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...

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...

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...

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...

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...

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...

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...

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...

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...

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,...

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...

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...

Mike Richards is well known in the UK - former Cancer Tzar, he now heads up the Care Quality Commission - regulator of all health and social care services, and therefore the body responsible for inspecting hospitals and GP practices. In this interview, BMJ’s head of news and views, Rebecca Coombes went to the CQC’s headquarters in London, and...

In this interview from Preventing Overdiagnosis 2017 (preventingoverdiagnosis.net) Stacy Carter, associate professor at Sydney Health Ethics - and the author of a recently written BMJ essay the ethical aspects of overdiagnosis, joins us to talk about how the cultural context of medicine seeps into our decision making processes and affects how...

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...

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...

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...

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,...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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,...

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 -...

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...

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...

More doctors are choosing to retire early, doctors who take career breaks find it hard to return to practice, and doctors at all stages of their careers are frustrated by the lack of support given to training and development in today’s NHS. Each year the BMJ holds a roundtable discussion at the Nuffield Summit - where health leaders come...

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....

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...

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...

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...

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...

Cannabinoid hyperemesis syndrome is a relatively newly recognised condition - but, according to one study, can account for up to 6% of patients presenting to emergency departments. The causal mechanism is as yet unclear - but currently the only known way to prevent the syndrome is for the patient to stop their cannabis use. Yaniv Chocron, chief...

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...

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...

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...

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...

Blockchain is the digital technology that underpins cryptocurrencies such as bitcoin, and has been proposed as the digital panacea of our times. But Leeza Osipenko, from the London School of Economics, has thought about how it could actually be used in clinical trials, and what else would need to change in our regulatory environment to make that...

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...

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 -...