INTRODUCTION
Transnasal endoscopy (TNE) is a rapidly expanding, novel approach to perform unsedated upper gastrointestinal esophagoscopy in pediatrics. It is an ambulatory, office-based procedure developed to evaluate the esophagus and obtain biopsies in diseases that require frequent endoscopic monitoring such as in eosinophilic esophagitis. While sedated esophagoscopy is widely accepted as a safe procedure, unsedated TNE is well-tolerated and its use decreases both the high cost and inherent risks associated with anesthetic use seen in traditional pediatric esophagoscopy.

The purpose of this webinar is gain understanding of the technique of TNE and the core elements of a TNE team, learn how to create and finance a TNE program, and review innovative research on transnasal duodenal imaging techniques. Dr. Nathalie Nguyen and Dr. Ramy Sabe are experts in development and implementation of TNE and will discuss the clinical application of TNE in the real-world practice. As nurses and skilled TNE technicians, Clinton Smith, Ellen Walden-Landry and Terrie Garcia will review important comprehensive procedural processes within TNE. Business of medicine experts Dr. James Franciosi and Dr. Matthew Ryan will reflect on the financial considerations and implications of TNE practice, a topic further augmented by discussion from Dr. David Piccoli, who as a division chief, offers knowledge and unique perspective on TNE cost analysis. Finally, Dr. Gary Tearney and Dr. Asad Ali will review their exciting innovative research on duodenal imaging utilizing an unsedated, transnasal procedure in infants. Dr. Vrinda Bhardwaj and Dr. Kristina Leinwand will serve as the moderators. The ultimate goal of the webinar is to enhance the knowledge of the practicing pediatric gastroenterologists in the rapidly expanding endoscopy tool that is TNE.

TARGET AUDIENCE
This activity is designed for pediatric gastroenterologists, pediatric gastroenterology fellows, pediatric gastroenterology nurse practitioners and pediatric gastroenterology dietitians.

LEARNING OBJECTIVES
Upon completion of this activity, participants should be better able to:
• Understand clinical applications for TNE in pediatric gastroenterology
• Understand the current safety data of pediatric TNE
• Understand what’s necessary to build a TNE program in pediatric gastroenterology
• Review clinical expectations and team components around a pediatric TNE practice
• Review challenges and solutions of pre-procedure, procedure and post-procedure processes for pediatric TNE
• Understand business model development, financial considerations and cost analysis of a TNE program
• Review developing research and future potential for expanding TNE in pediatrics

SATISFACTORY COMPLETION
Learners must complete an evaluation form to receive a certificate of completion. If you are seeking continuing education credit for a specialty not listed below, it is your responsibility to contact your licensing/certification board to determine course eligibility for your licensing/certification requirement.

ACCREDITATION STATEMENT
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) and The NASPGHAN Foundation for Children’s Digestive Health and Nutrition. NASPGHAN is accredited by the ACCME to provide continuing medical education for physicians.

CREDIT DESIGNATION STATEMENT
NASPGHAN is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. NASPGHAN designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABP MOC PART 2 CREDITS
Successful completion of this CME activity, which includes participation in the activity, with individual assessments of the participant and feedback to the participant, enables the participant to earn 1.0 MOC Part 2 points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABP MOC credit.
Participant must complete the evaluation within 30 days of the activity. Participant information will be uploaded to ABP 30 days post activity.

STATEMENT OF DISCLOSURE:
James Franciosi MD MS MSCE reports Royalties for PEESSV2.0 Questionnaire.
All others have nothing to disclose.

In accordance with ACCME Standards for Commercial Support of CME, NASPGHAN and The NASPGHAN Foundation implemented mechanisms to identify and resolve conflicts of interest for all individuals in a position to control content of this CME activity. To resolve identified conflicts of interest, the educational content was peer-reviewed by a physician member of the NASPGHAN Review Committee who has nothing to disclose. The resulting certified activity was found to provide educational content that is current, evidence-based, and commercially balanced.

MEDIUM OR COMBINATION OF MEDIA USED
This activity consists of a slide set plus online posttest and CME evaluation.

HOW TO RECEIVE CME CREDIT
To receive CME credit for this activity, participants must pass the posttest and complete evaluation questions at http://naspghan.cmecertificateonline.com and select the correct webinar. Certificates will be provided immediately after completion of both the posttest and evaluation. For any questions about receiving credit, please e-mail Tracy Sandstrom at tracy@amedcoemail.com.

PROVIDER INFORMATION
Jointly sponsored by NASPGHAN and The NASPGHAN Foundation.

DISCLAIMER
The content and views presented in this educational activity are those of the authors and do not necessarily reflect those of NASPGHAN, The NASPGHAN Foundation, or Olympus. This material is prepared based upon a review of multiple sources of information, but itis not exhaustive of the subject matter. Therefore, healthcare professionals and other individuals should review and consider other publications and materials on the subject matter before relying solely upon the information contained within this educational activity.

POLICY ON PRIVACY AND CONFIDENTIALITY
NASPGHAN and The NASPGHAN Foundation will make every effort to protect the privacy of every individual participant of this activity and will use information gathered only to maintain records as required by the American Medical Association (AMA) and ACCME.

This activity does not require readers to register to review the material, with the exception of physicians and other health care providers who desire to receive CME credit for this accredited activity. If an individual completes a CME for this accredited activity, we are required by the AMA and ACCME to collect personal information on the individual, such as their name, address, and phone number, that will allow us to issue a CME certificate to them and to keep this information on file for up to 6 years. Personal information gathered will not be released to any other company or organization for any purpose. This information remains totally confidential.

COMPUTER REQUIREMENTS
PC or Mac, a high-speed Internet connection and speakers required.

Jointly sponsored by NASPGHAN and The NASPGHAN Foundation.
This educational activity is supported by an independent medical education grant from Olympus America.
© Copyright 2020 NASPGHAN and The NASPGHAN Foundation

Produced by Limelight Communications