PEER REVIEW EVALUATION

Thank you for agreeing to review Emergency Medicine Practice / Pediatric Emergency Medicine Practice. Please review this article for medical accuracy, appropriateness, timeliness, and completeness of information. Please mail or fax this completed form to 770-500-1316 no later than the due date listed in the email you received. By sending your approval of this article, you agree to allow Emergency Medicine Practice/Pediatric Emergency Medicine Practice to list you as a peer reviewer in the published version of this article. You will be paid $100 upon publication for your peer review. Please use Microsoft Word's "Track Changes" option to make your revisions. In most versions of Word, simply click "Tools" and then "Track changes.” Be sure that your comments appear in a different color then the original manuscript. Once complete, please email the article as an attachment to jp@ebmedicine.net. Please complete and fax this peer review form and your statement of financial disclosure form to Jennifer Pai, Associate Editor, at (770) 500-1316 or mail it to the address below. Please call 1-800-249-5770 or e-mail jp@ebmedicine.net if you have any questions.

Name of Reviewer:

Article Title:

1. On a scale of 1 to 10 (with 10 being extremely relevant), indicate how relevant this article is to your practice of emergency medicine: ____________ Please tell us why you chose this score: ______________________________________________________________________ ______________________________________________________________________

2. On a scale of 1 to 10 (with 10 being very easy and enjoyable to read), indicate how easy/enjoyable to read this

article is: ____________ Please tell us why you chose this score and list suggestions for improvement: ______________________________________________________________________ ______________________________________________________________________

3. Do you think the level of complexity and sophistication of this activity is appropriate for the intended audience? yes no

4. Does this activity cover the topics adequately (identify major controversies, alternative approaches, etc.)? yes no

5. Were there any discussions of unlabelled or investigational use of a commercial product not yet approved by the FDA? yes no

6. Sponsored and certified CME activities must be free of commercial bias for or against any product. In this regard,

how would you rate this activity? strongly biased moderately biased free of bias

What influence did you perceive, if any?_____________________________________ ______________________________________________________________________

7. Does this activity present the information in a fair & balanced manner? yes no 10. Were trade names used in this activity? yes no If yes, were trade names of all similar products or those within a class also presented? yes no 11. Was the content evidence-based and does it conform to the general format of scientific data presentations?

yes no 12. Is all the material accurate and educational? yes no

13. Additional comments (attach separate sheet if necessary): __________________________

____________________________________________________________________________

____________________________________________________________________________

____________________________________________________________________________

14. Please select one of the following: ___ I approve the article as is. ___ I approve the article provided the indicated changes are made. ___ I do not approve this article in its current form. Please make the indicated changes and send me another draft for review. As a reviewer, I have no conflict of interest and I am qualified to review this article.

Signature Date

Return completed form to: Jennifer Pai. Phone: 678-366-7933 / Fax: 770-500-1316 Email: JP@ebmedicine.net. Address: 5550 Triangle Pkwy, Ste 150 / Norcross, GA 30092