en 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
en 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
en 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
en MVA85A trial investigation - press conference. By feeds.bmj.com Published On :: Thu, 11 Jan 2018 18:34:38 +0000 Trial MVA85A - monkey trials for a booster vaccine for BCG, developed by researchers at Oxford University, is the subject of an investigation published on bmj.com. Experts warn that today’s investigation is just one example of “a systematic failure” afflicting preclinical research and call for urgent action “to make animal research more fit for... Full Article
en Virginia Murray - the science of disaster risk reduction By feeds.bmj.com Published On :: Wed, 24 Jan 2018 10:42:11 +0000 Virginia Murray, public health consultant in global disaster risk reduction at Public Health England, was instrumental in putting together the Sendai Framework for Disaster Risk Reduction - an international agreement which aims to move the world from reacting to disasters, to proactively preventing them. In this podcast, she explains what they... Full Article
en How does it feel, to help your patient die? By feeds.bmj.com Published On :: Thu, 08 Feb 2018 11:55:00 +0000 Sabine Netters is an oncologist in The Netherlands - where assisted dying is legal. There doctors actually administer the drugs to help their patients die (unlike proposed legislation in the UK). In this moving interview, Sabine explains what was going through her head, the first time she helped her patient die - and how in the subsequent years,... Full Article
en How to stop generic drug price hikes (or at least reduce them) By feeds.bmj.com Published On :: Fri, 23 Mar 2018 16:27:36 +0000 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... Full Article
en Online Consultations - general practice is primed for a fight By feeds.bmj.com Published On :: Wed, 28 Mar 2018 15:28:48 +0000 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... Full Article
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en 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
en Assisted dying: should doctors help patients to die? By feeds.bmj.com Published On :: Mon, 04 Feb 2019 15:28:01 +0000 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... Full Article
en Should we be screening for AF? By feeds.bmj.com Published On :: Thu, 14 Feb 2019 17:38:45 +0000 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... Full Article
en Talk Evidence - Radiation, fertility, and pneumonia By feeds.bmj.com Published On :: Wed, 27 Feb 2019 09:54:48 +0000 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 how difficult a task it is to find evidence that's definitely practice changing, what GPs can learn from Malawian children with nonsevere fast-breathing pneumonia, how radiation dosage varies... Full Article
en Talk Evidence - Shoulders, statins and doctors messes By feeds.bmj.com Published On :: Thu, 28 Mar 2019 08:37:29 +0000 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)... Full Article
en Capital punishment, my sixth great grandfather, and me By feeds.bmj.com Published On :: Tue, 09 Apr 2019 16:49:48 +0000 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... Full Article
en Talk Evidence - health checks, abx courses and p-values By feeds.bmj.com Published On :: Wed, 17 Apr 2019 16:57:31 +0000 Helen Macdonald and Carl Heneghan are back again talking about what's happened in the world of evidence this month. (1.20) Carl grinds his gears over general health checks, with an update in the Cochrane Library. (9.15) Helen is surprised by new research which looks at over prescription of antibiotics - but this time because the courses... Full Article
en Could open access have unintended consequences? By feeds.bmj.com Published On :: Fri, 19 Apr 2019 11:43:04 +0000 An “author pays” publishing model is the only fair way to make biomedical research findings accessible to all, say David Sanders, professor of gastroenterology at Sheffield University, but James Ashton and worries that it can lead to bias in the evidence base towards commercially driven results - as those are the researchers who can pay for open... Full Article
en Introducing Sharp Scratch - our new podcast for students and junior doctors By feeds.bmj.com Published On :: Fri, 26 Apr 2019 16:22:39 +0000 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... Full Article
en Helping parents with children who display challenging behaviour By feeds.bmj.com Published On :: Fri, 17 May 2019 14:50:07 +0000 Looking after a young child is hard enough, but when that child has learning difficulties and displays challenging behaviour - the burden on parents can be extreme. That behaviour may prompt a visit to the doctor, and in this podcast we’re talking about how parents can be supported in that - what services are available. We’ll also be discussing... Full Article
en Talk evidence - cancer causing food, prostate cancer and disease definitions By feeds.bmj.com Published On :: Sat, 25 May 2019 12:11:43 +0000 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... Full Article
en Finding out who funds patient groups By feeds.bmj.com Published On :: Wed, 29 May 2019 16:32:22 +0000 We’ve been banging the drum about transparency of payment to doctors for years - we’ve even put a moratorium on financial conflicts of interest in the authors of any of our education articles. Not because we think that all doctors who receive money from industry are being influenced to push their agenda - but because we have no way of telling when... Full Article
en Talk Evidence - Z drugs, subclinical hypothyroidism and Drazen's dozen By feeds.bmj.com Published On :: Tue, 25 Jun 2019 16:58:44 +0000 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... Full Article
en After Grenfell By feeds.bmj.com Published On :: Mon, 01 Jul 2019 12:00:11 +0000 It's been just over two years since a fire broke out in Grenfell tower, in west London, claiming the lives of 72 residents. 223 people survived, thanks to the work of the fire brigade and health care. In this podcast we hear from Andrew Roe, assistant commissioner at London Fire Brigade, and Anu Mitra, consultant emergency physician at St Mary's... Full Article
en I have never encountered an organisation as vicious in its treatment of whistleblowers as the NHS By feeds.bmj.com Published On :: Thu, 04 Jul 2019 10:23:06 +0000 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... Full Article
en Talk evidence - smoking, gloves and transparency By feeds.bmj.com Published On :: Wed, 10 Jul 2019 11:11:50 +0000 This month we have some more feedback from our listeners (2.20) Carl says it's time to start smoking cessation (or stop the reduction in funding for smoking reduction) (11.40) and marvels at how pretty Richard Doll's seminal smoking paper is. It's gloves off for infection control (22.20) Andrew George, a non-executive director of the Health... Full Article