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Qualitative Systematic Review: Breast MRI In Diagnosis and Treatment of Cancer in Women at High Risk

The EBM Information Quest: Is it true? Is it useful? Is it usable?™

Delfini Co-founders: Michael E Stuart MD, President & Medical Director . Sheri Ann Strite, Managing Director & Principal

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Washington State Medical Technology Assessment

"Hello Sheri and Mike, thanks for shouting out to the Washington State Health Technology Clinical Committee. Along with the help of organizations like Delfini providing us with superb evidence reviews, we are showing a way that the US should follow, in my opinion. I appreciate your linking your contacts to our work. Best Wishes, Brian"

Brian R. Budenholzer, MD, FAAFP
Health Technology Clinical Committee Chair
Health Care Authority
State of Washington

Link to Delfini Washington State Health Care Technology work.


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Delfini conducted a qualitative systematic review which is being utilized by the Washington State’s Health Technology Assessment Program (HTA) and is available online: Delfini Qualitative Systematic Review: Breast MRI In Diagnosis and Treatment of Cancer in Women at High Risk. The aim of the review was to systematically review, critically appraise and analyze research evidence regarding the accuracy, efficacy, effectiveness and safety of MRI in the detection of breast cancer in women with a recent diagnosis of breast cancer and in women at high for breast cancer because of other risk factors such as a positive family history or known genetic mutations.

HTA is an innovative program that determines if health services used by state government are safe and effective and was showcased in the New England Journal of Medicine, where it was reported that the state estimated their first-year cost-savings to be 1.8 million dollars for a procedure that has good evidence that it is ineffective.

The primary goals of HTA are to make —

  • Health care safer by relying on scientific evidence and a committee of practicing clinicians
  • Coverage decisions of state agencies more consistent
  • State purchased health care more cost effective by paying for medical tools and procedures that are proven to work
  • Coverage decision process more open and inclusive by sharing information, holding public meetings, and publishing decision criteria and outcomes

HTA is leading the state effort to use evidence-based medicine to make health policy and coverage decisions that result in safer health care. The program acts as a resource to five participating agencies by sorting through a flood of information about selected medical technologies and producing reports that analyze the information and assess the quality of evidence. The program also provides transparency and consistency to industry stakeholders through publishing of criteria, inviting comments, holding open public meetings, and contracting for independent reports. Finally, coverage decisions are made by the Health Technology Clinical Committee (HTCC), an independent committee of health practitioners who review evidence on these medical devices, procedures, and test to ensure they are safe, work as promoted and provide value.

Read New England Journal of Medicine article referencing our work:
Franklin GM, Budenholzer BR. N Engl J Med. 2009 Oct 29;361(18):1722-5. Implementing evidence-based health policy in Washington State
. Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA. PMID: 19864671


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