Delfini NewSplashes™ — What's NEW at www.delfini.org
Quality Help for Quality Care Including Free Evidence-based Resources & Tools
An evidence-based healthcare approach matters to care for patients effectively, improve patient safety and reduce waste.
Help in evidence-based medicine (EBM) and evidence-based practice (EBP) in other disciplines as well such as critical appraisal of the medical literature to help you with medical literature evaluation, medical education, health care quality improvement, medical decision-making, health care quality, patient-centered care, doctor patient communications, decision support, committee work such as pharmacy and therapeutics and medical technology assessment including tips for drug monograph development, formulary work, leadership help, clinical guideline development, scientific reviews, cost analysis evaluation and more...
About PMID Numbers: We frequently utilize a PMID number in place of a citation. Where PMID numbers are available, enter that number into the PubMed search box to retrieve that citation and listing.
What's New?
Announcing
the Delfini
Summer Seminar
July 28 & 29, 2010—Portland OR
new! Early
Enrollment Discount until July 1st
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new! Continuing education credit (11 hours) may be earned by pharmacists in the States of Washington and Oregon.
07/20/2010: Must Clinical Trials be Randomized? A Look at Minimization Methods. At the DelfiniClick™.
07/19/2010: 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.Juneja R, Stuart ME, Strite SA
07/14/2010: HUGE IMPROVEMENT! As our tools and educational materials have swelled over the years, it has been more challening to find them online (even for me!) Our Tools & Educational Materials page has now undergone a major overhaul. It's all beautiful! And, our efforts trying to make this work doable and understandable never cease—we are very happy to make available to you our new series of 1-pagers on various critical appraisal topics. Key points and considerations for topics such as Analyzing Results, Composite Endpoints, Intention-to-Treat Analysis, Time-to-Event Analysis, Equivalence and Non-Inferiority Trials, Safety, How to Read a Forest Plot and more are now available in a highly condensed format with graphs and illustrations as needed. New tools are clearly marked at the new Delfini Tools & Educational Materials Library. Look for the dolphin-blue dots.
07/12/2010: Congratulations to DynaMed! DynaMed recently turned 5. Increasingly we are impressed with the evidence-based medical content information available through DynaMed. We have been associate editors for DynaMed from way back (unpaid, fyi), and have watched incredible progress over time, thanks to Founder and Editor-in-Chief, Brian Alper MD, his trusty aide-de-camp, Amelia Cottle, and the rest of the crew. We find ourselves using it frequently. (The usual cautions are always due as evidence review work is complex and a lot of judgments are required, not everyone agrees on all ratings, etc.) We have included DynaMed as a recommended resource on our short list in our Searching & Sources Tool available at Delfini Tools. DynaMed's webside is— http://www.ebscohost.com/dynamed/.
07/01/2010: A vitally important task in evidence-based practice is how information about evidence is communicated. Our Evidence Grading, Wording Conclusions & Results Tables Tool is a useful tool for several important steps to help accomplish just that. It is now updated and expanded. Also available at Delfini Tools.
06/28/2010: The Consort Statement: Consolidated Standards of Reporting Trials—CONSORT—has been updated. Read about it at the DelfiniClick™—see new under Bulletin Board to the left.
06/14/2010: We have made substantial improvements to our economic study evaluation tool which can be downloaded here. This tool can be used to evaluate cost-effectiveness studies and pharmcoeconomic studies. Also available at Delfini Tools and Resources > Delfini Favorites to the left.
06/01/2010: We are always seeking ways to make the work of critical appraisal easier, more understandable and faster without sacrificing rigor. We are so excited! We have a new tool that is about to become our new favored primary critical appraisal tool. This tool is especially designed for those new to critical appraisal and we designed it to be of use to us all.
Enter our new Delfini Pearls: Basics of Evaluating Evidence in Superiority Trials for Therapies! This new 1-pager provides a high-level and simplied step-by-step guide for evaluating a primary superiority study of a therapeutic intervention. For some of you, it may serve to replace our 1-page short critical appraisal tool. For others, it may serve as a complement to that tool or you may still prefer that tool in the checklist format. Our long critical appraisal tool for primary studies continues to be a key resource to explain items in each of these 1-page tools. At 14 pages, our long version is the shortest high qualty EBM primer or textbook you are likely to ever find. Download the new short PDF here. Also available at Delfini Tools and Resources > Delfini Favorites to the left along with the long version.
05/28/2010: For those who may wish another source for critical appraisal help, we recommend The Cochrane Handbook for Systematic Reviews of Interventions. It is a useful resource for all healthcare professionals doing critical appraisal of the medical literature. It was created to assist authors preparing systematic reviews (SRs) but is of great value to all of us who are assessing validity of studies. The section of interest is Part 2: General methods for Cochrane reviews. http://www.cochrane-handbook.org/. We have added the link to our Delfini Web Links and to our Recommended Reading.
05/10/2010: Some new additions, to make our lives better, on Delfini Web Links to some of our favorite sources:
Confidence Intervals
Our new favorite! From John C. Pezzullo's Home Page, confidence intervals and a whole lot more!
http://statpages.org/ctab2x2.htmlDiagnostic Testing
Center for Evidence-based Medicine Toronto (KTCEBM)
http://ktclearinghouse.ca/cebm/practise/ca/calculators/statscalc
04/26/2010: Kaplan Meier Curves—everyone is using them, but almost no one understands them. We are making available a new pearls page to help people better understand these survival curves and time-to-event analysis generally. At Delfini Tools.
04/13/2010: We have improved our criteria for diagnostic testing. It is now much more simplified! To that end, we have updated our Study Validity & Evidence Usability Assessment Critical Appraisal Tools. See Delfini Tools: Critical Appraisal for the long and short versions of our primary studies critical appraisal tools. These are probably the most important tools in our collection.
04/06/2010: New evidence-based review published in California Pharmacist. Treatment for Type 2 Diabetes Mellitus and Stable Ischemic Heart Disease. Pazirandeh, M and 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.) At Delfini Publication Page: California Pharmacist.
From our Previous DelfiniGram
04/01/2010: Happy Birthday, Delfini! We turn eight! To celebrate, we are pleased to bring to you another wonderful medial leader interview—a chat with Ward Hurlburt, MD, MPH, Chief Medical Officer & Director of the Alaska Division of Public Health. We have known Ward for many years, and he continues to be an inspiration. To read about Ward’s various sojourns through different healthcare terrains over a span of nearly fifty years, see his interview at MedicalLeaders.org. Ward talks to us about THE CHALLENGES AMERICA FACES IN HEALTH AND HEALTHCARE.
3/22/2010: We have completed a qualitative systematic review and written a paper with another wonderful friend and colleague, Rattan Juneja MD, on intensive insulin therapy for hyperglycemic adults in the intensive care unit setting which has been selected for Poster Presentation at the American Diabetes Association's 70th Scientific Sessions, June 25-29, 2010, in Orlando, FL. It will also be printed in the Scientific Sessions Abstract Book, the June 2010 supplement to the journal Diabetes.
03/21/2010: Happy Spring! We are in love with our new Pearls for Critical Appraisal for Therapies. We are always seeking ways to make the work of evaluating medical science easier and better. Designed especially with our busy physician friends in mind (and helpful for other friends too), the pearls give you process steps and tips in a handy 1-pager. In the future, it will be available at Delfini Tools.
03/12/2010: One of the nice things about having a website (yes, I currently can't cope with the Facebook phenomenon) is that we can post things that matter to us. As a public service entrepreneurship, we provide a lot of our services to people for free. But we want to let people know about other causes we celebrate and support and things that we think are of meaningful import in others' efforts to do greater good. Our new page we are starting is Delfini Supports which will be accessible from About Us and Resources.
03/10/2010: Dan Allen of The Regence Group inspired a helpful modification to our Oncology Outcomes chart. In the future, it will be available at Delfini Tools. Thanks, Dan!
02/24/2010: We have many resources freely available to help people learn (and avoid pitfalls of) performance measurement. We have now updated this page with sample training topics as well.
02/23/2010: Oh, the pesky problems of attrition bias and missing data points. We have a new primer available on Attrition Bias including the "evidence on the evidence. Permanent home for our primers is at Delfini Tools where both the PDF and a Word version is available.
02/08/2010: Our confidence interval training handout has been updated to show a nifty little way to understand why non-significant findings might simply mean there were not enough people studied to show a difference if there is one. In the future, it will be available at Favorites and at Delfini Tools.
01/25/2010: New articles available online. Strite SA, Stuart ME. Getting Started with Critical Appraisal of Medical Literature: It Is Easier Than You Think. & Chan M, Fong P and 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.) at our California Pharmacist publication page.
01/19/2010: Our Messaging Script for Hormone Replacement Therapy has been updated.
01/12/2010: PubMed is "new and improved" (we know it is new; we hope it is improved). In any event, it is different. Consequently, we have updated our Searching & Sources Tool. This tool will give you lots of step-by-step help for searching PubMed and will give you quality resources that are a good starting point for primary and secondary studies, secondary sources, guidelines, performance measures and more. At Delfini Tools: see Utility Tools.
01/11/2010: Our website, www.pharmacyleaders.org, has now been consolidated into www.medicalleaders.org. We will still invite interviews by pharmacists, but with a focus on advice to assist medical leaders in their work. Resources for pharmacists will be available at the Medical Leaders site.
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Delfini
SERVICES
We
offer a wide range
of supportive services
with the ultimate goal of increasing health care organizations’
and clinicians’ abilities to provide high quality, evidence-based
care and to improve medical decision-making
for organizations, leaders, teams, clinicians and patients.
Areas We Provide Help In
• Creating
the EBM Organization • Creating the Evidence-based Practitioner
Help for organizations to position for evidence-based care and
health care quality; help for healthcare leaders and for individuals
• Evidence-based
Healthcare Educational Opportunities
Medical education and continuing medical education resources to
provide evidence-based practice (EBP) training in evidence-based
medicine (EBM), evidence-based nursing & other disciplines
— we provide training in, and facilitation of, all aspects
of evidence-based health care such as in critical appraisal to
help you with medical literature review of scientific research
studies and in performing all aspects of healthcare quality improvement
activities
• Evidence
Assessment Training
How to perform a scientific review such as a systematic review
and evidence synthesis and how to create a clinical review, clinical
recommendation, clinical practice guideline, drug monograph, medical
technology assessment, scientific research paper, performance
measure, medical decision-making support such as communication
aid and shared decision-making aid, patient safety advisory or
other evidence-based clinical information
We can be engaged to perform scientific literature reviews to create systematic reviews, including comparative effectiveness research (CER), and can supply any kind of clinical content or clinical information item you wish such as those listed including clinical guidelines, drug monographs, decision support and more
• Committee
Help
Help for committee work such as pharmacy and therapeutics committee
(P & T committee) or medical technology assessment by providing
evidence-based guidelines and process steps including tips for
all aspects of committee work from committee management, structures,
processes and to clinical pharmacist education to inform all aspect
of staff work such as conducting evidence-based reviews, development
of drug monographs, meeting presentations and more such as formulary
management advice
Help for quality improvement teams by providing facilitation of facilitation of steps in systematic literature review, clinical practice guidelines development and clinical improvement projects, including project selection for success, cost analysis, implementation strategies and measuring performance for quality improvement in health care
• Healthcare
Leadership Help
If you are a healthcare leader, especially a medical leader or
pharmacy leader, we have special help for you through our services
and through our other website, medicalleaders.org
—
we can provide a variety of services including strategies for
effectiveness in quality management in healthcare, how to identify
good clinical practice guidelines, patient-centered care strategies
including doctor patient communication training, performance measurement
training and development of effective performance measures, tips
for meeting management and more in your efforts for improving
healthcare quality in your organization to provide true evidence-based
health care
Delfini About Our Work
Resources at —
