or

Money for editors

As journal editors, we’re aware of the fact that we have a role to play in scientific discourse - that’s why The BMJ has been so keen to talk about the way in which scientific knowledge is constructed, through our Evidence Manifesto. We also know that money has influence in the scientific literature - which is why we have a zero tolerance policy...




or

Early detection of eating disorders

Assessing young people with possible eating disorders can be complex for a variety of reasons. Building a therapeutic relationship with a young person with a possible eating disorder and their family is key to enabling a thorough assessment and ongoing management, but it introduces difficult issues regarding confidentiality and risk. In this...




or

I thought I wasn't thin enough to be anorexic

Assessing young people with possible eating disorders can be complex for a variety of reasons. Building a therapeutic relationship with a young person with a possible eating disorder and their family is key to enabling a thorough assessment and ongoing management, but it introduces difficult issues regarding confidentiality and risk. In this...




or

Manflu - are men immunologically inferior?

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...




or

Suspect, investigate, and diagnose acute respiratory distress syndrome

Acute respiratory distress syndrome was first described in 1967 and has become a defining condition in critical care. Around 40% of patients with ARDS will die, and survivors experience long term sequelae. No drug treatments exist for ARDS, however good supportive management reduces harm and improves outcome. In this podcast, John Laffey,...




or

neoadjuvant treatment for breast cancer - not living up to the promise

Neoadjuvant chemotherapy for breast cancer is a new strategy that was introduced towards the end of the 20th century with the aim of reducing tumour size - rendering an otherwise inoperable tumour operable, allowing more conservative surgery, and hopefully improving overall survival. Although data indicate that the first rationale remains valid,...




or

Katherine Cowan - Reaching A Priority

Its now widely agreed that one of the key ways of reducing the current high level of "waste " in biomedical research is to focus it more squarely on addressing the questions that matter to patients - and the people and medical staff that care for them. In this interview, Tessa Richards - the BMJ's patient partnership editor, talks to...




or

Should doctors prescribe acupuncture for pain?

Our latest debate asks, should doctors recommend acupuncture for pain? Asbjørn Hróbjartsson from the Center for Evidence-based Medicine at University of Southern Denmark argues no - evidence show's it's no worse than placebo. Mike Cummings, medical director of the British Medical Acupuncture Society argues yes - that there is evidence of efficacy,...




or

How to stop generic drug price hikes (or at least reduce them)

Ravi Gupta, is a resident in internal medicine at Johns Hopkins in Baltimore - and as he said has seen the influence of sudden price hikes on his patients - between 2010 and 2015 more than 300 drugs in the U.S. have seen sudden increases of over %100. Ravi and his co-authors have suggested, and tested the feasibility of, a possible answer to...




or

Online Consultations - general practice is primed for a fight

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...




or

What forced migration can tell us about diabetes

Worldwide, the rate of type II diabetes is estimated to be around 1 in 11 people - about 9%. For the Pima people of Arizona, 38% of the adult population have the condition - but across the border in Mexico, the rate drops down to 7%. The difference between the groups is their life experience - one side displaced, the other on their traditional...




or

New antivirals for Hepatitis C - what does the evidence prove?

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...




or

Biochem for kids

Each time you order a test for a child, do you think the population that makes up the baseline against which the results are measured? It turns out that that historically those reference intervals have been based on adults - but children, especially neonates and adolescents, are undergoing physiological changes that mean those reference intervals...




or

Ashish Jha tries to see the world as it is.

There’s a lot going on in the world at the moment - Ebola’s back, Puerto Rico is without power and the official estimations of death following the hurricane are being challenged. The WHO’s just met to decide what to do about it all, as well as sorting out universal healthcare, access to medicines, eradicating polio, etc etc. To make sense of that...




or

Doctors and vets working together for antibiotic stewardship

Doctors and the farming industry are often blamed for overuse of antibiotics that spurs the growing problem of antimicrobial resistance - but the professions are using different methods to combat resistance and reduce overuse. In this roundtable, we bring medics and vets together to discuss the problem - where antibiotic resistance arises, how...




or

Mendelian Randomisation - for the moderately intelligent

Mendelian randomisation - it’s a technique that uses the chance distribution of genes in a population, combined with big data sets, to investigate causative relationships. But there are a lot of questions we have in The BMJ about how the technique works - the association between genes and apparently non-biologically mediated behaviours, how much...




or

15 seconds to improve your workplace

15s30m is a social movement to reduce frustration & increase joy - the idea is to spend 15 seconds of your time now, and save someone else 30 minutes down the line. To talk about their movement we're joined by the founders, Rachel Pilling, consultant ophthalmologist, and Dan Wadsworth, transformation manager - both from Bradford Teaching...




or

Patient information is key to the therapeutic relationship

Sue Farrington is chair of the Patient Information Forum, a member organisation which promotes best practice in anyone who produces information for patients. In this podcast, she discusses what makes good patient information, why doctors should be pleased when patients arrive at an appointment with a long list of questions, and why patients are...




or

Nutritional science - Is quality more important than quantity?

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...




or

How often do hospital doctors change long term medication during an inpatient stay?

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...




or

Defending evidence informed policy making from ideological attack

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,...




or

Don't save on transport at the cost of the NHS

Last week we heard about how evidence in policy making is imperilled - but today we’re hearing about a plan to make evidence about health central to all aspects of government. Laura Webber, director of public health modelling at the UK Health Forum, Susie Morrow, chair of the Wandsworth Living Streets Group and Brian Ferguson, chief economist at...




or

UK children are drinking less and the importance of a publicly provided NHS

Brits have a reputation as Europe’s boozers - and for good reason, with alcohol consumption higher than much of the rest of the continent. That reputation is extended to our young people too - but is it still deserved? Joanna Inchley, senior research fellow at the University of St Andrews, explains new research on decreasing drinking -...




or

Acceptable, tolerable, manageable - but not to patients. How drug trials report harms.

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...




or

Making multisectoral collaboration work

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...




or

Goran Henriks - How an 80 year old woman called Esther shaped Swedish Healthcare

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...




or

Assisted dying: should doctors help patients to die?

The Royal College of Physicians will survey all its members in February on this most controversial question. It says that it will move from opposition to neutrality on assisted dying unless 60% vote otherwise. The BMJ explores several conflicting views. From Canada, palliative care doctor Sandy Buchman explains why he sees medical aid in dying...




or

Should we be screening for AF?

Current evidence is sufficient to justify a national screening programme, argues Mark Lown clinical lecturer at the University of Southampton, but Patrick Moran, senior research fellow in health economics at Trinity College Dublin, thinks there are too many unanswered questions and evidence from randomised trials is needed to avoid...




or

Sorry for the interruption in service

The problem we had publishing our feed has been fixed, and normal service has resumed. Thank you for subscribing to the podcast, if you have thoughts you'd like to express, we'd love to hear them. https://www.bmj.com/podcasts




or

Is opt-out the best way to increase organ donation?

As England’s presumed consent law for 2020 clears parliament, Veronica English, head of medical ethics and human rights at the BMA, say that evidence from Wales and other countries shows that it could increase transplantation rates. But Blair L Sadler, physician and senior adviser to California State University, consider such legal changes a...




or

Talk Evidence - Shoulders, statins and doctors messes

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)...




or

How to have joy at work

Jessica Perlo is the Director for Joy at Work at the Institute for Healthcare Improverment, and James Mountford is direct or of quality at the Royal Free London NHS Foundation Trust. Together they joined us at the International Forum on Quality and Safety in Healthcare to discuss joy at work - what that concept actually means, and practically,...




or

Introducing Sharp Scratch - our new podcast for students and junior doctors

Here's a taster for our new student podcast - Sharp Scratch. We're talking about the hidden curriculum, things you need to know to function as a doctor, but are rarely formally taught. This is a taster - if you enjoy, subscribe! https://podcasts.apple.com/gb/podcast/student-bmj-podcast/id331561304 Sharp Scratch episode 1: Surviving the night...




or

Doctors and extinction rebellion

Starting in the middle of April, the group “Extinction Rebellion” have organised a series of non-violent direct action protests. Most notably bringing central London to a standstill - but these events are now continuing around the country. Predictably, they have received a lot of criticism - they have also received a lot of support - amongst...




or

What caused the drop in stroke mortality in the UK

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...




or

Planning for the unplannable

Hi impact, low probability events are a planners nightmare. You know that you need to think about them, but how can you prioritise which event - terrorist attack, natural disaster, disease outbreak, deserves attention - and how can you sell the risks of that, but not oversell them? Risky business is a conference where some of these kind of things...




or

Thoroughly and deliberately targeted; Doctors in Syria

As Syria enters its ninth year of conflict, doctors are struggling to provide health care to a badly damaged country. While dealing with medicine shortages, mass casualties and everything that comes with working in a warzone, healthcare facilities and their staff are also facing an unprecedented number of targeted and often repeated attacks....




or

Working as a team, and combating stress, in space

Nicole Stott is an engineer, aquanaut and one of the 220 astronauts to have lived and worked on the International Space Station. In a confined space, under huge pressure, with no way out, it's important that teams maintain healthy dynamics, and individuals can manage their stress adequately, and in this podcast Nicole explains a little about...




or

Did international accord on tobacco reduce smoking?

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...




or

I have never encountered an organisation as vicious in its treatment of whistleblowers as the NHS

Margaret Heffernan has thought a lot about whistleblowing, and why companies don't respond well to it. She wrote the "Book Wilful Blindness: Why We Ignore the Obvious at our Peril". In this podcast she talks about how culture, and groupthink, leads to a culture where whistleblowers are ignored, and why the NHS needs to change the way it treats...




or

Fertility awareness based methods for pregnancy prevention

Fertility awareness based methods of contraception are increasingly being used for pregnancy prevention. In the US, the proportion of contraceptive users who choose such methods has grown from 1% in 2008 to approximately 3% in 2014.  Relative to other methods of pregnancy prevention, however, substantial misinformation exists around fertility...




or

Burnout - Don't try to make the canary in the coal mine more resilient

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...




or

Physical activity and mortality - "The least active quartile did less than 5 minute per day"

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...




or

Brexit - Planning for medicine shortages

This week we saw the release of the much awaited Yellowhammer documents from the government, documents which outline some of the risks involved with Britain’s sudden departure from the EU. The documents themselves outline that there are risks to the supply of medicines - but do not set out the detail of how those risks have been mitigated, and...




or

Cancer drug trials used for regulatory approval are at risk of bias

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...




or

Talk Evidence - Recurrent VTE, CRP testing for COPD, CMO report, and a consultation

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...




or

Ancestry DNA tests can over or under estimate genetic disease risk

Direct-to-consumer genetic tests are sold online and in shops as a way to “find out what your DNA says". They insights into ancestry or disease risks; others claim to provide information on personality, athletic ability, and child talent. However, interpretation of genetic data is complex and context dependent, and DTC genetic tests may produce...




or

Statins for primary prevention - How good is the evidence

Statins are now the most commonly used drug in the UK and one of the most commonly used medicines in the world, but debate remains about their use for primary prevention for people without cardiovascular disease. Paula Byrne from the National University of Ireland Galway, joins us to talk about the evidence of benefit for low risk individuals,...




or

Testing for TB is only skin deep

A TB infection can take two forms, active and latent. Active disease is transmissible, and causes the damage to the lungs which makes TB one of the biggest killers in the world. In the latent form, the bacteria Mycobacterium tuberculosis is quiescent and can stay that way for years until it becomes active and causes those clinical signs. Testing...




or

Nudging the calories off your order

There has been a lot of noise made about calorie counts on labels - the idea being it’s one of those things that might nudge people to make healthier choices. So much so that in 2018, in the USA, it became mandatory for food chains with more than 20 outlets to label the calories in their food. But the effectiveness of that is hard to gauge -...