Clinical Guideline
The content of this CME activity is a guideline for clinical care that is endorsed by the University of Michigan Health System and updated regularly.

Navigation
The main informational sections are outlined at the top of the screen.

Combining Online & Offline Participation
The Guideline consists of several formatted pages of text and tables that most people find easier to read and review in printed format than on a computer screen. We recommend that you:
1. Read the introductory information on-line ("orientation," "purpose, audience & acknowledgements," "about CME self study & credit").
2. Go to "guideline" and download and print it to read and retain off-line
3. Go to "CME test & credit request" on-line to complete the knowledge test and the form registering for credit and evaluating the activity.

Immediate Feedback & Credit
The knowledge test is immediately scored and correct answers explained. If you request CME credit, you immediately receive your certificate.

No Fee
No fee is charged for participating in this CME activity. The UM Hospitals and Health Centers funded the development of the guideline. The UM Department of Medical Education funded making this information available to you as a CME activity.

Technical Specification
This self-study activity requires:
• a connection to the Internet. A 14.4 baud modem on dial-up connection is adequate, though faster connections will result in improved performance.
• a web browser such as Microsoft Internet Explorer or Netscape Navigator, versions 3.0 or greater.
• Adobe Acrobat Reader. The guideline will be downloaded as an Adobe PDF file. If you do not have Acrobat Reader on your computer, then click here to download a free copy from the Adobe web site.

Privacy
We respect the privacy of individuals using our Internet self-study CME activities. The procedures to maintain your privacy are described in our Privacy Policy Statement.

Medical Disclaimer
The University of Michigan Health System web site does not provide specific medical advice and does not endorse any medical or professional service obtained through information provided on this site or any links to this site. Use of the UMHS web site does not replace medical consultation with a qualified health or medical professional to meet the health and medical needs of you or others. While the content of the UMHS web site is frequently updated, medical information changes rapidly and therefore, some information may be out of date, and/or contain inaccuracies or typographical errors.