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JAMA. 1999;282:1885-1886.

Physicians in the United States, Canada, and Mexico
Physicians with current and valid licenses in the United States, Canada, or Mexico who read any 3 of the selected continuing medical education (CME) articles in this issue of JAMA, complete the CME Evaluation Form, and fax it to the number or mail it to the address at the bottom of the CME Evaluation Form are eligible for category 1 CME credit. There is no charge.

The American Medical Association (AMA) is accredited by the Accreditation Council for Continuing Medical Education to sponsor CME for physicians. The AMA designates this educational activity for up to 1 hour of category 1 CME credit per JAMA issue toward the AMA Physician's Recognition Award (PRA). Each physician should claim for credit only those hours that were actually spent in this educational activity.

Physicians in Other Countries
Physicians with current and valid licenses in the United States, Mexico, or Canada are eligible for CME credit even if they live or practice in other countries. Physicians licensed in other countries are also welcome to participate in this CME activity. However, the PRA is available only to physicians licensed in the United States, Canada, or Mexico.

Earning Credit and the CME Evaluation Form
To earn credit, read 3 of the articles listed below that are designated for CME credit carefully and complete the CME Evaluation Form. The CME Evaluation Form must be submitted within 1 month of the issue date. A certificate awarding 1 hour of category 1 CME credit will be faxed or mailed to you; it is then your responsibility to maintain a record of credit received.

One of our goals is to assess continually the educational needs of our readers so we may enhance the educational effectiveness of JAMA. To achieve this goal, we need your help. You must complete the CME Evaluation Form to receive credit.

Statement of Educational Purpose
JAMA is a general medical journal. Its mission and educational purpose is to promote the science and art of medicine and the betterment of the public health. A flexible curriculum of article topics is developed annually by THE JOURNAL's editorial board and is then supplemented throughout the year with information gained from readers, authors, reviewers, and editors. To accommodate the diversity of practice types within JAMA's readership, the Reader's Choice CME activity allows readers, as adult learners, to determine their own educational needs and to assist the editors in addressing their needs in future issues.

Readers of JAMA should be able to attain the following educational objectives: (1) select and read at least 3 articles in 1 issue to gain new medical information on topics of particular interest to them as physicians, (2) assess the articles' value to them as practicing physicians, and (3) think carefully about how this new information may influence their own practices. The educational objective for each CME article is given after the article title below.

CME Articles in This Issue of JAMA
The following articles in this issue may be read for CME credit:

Fetal Surgery for Myelomeningocele and the Incidence of Shunt-Dependent Hydrocephalus (SEE ARTICLE)

Educational Objective: To learn some of the risks and benefits of intrauterine meningomyelocele repair.

Improvement in Hindbrain Herniation Demonstrated by Serial Fetal Magnetic Resonance Imaging Following Fetal Surgery for Myelomeningocele (SEE ARTICLE)

Educational Objective: To learn that fetal myelomeningocele repair may improve hindbrain herniation.

Live-Birth Rates and Multiple-Birth Risk Using In Vitro Fertilization (SEE ARTICLE)

Educational Objective: To learn how multiple birth rates may vary after in vitro fertilization.

Noninvasive Glucose Monitoring: Comprehensive Clinical Results (SEE ARTICLE)

Educational Objective: To learn how accurately a new device monitors glucose levels.

Statewide System of Electronic Notifiable Disease Reporting From Clinical Laboratories: Comparing Automated Reporting With Conventional Methods (SEE ARTICLE)

Educational Objective: To learn that an automated system for reporting notifiable diseases may be superior to conventional reporting.

Enhancement of Clinicians' Diagnostic Reasoning by Computer-Based Consultation: A Multisite Study of 2 Systems (SEE ARTICLE)

Educational Objective: To learn that computer programs may improve diagnostic reasoning.

Diaspirin Cross-Linked Hemoglobin (DCLHb) in the Treatment of Severe Traumatic Hemorrhagic Shock (SEE ARTICLE)

Educational Objective: To learn that an experimental oxygen-carrying resuscitation fluid may not decrease mortality.

After reading 3 of these articles, complete the CME Evaluation Form.

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RELATED ARTICLES

Fetal Surgery for Myelomeningocele and the Incidence of Shunt-Dependent Hydrocephalus
Joseph P. Bruner, Noel Tulipan, Ray L. Paschall, Frank H. Boehm, William F. Walsh, Sandra R. Silva, Marta Hernanz-Schulman, Lisa H. Lowe, and George W. Reed
JAMA. 1999;282(19):1819-1825.
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Improvement in Hindbrain Herniation Demonstrated by Serial Fetal Magnetic Resonance Imaging Following Fetal Surgery for Myelomeningocele
Leslie N. Sutton, N. Scott Adzick, Larissa T. Bilaniuk, Mark P. Johnson, Timothy M. Crombleholme, and Alan W. Flake
JAMA. 1999;282(19):1826-1831.
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Live-Birth Rates and Multiple-Birth Risk Using In Vitro Fertilization
Laura A. Schieve, Herbert B. Peterson, Susan F. Meikle, Gary Jeng, Isabella Danel, Nancy M. Burnett, and Lynne S. Wilcox
JAMA. 1999;282(19):1832-1838.
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Noninvasive Glucose Monitoring: Comprehensive Clinical Results
Janet A. Tamada, Satish Garg, Lois Jovanovic, Kenneth R. Pitzer, Steve Fermi, Russell O. Potts, and and the Cygnus Research Team
JAMA. 1999;282(19):1839-1844.
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Statewide System of Electronic Notifiable Disease Reporting From Clinical Laboratories: Comparing Automated Reporting With Conventional Methods
Paul Effler, Myra Ching-Lee, April Bogard, Man-Cheng Ieong, Trudi Nekomoto, and Daniel Jernigan
JAMA. 1999;282(19):1845-1850.
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Enhancement of Clinicians' Diagnostic Reasoning by Computer-Based Consultation: A Multisite Study of 2 Systems
Charles P. Friedman, Arthur S. Elstein, Fredric M. Wolf, Gwendolyn C. Murphy, Timothy M. Franz, Paul S. Heckerling, Paul L. Fine, Thomas M. Miller, and Vijoy Abraham
JAMA. 1999;282(19):1851-1856.
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Diaspirin Cross-Linked Hemoglobin (DCLHb) in the Treatment of Severe Traumatic Hemorrhagic Shock: A Randomized Controlled Efficacy Trial
Edward P. Sloan, Max Koenigsberg, David Gens, Mark Cipolle, Jeffrey Runge, Mary Nan Mallory, George Rodman, Jr, and for the DCLHb Traumatic Hemorrhagic Shock Study Group
JAMA. 1999;282(19):1857-1864.
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