2.46 million people in England have osteoarthritis of the hip, and many of those go on to eventually have a hip replacement - which is now widely considered one of the most commonly performed and successful operations in the world. Jessamy Bagenal, clinical fellow with The BMJ, talks to Nick Aresti, a specialist registrar in trauma and orthopaedic surgery and one of the authors of a clinical update on hip osteoarthritis, recently published on thebmj.com In a linked podcast, Nick Nicholas, a pati...
Jul 08, 2016•24 min
2.46 million people in England have osteoarthritis of the hip, and many of those go on to eventually have a hip replacement - which is now widely considered one of the most commonly performed and successful operations in the world. Jessamy Bagenal, clinical fellow with The BMJ, talks to Nick Nicholas, an obstetrician who has had OA and one of the authors of a clinical update on hip osteoarthritis, recently published on thebmj.com In a linked podcast, Nick Aresti, a specialist registrar in trauma...
Jul 08, 2016•13 min
The drug Truvada, licenced for HIV PrEP, costs £350 a month but is shown to be cost effective in preventing infection. However, in the English NHS, a row has broken out about which body should fund the treatment - NHS England claims local authorities have responsibility, local authorities believe NHS England does. In this podcast Jim McManus, director of public health at Hertfordshire County Council, explains why he believes local authorities cannot afford the treatment, and describes the pressu...
Jul 08, 2016•17 min
Guidelines usually assume a rational comprehensive decision model in which all values, means, and ends are known and considered. In clinical encounters, however, patients and doctors most often follow “the science of muddling through. Given that clinical knowledge does not follow the narrow rationality of “if-then” algorithms contained in guidelines, alternatives are desperately needed. Glyn Elwyn, professor at the Dartmouth Institute for Health Policy and Clinical Practice, joins us to discuss ...
Jul 01, 2016•20 min
When we think about medical evidence, we think of RCTs, registries and meta-analysis. But these EBM tools have yet to filter into the basic science that underpins clinical science. One person changing that is Emily Sena, research fellow in clinical brain sciences at the University of Edinburgh - and one of the few people who’s trying to meta-analyse animal studies.
Jun 24, 2016•17 min
The same piece of evidence may reach you via a journalist, or via your doctor - but the way in which that evidence is communicated is changed by your relationship between that person. Julia Beluz from Vox and Victor Montori from the Mayo Clinic join us to discuss if it's possible to reconcile those competing points of view.
Jun 23, 2016•17 min
In every 1000 pregnancies, between two and five infants are born to women with epilepsy. For such women, pregnancy can be a time of anxiety over maternal and fetal wellbeing. In 96% of pregnancies they will deliver a healthy child. However, some women will experience an increase in seizure frequency, which can be harmful for the mother or fetus, and evidence comes from observational study and registry data suggests some antiepileptic drugs are associated with an increased risk of congenital and ...
Jun 21, 2016•18 min
Delirium is common in the last weeks or days of life. It can be distressing for patients and those around them. A clinical update explains why successful management involves excluding reversible causes of delirium and balancing drugs that may provoke or maintain delirium while appreciating that most patients want to retain clear cognition at the end of life. Kate Adlington, clinical editor at The BMJ, is joined by the authors of the paper - Christian Hosker, consultant liaison psychiatrist at Le...
Jun 14, 2016•18 min
Global evidence indicates that mandated treatment of drug dependence conflicts with drug users’ human rights and is not effective in treating addiction. Karsten Lunze, associate professor at the Boston University School of Medicine, joins us to describe the evidence, and why he is convinced seemingly counter intuitive hard reduction works. http://www.bmj.com/content/353/bmj.i2943
Jun 10, 2016•12 min
How can asking patient to tell us their story improve healthcare? Helen Morant, content lead at BMJ, talks us through her project getting healthcare professionals to sit down with patients and record their conversations, and what on earth this has to do with quality improvement. We also hear some of the recordings she has gathered through the project. Here are links to the other podcasts and projects Helen mentions: Story Corps - https://storycorps.org/ The Listening Project - http://goo.gl/3auS...
Jun 03, 2016•26 min
Julian Treadwell, Neal Maskrey and Richard Lehman join us in the studio to argue that new models of evidence synthesis and shared decision making are needed to accelerate a move from guideline driven care to individualised care. Read the full analysis: www.bmj.com/content/353/bmj.i2452
May 27, 2016•22 min
There is insufficient evidence to know whether dressings reduce the risk of surgical site infection in closed primary surgical wounds. Jane Blazeby, professor of surgery at the University of Bristol, and Thomas Pinkney, consultant colorectal surgeon at the University of Birmingham, join us to discusses why there is a lack of evidence, and the implications for patient care. read the full article: http://www.bmj.com/content/353/bmj.i2270
May 26, 2016•12 min
Interviews from the Women deliver conference in Copenhagen. Donna McCarraher, director of reproductive, maternal, newborn and child health at FHI 360, explains why women should be at the centre of efforts to mitigate the effect of Zika Virus in Brazil.
May 25, 2016•8 min
Interviews from the Women deliver conference in Copenhagen. Catrin Schulte-Hillen, co-ordinator of reproductive health and sexual violence care at Medecins Sans Frontieres, explains why the development community shouldn't conflate sexual violence and access to abortion.
May 25, 2016•11 min
This week, we look at medication reconciliation. Joshua Pevnick, health services researcher and hospital physician at Cedars-Sinai Hospital, LA, US, talks us through what it is and why it can be so hard to get right. And Emma Iddles, a junior doctor in general surgery at Hairmyres Hospital, Lanarkshire, UK, explains how her project improved medicines reconciliation in the surgical admissions unit of the hospital. For more, read Joshua's full paper, http://goo.gl/O59BWo, and Emma's project write ...
May 20, 2016•14 min
We do we know about the weekend effect? As Martin McKee puts it in an editorial on thebmj.com, "almost nothing is clear in this tangled tale" In this roundtable, Navjoyt Ladher, Analysis editor for The BMJ is joined by some of the key academics who have published research and commented on the weekend effect to make sense of what we know and don’t know about weekend care in hospitals. http://www.bmj.com/weekend Taking part in the discussion are: Cassie Aldridge, HiSLAC study project manager at th...
May 20, 2016•54 min
Katja Iversen, CEO of Women Deliver, joins Rebecca Coombes to explain why the UN sustainable development goals are unachievable if we don't empower women and girls to take control of their health, wellbeing, and reproductive rights. http://womendeliver.org/
May 16, 2016•24 min
Travellers’ diarrhoea is one of the most common illnesses in people who travel internationally, and depending on destination affects 20-60% of the more than 800 million travellers each year. In most cases the diarrhoea occurs in people who travel to areas with poor food and water hygiene. Mike Brown, consultant in infectious diseases and tropical medicine at the London School of Hygiene and Tropical Medicine, explains the approach to the prevention and treatment of diarrhoea in travellers. Read ...
May 13, 2016•18 min
Providing information to enable informed choices about healthcare sounds immediately appealing to most of us. But Minna Johansson, GP trainee and PhD student at the University of Gothenburg, argues that preventive medicine and expanding disease definitions have changed the ethical premises of informed choice and our good intentions may inadvertently advance overmedicalisation. Read the full analysis: http://www.bmj.com/content/353/bmj.i2230
May 09, 2016•9 min
Or, the one where Fiona Moss and Don Berwick tells us what they think quality improvement is. Fiona Moss is dean, Royal Society of Medicine, and Don Berwick is president emeritus and senior fellow, Institute for Healthcare Improvement. Don's talk and the interview with Fiona were both recorded at the International Forum on Quality and Safety in Healthcare, Gothenburg, April 2016. Watch out for the extended versions of these recordings, up next Friday.
May 06, 2016•14 min
Medical error is not included on death certificates or in rankings of cause of death. Martin Makary, professor of surgery at Johns Hopkins University School of Medicine, joins us to explain why we don't measure medical error, and why it is so important that we start. Read the full analysis: http://www.bmj.com/content/353/bmj.i2139
May 04, 2016•12 min
Nicholas Hopkinson, reader in respiratory medicine at Imperial College London, joins us to explain why a new report from the Royal College of Physicians supports the role of electronic cigarettes as part of a comprehensive tobacco control strategy. Read the full analysis: http://www.bmj.com/content/353/bmj.i1745
Apr 29, 2016•15 min
The BMJ recently held a discussion between experts in the fields of general practice, emergency medicine, and paediatrics about the state of out of hours care in the UK, and crucially offered their vision for a better service. Are children a special case, can urgent care ‘hubs’ be a silver bullet, is NHS 111 up to the job of triaging patients, do there enough clinicians involved in out of hours care, and are other countries doing a better job? The state of out of hours care can best be described...
Apr 27, 2016•23 min
It's bad practice to prescribe a brand name drug when a cheaper, viable and approved generic is available. But, particularly in the US, this happens too much, at major cost to the health system. The team behind Michigan State University's paediatric clinics set out to increase their prescribing of generics, and found that much of the problem was that whilst brand names lodged in staff and patient's minds, generic names were easily forgotten. Sath Sudhanthar, paediatrician and assistant professor...
Apr 22, 2016•11 min
Sudden cardiac death of young athletes needs to be avoided but does screening really help? Hans Van Braband, researcher at the Belgian Health Care Knowledge Centre, joins us to explain that the evidence for screening doesn't show benefit, and may lead to harm. Read the full analysis: http://www.bmj.com/content/353/bmj.i1156
Apr 22, 2016•17 min
Sheyna Gifford has an unusual claim to fame—she is the first doctor ever to work on Mars. Not the planet Mars, of course, but Mauna Loa, a volcano in Hawaii, whose dusty, rust coloured landscape is probably the closest on earth to the red planet. She is serving on the Hi-Seas programme, a mission run the University of Hawaii and funded by NASA, whose purpose is to simulate a three year voyage to Mars and back. Since last August Gifford and six other scientists have been living in a 1000 square f...
Apr 15, 2016•30 min
In February World Health Organization (WHO) declared the microcephaly epidemic in South America an international public health emergency. Today, the US Centers for Disease Control and Prevention, the CDC, has confirmed that it’s is Zika virus which is causing that microcephaly. The outbreak was originally spotted in Recife, in Brazil, and it’s from there that the authors of this research paper have been carrying out imaging of the skulls of babies born with microcephaly and probable Zika virus i...
Apr 14, 2016•19 min
James Barrett, president of the British Association of Gender Identity Specialists, and Nina, a trans woman, join us to discuss how difficult it can be for trans people to access gender clinics, and what barriers are faced by the community after their transition has been completed. Read James Barrett's personal view: http://www.bmj.com/content/352/bmj.i1694
Apr 11, 2016•17 min
Alcohol consumption has been a perennial problem, but recently The economic downturn and rises in alcohol taxation seem to have stemmed the persistent rise in associated mortality. Nick Sheron, head of clinical herpetology at Southampton university, and one of the authors of an analysis article, explains how government fiscal policy has the ability to immediately reduce alcohol related deaths.
Apr 08, 2016•23 min
Abi Rimmer, BMJ Careers reporter, talks to junior doctors on the picket line at Northwick Park Hospital. Read her report: http://bmj.co/1qydmFq
Apr 08, 2016•6 min
