Sheri Ann Strite
For both Delfini and University of California, San Diego (UCSD), Sheri Strite has worked as a planner, developer and teacher of evidence- and value-based health care education programs and tools. Many of the innovations in method, presentation materials and tools in Delfini programs are the brain-child of Sheri, who frequently presents on the topics of evidence-based health care such as evidence-based medicine (EBM), evidence- and value-based clinical quality improvement (CQI), formulary management, evidence-based committee operations, assessment of medical technologies such as drugs and devices, and patient-centered strategies around the nation.

Sheri has done innovative work in designing clinical improvement methods and tools, with a focus on simplification, efficiency and immediate applicability. This work includes the well-received sequential model for Delfini QI and EBM processes and most especially for creating a highly simplified way of teaching applied critical appraisal along with a tool kit that has been implemented in numerous organizations. She has successfully trained thousands of health care professionals in her simplified critical appraisal methods and has achieved recognition for this work. She also has done significant program development work and tool creation and teaches on other topic areas such as health care organizational development for value, monograph preparation, performance measurement, analysis of systematic review methods, intention-to-treat analysis and approaches to health care economics, as examples.

Collectively, Sheri and Mike have developed effective methods for efficiently finding and applying useful evidence, streamlining clinical practice improvement processes including measurement, optimizing health care committee functioning and evaluating health care system quality. They also have developed methods for effective faculty development based on core principles and structured methods that create a successful learning experience for students.

Formulary management is an area of special expertise. Sheri is a contributing author to the textbook, Evidence-based Pharmacotherapy, along with Mike, and has co-authored several publications on formulary management. She has consulted with major groups to help them streamline their processes, restructure their monograph templates, increase their skills in critical appraisal and improve the functioning of their Pharmacy & Therapeutics (P&T) Committees.

She has developed tools for conducting Medical Technology Assessments (MTA) and help for MTA committees.

For performance meaures, she conceptualized new ways of evaluating measure validity, identifying and detailing key elements for measures and collaborated on the construction of a robust tool for developing, evaluating and applying performance measures.

In the area of cost analysis of practice change, she created well-received methods and tools that incorporate evidence of effectiveness into analysis along with a simplified cost-effectiveness analysis approach, are easy for users to utilize and result in meaningful outcomes that are easy for users to understand.

Her diagnostic testing work includes development of a computerized calculator that computes all measures of function for specific diagnostic testing results while providing clear, natural-language explanations of the meaning of the functions and how the results may be applied.

Patient communications and decision-making are other areas in which Sheri has done considerable work, creating useful models for practice and communications with patients that provide meaning to patients and are easy for health care professionals to apply. She was both inspiration for and a collaborator on the extremely well-received Delfini Rx Messaging Scripts ™.

An acclaimed trainer and teacher, Sheri has developed programs and presentations for the US Department of Defense, Veterans Affairs including the Veterans Health Administration Medical Advisory Panel and Pharmacy Benefits Managers, the State of Washington Department of Health & Human Services, the American Academy of Family Physicians (AAFP), McKesson (including InterQual), the Academy of Managed Care Pharmacy, numerous Blue Cross/Blue Shield groups including The Regence Group, Kaiser Permanente Southern California Clinical Practice Guidelines Unit (home to Dr. David Eddy), California Pharmacist Leadership Forum, Intermountain Health Care, Henry Ford Health System, Omnicare, PacifiCare, Kaiser Permanente - Hawaii, Health Care Partners, Sutter Health, Northwest Pharmacy Benefit and Medical Directors, University of Washington Medical Management Certification Program, Group Health Medical Leadership, pharmacy benefits managers, Abbott Laboratory leadership, Sanofi-Synthelabo and Novartis Pharmaceuticals national education programs on evidence-based medicine, as examples. Sheri is the creator of and a mentor for the Delfini Healthcare Quality Improvement Fellowship. She developed tools and a basis for web-based self-learning modules for the American Academy of Neurology.

Sheri has participated in policy development and proposals for groups working with State governments – National Academy for State Health Policy and Rainier Institute. Together with Drs. Bob Crittendon and Mike Stuart, she has written a white paper entitled "Promoting Better Quality and Decreasing Costs in Health Care," available at http://www.delfini.org/RainierInstitute_Promoting_Quality.pdf.

Sheri is an associate editor for DynaMed of Dynamic Medical Information Systems, LLC and guest editor for the California Pharmacist Journal. In addition to the aforementioned pharmacotherapy textbook chapter, together with Mike, Sheri authored a series of articles on the "Evidence-based Organization" for publication in The American College of Physician Executive's Journal of Medical Management. Sheri has co-authored articles, commentaries and related publications on critical appraisal, the taxonomy of evidence grading, health care organizational development for quality, evidence-based medicine, clinical practice guidelines, performance measures and the risks of gallstone disease in women which have been published in a variety of journals including The New England Journal of Medicine, the British Medical Journal, the American Journal of Epidemiology and the American Journal of Public Health.

She assisted Mike in the development of an "explicit" evidence-based clinical practice guideline, educational materials and an educational program for irritable bowel syndrome for Novartis Pharmaceuticals, she participated in guideline development and was a facilitator for the Kaiser Permanente Hawaii Chronic Kidney Disease Guideline, and she has been involved in various aspects of numerous other evidence-based clinical improvement activities. She has conducted numerous critical appraisals on many topics and has participated in creating numerous monographs and systematic reviews.

While at the University California, San Diego, Sheri was responsible for teaching medical and pharmacy students, residents and community physicians and was involved in faculty development. She has presented at the UCSD "Doctors as Teachers Program" and UCSD Faculty Development Program, "The Advanced Skills Workshop for Addressing the Health Needs of the Underserved." She served as a member of the UCSD Family Medicine Research Leaders. Her work at UCSD also included serving as advisor and faculty for the Family Medicine Research Fellowship program, advisor for the UCSD Family Practice EBM Journal Club, and faculty and curriculum developer for the School of Medicine and for disciplinary programs for referral by the California State Medical Board. Sheri is a past member of the Society for Teachers of Family Medicine (2003-2006).

Prior to her work with Delfini and UCSD, Sheri was with Group Health Cooperative in Seattle, Washington (1977-2002). There she held various positions including Senior Administrator, Clinical Improvement & Education; Senior Manager, Business and Research Administration; and Research Associate. Sheri was one of the first in the nation to be awarded a charter certification in research administration. Her background as manager also includes research project management and management representation and staffing oversight for Group Health’s Research and Human Subjects Review Committees. She has assisted with disease management and clinical improvement programs throughout Group Health.

While at Group Health, Sheri served as a co-investigator on studies examining the effects of estrogens and thiazides on gallstone disease.

Prior to her tenure with Group Health, Sheri worked as a medical and surgery assistant.

Sheri graduated summa cum laude from the University of Washington’s program in English Literature, with special emphasis in Medieval Literature, where she was awarded Phi Beta Kappa and Golden Key National Honor Society honors.

Strite Publications

• Strite SA, Stuart ME, Urban S. Process steps and suggestions for creating drug monographs and drug class reviews in an evidence-based formulary system. Formulary. April 2008;43:135–145.

• Nguyen K, Equinozio C, Stern C. Esprit Trial [evidence-based medicine review]. California Pharmacist 2008. Vol LV, No 1. Winter 2008: 30-31. (Stuart ME, Strite SA, peer reviewers and guest eds.) Online

• Chiquette E,Posey LM. Evidence-based Pharmacotherapy. American Pharmacists Association. APhA Publications; 1 edition (January 15, 2007). ISBN-10: 1582120684; ISBN-13: 978-1582120683
(Strite SA, Stuart ME, contributing authors. Chapter 7. Applying Evidence-Based Pharmacotherapy to Formulary Decisions)

• Delfini White Paper — Missing Data: Consideration. October 2007, updated February 2008. [WORD] & [PDF]

• Stuart M, Strite SA. 2005 Jan 30. Pitfalls to Performance Measurement. Modern Healthcare. http://www.modernhealthcare.com/article.cms?articleId=38458. Originally published 2006 Jan 23. Accessed 2006 Jan 30. See also related white papers. Delfini White Paper: Evidence-based Performance Measurement: Validity Issues & Avoiding Important Pitfalls — Long Version: Recommended [PDF] and Short Version [PDF]

• Stuart ME, Strite SA. Radical Prostatectomy versus Watchful Waiting. [Letter to the Editor Re: Bill-Axelson A, Holmberg L, Ruutu M, et al. Radical Prostatectomy versus watchful waiting in early prostate cancer. N Engl J Med 2005; 352:1977-84.] N Engl J Med 2005; 353; 12: 1298

• Stuart ME, Strite SA. British Medical Journal Rapid Response: Steroids Not Proven in Bell’s Palsy—The Legacy of Bad Science — response to Piercy J. Primary Care: Bell's Palsy. BMJ 2005; 330:1374 (11 June) Online

• Strite S, Stuart ME. “Closing Quality and Value Gaps. (Part 3)” The Physician Executive, Journal of Medical Management. May/June 2005; 58-61. PDF & Series Online

• Strite S, Stuart ME. “Finding Gaps in Quality and Value. (Part 2)” The Physician Executive, Journal of Medical Management. Mar/Apr 2005; 50-54. PDF

• Stuart ME, Strite SA. Bell’s Palsy. [Letter to the Editor Re: Gilden D. Bell’s Palsy. N Engl J Med 2004;351:1323-31.] N Engl J Med 2005; 352; 4: 416-418.

• Strite S, Stuart ME. “What is an Evidence-Based, Value-Based Health Care System? (Part 1)” The Physician Executive, Journal of Medical Management. Jan/Feb 2005; 50-54. PDF

• Strite SA, Stuart ME. “Response to Proposal for Strength of the Evidence Taxonomy (SORT)” Letter to the Editors. American Family Physician. December 15, 2004; Vol 70. No 12; 2268. Online

• Strite SA, Stuart ME. “Response to ‘Making Evidence-Based Medicine Doable in Everyday Practice: Finding the evidence you need is getting easier than you ever thought possible,” and ‘A Simple Method for Evaluating the Clinical Literature: The "PP-ICONS" approach will help you separate the clinical wheat from the chaff in mere minutes.” Letter to the Editor. Family Practice Management. October 2004; Vol 11. No 9; 14. Online

• Stuart ME, Strite SA. British Medical Journal Rapid Response: Corticosteriods are Not Proven for Treatment of Bell's Palsy — response to Holland JN, Weiner GM, Recent developments in Bell's palsy. BMJ 2004;329:553-557 (4 September) Online

• Peer-reviewer for DynaMed ® DynaMed® is a registered trademark of and published by Dynamic Medical Information Systems, LLC – Irritable Bowel Syndrome (1/2004) and Rotator Cuff Tear (2/2004)

• Crittendon R, Stuart ME, Strite SA. “Promoting Better Quality and Decreasing Costs in Health Care.” White paper presented at 2003 Annual Health Care Conference – We Can’t Wait: Improving Washington’s Health. Rainier Institute. White Paper. (9/2003) [PDF] This policy proposal was aimed at establishing an evidence-based technology review committee and set of work processes for evaluating and determining evidence basis for new medications and technologies being considered by the purchasers of health care in the State of Washington.

• Strite SA, “Clinical Practice Guidelines are Not Created Equal: A Guide to Choosing Clinical Practice Guidelines,” GHC Clinical Forum, Group Health Cooperative (Fall 1998).

• Strite SA, Stuart ME, Handley M, Braddick M. “Choosing Clinical Practice Guidelines,” White paper from Group Health Cooperative (1997).

• Strite SA. “Sir Gawain and the Green Knight: To Behead or Not to Behead – That is a Question,” Philological Quarterly 70 (1991) U of Iowa.

• Kakar F, Weiss NS, Strite SA. “Thiazide Use and the Risk of Cholecystectomy in Women,” American Journal of Epidemiology 1986 Sep: 1243):428-33.

• Kakar F, Weiss NS, Strite SA. “Non-contraceptive estrogen use and the risk of gallstone disease in women.” Am J Public Health. 1988 May;78(5):564-6.