Many of these patients undergo upper endoscopy and the vast majority has a normal study. Since many of these patients have no organic cause to explain their symptoms, therapies other than those which reduce gastric acid secretion have been used. In this study, a serotonin and norepinephrine reuptake inhibitor was used for patients with functional dyspepsia. The rationale for use of this drug includes which of the following:
a) b) c) d)
Acceleration of gastric emptying Reduction in colonic motility Increase in lower esophageal sphincter pressure Prior data suggesting efficacy of antidepressants in IBS
a) b) c) d)
10% 30% 50% 80%
Question 2: In studies where one is evaluating for symptom improvement and where there are no objective physiologic measures, placebo response rates are often high. In such situations, it is critical to power the study accordingly so that a type-2 error does not occur. In the study by van Kerkhoven et al, the pre-trial power calculations were based on a predicted response rate, to venlafaxine, of:
Question 3: In addition to pain scores, anxiety, depression, and quality of life were also measured. Their results show:
a) Mean number of symptoms did not improve over time in both groups b) There was no change in symptom severity over time in both groups c) Anxiety scores in both groups improved very early following drug initiation d) Approximately one third of patients in both groups were symptom free at 8 weeks
Question 4: A 42-year-old female business executive presents with a 2-month history of epigastric distress. An empirical trial of high-dose proton-pump inhibitors is ineffective. Upper endoscopy is normal. Based on the study of van Kerkhoven et al, which of the following could you tell the patient?
a) A trial of venlafaxine is likely to result in cure of her symptoms b) The use of venlafaxine has no side effects c) Using a high-dose of venlafaxine may be effective d) Your symptoms may improve over time regardless of treatment
CME Activities–Exams 1 and 2 C. Mel Wilcox, MD, Editor, CME Section
CME Credits: The American Gastroenterological Association (AGA) Institute is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AGA Institute designates this educational activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Faculty Disclosure: In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support of Continuing Medical Education, all faculty and planning partners must disclose any relevant financial relationship(s) or other relationship(s) held within the past 12 months. The AGA Institute implements a mechanism to identify and resolve all conflicts of interest prior to delivering the educational activity to learners.
Instructions: Category 1 credit can be earned by reading the relevant articles and taking these CME examinations online at http://www.cghjournal. org/content/cme. Answers can be obtained online after completing the exam(s).
Objectives: Upon completion of these activities, participants should be able to demonstrate an increase in or affirmation of their knowledge of clinical medicine and evaluate the appropriateness of the clinical information as it applies to the provision of patient care.
718
CME ACTIVITIES
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY Vol. 6, No. 7
Exam 1: Effect of the Antidepressant Venlafaxine in Functional Dyspepsia: a Randomized, Double-Blind, PlaceboControlled Trial van Kerkhoven LAS, et al, Authors Test ID No.: 0061
Contact hours: 1.0
Expiration Date: July 31, 2009
Question 1: Upper abdominal pain is a common symptom prompting referral to gastroenterologists. Many of these patients undergo upper endoscopy and the vast majority has a normal study. Since many of these patients have no organic cause to explain their symptoms, therapies other than those which reduce gastric acid secretion have been used. In this study, a serotonin and norepinephrine reuptake inhibitor was used for patients with functional dyspepsia. The rationale for use of this drug includes which of the following:
a) b) c) d)
Acceleration of gastric emptying Reduction in colonic motility Increase in lower esophageal sphincter pressure Prior data suggesting efficacy of antidepressants in IBS
a) b) c) d)
10% 30% 50% 80%
Question 2: In studies where one is evaluating for symptom improvement and where there are no objective physiologic measures, placebo response rates are often high. In such situations, it is critical to power the study accordingly so that a type-2 error does not occur. In the study by van Kerkhoven et al, the pre-trial power calculations were based on a predicted response rate, to venlafaxine, of:
Question 3: In addition to pain scores, anxiety, depression, and quality of life were also measured. Their results show:
a) Mean number of symptoms did not improve over time in both groups b) There was no change in symptom severity over time in both groups c) Anxiety scores in both groups improved very early following drug initiation d) Approximately one third of patients in both groups were symptom free at 8 weeks
Question 4: A 42-year-old female business executive presents with a 2-month history of epigastric distress. An empirical trial of high-dose proton-pump inhibitors is ineffective. Upper endoscopy is normal. Based on the study of van Kerkhoven et al, which of the following could you tell the patient?
a) A trial of venlafaxine is likely to result in cure of her symptoms b) The use of venlafaxine has no side effects c) Using a high-dose of venlafaxine may be effective d) Your symptoms may improve over time regardless of treatment