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Newest Entries

11/28/2017: Delfini is writing a series of articles for the Washington State Health Care Authority's Public Employees Benefit Board (PEBB) Program Newsletter: For Your Benefit. See page 4. Making the best of your medical encounter

09/17/2017: "How To Survive the Medical Misinformation Mess" by John P. A. Ioannidis, Michael E. Stuart, Shannon Brownlee, Sheri A. Strite, published in the European Journal of Clinical Investigation.

PubMed Abstract
https://www.ncbi.nlm.nih.gov/pubmed/28881000

Full Text

08/03/2017: Attrition Quick Test Calculator added to tools. Even a small loss of patients may impact study results. This calculator helps you determine whether the impact may be great or small to decide if you need to do further analyses.

06/2017: Delfini is writing a series of articles for the Washington State Health Care Authority's Public Employees Benefit Board (PEBB) Program Newsletter: For Your Benefit. See page 1, Making health care decisions

03/07/2017: Delfini is writing a series of articles for the Washington State Health Care Authority's Public Employees Benefit Board (PEBB) Program Newsletter: For Your Benefit. See page 5, Medical information and patient-centered care—you are at the center.

10/20/2016: The Case for An Evidence-Based Medicine Approach

09/01/2016: Delfini is writing a series of articles for the Washington State Health Care Authority's Public Employees Benefit Board (PEBB) Program Newsletter: For Your Benefit. See page 4, The right care for you— seven questions to ask.

08/06/2016: Delfini supports the Lown Institute's Right Care efforts. The Lown Institute calls on healthcare providers to recognize their ethical obligation to put patient care first—and that includes working for broader reforms that move the entire healthcare system in a patient-first direction. That's the thinking behind the Right Care Alliance and its organized, targeted campaigns. More information is here.

06/28/2016: Delfini is interviewed for a nice article: Down the Rabbit Hole of Medical Misinformation by Renee Despres and published on Your Medical Source

05/11/2016: Our site is really big with lots of EBCQI information freely available! We now have created a web page with our most popular selections. See Best Of Delfini.

05/01/2016: New Flier: Ways You Need Help With Overuse and Patient Safety at Why Critical Appraisal Matters.

04/16/2016: LOWN SUMMARY CONFERENCE CHICAGO

We were honored to participate in the Lown Institute's 4th Annual Conference in Chicago, April 16, 2016. John Ioannidis MD joined us to discuss "Medical Misinformation vs. Reliable and Clinically Useful Evidence for Truly Informed Consent and Improved Outcomes."

Workshop Summary: Knowing the reliability of medical evidence is required for making informed clinical decisions. There is a high likelihood of distorted study results when evidence is of low quality. However, most health care professionals are unaware that much medical science is not reliable or clinically useful. There currently exists a "medical misinformation mess"—a hidden and little known crisis affecting every patient. The basic skills for evaluating the quality of medical science are much easier to acquire and apply than most people think. Attendees learned to recognize the size and importance of this crisis through compelling cases, as well as to learned the basics about the common threats to validity in the medical literature.

Our take-home message to workshop attendees was simple:

1. If the evidence is of low quality the results are likely to be unreliable—therefore we must assess the validity of medical studies before seriously considering the results.

2. It is easy to learn how to assess medical evidence for reliability and clinical usefulness.

3. It is the responsibility of every healthcare professional to possess basic critical appraisal skills. We admire the Lown Institute for their efforts to inform others about the huge problems of bad science, overtreatment, under-treatment and the waste of valuable resources-- billions of wasted healthcare dollars each year.

02/29/2016: Searching Tool has been updated. See Searching, Sources & Terms Utility Tools in the Delfini Tools & Educational Library.

02/28/2016: Another Study Warns That Evidence From Observational Studies Provides Unreliable Results For Therapies at the DelfiniClick and Delfini Blog.

02/05/2016: House-buying for Sheri, holiday in Vietnam and moving into said-new house in Bellingham took us off Planet Delfini for a while. In the meantime, we have two new videos about what we call the Medical Misinformation Mess and why critical appraisal is vital to quality patient care and reducing waste. Also available at Tools & Educational Library.

1. Critical Appraisal Matters—Stories: COX2s—The Power of Reliable and Useful Evidence to Improve Outcomes, Value & Informed Consent

Much published medical science is of uncertain reliability. This can hurt patients through missed opportunities for right care, risk for harms and waste and insufficient information to choose decisions most right for them. Here are a few stories of why critical appraisal of the medical literature is needed to provide patients with reliable information to make good decisions.

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2. "Medical Misinformation Mess" Solutions— Communicating Reliable & Useful Evidence Must be at the Heart of Clinical Quality Improvement for Good Outcomes, Value & Informed Consent

Much published medical science is of uncertain reliability. This can hurt patients through missed opportunities for right care, risk for harms and waste and insufficient information to choose decisions most right for them. Here are our recommendations for change to give patients the care that is their right and that they deserve.

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09/10/2015: We are so pleased! We have a new freely available video tutorial on critical appraisal—while the video is at a high level, there's an "almost live" demo on how to do a critical appraisal fast, efficiently and effectively. Video slide printout and tools are also available at this link.

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09/04/2015: We've been a little absent from our blogging and commentary activities—but hard at work as we get ready to launch our latest book described in our 7/6th entry just below. We now have a beautiful new website for it—read why this book we have written for patients is so unique and soooo important.

07/06/2015: Last book in our Delfini Evidence-based Practice Series is now published—our book for patients. What You Don't Know Can Hurt You • A Guide for Patients: Help for Navigating Medical Information & Making Informed Decisions. We have a patient resource website as well. You can see it here.

05/29/2015: What's new? Our new book for performing evidence-based clinical quality improvement activities and clinical practice guidelines! The Evidence-Based Clinical Quality Improvement Project Process Map & Clinical Guideline Advice: Practical Guidance, Advice, Strategies, Tips and Efficiencies (Delfini Group Evidence-based Practice Series)

05/27/2015: We have turned our short critical appraisal checklist into a template for conducting appraisals of primary studies and documenting reviews. You can get it here or at the Delfini Tools & Educational Library.

05/26/2015: De-adopting Ineffective or Harmful Clinical Practices at the Delfini Blog and at the DelfiniClick™.

05/19/2015: We presented our clinical outcomes studies poster, Comparing the efficacy of denosumab versus zoledronic acid (ZA) for prevention of skeletal-related events (SREs): a critical appraisal of three pivotal trials, at ISPOR (International Society For Pharmacoeconomics and Outcomes Research) 20th Annual International Meeting. You can access the abstract and poster here. Attrition does not necessarily result in attrition bias. Of particular interest to many critical appraisers will be this case study for ideas for approaching the evaluation of studies with a high degree of attrition.

From Our DelfiniGram™ May 2015 Contact Us

04/27/2015: "Reading a Clinical Trial Won't Get You There—or Let's Review (and Apply) Some Basics About Assessing the Validity of Medical Research Studies Claiming Superiority for Efficacy of Therapies at the Delfini Blog and now our tutorial.

04/25/2015: What's new? Our new book for Medical Technology Assessment! The Medical Technology AssessmentEvidence-Based Decision-Making Handbook: Practical Guidance, Advice, Strategies, Tips and Efficiencies (Delfini Group Evidence-based Practice Series)

04/17/2015: What's new? Our new book for Pharmacy & Therapeutics Committees! The Pharmacy & Therapeutics Committee Evidence-Based Decision-Making Handbook: Practical Guidance, Advice, Strategies, Tips and Efficiencies (Delfini Group Evidence-based Practice Series)

04/01/2015: Happy Birthday, Delfini! Today we turn 13! No foolin'.

03/09/2015: Biosimilars & FDA's New "Purple Book" at the Delfini Blog and at the DelfiniClick™.

03/02/2015: Genomic Medicine Leaps Forward—More Drugs Targeting More Cancers at the Delfini Blog and at the DelfiniClick™.

02/27/2015: ISPOR (International Society For Pharmacoeconomics and Outcomes Research) 20th Annual International Meeting—Clinical Outcomes Studies Poster Presentation on May 19, 2015. Strite S, Stuart ME, Beckman V, Öhrling K. Comparing the efficacy of denosumab versus zoledronic acid (ZA) for prevention of skeletal-related events (SREs): a critical appraisal of three pivotal trials.

From Our DelfiniGram™ February 2015 Contact Us

02/01/2015: Progression Free Survival (PFS) in Oncology Trials at the Delfini Blog and at the DelfiniClick™.

01/30/2015: BMJ's Minerva featured as its top story this week, for its inside back cover, the paper we wrote with DynaMed Editorial colleagues—Journal of the Royal Society of Medicine: Evolution of evidence-based medicine to detect evidence mutations. BMJ 2015;350:h405: http://www.bmj.com/content/350/bmj.h405.

You can access our paper here at What's New. See entry immediately below for 01/07/15.

01/07/2015: Paper published with DynaMed editorial board colleagues in the Journal of the Royal Society of Medicine: Alper BS, Fedorowicz Z, Strite SA, Stuart ME, Shaughnessy AF. Evolution of evidence-based medicine to detect evidence mutations. J R Soc Med. 2015 Jan;108(1):8-10. doi: 10.1177/0141076814555936. PubMed PMID: 25572989. If you cannot retrieve the article directly, you can access the accepted paper here.

01/05/2015: Network Meta-analyses—More Complex Than Traditional Meta-analyses at the Delfini Blog and at the DelfiniClick™.

12/08/2014: Sounding the Alarm (Again) in Oncology at the Delfini Blog and at the DelfiniClick™.

10/29/2014: Comparative Effectiveness Research (CER), "Big Data" & Causality at the Delfini Blog and at the DelfiniClick™.

From Our DelfiniGram™ October 2014 Contact Us

10/13/2014: Cochrane Risk Of Bias Tool For Non-Randomized Studies at the DelfiniClick™.

10/06/2014: Comparison of Risk of Bias Ratings in Clinical Trials—Journal Publications Versus Clinical Study Reports at the DelfiniClick™.

08/20/2014: Clinical Guidelines and Elderly Patients—Proceed with Caution at the DelfiniClick™.

06/18/2014: Comparative Study Designs: Claiming Superiority, Equivalence and Non-inferiority—A Few Considerations & Practical Approaches available at the DelfiniClick™.

06/16/2014: We have a short article for industry colleagues now published in the Life Sciences Trainers & Educators Network Journal (formerly SPBT—Society of Pharmaceutical and Biotech Trainers).

Should research with "conflict of interest bias" be "explicitly downgraded in value," as some recent writers believe? We say, no. Or should good science and science reporting speak for themselves? We think, yes. Here are some tips for research quality and reporting and communicating about the evidence. 

Strite, Sheri Ann. Stuart, Michael E. Science-Based Skills: Building Trust & Relationships. Life Sciences Trainers & Educators Network Journal. June 2014.  Online. http://www.spbt.org/?page=June2014Trust

06/03/2013: We have updated several of our tools, including our Searching the Medical Literature Tool. You can read about the additions at our blog or download the tool directly at our Searching the Medical Literature Tool, along with others freely available, at our library of Tools & Educational Materials by Delfini: http://www.delfini.org/delfiniTools.htm

From Our DelfiniGram™ May 2014 Contact Us

05/05/2014: American College of Cardiology/American Heart Association Guidelines: Numbers-Needed-to-Treat (NNTs) for Statin Treatment in Primary Prevention of Cardiovascular Disease (CVD) with gratitude to our colleagues at DynaMed.

04/08/2014: See our blog entry on Involving Patients in their Care Decisions and JAMA Editorial: The New Cholesterol and Blood Pressure Guidelines: Perspective on the Path Forward, which will also be available at the DelfiniClick™, Use of Evidence: Applying the Evidence.

Krumholz HM. The New Cholesterol and Blood Pressure Guidelines: Perspective on the Path Forward. JAMA. 2014 Mar 29. doi: 10.1001/jama.2014.2634. [Epub ahead of print] PubMed PMID: 24682222.

http://jama.jamanetwork.com/article.aspx?articleid=1853201

03/17/2014: Critical appraisal considerations for cross-over designs. PDF and WORD versions available at Delfini Tools & Educational Library.

03/13/2014: We have a new book available for those working in manufacturing industries. EBM Guide For Scientists to Sales Reps—Medical Evidence in the World of Payers & Health Care Systems: A Handbook For Industry to Better Understand, Communicate and Navigate These Worlds

02/26/2014: Estimating Relative Risk Reduction from Odds Ratios—at the DelfiniClick™.

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