In the US the licence, or marketing authorisation, for alteplase is limited to 0-3 hours after onset of stroke, but some other countries - including the UK and Australia - have extended the licence to 4.5 hours. In an analysis article on thebmj.com Brian Alper, vice president of evidence based medicine research and development at Dynamed, and colleagues, interpret the evidence to suggest increased mortality with uncertain benefit for its use beyond three hours. Read their full analysis: http://w...
Mar 18, 2015•16 min
Chris Moulton is VP of the Royal College of Emergency Medicine and an A&E consultant in the Royal Bolton Hospital. He believes that the majority of patients who attend A&E cannot be adequately treated elsewhere, and that measures to try and reduce emergency presentations may be counterproductive. If you would like to contribute to this collection, please email a brief audio recording to voices@bmj.com or phone +44 (20) 3058 7427 and tell us what your main concern for the NHS is. Please i...
Mar 11, 2015•2 min
BMJ Voices is a collection of readers’ experiences of working in the NHS. For this, The BMJ is seeking short audio submissions from UK listeners. These submissions will be published on thebmj.com. Patrick Keating, a GP from Enfield, is concerned that small practices are under pressure to increase list size, but aren't able to muster resources to meet this increased demand. If you would like to contribute to this collection, please email a brief audio recording to voices@bmj.com or phone +44 (20)...
Mar 11, 2015•1 min
Obioma Ezekobe is a GP in an urgent care centre in Central Middlesex Hospital. She believes that the public need to be educated about the use of NHS resources, and be taught when it is appropriate to seek care. If you would like to contribute to this collection, please email a brief audio recording to voices@bmj.com or phone +44 (20) 3058 7427 and tell us what your main concern for the NHS is. Please include your name, job title, and place of work.
Mar 11, 2015•2 min
Katherine Henderson is the clinical lead of the emergency department at St Thomas's hospital in London. She worries that lack of ward space is having a domino effect throughout A and E and is the cause of increased waiting time for both patients and ambulances. If you would like to contribute to this collection, please email a brief audio recording to voices@bmj.com or phone +44 (20) 3058 7427 and tell us what your main concern for the NHS is. Please include your name, job title, and place of wo...
Mar 11, 2015•3 min
Abdominal aortic aneurysms (AAA) are usually asymptomatic until they rupture, which is fatal in more than 80% of cases. Screening aims to detect the aneurysm before it ruptures, enabling preventive surgery and hence reducing morbidity and mortality. However, preventive surgery has a mortality of 3.9-4.5%. As the prevalence of risk factors, ie smoking, decreases and the definition of the condition is expanded, Minna Johansson from the University of Gothenburg and colleagues wonder if the balance ...
Mar 06, 2015•8 min
Ashish Jha, professor of health policy and management at Harvard School of Public Health, talking about how the Affordable Care Act has fostered new models of integrated service delivery in the United States Read more from the summit: http://www.bmj.com/content/350/bmj.h1172
Mar 05, 2015•7 min
Bastiaan Bloem, consultant neurologist at Radboud University Nijmegen Medical Centre, Netherlands, discussing his revolutionary approach to patient centred care. Read more from the summit: http://www.bmj.com/content/350/bmj.h1172
Mar 05, 2015•14 min
Overdiagnosis means different things to different people. Stacy Carter, associate professor at the Centre for Values, Ethics and the Law in Medicine at the University of Sydney argues that we should use a broad term such as too much medicine for advocacy and develop precise, case by case definitions of overdiagnosis for research and clinical purposes. Read the full analysis article: http://www.bmj.com/content/350/bmj.h869 For the full overdiagnosis digital edition: http://www.bmj.com/specialties...
Mar 05, 2015•17 min
In this podcast Alexandra Barratt, professor of public health at the University of Sydney, discusses how questions about overdiagnosis in breast cancer screening programmes were first raised 45 years ago, and why it has taken so long for the concept to become mainstream. Read her full analysis: http://www.bmj.com/content/350/bmj.h867
Mar 04, 2015•21 min
The BMJ held a breakfast roundtable at the annual health policy summit held by the Nuffield Trust think tank to explore some of the key policy discussions that took place during the proceeding day. These included NHS England chief executive Simon Stevens' five year plan, whether politics can be removed from the NHS, and what the creation of a central unit to coordinate care for Manchester means for the rest of the NHS in England. Chaired by Fiona Godlee, editor in chief of The BMJ, the particp...
Feb 27, 2015•45 min
As the level of alcohol consumption goes up, so the risk of physical, psychological, and social problems increases. In this podcast we’re joined by Ed Day, consultant addiction psychiatrist at Kings College London, Alex Copello, professor of addiction research at the University of Birmingham, and Martyn Hull, GP with a special interest in substance misuse at the Ridgacre Medical Centres in Birmingham. They discuss practical aspects of the assessment and treatment of alcohol use disorders from th...
Feb 19, 2015•34 min
Jackie Applebee is a GP in Tower Hamlets in London, and is concerned that the way the GP funding formula is working doesn't take account of the earlier health needs of people in deprived areas. For more about the Tower Hamlets Save Our Surgery campaign, visit their facebook page https://www.facebook.com/SaveOurGPsurgeries BMJ Voices is a collection of readers’ experiences of working in the NHS. For this, The BMJ is seeking short audio submissions from UK listeners. These submissions will be publ...
Feb 13, 2015•5 min
Mark Folman, a GP in Nottinghamshire, is concerned that more and more work, with more and more patients, means less time with those who really need him. BMJ Voices is a collection of readers’ experiences of working in the NHS. For this, The BMJ is seeking short audio submissions from UK listeners. These submissions will be published on thebmj.com. If you would like to contribute to this collection, please email a brief audio recording to voices@bmj.com or phone +44 (20) 3058 7427 and tell us wha...
Feb 13, 2015•3 min
Michelle Sinclar, a GP in Hampshire who is concerned that GP premises aren't fit for purpose and limit her ability to provide fully rounded patient care. BMJ Voices is a collection of readers’ experiences of working in the NHS. For this, The BMJ is seeking short audio submissions from UK listeners. These submissions will be published on thebmj.com. If you would like to contribute to this collection, please email a brief audio recording to voices@bmj.com or phone +44 (20) 3058 7427 and tell us wh...
Feb 13, 2015•3 min
Participants in our discussion on person centred care in January agreed that a change in culture and better use of technology could benefit both patients and doctors. At the roundtable: Fiona Godlee (chair), editor in chief, The BMJ Tessa Richards, senior editor, patient partnership, The BMJ Rosamund Snow, patient editor, The BMJ Navjoyt Ladher, clinical editor, The BMJ Angela Coulter, director of global initiatives, Informed Medical Decisions Foundation (www.informedmedicaldecisions.org) Paul W...
Feb 10, 2015•1 hr 18 min
In our accompanying roundtable discussion,we hear views from a group of patients and clinicians based largely in the UK on the actions required to advance progress towards providing patient centred care. To extend the conversation we talked to members of the BMJ's international patient advisory panel and other patient advocates - and what follows are short clips of hour long conversations with people in the US, Europe, India, Equador and Uganda. While the quality of the recordings vary there is ...
Feb 10, 2015•52 min
Karen Grépin, assistant professor of global health policy at New York University, has been examining the pledges made by the international community to help fight the ebola virus outbreak - was it really too little, too late? Read her full analysis: http://www.bmj.com/content/350/bmj.h376
Feb 04, 2015•15 min
Katie Sidle is a consultant neurologist at the National Hospital for Neurology and Neurosurgery, in London. She helped actor Eddie Redmayne in his portrayal of theoretical physicist and cosmologist Stephen Hawking in the film The Theory of Everything. She joins us to describe how that process worked, and what Motor Neurone Disease patients thought about how their condition was depicted. Read the feature: http://www.bmj.com/content/350/bmj.h483
Feb 03, 2015•7 min
Bone pain is the most common type of pain from cancer and is present in around one third of patients with bone metastases, currently, improvements in cancer treatments mean that many patients are living with metastatic cancer for several years. Christopher Kane, NIHR academic clinical fellow in palliative medicine at Leeds University School of Medicine, and Michael Bennett, St Gemma’s professor of palliative medicine at University College London join us to discuss the management of cancer induce...
Jan 30, 2015•19 min
Private hospital chains have been “buying” referrals by offering clinicians lucrative packages, including free facilities in sought after locations. And the doctors’ regulator is turning a blind eye to those who are tempted, Reporter Jonathan Gornall joins us to discuss the investigation. Read the full report: http://www.bmj.com/content/350/bmj.h396
Jan 29, 2015•14 min
Multimorbidity presents a number of different challenges, for the patients living with the conditions, but also for the health professionals caring for them in systems that often are not designed with these more complex needs in mind. Emma Wallace, general practice lecturer, and Susan Smith, a professor of general practice at the Royal College of Surgeons in Ireland Medical School join us to discuss how to work within the system, and what their dream scenario for care would be. Read the full cli...
Jan 23, 2015•18 min
Philipe de Souto Barreto argues that, to reduce premature mortality, policies should focus on getting fully inactive people to do a little physical activity rather than strive for the entire population to meet current physical activity recommendations. Read the full analysis paper: http://www.bmj.com/content/350/bmj.h23
Jan 22, 2015•10 min
Dominique Thompson, GP and director of the Students’ Health Service at the University of Bristol, is concerned that young people's health is being neglected. BMJ Voices is a collection of readers’ experiences of working in the NHS. For this, The BMJ is seeking short audio submissions from UK listeners. These submissions will be published on thebmj.com. If you would like to contribute to this collection, please email a brief audio recording to voices@bmj.com or phone +44 (20) 3058 7427 and tell u...
Jan 19, 2015•3 min
Rabies is the archytypical zoonotic disease, and only by vaccination in animals will we prevent infections in people. In two podcasts linked to our latest clinical review "The prevention and management of rabies" we'll be discussing how we can get there. In this podcast Sarah Cleaveland, professor of comparative epidemiology at the University of Glasgow discusses controlling the disease in animals. To find out about the clincial presentation listen to the accompanying podcast with Natasha C...
Jan 16, 2015•15 min
Rabies is the archytypical zoonotic disease, and only by vaccination in animals will we prevent infections in people. In two podcasts linked to our latest clinical review "The prevention and management of rabies" we'll be discussing how we can get there. In this podcast Natasha Crowcroft, chief of infectious disease at Public Health Ontario to discuss the human aspect of the disease, and in the second Sarah Cleaveland, professor of comparative epidemiology at the University of Glasgow explains ...
Jan 16, 2015•20 min
Until recently, hepatitis C screening was offered to people at increased risk of infection - such as intravenous drug users - but now, the US Centers for Disease Control and Prevention has recommended screening all people born between 1945 and 1965. Kenny Lin, associate professor of family medicine at Georgetown University in Washington, DC, and Jeanne Lenzer, an investigative health journalist from New York, explain why they worry that the evidence doesn't support this expansion. ead their anal...
Jan 14, 2015•16 min
Drug development happens in stages – pre-clinical, phase I, II, III, and so on. But how much do trial participants know about what has happened before their enrolment to test for safety, and how much should they be told? Holger Pedersen from Denmark was one trial participant who tried to find information about the drug he was on, and was surprised at how little data had actually been collected, let alone shared – which has been detailed in an analysis article on thebmj.com He talks to Helen Macd...
Jan 08, 2015•9 min
Waiting times in theatre can be a source of friction – but is the delay due to mandatory anaesthetic faff around time (MAFAT), or AWOL surgeons? Elizabeth Travis, and orthopaedic house officer in New Zealand and colleagues, have been trying to create and evidence base to argue the toss, and she joins me now to discuss her study, Operating theatre time, where does it all go? Read the full research: http://www.bmj.com/content/349/bmj.g7182
Dec 19, 2014•6 min
Those who rise to the top in medicine see themselves as hardworking extroverts with a caring nature, suggests an unscientific analysis of the answers given by contributors to BMJ Confidential. But ask about their pet hates and another, less nurturing, side emerges. We gathered 6 former confidentialists in The BMJ studio to moan over mince pies. Read Doctors: caring extroverts or self deluded chocoholics?: http://www.bmj.com/content/349/bmj.g7623
Dec 18, 2014•21 min
