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Currently, Professor Djulbegovic serves as the director of the Hematology Stewardship Program in the Division of Hematology/Oncology at the [[Medical University of South Carolina]] in [[Charleston, South Carolina|Charleston, SC]].<ref>{{cite web |title=Djulbegovic - Faculty Directory |url=https://education.musc.edu/MUSCApps/facultydirectory/Djulbegovic-Benjamin |website=[[Medical University of South Carolina]]}}</ref> Djulbegovic is also an affiliate member of the Meta-Research Innovation Center at Stanford.<ref> n{{cite web |title=Benjamin Djulbegovic {{!}} Meta Research Innovation Center at Stanford|url=https://metrics.stanford.edu/people/benjamin-djulbegovic |website=[[Meta-Research Innovation Center at Stanford]] |language=en}}</ref>
Currently, Professor Djulbegovic serves as the director of the Hematology Stewardship Program in the Division of Hematology/Oncology at the [[Medical University of South Carolina]] in [[Charleston, South Carolina|Charleston, SC]].<ref>{{cite web |title=Djulbegovic - Faculty Directory |url=https://education.musc.edu/MUSCApps/facultydirectory/Djulbegovic-Benjamin |website=[[Medical University of South Carolina]]}}</ref> Djulbegovic is also an affiliate member of the Meta-Research Innovation Center at Stanford.<ref> n{{cite web |title=Benjamin Djulbegovic {{!}} Meta Research Innovation Center at Stanford|url=https://metrics.stanford.edu/people/benjamin-djulbegovic |website=[[Meta-Research Innovation Center at Stanford]] |language=en}}</ref>


From 2017 to 2023, he served as a professor at the [[City of Hope National Medical Center]], [[Beckman Research Institute]], CA. Before moving to the City of Hope, he was with the [[H. Lee Moffitt Cancer Center]] and the [[University of South Florida]] (USF), [[Tampa, Florida]], where he held the distinguished position of Distinguished Professor from 2010 to 2017.{{Additional citation needed|date=March 2024}}
From 2017 to 2023, he served as a professor at the [[City of Hope National Medical Center]], [[Beckman Research Institute]], CA. Before moving to the City of Hope, he was with the [[H. Lee Moffitt Cancer Center]] and the [[University of South Florida]] (USF), [[Tampa, Florida]], where he held the distinguished position of Distinguished Professor from 2010 to 2017. <ref> 2010 Distinguished USF Health Professors, Morsani College of Medicine, Ben Djulbegovic, MD, ScD https://health.usf.edu/facultyaffairs/DistinguishedProf</ref>


At USF, he founded the Center for Evidence-Based Medicine and the Health Outcomes Research Center, where he trained a cadre of researchers in evidence-based medicine{{According to whom|date=March 2024}}. Professor Djulbegovic's administrative portfolio at USF included serving as Chief for the Division of Evidence-based Medicine and Health Outcomes (2013-2017) and Director for the USF Center for Evidence-based Medicine and Health Outcomes Research (2008-2011).{{According to whom|date=March 2024}}
At USF, he founded the Center for Evidence-Based Medicine and the Health Outcomes Research Center, where he trained a cadre of researchers in evidence-based medicine <ref>Thomas Chalmers Award In Evidence-Based Medicine Goes To USF Health.https://hscweb3.hsc.usf.edu/awardsblog/2012/03/04/thomas-chalmers-award-in-evidence-based-medicine-goes-to-usf-health </ref> Professor Djulbegovic's administrative portfolio at USF included serving as Chief for the Division of Evidence-based Medicine and Health Outcomes (2013-2017) and Director for the USF Center for Evidence-based Medicine and Health Outcomes Research (2008-2011).


==Linking evidence-based medicine with decision-making==
==Linking evidence-based medicine with decision-making==

Revision as of 04:24, 12 March 2024


Benjamin Djulbegovic
File:BDjulbegovic-photo-.png
Distinguished Professor Benjamin Djulbegovic MS,MD,ScD
OccupationPhysician-scientist
Known for
  • Linking evidence-based medicine with formal decision sciences and decision-making by integrating concepts from evidence-based medicine, predictive analytics, health outcomes research, and decision sciences to optimize clinical research and medical practice and understanding medical evidence.
  • The development of threshold modelss a rational (and pragmatic) way to address the Sorites paradox and "acceptable regret" theory for clinical decision-making.
  • Proposed the "law of therapeutic discoveries," which predicts a 50–70% success rate for new treatments in randomized clinical trials.
  • Hozo and Djulbegovic developed the decision-theoretical concept of "acceptable regret." This concept allows clinicians, scientists, and policymakers to determine when they can accept findings, even if proven wrong later.

    • Benjamin Djulbegovic is an American distinguished physician-scientist whose academic and research focus revolves around optimizing clinical research and the practice of medicine by comprehending the nature of medical evidence and decision-making. In his work, he has integrated concepts from evidence-based medicine (EBM), predictive analytics, health outcomes research, and the decision sciences.

    Djulbegovic's academic accomplishments include being awarded the USF Faculty Outstanding Research Achievement Award for the development of two major theories in clinical research and decision-making: the theory regarding treatment success in clinical trials and the acceptable regret theory[1] In addition, his work on "Trial unpredictability yields predictable therapy gains"[2] was selected as BMJ Minerva's lead story and labeled a "classic short paper"(2013) [3] and his publication on the application of acceptable regret to screening mammography was featured on the cover of The Lancet as "Quotation of the Week" (2006)[4].

    Earlier, his published work on the unpredictability of clinical trials was featured as BMJ "Editor's Choice" [5] and was featured on the cover (2005). His work on uncertainty was recognized by James Lind Library (2005)

    In his early career, he was awarded the Thomas C. Chalmers Award, 2nd prize, for empirical verification of the uncertainty (equipoise) principle (1999).[6][7]

    He is recognized in the top 1% of cited scientists worldwide, ranked at 22,261 of 204,644 of the top 2% of all scientists.[8] He was listed in Newsweek's Top Cancer Doctors and was ranked within the top 1% of US doctors in the field of hematology by the U.S. News & World Report in 2011.[9]

    As of January 2024, he has over 52k citations with an h-index of 78. He has authored over 400 papers in peer-reviewed journals, four books, over 200 abstracts, book chapters, and editorials.[10]

    Education

    In 1983, Djulbegovic earned his medical degree and PhD in biomedical sciences from the University of Sarajevo. From 1983 to 1985, he received a Master of Science degree in biophysics from the University of Zagreb and was trained in internal medicine and hematology at the University of Sarajevo, Belgrade, and Christie Hospital, Manchester, England. Subsequently, from 1988 to 1991, he completed his residency in internal medicine and a fellowship in Hematology and Medical Oncology at the University of Louisville School of Medicine.[additional citation(s) needed]

    Career

    Currently, Professor Djulbegovic serves as the director of the Hematology Stewardship Program in the Division of Hematology/Oncology at the Medical University of South Carolina in Charleston, SC.[11] Djulbegovic is also an affiliate member of the Meta-Research Innovation Center at Stanford.[12]

    From 2017 to 2023, he served as a professor at the City of Hope National Medical Center, Beckman Research Institute, CA. Before moving to the City of Hope, he was with the H. Lee Moffitt Cancer Center and the University of South Florida (USF), Tampa, Florida, where he held the distinguished position of Distinguished Professor from 2010 to 2017. [13]

    At USF, he founded the Center for Evidence-Based Medicine and the Health Outcomes Research Center, where he trained a cadre of researchers in evidence-based medicine [14] Professor Djulbegovic's administrative portfolio at USF included serving as Chief for the Division of Evidence-based Medicine and Health Outcomes (2013-2017) and Director for the USF Center for Evidence-based Medicine and Health Outcomes Research (2008-2011).

    Linking evidence-based medicine with decision-making

    Djulbegovic's work includes the coherent linkage of evidence-based medicine (EBM) to formal systems in decision sciences. His collaboration with colleague Iztok Hozo summarized their previous extensive work in the book "Threshold Models For Decision-Making in Clinical Medicine," published in 2023. [15] This work demonstrates the logical connection between EBM and structured frameworks in the decision sciences.[according to whom?]

    Djulbegovic has argued that underuse and overuse observed in clinical practice is a consequence of a relationship between scientific evidence (that exists on a continuum of credibility) and decision-making (that is, categorical, yes/no exercises, as decisions, have to be made) that creates the Sorites paradox. At which point is the probability of disease or outcomes sufficiently high or low enough for us to act? [16]

    He and Hozo proposed threshold models as a rational (and pragmatic) way to address the Sorites paradox. Djulbegovic et al have also posited that the appropriateness of care, whether underuse or overuse, depends on the choice of a decision-theoretical framework.[17]

    These principles were translated into the systematic application of the science of EBM and decision analysis in the fields of hematology and oncology, which resulted in two books. [18] [19]which were listed as leading contributions to the field of hematology[20]and in oncology[21]by the Journal of the National Cancer Institute.

    The law of therapeutic discoveries

    Through the analysis of the role of uncertainty in medicine and the clinical equipoise principle, Djulbegovic introduced the concept of "the law of therapeutic discovery."[22] [23] This theory predicts a 50-70% success rate in discovering new treatments in randomized clinical trials (RCT) based on the foundational ethical and scientific justification for conducting trials in humans. This principle - which links key precepts of moral philosophy with theories of rational decision-making is further explained and demonstrated in the classic BMJ manuscript thats asks and then answers "Are experimental treatments for cancer in children superior to established treatments?"[24]Furthermore, Djulbegovic communicates how uncertainty and a loss of equipoise can fuel misinformation in patient populations.[25]

    Rational clinical decision-making and development of "Acceptable Regret" theory

    Together with Hozo, Djulbegovic developed the decision-theoretical concept of "acceptable regret." This concept allows clinicians, scientists, and policymakers to determine when they can accept findings, even if proven wrong later. "Acceptable regret" has been used to explain both underuse and overuse in the delivery of health services, offering insights into the decision-making process of satisficing in clinical practice.[26] Most importantly, acceptable regret sheds light on why most people, whether patients or relatives caring for patients at the end-of-life require almost absolute certainty of imminent death before accepting referrals to hospice.[27]

    The Art of Communicating Uncertainty

    Dr. Djulbegovic, a practicing oncologist and hematology specialist, observes the pathos of patients and families struggling to come to terms with uncertainty and the shadow of death.[relevant?]

    While methodology and statistical acumen are admirable, there is still the patient and his or her family struggling for meaning, hope, and connection in this digital age.[relevant?]

    He translated his scientific writings into a play titled "An Impossible Decision: The Life Interrupted by Uncertainty." Using the Socratic dialogue and playwright format, he illustrates the applicability of theoretical concepts of the science of uncertainty to real-life decision-making and how they do matter to all of us individually and collectively.The screenplay is open access and available to all.[28]

    Selected publications

    Linking evidence-based medicine with decision-making

    • Djulbegovic, Benjamin; Guyatt, Gordon H (July 2017). "Progress in evidence-based medicine: a quarter century on". The Lancet. 390 (10092): 415–423. doi:10.1016/S0140-6736(16)31592-6. PMID 28215660. S2CID 46762513.
    • Djulbegovic, Benjamin; Hozo, Iztok (2023). "Evidence and Decision-Making". Threshold Decision-making in Clinical Medicine. Cancer Treatment and Research. Vol. 189. pp. 1–24. doi:10.1007/978-3-031-37993-2_1. ISBN 978-3-031-37992-5. PMID 37789157.
    • Djulbegovic, Benjamin; Hozo, Iztok (2023). Threshold Decision-making in Clinical Medicine: With Practical Application to Hematology and Oncology. Cancer Treatment and Research. Vol. 189. doi:10.1007/978-3-031-37993-2. ISBN 978-3-031-37992-5. S2CID 263612558.

    The law of therapeutic discoveries

    Rational clinical decision-making and development of "Acceptable Regret" theory

    References

    1. ^ Worth, Sarah. "USF Health faculty members honored for outstanding research". University of South Florida College of Medicine.
    2. ^ Kumar A, Glasziou P, Miladinovic B, Chalmers I, Djulbegovic B. Trial unpredictability yields predictable therapy gains. Nature 2013;500:395 396;https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819120/,
    3. ^ Trial predictability and other stories . . . BMJ 2013; 347 :f5444 doi:10.1136/bmj.f5444
    4. ^ Djulbegovic B, Lyman G. Screening mammography for women age 40-49: regret or no regret? Lancet 2006;368:2035-2037
    5. ^ Godlee F. In praise of uncertainty BMJ 2005;331:0fdoi:10.1136/bmj.331.7528.0-f
    6. ^ Djulbegovic B, Lacevic M, Lyman GH. Empirical verification of the uncertainty principle in conducting randomized trials. Proceedings of the 7th Cochrane Colloquium, 1999 https://community.cochrane.org/news/prizes-and-awards/thomas-c-chalmers-award
    7. ^ "Thomas Chalmers Award In Evidence-Based Medicine Goes To USF Health". University of South Florida College of Medicine.
    8. ^ Ioannidis JPA, Baas J, Klavans R, Boyack KW (2019) A standardized citation metrics author database annotated for scientific field. PLoS Biol17(8): e3000384. https://doi.org/10.1371/journal. pbio.3000384
    9. ^ U.S. News Top Doctors are at USF Health https://hscweb3.hsc.usf.edu/health/now/u-s-news-top-doctors-are-at-usf-health/index.html=en
    10. ^ "Benjamin Djulbegovic". Google Scholar.
    11. ^ "Djulbegovic - Faculty Directory". Medical University of South Carolina.
    12. ^ n"Benjamin Djulbegovic | Meta Research Innovation Center at Stanford". Meta-Research Innovation Center at Stanford.
    13. ^ 2010 Distinguished USF Health Professors, Morsani College of Medicine, Ben Djulbegovic, MD, ScD https://health.usf.edu/facultyaffairs/DistinguishedProf
    14. ^ Thomas Chalmers Award In Evidence-Based Medicine Goes To USF Health.https://hscweb3.hsc.usf.edu/awardsblog/2012/03/04/thomas-chalmers-award-in-evidence-based-medicine-goes-to-usf-health
    15. ^ Threshold Decision-making in Clinical Medicine: With Practical Application to Hematology and Oncology Cancer Treatment and Research, Djulbegovic B and Hozo I Springer, 1st ed. 2023 edition, ISBN-10 3031379926, ISBN-13 978-3031379925
    16. ^ Djulbegovic B, Hozo I, Mandrola J. Sorites paradox and persistence in overuse and underuse in delivery of health services. J Eval Clin Pract 2023; Sep;29(6):877-879. doi: 10.1111/jep.13851.
    17. ^ Djulbegovic B, Elqayam S, Dale W. Rational decision-making in medicine: implications for overuse and underuse. J Eval Clin Practice 2018 Jun; 24(3): 655–665. [PMID: 29194876]
    18. ^ Djulbegovic B and Beganovic S, Reasoning and Decision Making in Hematology, 1st ed. 1992, Churchill Livingstone, ISBN-13 978-0443088582
    19. ^ Djulbegovic B and Sullivan M,Decision Making in Oncology: Evidence-Based Management, 1st ed. 1997, Churchill Livingstone, ISBN-13978-0443089893
    20. ^ Seifter E.J M.D.JNCI: Journal of the National Cancer Institute, Volume 85, Issue 10, 19 May 1993, Pages 829–830, https://doi.org/10.1093/jnci/85.10.829
    21. ^ Seifter E.J.MD, JNCI: Journal of the National Cancer Institute, Volume 90, Issue 8, 15 April 1998, Page 627, https://doi.org/10.1093/jnci/90.8.627
    22. ^ Djulbegovic B. Paradox of equipoise: the principle that drives and limits discoveries in clinical research. Cancer Control 2009;16:342–347; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2782889/
    23. ^ Kumar A, Glasziou P, Miladinovic B, Chalmers I, Djulbegovic B. Trial unpredictability yields predictable therapy gains. Nature 2013;500:395–396;https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819120/,
    24. ^ Kumar A, Soares H, Wells R, Clarke M, Hozo I, Bleyer A, Chalmers I, Djulbegovic B. Are experimental treatments for cancer in children superior to established treatments? Observational study of randomised controlled trials by the Children's Oncology Group BMJ 2005; 331 :1295 doi:10.1136/bmj.38628.561123.7C
    25. ^ Djulbegovic, B. (November 2021). "Ethics of uncertainty". Patient Education and Counseling. 104 (11): 2628–2634. doi:10.1016/j.pec.2021.07.025. PMID 34312034. S2CID 236451819.
    26. ^ Djulbegovic, B.; Hozo, I.; Schwartz, A.; McMasters, K. M. (September 1999). "Acceptable regret in medical decision making". Medical Hypotheses. 53 (3): 253–259. doi:10.1054/mehy.1998.0020. PMID 10580533.
    27. ^ Tsalatsanis A, Hozo I, and Djulbegovic B. Acceptable regret model in the end of life setting: Patients require high level of certainty before forgoing management recommendations. Eur J Cancer 2017; 75:159-166 [PMID: 28235727
    28. ^ Djulbegovic B, An Impossible Decision: The Life Interrupted by Uncertainty, Int J Biomed Healthc.:2022-1; 10-4-suppl.1: 274-302nPDF - FULL TEXT | DOI: 10.5455/ijbh.2022.10.274-302 https://www.ejmanager.com/mnstemps/220/220-1682836071.pdf?t=1707760409; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10498372/
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