Board Meeting Minutes

American Academy of Emergency Medicine
Minutes of Board of Directors Conference Call
June 25, 2002

IN ATTENDANCE: Joseph Wood, MD, JD; Robert McNamara, MD; A. Antoine Kazzi, MD; Tom Scaletta, MD; Carol Barsky, MD; Howard Blumstein, MD; William Durkin, Jr., MD; James Li, MD; Raymond Roberge, MD; Kevin Rodgers, MD, Paul Sierzenski, MD; Scott Weiner, MD. Absent: Anthony DeMond, MD; Geoffrey Mitchell, MD. Staff: Kay Whalen.

Approval of May 18-19, 2002 Board of Directors Meeting Minutes

Dr. Wood welcomed everyone to the call and turned the Board's attention to the first agenda item. After a review of the minutes from the St. Louis Board meeting, Dr. Scaletta moved and Dr. Durkin seconded that the May 18-19, 2002 minutes be approved. MOTION PASSED UNANIMOUSLY.

President's Report

Dr. Wood reported he and Dr. Kazzi had met with the ACEP leadership in St. Louis during the SAEM meeting. At that time, AAEM had asked ACEP if there were ways in which the two organizations would be able to work together legislatively. Dr. Carius, ACEP president, contacted Dr. Wood to decline AAEM's offer to work together. The Committee that was established during the strategic planning session and chaired by Dr. McNamara will now identify various options for legislative representation.

Dr. McNamara and Dr. Kazzi will both be speaking at residency programs in July.

Treasurer's Report

Dr. Scaletta then reviewed the May 31, 2002 financial statements which were included in the agenda packet. He noted that, after the $55/member dues assignment for each AAEM member, the Scientific Assembly would, at a minimum, be a break-even proposition. Dr. McNamara questioned the significant increase in catering costs. Ms. Whalen responded that in addition to the higher cost of catering, a second lunch in the exhibit hall had been added. The Board did not feel that this would be necessary for 2003.

Dr. Scaletta also noted that he had asked staff to investigate a higher interest rate on AAEM's investments. Staff researched the option that Dr. Li had suggested, but this investment is only available to individuals. Interest rates on longer term CDs are paying slightly higher interest rates than AAEM's money market account, but purchasing a CD would lock us into a relatively low interest rate at the current time.
Membership

Ms. Whalen presented the membership report. Full voting members are currently 5.9% ahead of last year's pace. Associate members are 60% of last year's pace. In fact, membership in all categories has increased.

The Board then turned its attention to Dr. Kazzi's nomination of Dr. Hashim Allam, the Undersecretary of Health for Emergency Medical Services in Egypt, for honorary international membership. Dr. Roberge noted that AAEM's bylaws limit membership in this category to presidents of international medical societies. Dr. Kazzi stated that Dr. Allam may establish an Egyptian Emergency Medicine Society. Dr. Roberge moved and Dr. Scaletta seconded that the nomination of Dr. Hashim Allam as an international member be tabled. MOTION PASSED UNANIMOUSLY.

Conference Call Scheduling

Dr. Wood then noted that he had received requests to schedule Board meetings and conference calls for the remainder of the year. After discussion, the remaining full Board conference calls were scheduled for August 12th and December 9th. The Board will also meet in-person in Chicago on October 26th.

Certification Cards

Dr. Scaletta then presented a draft of cards that state Emergency Medicine physicians are qualified in cardiac, pediatric and trauma resuscitation due to the training and skills necessary to become board certified. Dr. McNamara moved and Dr. Scaletta seconded that AAEM provide cards to its fellows as a membership benefit. After much discussion, Dr. Roberge moved and Dr. Scaletta seconded that the previous motion regarding resuscitation cards be tabled. MOTION PASSED 6-5. Dr. Scaletta then moved and Dr. McNamara seconded that AAEM send an e-mail to a sample of AAEM fellows to determine if AAEM's membership would find resuscitation cards helpful. MOTION PASSED UNANIMOUSLY. If the membership would find these cards valuable, Ms. Whalen will seek legal counsel regarding any possible trademark issues.

Draft Code of Ethics

Dr. Wood then drew the Board's attention to the draft code of ethics that was included in the agenda packet. He noted that the Executive Committee had reviewed this document and recommended adoption. Dr. Scaletta moved and Dr. Kazzi seconded that AAEM adopt the code of ethics as presented. MOTION PASSED 10-1.

Amiodarone Position Statement

Dr. Li then asked the Board to consider modifying or removing AAEM's position statement on amiodarone based on new evidence. Dr. Li moved and Dr. McNamara seconded that the amiodarone work group reconsider the position statement based on new evidence unless the efforts of the work group have already addressed this issue. MOTION PASSED UNANIMOUSLY.

Mediterranean Congress Budget 2003

Dr. Kazzi then reported that the dates of the 2003 Mediterranean Congress in Spain have been moved to September 20-23. The budget included in the agenda book was still preliminary. AAEM staff will be more involved in the planning of the 2003 meeting to ensure ACCME requirements and other financial reporting requirements will be met.

Guidelines for Medical Research

Dr. Li then outlined his reasons for developing guidelines for researchers involved in clinical trials. Dr. Li moved and Dr. McNamara seconded that the following be approved:

Guidelines for Researchers Involved in Manufacturer-sponsored Trials

Background
As medical research of drugs and devices has evolved, the quality of available evidence has benefited from increasing numbers of well designed randomized controlled trials, leading directly to reductions in selection bias. An additional source of potential bias is found when manufacturers with interests vested in positive trial outcomes sponsor trials themselves. In order to reduce this type of bias, the following guidelines are presented for medical journals that publish manufacturer-sponsored research. These guidelines are meant to supplement authorship disclosure of potential conflicts.

Recommended supplement to authorship guidelines
Manufacturers sponsoring trials should make significant efforts to remove individual investigators
from potential funding bias. To this end, study protocols should be initiated by investigators who are neither compensated nor employed by the manufacturer. Such trials should be executed and their results analyzed without any contribution from the study sponsors. Additionally, trial reports should be written entirely by the study authors and not be sent to agents of the sponsoring manufacturer for prepublication review.

Authors who submit manuscripts according to these guidelines are encouraged to include the
following language in their Methods:

"The manufacturer, XXX, donated medications and funding for the trial, but agreed that the trial be conducted independently in order to reduce funding bias. This agreement specified that results of the trial could be published in the particular case where an outcome could negatively impact the
manufacturer's market value. Accordingly, the trial was designed, conducted, analyzed, interpreted, and written by investigators independent of XXX, and was not sent to agents of XXX for prepublication review or approval."

For review articles, authors should explicitly state that they are directly responsible for writing.
Substitute authoring (also known as "ghost writing") should be clearly identified.

Recommendations to editors
Manuscripts from manufacturer-sponsored trials where efforts have been made to eliminate funding bias should be given priority for publication over similar manuscripts where funding bias remains possible.

Employees of sponsors must be clearly identified if involved in manuscript authorship. Any other
relationships between authors and sponsors must also be clearly identified within the author section
of the publication.

Recommended supplement to expert guideline classification
In addition to classifying research evidence by trial design (where, for example, a randomized
controlled trial is considered Level I evidence), expert guidelines should also denote potential funding bias. The highest level of evidence should be reserved for randomized controlled trials that are clearly independent of such bias.

MOTION PASSED UNANIMOUSLY.

Public Service Announcement

Dr. Li then reported that he had researched the possibility of producing a public service announcement (PSA) stressing the importance of board certification in Emergency Medicine. He estimated the costs to be about $5,000. After discussion, Ms. Whalen volunteered to research the costs of production and distribution of such a PSA further.

New Business

Dr. Wood announced that AAEM had been accepted into the Specialty and Service Society (SSS) of the AMA. He also noted that AAEM has received a number of positive e-mails in response to our letter to Child magazine. We also had 10 hospitals apply to be listed on the www.911emergency.org website.

There being no further business, the conference call meeting was adjourned.

Respectfully submitted,


Kay Whalen
Organizational Director