v Gottfried Hirnschall is optimistic about ending the HIV epidemic By feeds.bmj.com Published On :: Thu, 15 Aug 2019 16:45:11 +0000 In 2001, Gottfried Hirnschall joined the WHO to work on the global response to HIV/AIDs, 18 years later he just retired as the director of WHO’s department for HIV and Hepatitis. The intervening period, almost half the time we’ve been aware of the disease the fight against the infection has been characterised by scientific breakthroughs, and... Full Article
v Talk Evidence - Tramadol, medical harm, and alexa By feeds.bmj.com Published On :: Wed, 21 Aug 2019 10:49:28 +0000 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... Full Article
v Physical activity and mortality - "The least active quartile did less than 5 minute per day" By feeds.bmj.com Published On :: Fri, 23 Aug 2019 14:29:32 +0000 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... Full Article
v The government is lacking detail over Brexit planning By feeds.bmj.com Published On :: Wed, 04 Sep 2019 17:43:31 +0000 Brexit. Who knows what’s going to happen in the next few weeks, months, years - the uncertainty is high. In the face of that, you’d hope that the government was doing all it could to plan for any eventuality - let alone for a massive, country altering one like suddenly crashing out without a deal - but Martin McKee, professor of public health at... Full Article
v Vaping deaths - does this change what we think about public health messages By feeds.bmj.com Published On :: Thu, 12 Sep 2019 16:58:18 +0000 This week the Trump administration has banned the sale of flavoured vapes in the USA. The reason for that is the sudden rash of cases of pulmonary disease, including deaths, linked to vaping. The mechanism by which vaping may be causing damage to the lungs is as yet unclear, and our understanding is hampered by the heterogeneous nature of the... Full Article
v Cancer drug trials used for regulatory approval are at risk of bias By feeds.bmj.com Published On :: Thu, 19 Sep 2019 14:09:14 +0000 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... Full Article
v Talk Evidence - Recurrent VTE, CRP testing for COPD, CMO report, and a consultation By feeds.bmj.com Published On :: Mon, 23 Sep 2019 10:21:58 +0000 Helen talks about new research on prevention of recurrent VTE - and Carl things the evidence goes further, and we can extend prophylaxis for a year. 13.00 - CRP testing for antibiotic prescription in COPD exacerbations, should we start doing it in primary care settings - and what will that mean. We also hear from Chris Butler, one of the... Full Article
v Climate change will make universal health coverage precarious By feeds.bmj.com Published On :: Tue, 24 Sep 2019 14:26:52 +0000 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... Full Article
v Talk Evidence - eating less, drinking less, drug approval data By feeds.bmj.com Published On :: Fri, 04 Oct 2019 16:41:57 +0000 Talk Evidence is back, with your monthly take on the world of EBM with Duncan Jarvies and GPs Carl Heneghan (also director for the Centre of Evidence Based Medicine at the University of Oxford) and Helen Macdonald (also The BMJ's UK research Editor). This month Carl talks about evidence that restricting your diet might improve health at a... Full Article
v A new way to look at behaviour change in UK GPs By feeds.bmj.com Published On :: Tue, 08 Oct 2019 14:52:42 +0000 In quality improvement, measurement is seen as a key driver of change - how well do you know you’re doing, if you can’t actually measure it. So, when something changes in the NHS (say a new guideline) how can you tell how quickly that’s filtering down to the front line. Ben goldacre, from the Nuffield Department of Primary Care Health Sciences... Full Article
v How Blockchain could improve clinical trial transparency By feeds.bmj.com Published On :: Sat, 12 Oct 2019 13:06:50 +0000 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... Full Article
v Ancestry DNA tests can over or under estimate genetic disease risk By feeds.bmj.com Published On :: Thu, 17 Oct 2019 14:36:18 +0000 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... Full Article
v Statins for primary prevention - How good is the evidence By feeds.bmj.com Published On :: Mon, 21 Oct 2019 10:12:15 +0000 Statins are now the most commonly used drug in the UK and one of the most commonly used medicines in the world, but debate remains about their use for primary prevention for people without cardiovascular disease. Paula Byrne from the National University of Ireland Galway, joins us to talk about the evidence of benefit for low risk individuals,... Full Article
v 20 Arnav Agarwal By feeds.bmj.com Published On :: Tue, 22 Oct 2019 22:59:17 +0000 This week, Dr Arnav Agarwal joins Ray to share the perspective and experiences of a young, recently graduated doctor working in a busy, metropolitan hospital. Despite the long shifts and demanding environment, Arnav makes time and space to reflect on work, life and mortality through his thought-provoking poetry and volunteer work. Full Article
v Talk Evidence - aggravating acronyms, a time to prescribe, and screening (again) By feeds.bmj.com Published On :: Mon, 11 Nov 2019 11:51:44 +0000 Talk Evidence is back, with your monthly take on the world of EBM with Duncan Jarvies and GPs Carl Heneghan (also director for the Centre of Evidence Based Medicine at the University of Oxford) and Helen Macdonald (also The BMJ's UK research Editor). This month Helen talks about the messy business of colon cancer screening - which modality is... Full Article
v Reversing our preconceptions about where innovation comes from By feeds.bmj.com Published On :: Thu, 14 Nov 2019 16:51:19 +0000 Reverse innovation may sound like some attempt to return to the dark ages - but it has a specific meaning, especially when it comes to med-tech. It’s about where we look for innovation - and overturning our preconceived ideas of where new ideas come from. Mark Skopec, and Matthew Harris - both from Imperial College London are two of the authors... Full Article
v Talk Evidence - Talking about harms By feeds.bmj.com Published On :: Fri, 13 Dec 2019 18:18:10 +0000 In this special edition of talk evidence, Helen Macdonald and Carl Henneghan talk about creating an evidence base from harms. We hear from a member of the pubic who experienced harm from a drug, and now advises the FDA. A former regulator who explains why reporting harms is so important. And finally, an investigative journalist who explains what... Full Article
v Talk Evidence - digital clubbing, osteoarthritis & sustainable EBM By feeds.bmj.com Published On :: Mon, 16 Dec 2019 19:36:54 +0000 We’re back for the December Talk Evidence, and this month we’re being very digital Firstly,(1.20) Helen tells us about arthritic fingers - should we be using prednisolone for treatment when people have painful osteoarthritis of the hand Then (13.30) Carl gets us all to check our fingers for clubbing, and we find out how useful it is as a test... Full Article
v Talk Xmas Evidence By feeds.bmj.com Published On :: Tue, 31 Dec 2019 14:52:53 +0000 Welcome to the festive talk evidence, giving you a little EBM to take you into the new year. As always Duncan Jarvies is joined by Helen Macdonald (resting GP and editor at The BMJ) and Carl Heneghan (active GP, director of Oxford University’s CEBM and editor of BMJ Evidence) This month: (2.00) Helen look back at a Christmas article, which... Full Article
v From dance class to social prescription - starting and evaluating an idea By feeds.bmj.com Published On :: Tue, 07 Jan 2020 10:47:03 +0000 If you read the Christmas BMJ in the last few weeks, you might have noticed a lot around art and health - the way in which engagement in arts can help in prevention and treatment, but can also affect those more nebulous things which really matter to patients - loneliness, self expression, being connected to the wider community. That obviously... Full Article
v Is it possible to have fair pricing for medicines By feeds.bmj.com Published On :: Fri, 17 Jan 2020 17:50:54 +0000 Is it possible to have a fair price for medicines? Yes, according to a new collection just published on bmj.com. The authors set out to evaluate how we could improve the functioning of the market for medicines, to honestly compensate industry for innovation, whilst allowing the poorest to afford them. Suerie Moon, co-director of global health at... Full Article
v Surviving childhood cancer treatment By feeds.bmj.com Published On :: Tue, 21 Jan 2020 13:21:18 +0000 In a British cohort, 30% of patients who had survived childhood cancer had died within 45 years of diagnosis; only 6% were expected to have died. 51% had developed a new primary cancer, but a 26% died of cardiovascular disease - thought to be caused by their treatment. Consequently, efforts to reduce long term mortality have focused on reducing... Full Article
v Talk Evidence - Sepsis, talc and blindsided by blinding By feeds.bmj.com Published On :: Wed, 22 Jan 2020 17:40:40 +0000 Welcome to the festive talk evidence, giving you a little EBM to take you into the new year. As always Duncan Jarvies is joined by Helen Macdonald (resting GP and editor at The BMJ) and Carl Heneghan (active GP, director of Oxford University’s CEBM and editor of BMJ Evidence)* This month: (1.20) Carl tells us about new research on treating... Full Article
v Prevalence and treatment of precocious puberty By feeds.bmj.com Published On :: Tue, 28 Jan 2020 17:19:40 +0000 Precocious puberty, that is puberty that starts before age 8 in girls and 9 in boys seems to be on the rise, but whether that’s because of an increase in incidence, or greater attention is unknown - what we do know that precocious puberty in girls is commonly idiopathic, while in boys is a red flag for pathology. But either way ther first point of... Full Article
v QI and improvement are not synonyms By feeds.bmj.com Published On :: Fri, 31 Jan 2020 18:17:26 +0000 In October 2019, Mary Dixon-Woods, director of the THIS Institute, dedicated to healthcare improvement. In that she explained how she believed healthcare improvement could be improved. The essay took the position that "Quality Improvement" isn't necessarily the best way to improve healthcare, and that more rigour needs to be brought to the field.... Full Article
v David Williams - everyday discrimination is an independent predictor of mortality By feeds.bmj.com Published On :: Thu, 13 Feb 2020 12:44:12 +0000 There comes a tipping point in all campaigns when the evidence is overwhelming and the only way to proceed is with action. According to David Williams, it’s time to tackle the disproportionate effects of race on patients in the UK. David Williams, from Harvard University, developed the Everyday Discrimination Scale that, in 1997, launched a new... Full Article
v Talk Evidence - Building an evidence base for covid-19 By feeds.bmj.com Published On :: Mon, 17 Feb 2020 15:22:17 +0000 We're taking a break from the usual Talk Evidence to focus on the new corona virus that has emerged in China. With a brand new disease, we have to build our evidence base from scratch - basic virology, epidemiology, pathogenicity, transmissibility, and ultimately treatment are all unknowns. In this episode of Talk Evidence, we're trying to get... Full Article
v Yvonne Coghill is trying to fix racism in the NHS By feeds.bmj.com Published On :: Fri, 28 Feb 2020 11:59:19 +0000 In this week's special episode of Sharp Scratch, we've got something a little different for you! Last week the panel talked microaggressions, so this week we're hearing from an expert guest who is leading the work the NHS is doing to combat inequality in healthcare. If you like this special edition, let us know on Facebook, Instagram or Twitter... Full Article
v For a greener NHS - a call for evidence By feeds.bmj.com Published On :: Sat, 14 Mar 2020 12:46:26 +0000 The NHS is a world leader in sustainable healthcare - and it's the staff who have have been leading the charge. The For A Greener NHS campaign is asking everyone who has made a change to the way they work, to submit evidence and help shape the whole organisation's response to the climate emergency. In this podcast, Isobel Braithwaite, public... Full Article
v Talk Evidence - testing under the microscope and opioid prescription By feeds.bmj.com Published On :: Fri, 20 Mar 2020 20:08:10 +0000 This edition of talk evidence was recorded before the big increase in covid-19 infections in the UK, and then delayed by some self isolation. We'll be back with more evidence on the pandemic very soon. As always Duncan Jarvies is joined by Helen Macdonald (resting GP and editor at The BMJ) and Carl Heneghan (active GP, director of Oxford... Full Article
v Organisational kindness during covid-19 By feeds.bmj.com Published On :: Thu, 26 Mar 2020 11:52:48 +0000 Reports from Italy, and more recently from the U.S. show the strain the healthcare system is under during this pandemic. We know that staff will step up in an emergency, but this isn’t a fire or a bombing, this is going to last for months. So how can organisations be proactive in supporting staff, and how can leaders try to mitigate the... Full Article
v Talk Evidence Covid-19 update - Confused symptoms, fatality rate uncertainty, Iceland's testing By feeds.bmj.com Published On :: Fri, 27 Mar 2020 16:14:17 +0000 For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give... Full Article
v WHO's response to covid-19 By feeds.bmj.com Published On :: Sun, 05 Apr 2020 17:01:53 +0000 We knew a pandemic was coming at some point - it’s kind of why we have the WHO. We have had various smaller scale tests of the international response to an infectious disease outbreak - Ebola in west africa being the most recent. After that, reports criticised the WHO's response - citing problems around the swiftness of their action, the lack of... Full Article
v Look after yourself during covid-19 By feeds.bmj.com Published On :: Tue, 07 Apr 2020 14:44:42 +0000 Continuing our series on wellbeing during the pandemic, in this podcast we speak to Occupational Psychologist Roxane Gervais about how doctors can look after themselves during the covid-19 pandemic. We discuss the importance of reaching out to friends and family during this difficult time, how to deal with the loss of control, as well how to... Full Article
v Wellbeing - Some advice on working in PPE By feeds.bmj.com Published On :: Wed, 08 Apr 2020 17:38:56 +0000 Wellbeing might not seem the obvious place to talk about PPE - but lack of appropriate PPE is causing healthcare staff a great deal of stress now. Mary Brindle is a pediatric surgeon and the director of The EQuIS (Efficiency Quality Innovation and Safety) Research platform at Alberta Children’s hospital. In this podcast she reflects on the use... Full Article
v Talk Evidence covid-19 update - pneumonia, guidelines, preprints and testing By feeds.bmj.com Published On :: Thu, 09 Apr 2020 09:53:16 +0000 For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give... Full Article
v The public health response to covid - 19 By feeds.bmj.com Published On :: Sun, 12 Apr 2020 19:40:26 +0000 As part of our response to the covid-19 pandemic, we’re going to be running a series of discussions with experts about some of the big issues arising from the virus. In this one, we’re asking about the public health response to an outbreak - what’s necessary, and is it possible to go to far. Joining us are Martin Mckee - professor of european... Full Article
v Talk Evidence covid-19 update - hydroxy/chloroquinine, prognostic models and facemaskss By feeds.bmj.com Published On :: Mon, 13 Apr 2020 20:39:17 +0000 For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give... Full Article
v Wellbeing - some advice for telehealth in secondary care By feeds.bmj.com Published On :: Thu, 16 Apr 2020 18:30:00 +0000 We’ve published info on Telehealth in primary care - and have been overwhelmed by the response from GPs who are finding it useful. But it’s not only primary care that is dramatically shifting to remote care - routine hospital care is moving online too, so we’ve asked Rowena McCash - GP and out of hours triage trainer joins us to give some tips... Full Article
v Talk Evidence - Remdesivir, care homes, and death data By feeds.bmj.com Published On :: Fri, 17 Apr 2020 15:00:49 +0000 For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give... Full Article
v Wellbeing – advice from a military medic to frontline clinicians By feeds.bmj.com Published On :: Wed, 22 Apr 2020 11:53:26 +0000 There is no doubt that anxiety levels that clinicians are feeling during this pandemic are high. One military medic believes the current situation is comparable to his experience when posted during British campaigns in Afghanistan and Iraq. Cormac Doyle offers advice on how to deal with high-stress conditions, both in a work and at home, as... Full Article
v Teleconsulting with Trish Greenhalgh and Fiona Stevenson By feeds.bmj.com Published On :: Wed, 22 Apr 2020 17:41:46 +0000 A new podcast from The BMJ, to help GP's feel more connected, heard, and supported. Subscribe on; Apple podcasts - https://bit.ly/applepodsDBI Spotify - https://bit.ly/spotifyDBI Google podcasts - https://bit.ly/googlepodsDBI In our first episode, we discuss the highs and lows of video consultations, and how coronavirus has altered the landscape... Full Article
v Talk Evidence - covid ethics, waste and a minimum RCT size By feeds.bmj.com Published On :: Fri, 24 Apr 2020 16:19:18 +0000 For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give... Full Article
v Frontline stories - working as a GP during covid By feeds.bmj.com Published On :: Mon, 27 Apr 2020 16:56:13 +0000 As the pandemic plays out - the way in which doctors in the UK practice is changing, hospitals are reconfigured to increase critical care capacity, GPs are working from home and doing their day to day work remotely. Some of the changes have come at the detriment of staff and patient wellbeing but covid-19 has also helped cut through some of the... Full Article
v Public Health Vs The Economy By feeds.bmj.com Published On :: Tue, 28 Apr 2020 17:49:55 +0000 Around the world, as the covid pandemic plays out, and some countries are starting to ease their restrictions, this narrative of the economy and public health being opposing weights on a set of scales keeps returning - they need to be balanced. But before this, a healthy population is very much seen as being supportive of the economy. So is a... Full Article
v Talk Evidence covid-19 update - lack of testing transparency, how to give good debate By feeds.bmj.com Published On :: Mon, 04 May 2020 16:25:18 +0000 For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give you... Full Article
v Frontline stories - caring for non-covid patients By feeds.bmj.com Published On :: Tue, 05 May 2020 19:32:52 +0000 As the pandemic plays out - hospitals are reconfigured to increase critical care capacity, outpatient clinics become virtual, and elective procedures delayed. How are these affecting care for those who are in hospital but don't have covid-19? In this podcast, Matt Morgan,honorary senior research fellow at Cardiff University, consultant in... Full Article
v Coping with Covid with Monica Schoch-Spana and Jud Brewer By feeds.bmj.com Published On :: Wed, 06 May 2020 23:27:26 +0000 In this week’s episode, we discuss bystander guilt, convergence, brain hacks and “how you can sneeze on someone’s brain from anywhere in the world”. How can GPs cope with the myriad worries around treating patients during the current pandemic, both on the frontline and in general practice? How do we recognise and break unhelpful anxious behaviour... Full Article
v Wellbeing – coping with Covid fatigue By feeds.bmj.com Published On :: Fri, 08 May 2020 10:00:46 +0000 We are more than six weeks into the lockdown and if you were to gauge the mood of the nation, it would be one of fatigue. It started as an all-hands-on-deck emergency situation, but it now transpires that the current work situation for healthcare professionals is not going to change any time soon. This is a marathon rather than a sprint. So how... Full Article
v Talk evidence covid-19 update: natural history of covid, include patients in guidelines By feeds.bmj.com Published On :: Sat, 09 May 2020 09:13:00 +0000 For the next few months Talk Evidence is going to focus on the new corona virus pandemic. There is an enormous amount of uncertainty about the disease, what the symptoms are, fatality rate, treatment options, things we shouldn't be doing. We're going to try to get away from the headlines and talk about what we need to know - to hopefully give you... Full Article