HbA1c concentration is used as the biomarker for long term glycaemic control, however if the lifespan of red blood cells is altered, that may lead to an over, or under estimation of that control. In this podcast Ravinder Sodi, consultant clinical biochemist at University Hospitals of Morecambe Bay NHS Foundation Trust, explains when to suspect HbA1c is not an accurate measure of glycemic control, and what alternative tests are available. Read the full article: https://www.bmj.com/content/363/bmj...
Jan 15, 2019•18 min
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 gatekeeper for foreign doctors who who wish to work here. As the rules on EU doctors change, the GMC’s regulatory practice may have to change too. In this podcast,...
Jan 15, 2019•23 min
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 the podcast to talk about why a communist country would embrace a message from an icon of capitalism, and what attitudes toward financial conflicts of in...
Jan 09, 2019•25 min
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 accidents. Consumption, flux, and dropsy: counting deaths in 17th century London https://www.bmj.com/content/363/bmj.k5014 Christmas guide to clinical coding https://www.bm...
Jan 04, 2019•36 min
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 to discuss their research into mother's experiences of being doctors - and how discrimination is still rife against them. Also Sarah Lowry, from the Roy...
Dec 21, 2018•42 min
the Christmas BMJ season is upon us - if you’re to go to our website now, you’ll see that it’s been a bumper year. In the podcast, we’re going to be bringing you a select few - we’ll be looking at motherhood. Trying to figure out what 17th Century causes of death were, and - as it’s christmas - in this pod we’ll be looking at food. We talk to Frances Mason and Amanda Farley, from the University of Birmingham, about their RCT examining the “Effectiveness of a brief behavioural intervention to pre...
Dec 16, 2018•35 min
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 women. Deb joins us to talk about the massive, international, investigation into failing regulation for implantable devices - and shares some of the stories wher...
Dec 12, 2018•36 min
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 achieving effective multisectoral collaboration. In this podcast, Wendy Graham, professor of obstetric epidemiology at the London School of Hygiene and Tropical ...
Dec 07, 2018•46 min
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 associated with the marketing of specialist milk formula for children with cow’s milk protein allergy, and asks whether doctors organisations should be rece...
Dec 05, 2018•32 min
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 families. In this podcast, Caitlin Dean Phd Candidate, Gillian Ostrowski, general practitioner, Rebecca C Painter, consultant obstetrician join us to expl...
Dec 01, 2018•49 min
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 analysis: https://www.bmj.com/content/363/bmj.k4537
Nov 27, 2018•46 min
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 - independent chair of the Greater Manchester Carers Strategic Group. Christine has a mission to bring the needs of carers into thinking and planning about th...
Nov 22, 2018•28 min
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 trials, and how they reduce the readers appreciation of the adverse effects of these novel drugs. Read the full analysis: https://www.bmj.com/content/363/bm...
Nov 19, 2018•26 min
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 about stats, and rant about the unevidence based world in which we live. This week we talk about: Vitamin D https://www.thelancet.com/journals/landia/arti...
Nov 16, 2018•41 min
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 Reactions. Read the full practice article: https://www.bmj.com/content/363/bmj.k4051
Nov 06, 2018•31 min
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 future belongs to robot doctors - but Vanessa Rampton, Branco Weiss fellow at McGill Institute for Health and Social Policy, says they'll never be able to emul...
Nov 05, 2018•33 min
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, general internist at McMaster University and Gordon Guyatt, distinguished professor at McMaster University. Read the full recommendation: https://www.bm...
Nov 01, 2018•32 min
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 Neurodegenerative diseases, and Susanna Larsson, associate professor at the Karolinska Institutet. Read the full open access research: https://www.bmj.com/con...
Oct 30, 2018•17 min
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, patients or their families don’t fully understand the implication of that admission. To discuss, we're joined by Jamie Gross, consultant in intensive care m...
Oct 26, 2018•33 min
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 Mieke van Driel - GP in Australia and a professor of primary care at The University of Queensland, and An De Sutter - GP in Belgium and professor of family ...
Oct 14, 2018•22 min
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; that surgeons failed to set up mesh registries that would have identified complications sooner; and that the National Institute for Health and Clinical ...
Oct 12, 2018•30 min
There is very little guidance on withdrawing or tapering opioids in chronic pain (not caused by cancer). People can fear pain, withdrawal symptoms, a lack of social and healthcare support, and they may also distrust non-opioid methods of pain management. This can mean that patients receive repeat opioid prescriptions for extended periods of time. In this podcast, Harbinder Sandhu, health psychologist in pain management at Warwick Medical School, Andrea Furlan, associate professor of medicine at ...
Oct 11, 2018•30 min
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 for designing a more effective placebo, and asking whether it's time to start honestly prescribing placebos in the clinic. Read his full analysis: http...
Oct 06, 2018•28 min
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 disease in clinical trials may be getting so broad that outcomes are becoming less meaningful and harder to interpret. Read the full analysis: https://www.bmj...
Oct 03, 2018•29 min
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 - http://www.hbsc.org/ Also this week, as part of our coverage of the 70th anniversary of the founding of the NHS, we’ve been running a series of articles exploring...
Sep 28, 2018•35 min
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 Public Health England join us to discuss a “health in all policies” approach, with protected funding for preventive interventions. Read their full analy...
Sep 24, 2018•19 min
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 in part through her much-loved writing in the BMJ, Iona is unlike many of our previous guests. For a start, she loves words more than numbers, and lit...
Sep 18, 2018•25 min
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, and worries that the rise of populism is pushing evidence even further out of policy decision. Read the accompanying essay: https://www.bmj.com/content/...
Sep 17, 2018•28 min
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 controlled outpatient blood pressure. To discuss what they found, we're joined by Timothy Anderson, primary care research fellow, and Michael Steinman, ...
Sep 14, 2018•27 min
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 competing ideas to write articles to elucidate where there’s agreement, and where there is still contention. There was lots of disagreement - but one thing that...
Sep 07, 2018•36 min
