Evidence-Based Risk Communication in Annals of Internal Medicine

Dr. Daniella Zipkin, an Associate Professor of Medicine at Duke University Medical Center, is one of 14 authors who contributed to “Evidence-Based Risk Communication: A Systematic Review,” published in Annals of Internal Medicine in August 2014.

“Evidence-Based Risk Communication: A Systematic Review” reviewed 84 articles focusing on 91 studies that assessed different methods of communicating risks and benefits to patients regarding their health care options. The goal of the review was to identify the communication methods that maximize patient understanding, which is a component of evidence-based medicine (EBM).

The systematic review concluded that visual aids, such as bar graphs or displays of icons, are capable of increasing patient understanding and satisfaction. Other presentation methods reduced patient understanding, such as “number needed to treat” statistics, which are commonly used in health care to express the average number of people who need to receive treatment in order to prevent an additional negative outcome.

In addition to her published research, Dr. Daniella Zipkin also promotes evidence-based medicine in her work as a member of the Evidence-Based Medicine Task Force within the Society of General Internal Medicine.

The Basics of Evidence-Based Medicine

Daniella Zipkin serves as an Associate Professor of Medicine at Duke University Medical Center in Durham, North Carolina. Over the course of her career, Daniella Zipkin has made numerous contributions to the Evidence-Based Medicine (EBM) movement though research, instructional courses, and national presentations. EBM is an approach to patient care that focuses on integrating patient values, clinical experience, and best available research.

In order to effectively utilize EBM, medical professionals must remain well versed in the most recent and relevant data, and communicate the evidence effectively to patients. Dr. Zipkin has reviewed the literature on best practices regarding presenting risks and benefits to patients, and the review was published in the Annals of Internal Medicine in 2014, accessible at http://annals.org/issue.aspx?journalid=90&issueid=930674.

This review has informed the production of Bottom Line evidence summaries, available through the Web Only section of the Journal of General Internal Medicine’s website, at http://www.sgim.org/web-only, and then choosing the “Bottom Line Summary” box.

EBM begins and ends with the patient. Bottom Line summaries can be used by clinicians in encounters with patients, to aid in communicating high impact data in a way that patients can apply to their own experience.

How Parents Can Find a Balance Between Work and Home




An assistant professor at the Duke University School of Medicine, Dr. Daniella Zipkin also practices her specialty, internal medicine. Married with two children, Dr. Daniella Zipkin daily confronts the challenges of balancing a busy medical career with caring for and raising her family.

Working parents sometimes lose track of how well–or how poorly–they are balancing their work life with their home life. It is easy to think that as long as a child is well cared for, as in child care, all of his or her needs are being met. Parents of young children should try to take time during the day to spend with their children while they are fully awake and active. Parents for whom that is impossible should make a point to participate in activities with their children during the weekend.

As children grow older, they can help with getting the family’s chores done, both on weekday evenings and weekends. This is not only great family time, but it also helps develop a work ethic. Family time spent together should not be all work and no play, though. There needs to be time set aside for doing fun things. This includes attending and participating in events and activities at children’s schools. In addition, parenting partners must set aside private time for themselves to maintain and strengthen their own relationship.

Utah’s Snow is Among the Greatest on Earth

A graduate of the University of California, San Francisco School of Medicine, Daniella Zipkin, MD, is currently an assistant professor at the Duke University Medical Center, where she teaches a curriculum in evidence-based medicine. In her personal life, Dr. Daniella Zipkin is an avid snowboarder with a special affinity for the powdery snow of Utah’s mountains.

Marketed as the greatest on earth, Utah’s snow is well known for being dry and light, which produces the high-quality powder that attracts skiers from around the world. In addition, Utah receives many significant snow storms each year, which increases the number of powder days and often leads to long seasons of very enjoyable skiing. In fact, Utah’s snow is so fun to ski that in 2010 it took seven of Ski Magazine’s top 10 rankings for snow.

The reason for Utah’s excellent skiing is largely the result of its geography. Because most of the state is considered desert, it is quite arid, which saps its snow of much of its moisture and allows it to remain light and fluffy. Also, the Great Salt Lake in northern Utah is so large that it creates a lake effect on regional snow storms and leads to huge accumulations in the surrounding mountains. These facts, combined with Utah’s large mountain peaks, make the state’s resorts a world-class destination for ski and snow enthusiasts.

Research Explores Evidence-Based Medicine and Primary Care

According to a paper co-authored by Dr. Daniella Zipkin of the Duke University Medical Center and published recently in the Mount Sinai Journal of Medicine, primary-care medical professionals deal with several challenges in incorporating evidence-based medicine into their practices. Evidence-based medicine constitutes using the most up-to-date and highest-quality research in carrying out decisions related to patient care.

Daniella Zipkin’s paper, titled “Evidence-Based Medicine and Primary Care: Keeping Up is Hard to Do,” explores in-depth the data in support of evidence-based medicine, and suggests methods for overcoming the difficulties and integrating it smoothly into everyday care practices. Moreover, Dr. Zipkin’s research highlights the increasingly important role evidence-based medicine will play in the health care establishment, especially considering that professionals can fulfill Patient Protection and Affordable Care Act of 2010 criteria through the practice of evidence-based medicine.

To read Daniella Zipkin’s paper in its entirety and to browse other articles in the September/October 2012 issue of the Mount Sinai Journal of Medicine, please visit
http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1931-7581.

Research Explores Evidence-Based Medicine and Primary Care

According to a paper co-authored by Dr. Daniella Zipkin of the Duke University Medical Center and published recently in the Mount Sinai Journal of Medicine, primary-care medical professionals deal with several challenges in incorporating evidence-based medicine into their practices. Evidence-based medicine constitutes using the most up-to-date and highest-quality research in carrying out decisions related to patient care. Daniella Zipkin’s paper, titled “Evidence-Based Medicine and Primary Care: Keeping Up is Hard to Do,” explores in-depth the data in support of evidence-based medicine, and suggests methods for overcoming the difficulties and integrating it smoothly into everyday care practices. Moreover, Dr. Zipkin’s research highlights the increasingly important role evidence-based medicine will play in the health care establishment, especially considering that professionals can fulfill Patient Protection and Affordable Care Act of 2010 criteria through the practice of evidence-based medicine. To read Daniella Zipkin’s paper in its entirety and to browse other articles in the September/October 2012 issue of the Mount Sinai Journal of Medicine, please visit http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1931-7581.

Medical Education Community Lacks Proper Training on Physician-Pharmaceutical Company Interactions

Each year, pharmaceutical companies spend billions of dollars on marketing and outreach, and an overwhelming majority of those funds support promoting drugs to physicians and other medical professionals. Studies and literature show that these promotional activities effectively influence doctors some to most of the time, including affecting their prescribing actions and their decisions in stocking their pharmacies.

However, interactions between pharmaceutical companies and physicians often begin before the latter population even finishes medical school. Drug manufacturers sponsor meals and conferences for doctors-in-training, provide them with books and gifts, and even back scientific meetings that they attend. In one study, medical students reported an average of 10 to 11 contacts with pharmaceutical representatives each month. Plus, many medical school program directors allow these interactions to take place by providing opportunities for drug reps to give presentations to and meet with students. At the same time, the majority of physician trainees report being underprepared for such meetings and interactions and not fully aware of the guidelines governing them. According to one study, only about 23 percent of medical residents reported reading such guidelines.

About the Author:
Daniella Zipkin, M.D., researched medical student-pharmaceutical company relationships while working as an Attending Physician in the Department of Internal Medicine at the California Pacific Medical Center in San Francisco.