Quality and Safety
by Laura DeStefano | May 18, 2012 | Discussion Paper, Perspectives
Introduction Traditional randomised clinical trials are very expensive and time-consuming and often have poor external validity (Ware and Hamel, 2011). The challenge for modern medicine is to find ways of producing good-quality evidence with good external validity and...
by Laura DeStefano | May 18, 2012 | Discussion Paper, Perspectives
The arrangements for the regulation and governance of health research in the United Kingdom (UK) have evolved, piecemeal, over the past 30 years, and much is now enshrined in UK and European Union (EU) legislation. Each individual measure was introduced with the best...
by Laura DeStefano | May 4, 2012 | Discussion Paper, Perspectives
Introduction Clinical trials are a means of gathering information about medical products or services. In medicine, however, they are also the fundamental means for advancing the underlying science and have enabled the many advances we have made in health care over the...
by Laura DeStefano | May 4, 2012 | Commentary, Perspectives
Once again, the challenge of how to constrain rising health care expenditures has caught the public interest, stimulated by concerns over rising federal debt and limited ability to generate tax revenues. I recently chronicled my unsuccessful efforts at stimulating...
by Laura DeStefano | May 4, 2012 | Commentary, Perspectives
One session of the November 2011 Institute of Medicine (IOM) workshop Envisioning a Transformed Clinical Trials Enterprise in the United States: Establishing an Agenda for 2020 focused on the need to develop new economic models for clinical trials and to change the...
by Laura DeStefano | Apr 27, 2012 | Discussion Paper, Perspectives
Introduction The gap between the growing demand for evidence to inform practice and our current state of knowledge calls for serious consideration about the best approach to developing a workforce capable of meeting those demands. As referenced in the discussion paper...
by Laura DeStefano | Apr 20, 2012 | Commentary, Perspectives
Four years ago, UCLA’s medical center was ranked as an honor-roll hospital by U.S. News and World Report—but our patients would seldom “refer us to a friend.” We skillfully performed today’s health care miracles: organ transplants, complex neurosurgical repairs, and...
by Laura DeStefano | Apr 20, 2012 | Discussion Paper, Perspectives
Introduction Over the past decade, the symbiotic relationship between the clinical trials enterprise (CTE) and the health care delivery system has been subject to increasing amounts of stress. During this period, the CTE has primarily focused on process improvement,...
by Laura DeStefano | Apr 6, 2012 | Commentary, Perspectives
With all the attention being paid to emerging accountable care organizations throughout the country, a California model is delivering measurable results. Catholic Healthcare West (CHW) (now Dignity Health), Hill Physicians Medical Group, and Blue Shield of California...
by Laura DeStefano | Mar 23, 2012 | Commentary, Perspectives
The health care field is filled with committed and passionate professionals from all disciplines delivering and improving patient care every day in our country. And over the last several years, the volume of innovation and the creation of new best practices have been...
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