The world bank was set up in 1944. In the aftermath of the second world war, the institution was there to give loans to countries rebuilding after the conflict. Their first loan went to France - but with stipulations about repayment that set a tone for future funds. A new series, authored by Devi Sridhar, and her team from the University of...

The Three Talk Model of shared decision is a framework to help clinicians to think about how to structure their consultation to ensure that shared decision making can most usefully take place. The model is based around 3 concepts - option talk, decision talk, and team talk - with active listening at the centre. Three Talk was first proposed in...

Manflu, the phenomenon that men experience the symptoms of viral illness more than woman, is usually used with derision - but a new review, published in the Christmas edition, is asking - is there a plausible biological basis for this sex difference? Kyle Sue is a clinical assistant professor in family medicine at Memorial University of...

Winter pressures on NHS services have kicked in a little bit earlier than usual. So here to discuss that, and also the issue of how local NHS leaders can support staff in times of extreme pressure. Discussing that with Rebecca Coombes, The BMJ’s head of news and views, are Matthew Inada-Kim, a consultant in acute and general medicine at...

Trial MVA85A - monkey trials for a booster vaccine for BCG, developed by researchers at Oxford University, is the subject of an investigation published on bmj.com. Experts warn that today’s investigation is just one example of “a systematic failure” afflicting preclinical research and call for urgent action “to make animal research more fit for...

A study published by The BMJ today reports a possible association between intake of highly processed (“ultra-processed”) food in the diet and cancer. Ultra-processed foods include packaged baked goods and snacks, fizzy drinks, sugary cereals, ready meals and reconstituted meat products - often containing high levels of sugar, fat, and salt, but...

That’s Jo Shapiro is a surgeon and manager in Brigham and Women’s hospital, she’s also director of the Center for Professionalism and Peer Support, and has written an editorial for The BMJ on tackling unprofessional behaviour. In this discussion, she and I talked about what she thinks (beyond the illegal) are the most damaging behaviours seen...

The first digital banking in the UK was launched in 1983, Skype turns 15 this year, but 2017 finally saw panic over the impact that online consultations may have on general practices. In this podcast Martin Marshall, professor of healthcare improvement at University College London joins us to discuss whether video conference actually is a...

We talk about financial conflicts of interest a lot atThe BMJ - and have take taken the decision that our educational content should be without them. We also talk a lot about non-financial conflicts of interest, but the choppy waters of those are much more difficult to navigate. In this podcast, we discuss whether we should, or if we could even...

There’s been a lot of attention given to the new antirviral drugs which target Hepatitis C - partly because of the burden of infection of the disease, and the lack of a treatment that can be made easily accessible to around the world, and partly because of the incredible cost of a course of treatment. But a new article on BMJ talks about the...

At Evidence Live this year, the focus of the conference was on communication of evidence - both academically, and to the public. And part of that is the role that investigative journalism has to play in that. At the BMJ we’ve used investigative journalistic techniques to try and expose wrong doing on the part of government and industry - always...

This week, a very special conversation with a maverick British medico who set up a tiny research centre in Oxford and watched it grow into a global collaboration of over 40,000 people across 130 countries. Three decades on, the Cochrane Collaboration now produces the world's most trusted health evidence that's used by patients, health...

We at The BMJ care about food, and if our listener stats are to be believed, so do you. In this podcast we’re looking at quality as an important driver of a good diet. At our recent food conference - Food For Thought - hosted in Zurich by Swiss Re we brought researchers in many fields of nutritional science together. We asked people with...

More than ½ of patients leave hospital with changes to four or more of their long-term medications - but how appropriate are those changes? New research published on bmj.com looks at antihypertensive medication prescription changes to try and model that - and found that more than half of intensifications occurred in patients with previously well...

If you’re of a scientific persuasion, watching policy debates around Brexit, or climate change, or drug prohibition are likely to cause feelings of intense frustration about the dearth of evidence in those discussions. In this podcast we're joined by Chris Bonell, professor of public health sociology - in this podcast he airs those frustrations,...

We want clinical trials to be thorough - but Vinay Prasad, assistant professor of medicine at Oregon Health Science University, argues that the problem of overdiagnosis may be as prevalent, in the way we measure disease in our research, as our practice. In this podcast he joins us to discuss the problem, and why he thinks what qualifies as...

What can we learn from the shameful story of vaginal mesh? That thousands of women have been irreversibly harmed; that implants were approved on the flimsiest of evidence; that surgeons weren’t adequately trained and patients weren’t properly informed; that the dash for mesh, fuelled by its manufacturers, stopped the development of alternatives;...

The common cold is usually mild and self limiting - but they’re very annoying, especially the runny nose and bunged up feeling that form the nasal symptoms. A new practice article, published on BMJ.com looks at the available evidence for treatment of those nasal symptoms - both pharmacological and alternative. In this podcast we're joined by...

On the podcast, we’ve talked a lot about the limits of medicine - where treatment doesn’t work, or potentially harms. But in that conversation, we’ve mainly focused on specific treatments. Now a new analysis, broadens that to talk about patients being admitted to a whole ward - intensive care. The authors of that article contend that, often,...

Machines that can learn and correct themselves already perform better than doctors at some tasks, but not all medicine is task based - but will AI doctors ever be able to have a therapeutic relationship with their patients? In this debate, Jörg Goldhahn, deputy head of the Institute for Translational Medicine at ETH Zurich thinks that the...

Welcome to this, trial run, of a new kind of BMJ podcast - here we’re going to be focusing on all things EBM. Duncan Jarvies, Helen Macdonald and Carl Heneghan - and occasional guests- will be back every month to discuss what's been happening in the world of evidence. We'll bring you our Verdict on what you should start or stop doing, geek out...

You’ll have read in a clinical trial “Most patients had an acceptable adverse-event profile.” Or that a drug “has a manageable and mostly reversible safety profile.” And that “the tolerability was good overall.” In this podcast, Bishal Gyawali (@oncology_bg) joins us to describe what events those terms were actually describing in cancer drug...

A new collection of articles published by The BMJ includes twelve country case studies, each an evaluation of multisectoral collaboration in action at scale on women’s, children’s, and adolescent’s health. Collectively these twelve studies inform an overarching synthesis and accompanying commentaries, drawing together lessons learned in...

In the second of our EBM round-ups, Carl Heneghan, Helen Macdonald and Duncan Jarvies are joined by Deborah Cohen, investigative journalist and scourge of device manufacturers. We're giving our verdict on the sensitivity and specificity of ketone testing for hyperemesis, and the advice to drinking more water to prevent recurrent UTIs in...

In this EBM round-up, Carl Heneghan, Helen Macdonald and Duncan Jarvies are back to give you an update Dual vs single therapy for prevention of TIA or minor stroke - how does the advice that dual work better translate in the UK? Carl explains why Japan can teach us to get active and, how GPs can use that information to "drop a decade" in...

Jönköping has been at the centre of the healthcare quality improvement movement for years - but how did a forested region of Sweden, situated between it's main cities, come to embrace the philosophy of improvement so fervently? Goran Henriks, chief executive of learning and innovation at Qulturum in Jönköping joins us to explain. He also tells...

Helen Macdonald and Carl Heneghan are back again talking about what's happened in the world of evidence this month. They start by talking about how difficult a task it is to find evidence that's definitely practice changing, what GPs can learn from Malawian children with nonsevere fast-breathing pneumonia, how radiation dosage varies...

If you've been keeping up to day with The BMJ - online on in print, you might have noticed that we've got a new type of article - NIHR Signals - and they are here to give busy clinicians a quick overview of practice changing research that has come out of the UK's National Institute for Health Research. Tara Lamont, director of the NIHR...

Renza Scibilia and Chris Aldred have diabetes, and their introduction to the idea of complications arising from the condition were terrifying. Because of this early experience, and Chris's later development of complications, they have campaigned to make doctors really think about the way in which they talk about complications with patients....

Helen Macdonald and Carl Heneghan are back again talking about what's happened in the world of evidence this month. They start by talking about shoulders - what does the evidence say about treating subacromial pain, and why the potential for a subgroup effect shouldn't change our views about stop surgery (for now, more research needed). (16.00)...

Non-medical interventions are increasingly being proposed to address wider determinants of health and to help patients improve health behaviours and better manage their conditions - this is known as social prescribing. In England, the NHS Long Term Plan states that nearly one million people will qualify for referral to social prescribing schemes...

On the 7th of June, 1753, Dr Archibald Cameron was executed at Tyburn. "The body, after hanging twenty minutes, was cut down: it was not quartered; but the heart was taken out and burnt. " 250 years later, his sixth great grandson, Robert Syned found himself deeply involved in the process of execution, as an expert witness in a case about the use...

Helen Macdonald and Carl Heneghan are back again talking about what's happened in the world of evidence this month. (1.20) Carl grinds his gears over general health checks, with an update in the Cochrane Library. (9.15) Helen is surprised by new research which looks at over prescription of antibiotics - but this time because the courses...

In the UK, there's an ethnic group that is surprisingly large, but often overlooked by society, and formal healthcare services. The gypsy traveller community have poorer health outcomes because of systemic issues around access to health and education. In this podcast we're joined by Michelle Gavin and Samson Rattigan, who both work for Friend's...

Looking after a young child is hard enough, but when that child has learning difficulties and displays challenging behaviour - the burden on parents can be extreme. That behaviour may prompt a visit to the doctor, and in this podcast we’re talking about how parents can be supported in that - what services are available. We’ll also be discussing...

Stroke mortality rates have been declining in almost every country, and that reduction could result from a decline in disease occurrence or a decline in case fatality, or both. Broadly - is that decline down to better treatment or better prevention. Olena Seminog, a researcher, and and Mike Rayner, professor of population health, both from the...

Helen Macdonald and Carl Heneghan are back again talking about what's happened in the world of evidence this month. (1.05) Carl rants about bacon causing cancer (7.10) Helen talks about prostate cancer, and we hear from the author of the research paper which won Research Paper Of The Year at the BMJ awards. We also cover disease definition and...

The NHS is about caring for people, free at the point of care, creating a safety net which catches the most vulnerable. Tech has been defined by the facebook maxim "move fast, break things" - looking to disrupt a sector, get investment and move on.  We want to be able to harness the potential utility of digital tech in the NHS - but how can those...

WHO Director-General Dr. Tedros recently said “Since it came into force 13 years ago, the Framework Convention on Tobacco Control remains one of the world’s most powerful tools for promoting public health,”. But is it? That’s what a to studies just published on bmj.com try and investigate - one of which pulls together all the data we have on...

This week on the podcast, (2.02) a listener asks, when we suggest something to stop, should we suggest an alternative instead? (8.24) Helen tells us to stop putting people on treatment for subclinical hypothyroidism, but what does that mean for people who are already receiving thyroxine? (20.55) Carl has a black box warning about z drugs, and...

This month we have some more feedback from our listeners (2.20) Carl says it's time to start smoking cessation (or stop the reduction in funding for smoking reduction) (11.40) and marvels at how pretty Richard Doll's seminal smoking paper is. It's gloves off for infection control (22.20) Andrew George, a non-executive director of the Health...

The UK has just seen it’s hottest July on record, including the highest ever temperature recorded. With climate change in the forefront of our minds, it’s timely that we have two editorials on the sustainability and health. Michael Depledge, emeritus professor of environment and human health at University of Exeter Medical School, and author of...

Burnout is a problem in healthcare - it’s a problem for individuals, those who experience it and decide to leave a career they formerly loved, but it’s also a problem for our healthcare system. Burnout is associated with an increase in medical errors, and poor quality of care. Fundamentally it’s a patient safety issue. But, unlike other patient...

In 2001, Gottfried Hirnschall joined the WHO to work on the global response to HIV/AIDs, 18 years later he just retired as the director of WHO’s department for HIV and Hepatitis. The intervening period, almost half the time we’ve been aware of the disease the fight against the infection has been characterised by scientific breakthroughs, and...

Welcome back to Talk Evidence - where Helen Macdonald and Carl Heneghan take you through what's happening in the world of Evidence. This month we'll be discussing tramadol being prescripted postoperatively, and a new EBM verdict says that should change(1.36). How much preventable harm does healthcare causes (11.20. A canadian project to help...

We know that exercise is good for you - the WHO recommends at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity aerobic physical activity each week. That recommendation is built on evidence that relied on self reporting that may underestimate the amount of lower intensity exercise those people were doing, and at the...

This week the Trump administration has banned the sale of flavoured vapes in the USA. The reason for that is the sudden rash of cases of pulmonary disease, including deaths, linked to vaping. The mechanism by which vaping may be causing damage to the lungs is as yet unclear, and our understanding is hampered by the heterogeneous nature of the...

Around half of trials that supported new cancer drug approvals in Europe between 2014 and 2016 were judged to be at high risk of bias, in a new study. Huseyin Naci,assistant professor of health policy a the London School of Economics joins us to talk about why potential bias may mean potential exaggeration of treatment effects, and could be...

Helen talks about new research on prevention of recurrent VTE - and Carl things the evidence goes further, and we can extend prophylaxis for a year. 13.00 - CRP testing for antibiotic prescription in COPD exacerbations, should we start doing it in primary care settings - and what will that mean. We also hear from Chris Butler, one of the...

The BMJ in partnership with The Harvard Global Health Institute has launched a collection of articles exploring how to achieve effective universal health coverage (UHC). The collection highlights the importance of quality in UHC, potential finance models, how best to incentivise stakeholders, and some of the barriers to true UHC. One of those...