Biographical Information: Michael E. Stuart MD
Evidence-based Practice Resources & Services for Value & Patient-centered Care
Help For Health Care Decision-makers & Help to Achieve Clinical Quality Improvement

Mike Stuart MD

Michael E. Stuart MD
President &
Medical Director

Delfini Group EBM DolphinDelfini Group EBM Dolphin

 

Michael E. Stuart MD
For over two decades, Dr. Mike Stuart has provided skills, tools and medical education resources for medical leaders and health care professionals to assist them in evidence-based medicine (EBM) and the evidence-based clinical improvement process to achieve health care quality. As president and medical director of Delfini Group, he teaches applied evidence- and value-based health care methods covering topics such as searching and critically appraising the medical literature, clinical guidelines, optimal functioning of pharmacy & therapeutics (P&T) and technology assessment committees and other EBM topics.

Dr. Stuart is a diplomate of the American Board of Family Practice. He is a contributing author to the textbooks, Evidence-Based Clinical Practice: Concepts and Approaches and Evidence-based Pharmacotherapy. Topics on which Dr. Stuart has authored or co-authored articles, systematic reviews and book chapters include clinical guidelines, evidence-based clinical improvement processes, use of balance sheets for projecting economic and health outcomes in planning evidence-based clinical improvements,  performance measurement and specific healthcare topics such as venous thromboembolism prophylaxis, intensive insulin therapy in the ICU and various technology assessments. His work and comments have been published in the New England Journal of Medicine, JAMA, British Medical Journal, The Physician Executive Journal of Medical Management, Journal of the American Board of Family Practice, HMO Practice, Formulary and others. Currently, Dr. Stuart is an associate editor for DynaMed and a guest editor for the California Pharmacist Journal.

Dr. Stuart has been on the clinical faculty of the University of Washington School of Medicine since 1975, where he received his medical degree, and teaches Selected Topics in Evidence-based Medicine: Guidelines, Searching and Sources, Critical Appraisal of the Medical Literature to professionals enrolled in the Medical Practice Quality Measurement and Management certificate course sponsored by the University of Washington School of Medicine and the UW School of Public Health and Community Medicine.

Prior to starting Delfini, Dr. Stuart directed the Department of Clinical Improvement and Education, along with the Medical Libraries at Group Health Cooperative in Seattle, Washington (1984—2002), where he also practiced family medicine (1973—1997). He was responsible for developing evidence-based guidelines, pathways and clinical recommendations, conducting technology assessments, maintaining the clinical side of GHC’s intranet, leading the patient information initiative and providing continuing medical education. Dr. Stuart was responsible for developing core evidence-based medicine processes and tools, totaling over 35 evidence-based clinical guidelines, and many more clinical improvement projects. While at Group Health, he also chaired both the Pharmacy & Therapeutics and Medical Technology Assessment Committees. He has also participated actively in the Seattle health care community including as the evidence-based medicine leader for the King County Health Advisory Task Force (HATF) in 2004.

Dr. Stuart’s work has received accolades from such distinguished colleagues as David Eddy MD, Don Berwick MD, the Health Ministry of New Zealand, and the US Navy’s Bureau of Medicine, as examples. He has worked with many groups and organizations including academia, government, major health plans, health systems, specialty societies, industry and more.

Stuart Publications

  1. Stuart ME, Strite SA.  Systematic Review: Comparative Safety of Six Biologic Agents For The Treatment of Rheumatoid Arthritis, Psoriasis and Psoriatic Arthritis.  June 2011. http://www.delfini.org/index_DelfiniShowcase.htm#DMARDS.  Accessed 08/16/2011.
  2. Chien M, Yee J, Stern C.  Arbiter 6 Halts Trial.  [evidence-based medicine review]. California Pharmacist 2011. Vol. LVIII, No.2 Spring 2011: 54-57. (Stuart ME, Strite SA, peer reviewers and guest eds.)
  3. Strite SA, Stuart ME. BMJ Rapid Response: Attrition Bias Caution: Non-differential Loss Between Groups Can Threaten Validity. BMJ 2011; http://www.bmj.com/content/341/bmj.c7053.extract/reply#bmj_el_247314 [Link]
  4. Strite SA, Stuart ME. Letter to the Editor: How to Evaluate Medical Science. The Atlantic. January/February 2011.
  5. Strite SA, Stuart ME. Importance of Blinding in Randomized Trials: To the Editor. JAMA. 2010 Nov 17;304(19):2127-8.
  6. Pazirandeh M, Stern C. Treatment for Type 2 Diabetes Mellitus and Stable Ischemic Heart Disease. [evidence-based medicine review]. California Pharmacist 2010. Vol. LVII, No. 1. Winter 2010: 46-49. (Stuart ME, Strite SA, peer reviewers and guest eds.) [PDF] [Note: PDF says Winter 2009, but this is a misprint; should read Winter 2010.]
  7. Stuart ME, Strite SA. Washington State Health Care Technology Assessment: Breast MRI In Diagnosis and Treatment of Cancer in Women at High Risk. Systematic Review. July 23, 2010.
  8. Liu T, Stern C. The Platelet Inhibition and Patient Outcomes (PLATO) Trial. [evidence-based medicine review]. California Pharmacist 2010. Vol. LVII, No. 2. Spring 2010: 46-48. (Stuart ME, Strite SA, peer reviewers and guest eds.)[PDF]
  9. Juneja R, Stuart ME, Strite SA. Intensive Insulin Therapy for The Treatment of Hyperglycemia in Critically Ill Adults: A Qualitative Systematic Review and Critical Appraisal of the Evidence. Selected for Poster Presentation at the American Diabetes Association's 70th Scientific Sessions, June 25-29, 2010. [Link]
  10. Strite SA, Stuart ME. Getting Started with Critical Appraisal of Medical Literature: It Is Easier Than You Think. California Pharmacist 2009. Vol. LVI, No.4. Fall 2009: 52-55. Online
  11. Chan M, Fong P, Stern C. Chloramphenicol Wound Infection Prophylaxis. [evidence-based medicine review]. California Pharmacist 2009. Vol. LVI, No.4. Fall 2009: 56-58. (Stuart ME, Strite SA, peer reviewers and guest eds.) Online
  12. Strite SA, Stuart ME. BMJ Rapid Response: Re: Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement— response to David Moher, Alessandro Liberati, Jennifer Tetzlaff, Douglas G Altman for the PRISMA Group
    Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009; 339: b2535 Online
  13. Stuart ME, Strite SA. BMJ Rapid Response: Re: The role of specialists, information systems and an evidence-based approach in managing the health of populations with chronic illness— response to Lee, B. Practice. BMJ 2009;339:b2395 Online
  14. Salman G, Tran K, Chan S and Stern C. Jupiter Trial. [evidence-based medicine review]. California Pharmacist 2009. Vol. LVI, No.2. Spring 2009: 54-55. (Stuart ME, Strite SA, peer reviewers and guest eds.) [PDF]
  15. Carrillo M, Preechakul R and Stern C. A Randomized, Double-Blind, Placebo-Controlled, Phase III Trial of Pregabalin in the Treatment of Patients with Fibromyalgia. [evidence-based medicine review]. California Pharmacist 2009. Lol. LVI, No.1. Winter 2009: 52-53. (Stuart ME, Strite SA, peer reviewers and guest eds.) [PDF]
  16. Patel S, Strite SA, Stuart ME, Stern C. ADVANCE Trial. [evidence-based medicine review]. California Pharmacist 2008. Vol LV, No. 4. Fall 2008: 58-61. [PDF]
  17. Stuart ME, Strite SA. Washington State Health Care Technology Assessment: Evidence Report Arthroscopic Surgery of the Knee for Osteoarthritis. Systematic Review. July 18, [Link]
  18. Strite SA, Stuart ME. An Introduction to Systematic Reviews: The Lifeblood of Medical Decision-making. California Pharmacist 2008. Vol LV, No. 3. Summer 2008: 52-56. [PDF]
  19. Ericksen J, Strite SA, Stuart ME, Stern C. CATIE Trial Review of Phases 1 and 2. [evidence-based medicine review]. California Pharmacist 2008. Vol LV, No. 3. Summer 2008: 52-56. [PDF]
  20. 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.
  21. 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
  22. 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)
  23. Delfini White Paper — Missing Data: Consideration. October 2007, updated February 2008. [WORD] & [PDF]
  24. Stuart M, Strite SA. 2005 Jan 30. Pitfalls to Performance Measurement. Modern Healthcare. http://www.delfini.org/Showcase_Publication_PerformanceMeasures.htm#mhc_article. 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]
  25. 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
  26. 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
  27. 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
  28. 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
  29. 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.
  30. 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
  31. 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
  32. 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
  33. 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
  34. “Their Job—Cure the Health Care Crisis”. Seattle Post Intelligencer newspaper interview by Seattle PI staff writer, Neil Modie, regarding King County Health Care Advisory Task Force’s strategies for improving quality and lowering costs in the Puget Sound region.
    Feb. 19, 2004.
  35. 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)
  36. 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.
  37. Braddick M, Stuart ME, Hrachovec J. “The Use of Balance Sheets in Developing Clinical Guidelines.” Geyman J, Deyo R, Ramsey S (Eds.), Evidence-Based Clinical Practice: Concepts and Approaches. Woburn, MA: Butterworth Heinemann, 1999.
  38. Braddick M, Stuart ME, Hrachovec J. “The Use of Balance Sheets in Developing Clinical Guidelines.” Journal American Board of Family Practice, Jan-Feb 1999, Vol. 12, No. 1, 48-54.
  39. Stuart ME, Macuiba J, Heidrich F, et al., Successful Implementation of an Evidence-Based Clinical Practice Guideline: Acute Dysuria/Urgency in Adult Women. HMO Practice. December 1997, 11(4):150-157.
  40. Strite SA, Stuart ME, Handley M, Braddick M. “Choosing Clinical Practice Guidelines,” White paper from Group Health Cooperative (1997).
  41. Strosahl K, Baker N, Braddick M, Stuart ME & Handley MR. “Integration of Behavioral Health and Primary Care Services: The Group Health Cooperative Model. In Cummings NA, Cummings JL & Johnson JN (Eds.), Behavioral Health in Primary Care: A Guide for Clinical Integration. Madison, CT: Psychosocial Press, in press.
  42. Stuart, M. “Changing Clinical Practice: Messages, Messengers, and Methods.” HMO Practice. September 1996;10(3): 100-102.
  43. Payne TH, Taplin SH, Savarino J, Galvin MS, Stuart M, Wagner E. Practicing population-based care in an HMO. HMO Practice, 1995;9:101-106.
  44. Thompson RS, Woolf SH, Taplin SH, Davis BV, Payne TH, Stuart ME, Wagner EH. “How to Organize a Large Health Care System for the Development and Delivery of Preventive Care Services.” In: Woolf Sh, Jonas S, Lawrence RS (Eds). US Preventive Services Task Force. Health Promotion and Disease Prevention in Clinical Practice, Chapter 23, Baltimore, Maryland, Williams & Wilkins, 1995.
  45. Thompson RS, McAfee TA, Stuart ME, Smith AE, Wilson J, Handley MR. A Review of Clinical Prevention Services at Group Health Cooperative of Puget Sound. American Journal of Preventive Medicine 1995;11(6):409-416.
  46. Handley MR, Stuart ME. “The Use of Prostate Specific Antigen for Prostate Cancer Screening: A Managed Care Perspective.” J Urology. November 1994; 152: 1689–1692.
  47. Thompson RS, Taplin SH, Davis BV, Payne TH, Stuart ME, Wagner EH. “How to Organize a Practice for the Development and Delivery of Preventive Care Services.” Chapter 24 in Health Promotion and Disease Prevention. In press.
  48. Handley MR, Stuart ME, Kirz HL. “An Evidence-Based Approach to Evaluating and Improving Clinical Practice: Implementating Practice Guidelines. ” HMO Practice. June 1994; 8(2): 75–83.
  49. Oshiro EA, Stuart ME. “Influencing Physician Behavior Change Through Participation in Evidence-Based Medicine Projects.” Proceedings of the Group Health Institute, June 1994, Miami Beach, Florida.
  50. Handley MR, Stuart ME. “An Evidence-Based Process for Evaluating and Improving Clinical Practice: Guideline Development.” HMO Practice. March 1994; 8(1): 10–19.
  51. Oshiro EA, Stuart ME. “International Volunteer Service: A Professional Satisfaction Project.” Proceedings of the Group Health Institute, June 1993, San Francisco, California.
  52. Stuart ME, Handley MR, Thompson RS, Conger M, Timlin D. “Clinical Practice and New Technology: Prostate-Specific Antigen (PSA). ” HMO Practice. Dec. 1992; 6: 11-19.
  53. Stuart ME, Handley MR, Conger MR. “Cancer of the Prostate.” Letter to the editor #LR 2130. JAMA. Dec. 1992.
  54. Stuart ME, Handley MR. “Prostate Screening May Do More Harm Than Good.” Letter in the Seattle Times, October 10, 1992.
  55. Stuart ME. “Current Literature Comments: PSA as a Screening Test.” HMO Practice. 1992; 6: 47.
  56. Oshiro EA, Stuart ME, Handley MR. “Just-in-time Continuing Medical Education.” Proceedings of the Group Health Association of America, 1992; 643-649.
  57. Oshiro EA, Stuart ME. “Just-in-time Continuing Medical Education.” Proceedings of the Group Health Institute, June 1992, San Francisco, California.
  58. Stuart ME, Handley MR. “What Men Should Know about the PSA Screening Test for Prostate Cancer.” GHC Center for Health Promotion Pamphlet Service, 1992.
  59. Stuart ME, Handley MR, Chamberlain MA, Wallach RW, et al. “Successful Implementation of a Guideline Program for the Rational Use of Lipid-Lowering Drugs.” HMO Practice. Nov./Dec. 1991; 5(6): 198-204.
  60. Handley MR, Stuart ME. “An Enlightened Approach to Cardiac Risk Management. ” GHC Medical Forum. 1991; 5: 4-8.
  61. Thompson RS, Taplin SH, McEvoy JP, Sailer JF, Stuart ME, Green BB, Kelly MM, Wagner EH. “Prostate-Specific Antigen: A Useful Screening Test?” GHC Medical Forum. 1991; 5: 17-18.
  62. Scheingold LD, Stuart ME. “The Art of Medicine Seminars.” HMO Practice. Dec. 1988; 2(6): 225-230.
  63. Oshiro EA, Stuart ME. “Practice Management Seminars in an HMO.” Proceedings of Group Health Association of America, June 1988.
  64. Sheingold LD, Stuart ME. “The Art of Medicine Seminars for Practicing Physicians.” Mobius, the Journal of Continuing Education for Health Science Professionals. July 1987; 27-31.
  65. Stuart ME, Oshiro EA. “Eleven Elements in the Successful Medical Encounter.” Proceedings of the Group Health Association of America, June 24, 1987.
  66. Oshiro EA, Stuart ME. “The Art of Medicine. ” Proceedings of the Group Health Association of America, June 23, 1987.
  67. Miller JW, Stuart ME, Titus JS, Hill LD, Beebe HG. “Gluteal Artery Aneurysm: Case Report.” Journal Bone Joint Surgery. April 1974; 56a: 620-622.


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Testimonials: Mike Stuart — EBM Leader

Mike Stuart, MD "The Father of Evidence-based Medicine at Group Health Cooperative—1973 - 2002 — 'Let's start with the evidence.'  Mike Stuart exemplifies the very best of our values and practice:
Respect • Integrity • Scientific Discipline • Pioneering Spirit • Stewardship."

Gary Feldbau, MD, Medical Director
Cheryl Scott, President and CEO
Group Health Cooperative, Seattle WA

Upon Mike's retirement from Group Health Cooperative, Seattle, WA...

Group Health News March 15, 2002: Stuart retires after nearly 30 years
Valentine's Day brought mixed emotions for many Group Health staff when Mike Stuart, director of Clinical Improvement & Education, announced his plans to retire after nearly 30 years of work at Group Health.

Over the years, Stuart has become a national leader in the field of evidence-based medicine, and through his pioneering work, brought enormous prestige to the Cooperative by building an evidence-based discipline into clinical planning.

"I am one of the many people who have benefited from Mike's vision, instruction, and mentoring," said Associate Medical Director Hugh Straley. "He has been a valued colleague and friend, and I will miss him greatly. He has left us a wonderful legacy of excellence in clinical planning."

Health care visionaries have had this to say about evidence-based clinical improvement work and guidelines accomplished under Mike's direction —

"Always a leader, Group Health has managed to create rigorous, evidence-based guidelines that embody the things I advocate. They use balance sheets to evaluate the benefits, harms and costs of treatments, and use the guidelines in a real-life setting. Anyone who uses these guidelines can expect to achieve better decision-making and improved-outcomes."

David Eddy, MD, PhD
Author of Clinical Decision Making: From Theory to Practice: A Collection of Essays from JAMA, and
A Manual for Assessing Health Practices & Designing Practice Policies: The Explicit Approach

"Group Health Cooperative’s Clinical Practice Guidelines are among the very best available. They are carefully developed, thoroughly documented, assiduously updated, and presented in an easy-to-use form. They provide a superb example of what 'evidence-based medicine' can and should mean."

Donald M. Berwick, MD
President and CEO, Institute for Healthcare Improvement

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