i Julia Beluz And Victor Montori - Journalists And doctors; separated by a common evidence By feeds.bmj.com Published On :: Thu, 23 Jun 2016 15:52:37 +0000 The same piece of evidence may reach you via a journalist, or via your doctor - but the way in which that evidence is communicated is changed by your relationship between that person. Julia Beluz from Vox and Victor Montori from the Mayo Clinic join us to discuss if it's possible to reconcile those competing points of view. Full Article
i Having hip osteoarthritis By feeds.bmj.com Published On :: Fri, 08 Jul 2016 16:25:01 +0000 2.46 million people in England have osteoarthritis of the hip, and many of those go on to eventually have a hip replacement - which is now widely considered one of the most commonly performed and successful operations in the world. Jessamy Bagenal, clinical fellow with The BMJ, talks to Nick Nicholas, an obstetrician who has had OA and one of... Full Article
i Treating hip osteoarthritis By feeds.bmj.com Published On :: Fri, 08 Jul 2016 16:26:00 +0000 2.46 million people in England have osteoarthritis of the hip, and many of those go on to eventually have a hip replacement - which is now widely considered one of the most commonly performed and successful operations in the world. Jessamy Bagenal, clinical fellow with The BMJ, talks to Nick Aresti, a specialist registrar in trauma and... Full Article
i Should we scrap the internal market in England's NHS By feeds.bmj.com Published On :: Fri, 15 Jul 2016 13:45:11 +0000 The "internal market" was created after the 1987 UK general election focused attention on inadequate funding in the NHS, long waiting lists for elective surgery, and large unwarranted variations in clinical care. Economists attributed these problems to a lack of incentives for efficiency, and the remedies offered included increasing competition... Full Article
i You've been ICE'd By feeds.bmj.com Published On :: Fri, 22 Jul 2016 11:24:02 +0000 We’re taught that patients' ideas, concerns, and expectations are central to a successful consultation, but has ICEing gone too far? A “What your patient is thinking” article published this week talks about the pressure that asking questions in the wrong way can put on a patient. Sophie Cook, education editor for The BMJ, is joined by the author... Full Article
i What went wrong with care.data? By feeds.bmj.com Published On :: Fri, 22 Jul 2016 16:20:00 +0000 Failures in implementation of data sharing projects have eroded public trust. In the wake of NHS England’s decision to close down its care.data programme, Tjeerd-Pieter van Staa professor of health e-research at the University of Manchester, examines what lessons must be learnt, and what we can do better next time. Read the full... Full Article
i How does maximizing shareholder value distort drug development? By feeds.bmj.com Published On :: Thu, 28 Jul 2016 09:01:43 +0000 With the emergence of sofobuvir, a new direct acting antiviral, treatment for Hepatitis C infection is currently undergoing it's greatest change since the discovery of the virus 25 years ago. However Gilead, who manufacture the treatment, are under fire for the cost of the druge - around $90 000 for a course of treatment. Victor Roy, doctoral... Full Article
i Likelihood ratios in diagnostic tests By feeds.bmj.com Published On :: Tue, 16 Aug 2016 15:24:50 +0000 Andrew Elder, a professor at the University of Edinburgh talks about likelihood ratios in diagnostic testing, and how they’re helpful in thinking about how context changes the predictive value of a test. This is part of a wider discussion on the evidence behind clinical examination of the cardiovascular system... Full Article
i A maladaptive pathway to drug approval By feeds.bmj.com Published On :: Fri, 19 Aug 2016 14:04:41 +0000 The European Medicines Agency (EMA) has embraced a new model of drug testing and marketing called “adaptive pathways”, allowing new drugs for “unmet medical needs” to be launched on the market faster, on the basis of fewer data. While industry claims this is necessary, an analysis on thebmj.com looks at the assumptions underlying the new pathway,... Full Article
i Not just our ethical credibility as a profession, but our shared humanity By feeds.bmj.com Published On :: Tue, 30 Aug 2016 10:30:57 +0000 "I say to all Australian doctors - young, old, the political and the apolitical - that on this depends not just our ethical credibility as a profession, but our shared humanity. " Following the leaked emails published in The Guardian newspaper, alleging abuse of asylum seekers detained by the Australian government on the Pacific island of Nauru,... Full Article
i Late effects of anticancer chemotherapy: It's hard to trust your body, after it's betrayed you By feeds.bmj.com Published On :: Thu, 08 Sep 2016 13:30:40 +0000 Lily was diagnosed at 14 years old with stage four Hodgkin's lymphoma and received six rounds of chemotherapy and two weeks of radiotherapy. She survived but now lives with the long term effects of that therapy - and joins us to discuss how it has impacted her quality of life. We're also joined by Saif Ahmad and Thankamma Ajithkumar, oncologists... Full Article
i Reprehensible, but the people carrying out atrocities have very low rates of mental disorders By feeds.bmj.com Published On :: Thu, 08 Sep 2016 14:46:46 +0000 Oversimplification and lack of evidence stigmatise people with mental illness and impede prevention efforts, says Simon Wessley, professor of psychiatry at King's College London, in an editorial published on thebmj.com. Read the full editorial: http://www.bmj.com/content/354/bmj.i4869 Full Article
i Middle East respiratory syndrome By feeds.bmj.com Published On :: Fri, 21 Oct 2016 15:25:24 +0000 Middle East respiratory syndrome (MERS) is an acute viral respiratory tract infection caused by the novel betacoronavirus. Cases have been limited to the Arabian Peninsula and its surrounding countries, and to travellers from the Middle East or their contacts. The clinical spectrum of infection varies from no symptoms or mild respiratory... Full Article
i Advertising junk food to children By feeds.bmj.com Published On :: Fri, 04 Nov 2016 17:18:13 +0000 In the UK, junk food advertising is banned on children’s TV - but manufactures are still able to target children in other ways. A recent report from the WHO "Tackling food marketing to children in a digital world", takes a look at the issue. In this podcast we're joined by João Breda, programme manager for nutrition physical activity and... Full Article
i Blinding the randomisation By feeds.bmj.com Published On :: Fri, 18 Nov 2016 15:58:27 +0000 Allocation concealment - blinding which arm of a trial a patient is randomised to - is being questioned in an analysis published on thebmj.com. David Torgerson, director of the York Trials Unit at the university of York and colleagues have been looking at the way in which trials do this randomisation, and how they subsequently report it - and... Full Article
i Evidence for vitamin D supplimentation By feeds.bmj.com Published On :: Fri, 25 Nov 2016 16:15:14 +0000 Despite high quality systematic reviews reporting ineffectiveness, many guideline groups continue to recommend vitamin D supplementation (with or without calcium) for fall or fracture prevention. Recently Public Health England recommended that everyone needs vitamin D equivalent to an average daily intake of 10 μg (400 IU) to protect bone and... Full Article
i Margaret McCartney wants to fix the NHS By feeds.bmj.com Published On :: Mon, 28 Nov 2016 17:15:18 +0000 Glasgow GP, writer, broadcaster, and The BMJ's weekly columnist Margaret McCartney joins us to talk about her new book "The State of Medicine: Keeping the Promise of the NHS". Read all of Margaret's columns: goo.gl/iKmmie Full Article
i Caring for renal transplant patients By feeds.bmj.com Published On :: Fri, 02 Dec 2016 18:28:42 +0000 Renal transplantation improves quantity and quality of life compared with chronic dialysis. A UK general practice with 8000 patients will have around four patients with a functioning renal transplant, one patient on the transplant waiting list, and several under consideration for transplantation. Many medical problems in renal transplant... Full Article
i Education round up - November By feeds.bmj.com Published On :: Wed, 07 Dec 2016 17:40:56 +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 new monthly audio round-up The BMJ’s clinical editors discuss what they have learned, and how they may alter their practice. In our second audio... Full Article
i Christmas 2016 - ideologies and moralities By feeds.bmj.com Published On :: Fri, 16 Dec 2016 18:10:32 +0000 In an ideal world, policies would be evidence based - but governments are made of humans, who have positions and ideologies and moral bases. In this podcast Anthony Painter, from the RSA will be talking about why universal basic income may work, but who’s proponents cross ideological barriers, and writer and philosopher AC Grayling explains how... Full Article
i Christmas 2016 - Health and happiness By feeds.bmj.com Published On :: Wed, 21 Dec 2016 11:59:28 +0000 Underneath all of our civilisation and science, we’re still primates - and the connection between patient and doctor can be reinforced by simply taking a hand. Robin Youngson, cofounder of hearts in healthcare, and Mitzi Blennerhassett, who has written extensively on patient engagement, have co-authored an editorial calling for the humanisation... Full Article
i Surrogate outcomes distorting medicine By feeds.bmj.com Published On :: Fri, 06 Jan 2017 18:47:05 +0000 Surrogate endpoints are commonly used in clinical trials to get quicker results, however Michael Baum, emeritus professor at University College London, worries that by not focusing on real outcomes - length of life, and quality of life - that these are being used to justify expensive treatments which may not benefit patients. Read the full... Full Article
i Should all American doctors be using electronic medical records? By feeds.bmj.com Published On :: Thu, 19 Jan 2017 17:40:39 +0000 Evidence shows using electronic health records can increase efficiency, and reduce preventable medical errors - but only if they are used properly. However, in the US, the president of the American Medical Association calls them almost unusable. In this debate, Richard Hurley is joined by George Gellert, Regional Medical Informatics Officer at... Full Article
i Helping patients with medically unexplained symptoms By feeds.bmj.com Published On :: Fri, 17 Feb 2017 16:59:25 +0000 Persistent physical symptoms are common and include those symptoms that last at least three months and are insufficiently explained by a medical condition after adequate examination and investigation. Observational studies in primary care report that women, especially those aged 35-45 years, more commonly present with these symptoms. In this... Full Article
i How people die remains in the memory of those who live on - supporting the relatives of the dying By feeds.bmj.com Published On :: Tue, 21 Feb 2017 11:00:38 +0000 All doctors, irrespective of their specialty or the setting in which they work, will care for patients who die. Around half of all deaths occur in hospitals. Evidence suggests that the quality of communication around this process is poorer in hospitals than in other settings, according to responses from relatives who have experienced bereavement.... Full Article
i The inadequacy of the UK's childhood obesity strategy By feeds.bmj.com Published On :: Thu, 02 Mar 2017 17:39:18 +0000 The UK government published its report Childhood Obesity: a Plan for Action, in August 2016. A new analysis article takes them to task for the inadequacy of that response to a growing problem. Neena Modi is a professor of neonatal medicine, at Imperial College London, and president of the Royal College of Paediatrics and Child Health, and joins... Full Article
i Palliative care is about life, not death By feeds.bmj.com Published On :: Fri, 03 Mar 2017 17:04:51 +0000 Scott Murray, professor of primary palliative care at the University of Edinburgh, has written, and talked in this podcast before, about the benefits of early palliative care - and today he’s back to explain how illness trajectory, and the pattern of decline at the end of life, affects 4 main areas of wellness - physical, social, psychological and... Full Article
i Emergency care plans at the end of life By feeds.bmj.com Published On :: Wed, 08 Mar 2017 16:48:04 +0000 When a person’s heart or breathing stops and the cause is reversible, immediate cardiopulmonary resuscitation (CPR) offers a chance of life. However, when a person is dying—for example, from organ failure, frailty, or advanced cancer—and his or her heart stops as a final part of a dying process, CPR will not prevent death and may do harm. But... Full Article
i Nuffield Summit 2017 - Reducing Demand By feeds.bmj.com Published On :: Thu, 16 Mar 2017 13:47:20 +0000 As the NHS strains under pressure from rising patient activity, an ageing population, and financial constraints, The BMJ hosted a discussion on how clinicians should be helping to manage demand at last week’s Nuffield Trust health policy summit. Taking part are: - Eileen Burns, president of the British Geriatrics Society - Andrew Fernando, GP... Full Article
i Identifying a viral rash in pregnancy By feeds.bmj.com Published On :: Fri, 17 Mar 2017 15:33:02 +0000 Viral exanthema can cause rash in a pregnant woman and should be considered even in countries that have comprehensive vaccination programmes. Measles and rubella can cause intrauterine death. Intrauterine infection with rubella can lead to congenital rubella syndrome in the liveborn baby. In this podcast, Jack Carruthers, honorary clinical... Full Article
i Education round up - HIV testing, legal highs and care for relatives of the dying By feeds.bmj.com Published On :: Fri, 17 Mar 2017 15:44:23 +0000 The BMJ publishes a lot of educational articles, and in an attempt to help you with your CPD, we have put together this round-up. Our authors and editors will reflect on the key learning points in the articles we discuss, and explain how they may change their practice in light of that new understanding. In this week's round up we're... Full Article
i American healthcare - what next? By feeds.bmj.com Published On :: Wed, 29 Mar 2017 09:10:02 +0000 For seven years, Republicans have vowed to repeal the Affordable Healthcare Act (Obamacare), and that promise took a central place in President Trump's campaign. The first major vote to replace it was due to happen last week, but was cancelled at the 11th hour. In advance of the potential vote, The BMJ published a debate asking "Should US doctors... Full Article
i High integrity child mental healthcare By feeds.bmj.com Published On :: Thu, 06 Apr 2017 14:54:29 +0000 Around 1 in 10 children and young people worldwide have mental health difficulties that substantially affect their lives. Child mental health services often concentrate on risk reduction, at the expense of the wider aspects of a child's wellbeing. As part of the high integrity healthcare series, this podcast focuses on novel ways of providing... Full Article
i Fighting inequality, corruption, and conflict - how to improve South Asia's health By feeds.bmj.com Published On :: Tue, 11 Apr 2017 15:29:46 +0000 The BMJ has published a series of articles, taking an in-depth look at health in South Asia. In this collection, authors from India, Pakistan, Nepal, Bangladesh, Sri Lanka, and Afghanistan collaborate to identify evidence-based solutions to shape health policy and interventions, and drive innovations and research in the region. In this podcast,... Full Article
i "We're kicking the can down the road" - how to get agreement on the future of the NHS By feeds.bmj.com Published On :: Wed, 12 Apr 2017 14:54:57 +0000 Our latest debate asks whether there should be a Royal Commission (a high level enquiry, with statutory powers) into the future of the NHS. A high level inquiry could detoxify the radical changes needed and command wide support, say Maurice Saatchi, conservative peer, and Paul Buchanan, The BMJ's patient editor; but Nigel Crisp, independent peer,... Full Article
i Assessing and treating an electrical injury By feeds.bmj.com Published On :: Thu, 13 Apr 2017 15:14:37 +0000 Thankfully, electrical injuries are relatively uncommon - but that means that lack of evidence regarding the management of patients who have been electrocuted, which can cause concern for clinicians when these patients present. In this podcast, Cath Brizzel, clinical editor for The BMJ, is joined by one of the authors of a clinical update on the... Full Article
i 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
i “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
i 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
i The magic of shared decision making By feeds.bmj.com Published On :: Tue, 09 May 2017 09:48:25 +0000 Adoption of shared decision making into routine practice has been remarkably slow, despite 40 years of research and considerable policy support. In 2010, the Health Foundation in the UK commissioned the MAGIC (Making Good Decisions in Collaboration) programme to design, test, and identify the best ways to embed shared decision making into... Full Article
i Helping patients with complex grief By feeds.bmj.com Published On :: Thu, 18 May 2017 16:44:07 +0000 Each individual’s grief process is unique, when confronted with the death of a loved one, most people experience transient rather than persistent distress - however 10% of bereaved individuals, with an increased risk following the death of a partner or child and loss to unnatural or violent circumstances, experience prolonged grief disorder. In... Full Article
i 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
i 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
i How to build a resillient health system By feeds.bmj.com Published On :: Thu, 08 Jun 2017 11:02:37 +0000 The 2014 west African Ebola epidemic shone a harsh light on the health systems of Guinea, Liberia, and Sierra Leone. While decades of domestic and international investment had contributed to substantial progress on the Millennium Development Goals, national health systems remained weak and were unable to cope with the epidemic. Margaret Kruk... Full Article
i "The interest of diesel drivers over the interest of the public" - tackling air pollution By feeds.bmj.com Published On :: Thu, 15 Jun 2017 16:47:27 +0000 Air pollution is a truly damaging environmental insult to the human body. The numbers of premature deaths, in the UK alone, that can be attributed to it are calculated to be 40,000 a year. Yet despite this, action to tackle the problem - as with the other huge environmental issue of our time, climate change - is distinctly lacking. Robin... Full Article
i 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
i 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
i 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
i 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
i Biomarkers - miracle or marketing? By feeds.bmj.com Published On :: Tue, 18 Jul 2017 16:20:32 +0000 The BMJ has been campaigning for an end to “too much medicine” - the pernicious effect of marketing on the range of tests and treatments that doctors offer patients - tests and treatments which are motivated by the financial reward to the system, than the health of the individual. A new analysis on BMJ.com takes a look at what’s happening in the... Full Article