n 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
n 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
n 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
n 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
n 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
n Darknet Opioids By feeds.bmj.com Published On :: Fri, 15 Jun 2018 09:07:22 +0000 When tackling societal problems - like the opioid epidemic in the US - there are two ways of approaching it. One is to reduce demand - by organising treatment programmes, or reducing the underlying reasons why people may become addicted in the first place - but that’s hard. So governments often turn to the other route - reducing supply - and... Full Article
n 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
n 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
n 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
n 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
n James Munro cares about patients opinions. By feeds.bmj.com Published On :: Thu, 05 Jul 2018 16:00:39 +0000 Getting feedback from people who use NHS services is essential to assessing their value - and improving their quality. Hospitals and general practices widely post information about patient's satisfaction with their services on their websites, but approach tells us little about how feedback changes things on the ground . In this podcast, James... Full Article
n 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
n What does the public think of the NHS? By feeds.bmj.com Published On :: Thu, 12 Jul 2018 17:02:32 +0000 It’s been quite a year for the NHS - it just turned 70, had a winter crisis like never before, got over junior doctor strikes, but then was hit by a series of scandals about breast screening, and now opiate prescriptions. At the same time, we’ve seen demonstrations in favour of the service and even widespread public backing for more money. So... Full Article
n 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
n 15 seconds to improve your workplace By feeds.bmj.com Published On :: Fri, 27 Jul 2018 16:23:56 +0000 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... Full Article
n Patient information is key to the therapeutic relationship By feeds.bmj.com Published On :: Fri, 10 Aug 2018 11:13:41 +0000 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... Full Article
n 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
n 13 Iain Chalmers By feeds.bmj.com Published On :: Wed, 22 Aug 2018 07:50:10 +0000 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... Full Article
n Have we misunderstood TB's timeline? By feeds.bmj.com Published On :: Thu, 23 Aug 2018 09:46:24 +0000 The number of people estimated to be latently infected with TB - that is infected with TB, which has not yet manifested symptoms - is around 2 billion. That is 1 in 3 people on the planet are infected by the bacteria. The World Health Organization’s website notes that on average 5-10% of those infected with TB will develop active TB. That number... Full Article
n Preventing overdiagnosis 2018 - Part 1 By feeds.bmj.com Published On :: Fri, 24 Aug 2018 15:02:10 +0000 This week saw the latest Preventing Overdiagnosis conference - this time in Copenhagen. The conference is a is a forum where researchers and practitioners can present examples of overdiagnosis - and we heard about the various ways which disease definitions are being subtly widened, and diagnostic thresholds lowered. In this podcast we talk to... Full Article
n Preventing Overdiagnosis 2018 - part 2: What opened your eyes to overdiagnosis? By feeds.bmj.com Published On :: Fri, 31 Aug 2018 18:27:16 +0000 The concept of overdiagnosis is pretty hard to get - especially if you’ve been educated in a paradigm where medicine has the answers, and it’s only every a positive intervention in someone’s life - the journey to understanding the flip side - that sometimes medicine can harm often takes what Stacey Carter director of Research for Social Change at... Full Article
n 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
n 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
n Defending evidence informed policy making from ideological attack By feeds.bmj.com Published On :: Mon, 17 Sep 2018 16:00:21 +0000 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,... Full Article
n 15 Iona Heath By feeds.bmj.com Published On :: Tue, 18 Sep 2018 04:16:16 +0000 This week a very different kind of conversation on the Recommended Dose – one that considers the art of medicine more than the science. Iona Heath is a long-time family doctor who has worked in a London GP clinic for over 30 years, and at one time became President of the Royal College of General Practitioners. With an international profile, gained... Full Article
n 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
n 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
n Vinay Prasad - there is overdiagnosis in clinical trials By feeds.bmj.com Published On :: Wed, 03 Oct 2018 17:11:07 +0000 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... Full Article
n The counter intuitive effect of open label placebo By feeds.bmj.com Published On :: Sat, 06 Oct 2018 10:42:16 +0000 Ted Kaptchuk, professor of medicine at Harvard Medical school - and leading placebo researcher, has just published an analysis on bmj.com describing the effect of open label placebo - placebos that patient's know are placebos, but still seem to have some clinical effect. Ted joins us to speculate about what's going on in the body, what this means... Full Article
n What's it like to live with a vaginal mesh? By feeds.bmj.com Published On :: Fri, 12 Oct 2018 16:52:37 +0000 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;... Full Article
n Nasal symptoms of the common cold By feeds.bmj.com Published On :: Sun, 14 Oct 2018 14:52:55 +0000 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... Full Article
n Talking honestly about intensive care By feeds.bmj.com Published On :: Fri, 26 Oct 2018 19:35:20 +0000 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,... Full Article
n How does lifestyle affect genetic risk of stroke? By feeds.bmj.com Published On :: Tue, 30 Oct 2018 13:35:23 +0000 Cardiovascular factors are associated with risk of stroke - and those factors can be mediated by lifestyle and by genetic make up. New research published by The BMJ sets out to explore how these risks combine, and we're joined on the podcast by two of the authors - Loes Rutten-Jacobs, senior postdoctoral researcher at the German Center for... Full Article
n How much oxygen is too much oxygen? By feeds.bmj.com Published On :: Thu, 01 Nov 2018 18:05:18 +0000 As the accompanying editorial to this article says, "oxygen has long been a friend of the medical profession Even old friendships require reappraisal in the light of new information." And that’s what a new rapid reccomendation - Oxygen therapy for acutely ill medical patients - does. To discuss we're joined by two of the authors, Reed Simieniuk,... Full Article
n HAL will see you now By feeds.bmj.com Published On :: Mon, 05 Nov 2018 14:17:12 +0000 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... Full Article
n Adverse drug reactions By feeds.bmj.com Published On :: Tue, 06 Nov 2018 15:53:33 +0000 Clinical trials for regulatory approval are designed to test efficacy, but new drugs might have adverse reactions - reactions those trials aren’t designed to spot. To talk about those adverse reactions - how to spot them, how to report them and what to do about them, we're joined by Robin Ferner, from the West Midlands Centre for Adverse Drug... Full Article
n 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
n 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
n Carers need a voice in the NHS By feeds.bmj.com Published On :: Thu, 22 Nov 2018 17:05:00 +0000 Until recently, The BMJ had a campaign of patient partnership - now we have a patient and public partnership campaign. The reason for that change is that medicine has an effect beyond the individual being treated - and this podcast interview is a very good example of that. Anya De Iong, patient editor for The BMJ, talks to Christine Morgan -... Full Article
n God is in Operating Room 4 By feeds.bmj.com Published On :: Tue, 27 Nov 2018 17:30:38 +0000 Healthy self confidence has an important role in surgery, but what came first - the surgeon or the ego? In this conversation, Christopher Myers, Yemeng Lu-Myers, and Amir Ghaferi join us to talk about the (very few) surgeons who behave badly in theatre, and why that behaviour has persisted, and can be detrimental. Read their full... Full Article
n The bone crushing nausea of hyperemesis By feeds.bmj.com Published On :: Sat, 01 Dec 2018 11:40:56 +0000 Nausea and vomiting in pregnancy affects around 70% of pregnancies. It is mild for around 40% of women, moderate for 46%, and severe for 14%. By contrast, hyperemesis gravidarum is a complication of pregnancy rather than a normal part of it and occurs in around 1.5% of pregnancies. The psychosocial burden of HG can be heavy for women and their... Full Article
n 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
n Making multisectoral collaboration work By feeds.bmj.com Published On :: Fri, 07 Dec 2018 22:30:54 +0000 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... Full Article
n 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
n Women in medicine at Christmas By feeds.bmj.com Published On :: Fri, 21 Dec 2018 15:44:51 +0000 2018 will go down in history as a year of reckoning as the year that that some men’s behaviour came back to bite them. The continuing impact of #MeToo across the world has prompted another round of thinking about women’s experiences in medicine, which can be seen this year’s christmas journal In this podcast, Esther Choo and Eleni Lenos, join us... Full Article
n Coding at Christmas By feeds.bmj.com Published On :: Fri, 04 Jan 2019 18:41:45 +0000 For many of you Christmas is over and, you’re back to work. Admin piled up over christmas? Feeling resentful for all those forms, and the weird codes they make you put in them? In this podcast I hope we can explain why that’s important, with 17th century death, the esoteria of reed codes, and why the WHO cares about spaceship... Full Article
n 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
n Terence Stephenson - looking back at chairing the GMC By feeds.bmj.com Published On :: Tue, 15 Jan 2019 06:14:17 +0000 Terence Stephenson is a consultant paediatrician who became been chair of the General Medical Council in 2015. His 4 year tenure has now come to an end, but during his time with the regulator the medical profession faced a number of challenges - the case of Hadiza Bawa Garba and a growing recruitment crisis in the NHS - the GMC is the... Full Article
n 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
n 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