From Hippocrates to Delphi: A Practical Guide to Clinical Guideline Development Part 2: GRADE, AGREE, and the Alphabet Soup of Evidence Appraisal In 1990, while serving as director of the internal medicine residency program at McMaster University in Hamilton, Ontario, Gordon Guyatt introduced a new approach to teaching at the bedside. He called it …
This is the first in a five-part series on the science and methodology behind clinical practice guidelines and consensus statements. The series “From Hippocrates to Delphi” is named for the arc that connects the earliest attempts to codify medical practice to the structured consensus methods we use today. Hippocrates gave us the idea that clinical …
On April 2, 2026, the U.S. Food and Drug Administration issued a warning letter to a Michigan-based manufacturer of drug products called Purolea Cosmetics Lab. At first glance, it looked routine: cGMP violations, missing process validation, inadequate quality controls. But buried in the letter was something unprecedented: a dedicated section titled “Inappropriate Use of Artificial …
Continue reading “FDA Just Issued Its First AI Warning Letter: Medical Affairs Should Pay Attention”
Here’s a pattern I’ve seen repeatedly. A medical affairs team builds a publication plan. Timelines align to a congress deadline. Authors are confirmed. A solid first draft is delivered on time. Then the manuscript enters medical-legal-regulatory review, and disappears. Weeks later, it resurfaces covered in tracked changes that contradict each other. Medical pushes for bolder …
Continue reading “Your Publication Plan Isn’t Failing at MLR: It’s Failing at the Outline”
On March 30, 2026, I attended RISE Together: Data Sharing Across the Rare Disease Ecosystem [1] expecting a discussion about the platforms and infrastructure needed to move data more efficiently across systems. Instead, what surfaced over the course of the day was something more fundamental, and more difficult to resolve. The rare disease field is …
Continue reading “When the Data Exists but Doesn’t Travel: Lessons from RISE Together 2026”