an The evidence manifesto - better trials, better use of trial data By feeds.bmj.com Published On :: Fri, 21 Apr 2017 15:48:21 +0000 We're creating a manifesto for better evidence. The centre for Evidence Based Medicine at the University of Oxford, and the BMJ, are asking what are the problem with medical evidence, and how can we fix them? In this second discussion we went to Nottingham University, to find out what the people who create the bread and butter of EBM -... Full Article
an “I had two herniated discs in my back, and I was still running” - addicted to exercise By feeds.bmj.com Published On :: Thu, 27 Apr 2017 10:05:01 +0000 It’s been called “the universal panacea” - exercise has a positive effect on almost all health measures, and governments are actively campaigning for us to do more. But at the opposite end of the scale, the realisation that some people may be addicted to exercise is gaining traction. In this podcast we're joined by Heather Hausenblas - professor... Full Article
an Drug promotion, prescription, and value By feeds.bmj.com Published On :: Thu, 04 May 2017 09:55:13 +0000 Pharma companies say that money spent on promotion is essential to educate doctors about the best drugs - but when a medical student asked Joseph Ross, associate professor of medicine and public health at Yale, if those companies are promoting the right drugs for that message to be true, the answer wasn't available. Ross and Tyler Greenaway, his... Full Article
an Government and evidence By feeds.bmj.com Published On :: Fri, 02 Jun 2017 14:58:59 +0000 We're creating a manifesto for better evidence. The centre for Evidence Based Medicine at the University of Oxford, and the BMJ, are asking what are the problem with medical evidence, and how can we fix them? In this third discussion we went to Scotland, to find out what the people who create policy think about the issues with evidence synthesis,... Full Article
an Future Earth - linking health and environmental research By feeds.bmj.com Published On :: Fri, 02 Jun 2017 15:02:50 +0000 The rapid changes in the global environment have led many scientists to conclude that we are living in a new geological epoch—the Anthropocene—in which human activities have become the dominant driving force transforming the Earth’s natural systems. A recent joint publication by the World Health Organization and Convention on Biological Diversity... Full Article
an The Evidence Manifesto - it's time to fix the E in EBM By feeds.bmj.com Published On :: Fri, 23 Jun 2017 17:06:38 +0000 "Too many research studies are poorly designed or executed. Too much of the resulting research evidence is withheld or disseminated piecemeal. As the volume of clinical research activity has grown the quality of evidence has often worsened, which has compromised the ability of all health professionals to provide affordable, effective, high value... Full Article
an Childhood IQ and cause of death By feeds.bmj.com Published On :: Thu, 29 Jun 2017 11:23:49 +0000 Findings from a range of prospective cohort studies based around the world indicate that higher intelligence in children is related to a lower risk of all cause mortality in adulthood - and now a new study, published on bmj.com, is trying to dig into that association further, with a whole population cohort and data on cause specific... Full Article
an Dementia prevalance in 2040 By feeds.bmj.com Published On :: Wed, 05 Jul 2017 17:07:08 +0000 The Alzheimer’s society, in the UK, predicts that if the rates of dementia remain constant there’ll be 1.7 million people in the country living with the condition by 2050. We also know that things like improvements in cardiovascular health are changing those rates. New research published on bmj.com attempts to model what the outcomes of those... Full Article
an James Kinross and Chris Hankin WannCry about NHS IT By feeds.bmj.com Published On :: Fri, 14 Jul 2017 16:13:20 +0000 Earlier this year, the WannaCry ransomeware attack took control of computers in 40 NHS trusts, blocking access to the data held on them. This wasn’t the first time that NHS computers had been infected by malware, but it brought the danger of cyber attack into the consciousness of doctors and patients. In this podcast we hear from two people who... Full Article
an What's going on with life expectancy? By feeds.bmj.com Published On :: Fri, 21 Jul 2017 13:35:10 +0000 The increase in life expectancy in England has almost “ground to a halt” since 2010 and austerity measures are likely to be a significant contributor. In this podcast Michael Marmot, director at University College London’s Institute of Health Equity, joins us to discuss what might be causing that drop off, and why a decrease in early life chances... Full Article
an The World Bank - why it matters for global health By feeds.bmj.com Published On :: Fri, 01 Sep 2017 08:59:54 +0000 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... Full Article
an The World Bank - Universal Healthcare By feeds.bmj.com Published On :: Fri, 01 Sep 2017 09:01:34 +0000 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... Full Article
an The World Bank - trust funds By feeds.bmj.com Published On :: Fri, 01 Sep 2017 09:03:51 +0000 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... Full Article
an The World Bank - the Global Financing Facility By feeds.bmj.com Published On :: Fri, 01 Sep 2017 09:05:03 +0000 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... Full Article
an HIV in pregnancy - "without the big picture, people aren't going to be able to take the medication" By feeds.bmj.com Published On :: Fri, 15 Sep 2017 17:11:27 +0000 A new Rapid Recommendation from The BMJ suggests that for pregnant women, they may wish to avoid certain antiviral treatments for HIV. This recommendation differs from the WHO's, and to discuss why that is, and what makes that difference important, we're joined by Reed Siemieniuk, a physician and methodologist from McMaster University, and Alice... Full Article
an I thought I wasn't thin enough to be anorexic By feeds.bmj.com Published On :: Sun, 10 Dec 2017 16:57:03 +0000 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... Full Article
an Manflu - are men immunologically inferior? By feeds.bmj.com Published On :: Tue, 12 Dec 2017 16:26:51 +0000 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... Full Article
an Suspect, investigate, and diagnose acute respiratory distress syndrome By feeds.bmj.com Published On :: Wed, 03 Jan 2018 14:42:46 +0000 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,... Full Article
an neoadjuvant treatment for breast cancer - not living up to the promise By feeds.bmj.com Published On :: Thu, 11 Jan 2018 18:07:35 +0000 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,... Full Article
an They can't hear you - how hearing loss can affect care. By feeds.bmj.com Published On :: Fri, 19 Jan 2018 12:31:52 +0000 Many older adults have difficulty understanding speech in acute healthcare settings owing to hearing loss, but the effect on patient care is often overlooked. Jan Blustein professor of health policy and medicine at New York University, and who has also experienced the affects of hearing loss, joins us to explain what that's like, and gives some... Full Article
an Education round-up - January 2018 By feeds.bmj.com Published On :: Mon, 22 Jan 2018 17:30:44 +0000 The BMJ publishes a variety of education articles, to help doctors improve their practice. Often authors join us in our podcast to give tips on putting their recommendations into practice. In this audio round-up The BMJ’s clinical editors discuss what they have learned, and how they may alter their practice. Kate Addlington, associate editor and... Full Article
an Smoking one a day can't hurt, can it? By feeds.bmj.com Published On :: Thu, 25 Jan 2018 14:59:12 +0000 We know that smoking 20 cigarettes a day increases your risk of CHD and stroke - but what happens if you cut down to 1, do you have 1/20th of that risk? Allan Hackshaw, professor of epidemiology at UCL joins us to discuss a new systematic review and meta analysis published on bmj.com, examining the risk of smoking just one or two cigarettes a... Full Article
an "We don't really know the impact of these products on our health": Ultraprocessed food & cancer risk By feeds.bmj.com Published On :: Thu, 15 Feb 2018 10:47:09 +0000 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... Full Article
an SDGs - How many lives are at stake? By feeds.bmj.com Published On :: Sat, 17 Feb 2018 12:58:17 +0000 In a new analysis John McArthur and Krista Rasmussen, from the Global Economy and Development Program at the Brookings Institution, and Gavin Yamey from Duke University, have set out to analyse the potential for lives saved by the goals set in the Sustainable Development Goals In this conversation I talked to Gavin and John about the numbers,... Full Article
an Katherine Cowan - Reaching A Priority By feeds.bmj.com Published On :: Fri, 02 Mar 2018 15:59:43 +0000 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... Full Article
an Civilians under siege in Eastern Ghouta By feeds.bmj.com Published On :: Tue, 03 Apr 2018 10:03:35 +0000 In 2016, from an estimated pre-war population of 22 million, the United Nations (UN) identified 13.5 million Syrians requiring humanitarian assistance, of which more than 6 million are internally displaced within Syria, and around 5 million are refugees outside of Syria. In this podcast, Aula Abarra, consultant in infectious disease from London,... Full Article
an Can we regulate intellectual interests like financial ones? By feeds.bmj.com Published On :: Fri, 13 Apr 2018 19:07:09 +0000 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... Full Article
an What forced migration can tell us about diabetes By feeds.bmj.com Published On :: Tue, 08 May 2018 17:04:46 +0000 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... Full Article
an New antivirals for Hepatitis C - what does the evidence prove? By feeds.bmj.com Published On :: Sat, 12 May 2018 11:44:15 +0000 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... Full Article
an Antidepressants and weight gain By feeds.bmj.com Published On :: Fri, 25 May 2018 16:56:21 +0000 Patients who are depressed and prescribed antidepressants may report weight gain, but there has been limited research into the association between the two. However new observational research published on bmj.com aims to identify that association. Rafael Gafoor, a psychiatrist and researcher at Kings College London, and one of the authors of that... Full Article
an 09 John Ioannidis By feeds.bmj.com Published On :: Fri, 15 Jun 2018 02:09:01 +0000 Series two of The Recommended Dose kicks off with polymath and poet, Dr John Ioannidis. Recognised by The Atlantic as one the most influential scientists alive today, he’s a global authority on genetics, medical research and the nature of scientific inquiry itself – among many other things. A professor at Stanford University, John has authored... Full Article
an Don Berwick - you can break the rules to help patients By feeds.bmj.com Published On :: Fri, 15 Jun 2018 12:52:40 +0000 Don Berwick, president emeritus of the Institute of Healthcare Improvement, and former Administrator of the Centers for Medicare and Medicaid Services. In this conversation he discusses how he went from being a paediatrician to running Medicare for Obama, how we can create headroom in stressed systems, and breaking the rules to make things better... Full Article
an When an investigative journalist calls By feeds.bmj.com Published On :: Fri, 22 Jun 2018 17:11:23 +0000 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... Full Article
an Evidence in a humanitarian emergency By feeds.bmj.com Published On :: Mon, 25 Jun 2018 09:52:03 +0000 At evidence live this year, one of the sessions was about the work of Evidence Aid - and their attempt to bring high quality evidence to the frontline of a humanitarian crisis. In that situation, it’s very difficult to know what will work - a conflict, or even immediately post-conflict situation is characterised by chaos - and merely doing... Full Article
an Your recommended dose of Ray Moynihan By feeds.bmj.com Published On :: Thu, 28 Jun 2018 14:22:05 +0000 Ray Moynihan is a senior research assistant at Bond University, a journalist, champion of rolling back too much medicine, and host of a new series “The Recommended Dose” from Cochrane Australia. In the series, Ray has talked to some of the people who shape the medical evidence that underpin healthcare around the world - the series aim is to... Full Article
an Doctors and vets working together for antibiotic stewardship By feeds.bmj.com Published On :: Wed, 11 Jul 2018 15:00:36 +0000 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... Full Article
an Mendelian Randomisation - for the moderately intelligent By feeds.bmj.com Published On :: Mon, 16 Jul 2018 18:47:48 +0000 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... Full Article
an The diagnosis and treatment of dyspareunia By feeds.bmj.com Published On :: Mon, 13 Aug 2018 17:16:01 +0000 Dyspareunia is a common but poorly understood problem affecting around 7.5% of sexually active women. It is an important and neglected area of female health, associated with substantial morbidity and distress. Women may be seen by several clinicians before a diagnosis is reached, There are also specialist psychosexual clinics, where men and women... Full Article
an Nutritional science - Is quality more important than quantity? By feeds.bmj.com Published On :: Fri, 07 Sep 2018 17:39:13 +0000 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... Full Article
an How often do hospital doctors change long term medication during an inpatient stay? By feeds.bmj.com Published On :: Fri, 14 Sep 2018 18:00:24 +0000 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... Full Article
an Don't save on transport at the cost of the NHS By feeds.bmj.com Published On :: Mon, 24 Sep 2018 10:49:38 +0000 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... Full Article
an UK children are drinking less and the importance of a publicly provided NHS By feeds.bmj.com Published On :: Fri, 28 Sep 2018 18:36:43 +0000 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 -... Full Article
an Talk evidence - Vitamin D, Oxygen and ethics By feeds.bmj.com Published On :: Fri, 16 Nov 2018 11:30:56 +0000 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... Full Article
an Acceptable, tolerable, manageable - but not to patients. How drug trials report harms. By feeds.bmj.com Published On :: Mon, 19 Nov 2018 18:02:11 +0000 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... Full Article
an Trojan Milk By feeds.bmj.com Published On :: Wed, 05 Dec 2018 19:23:58 +0000 Infant formula manufacturers were made pariah in the 70s, because of their marketing practices - this lead to “The Code”, adopted by the WHO, which set out clear guidelines about what those practices should be. Now an investigation on bmj.com by Chris Van Tulleken, honorary senior lecturer at University College London, examines the practices... Full Article
an Talk Evidence - Devices and facebook vaccines By feeds.bmj.com Published On :: Wed, 12 Dec 2018 11:11:18 +0000 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... Full Article
an How Coca-Cola shaped obesity science and policy in China By feeds.bmj.com Published On :: Wed, 09 Jan 2019 17:25:25 +0000 Susan Greenhalg is a research professor of chinese society in Harvard’s department of anthropology - not a natural fit for a medical journal you may think, but recently she has been looking at the influence of Coca Cola on obesity policy in China. She has written up her investigation in an article published on bmj.com this week, and joins us in... Full Article
an HIV - everything you wanted to know about PeP and PreP By feeds.bmj.com Published On :: Tue, 15 Jan 2019 23:12:27 +0000 We have had two articles published recently on bmj.com, looking at drug prevention of HIV; PeP - Post-exposure Prophylaxis and PreP - Pre-exposure Prophylaxis, neither prevent the virus from entering the body, but they do prevent the infection from taking hold. There are lots of questions that doctors have about these - what are the risk... Full Article
an Talk evidence - TIAs, aging in Japan and women in medicine By feeds.bmj.com Published On :: Wed, 23 Jan 2019 10:16:29 +0000 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... Full Article
an Goran Henriks - How an 80 year old woman called Esther shaped Swedish Healthcare By feeds.bmj.com Published On :: Fri, 25 Jan 2019 06:11:19 +0000 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... Full Article