http://evidencelive.org/manifesto/ The BMJ, and the Centre for Evidence Based Medicine in Oxford have long collaborated to document the problems with the creation and use of Evidence based medicine - and together we host evidence gatherers, synthesisers and users in the conference Evidence Live. We know what the problems are - but what would positive change, when it comes to the creation and use of medical evidence look like? To find out we’re doing a series of discussions at various places arou...
Jan 19, 2017•18 min
Should gluten-free foods be available on prescription? A gluten free diet is the main treatment for celiac disease, and gluten-free food has been available on prescription from the NHS. However, as finances become tighter, in some areas patients no longer have that option. Prescriptions of gluten free food is the same as a prescription for a drug, argues David Sanders, professor of gastroenterology from Royal Hallamshire Hospital, but James Cave lambasts a costly system that frustrates patients ...
Jan 13, 2017•19 min
Surrogate endpoints are commonly used in clinical trials to get quicker results, however Michael Baum, emeritus professor at University College London, worries that by not focusing on real outcomes - length of life, and quality of life - that these are being used to justify expensive treatments which may not benefit patients. Read the full analysis: http://www.bmj.com/content/355/bmj.i6286
Jan 06, 2017•14 min
State regulation is necessary for safety, says Simon Capewell, professor of public health and policy at the University of Liverpool. Richard Lilford, professor of public health at the University of Warwick, argues that restricting adults’ choice can undermine such aims. Read the debate: http://www.bmj.com/content/355/bmj.i6341
Jan 03, 2017•15 min
In this year's Christmas BMJ 2016 podcasts, we’ve been discussing morality, compassion, truth. In this final one, it's time for war. After the second world war, there was an attempt to bring a moral sense to conflict - and Julian Sheather, specialist adviser on ethics and human rights to the BMA, and author of the christmas editorial “medicine under fire” is worried about the retrenchment of those ideals. http://www.bmj.com/content/355/bmj.i6464 Peter Wever is a doctor in The Netherlands, and ha...
Dec 23, 2016•27 min
In response to the turmoil of 2016, with political campaigns being run on, and won on, misinformation - many commentators are disparing that we’ve become a post-truth society. And what is truth anyway? Tracy Brown, director of Sense about Science, the charity set up to champion evidence in everyday life, is less pessimistic about the public's appetite for evidence. http://www.bmj.com/content/355/bmj.i6467 Anders Huitfeldt, a postdoctoral scholar at Stanford University School of Medicine, and has...
Dec 22, 2016•27 min
Underneath all of our civilisation and science, we’re still primates - and the connection between patient and doctor can be reinforced by simply taking a hand. Robin Youngson, cofounder of hearts in healthcare, and Mitzi Blennerhassett, who has written extensively on patient engagement, have co-authored an editorial calling for the humanisation of medicine, and we talk to them about the power of touch. Read the editorial: www.bmj.com/content/355/bmj.i6262 Andrew Steptoe is the British Heart Foun...
Dec 21, 2016•24 min
In an ideal world, policies would be evidence based - but governments are made of humans, who have positions and ideologies and moral bases. In this podcast Anthony Painter, from the RSA will be talking about why universal basic income may work, but who’s proponents cross ideological barriers, and writer and philosopher AC Grayling explains how economic arguments become moral crusades. A universal basic income: the answer to poverty, insecurity, and health inequality? http://www.bmj.com/content/...
Dec 16, 2016•33 min
The BMJ publishes a variety of education articles, to help doctors improve their practice. Often authors join us in our podcast to give tips on putting their recommendations into practice. In this new monthly audio round-up The BMJ’s clinical editors discuss what they have learned, and how they may alter their practice. In our second audio edition, GPs Sophie Cook and Helen Macdonald, surgical trainee Jessamy Baganel, and internalist and methodologist Reed Siemieniuk, talk about the evidence for...
Dec 07, 2016•36 min
Renal transplantation improves quantity and quality of life compared with chronic dialysis. A UK general practice with 8000 patients will have around four patients with a functioning renal transplant, one patient on the transplant waiting list, and several under consideration for transplantation. Many medical problems in renal transplant recipients will be managed by non-specialist clinicians, and this article provides advice for the non-specialist on managing renal transplant patients. In this ...
Dec 02, 2016•31 min
Glasgow GP, writer, broadcaster, and The BMJ's weekly columnist Margaret McCartney joins us to talk about her new book "The State of Medicine: Keeping the Promise of the NHS". Read all of Margaret's columns: goo.gl/iKmmie
Nov 28, 2016•22 min
Despite high quality systematic reviews reporting ineffectiveness, many guideline groups continue to recommend vitamin D supplementation (with or without calcium) for fall or fracture prevention. Recently Public Health England recommended that everyone needs vitamin D equivalent to an average daily intake of 10 μg (400 IU) to protect bone and muscle health, In this podcast, Andrew Grey, associate professor of medicine at the University of Aukland joins us to discuss what the evidence says for wh...
Nov 25, 2016•13 min
Allocation concealment - blinding which arm of a trial a patient is randomised to - is being questioned in an analysis published on thebmj.com. David Torgerson, director of the York Trials Unit at the university of York and colleagues have been looking at the way in which trials do this randomisation, and how they subsequently report it - and have found both lacking. Read the full analysis: http://www.bmj.com/content/355/bmj.i5663
Nov 18, 2016•12 min
Concussion is a clinical diagnosis made after a head injury with consequent associated signs, symptoms, and neurological or cognitive impairment (infographic - http://bmj.co/conrecG). In the absence of strong evidence, most recommendations on the management and recovery from concussion are based on international expert consensus. In this podcast John Brooks, academic clinical fellow in general practice, and Simon Kemp, chief medical officer for the Rugby Football Union take us through the proces...
Nov 18, 2016•18 min
Between 13 & 33% of the adult population have regular difficulty in getting to sleep, or staying asleep. It's important to recognise the difference between acute and chronic insomnia, as treatment strategies differ. David Cunnington, director of the Melbourne Sleep Disorders Centre, joins us to explain what non-drug interventions are available to help those with chronic insomnia. Read the full clinical review: http://www.bmj.com/content/355/bmj.i5819
Nov 17, 2016•21 min
Despite considerable investment and innovation, chemotherapy drugs have had little effect on survival in adults with metastatic cancer. In this podcast, Navjoyt Ladher, clinical editor for The BMJ, talks to Peter Wise, former consultant physician and senior lecturer Imperial College School of Medicine, and author of a recent analysis on TheBMJ.com Read the full analysis: http://www.bmj.com/content/355/bmj.i5792
Nov 11, 2016•17 min
In the UK, junk food advertising is banned on children’s TV - but manufactures are still able to target children in other ways. A recent report from the WHO "Tackling food marketing to children in a digital world", takes a look at the issue. In this podcast we're joined by João Breda, programme manager for nutrition physical activity and obesity at the regional office for Europe of the World Health Organisation, and Mimi Tatlow-Golden, lecturer in childhood studies and developmental psychology a...
Nov 04, 2016•19 min
To avoid waste of research, no new studies should be done without a systematic review of existing evidence. That argument has been made for 20 years, yet the lack of reference to a systematic review before designing new studies is still a problem. Hand Lund, professor at the University of Southern Denmark joins us to explain why research before researching is still an issue. Read the full analysis: http://www.bmj.com/content/355/bmj.i5440
Nov 04, 2016•12 min
In patients with symptomatic severe aortic stenosis but at lower risk of perioperative death, how do minimally invasive techniques compare with open surgery? Prompted by a recent trial, an expert panel produced these recommendations based on three linked rapid systematic reviews. In this podcast we talk to Michael Shapiro who was a patient representative on that panel about what matters to patients, and how he found taking part in creating the recommendation. Read the recommendation in full: htt...
Nov 01, 2016•14 min
Catherine Calderwood has been chief medical officer for Scotland since March 2015 - her first CMO report, which she titled “Realistic Medicine” has created a stir beyond the borders of Scotland. The BMJ, sat down with Catherine at a the Preventing Overdiagnosis conference to find out what she intended with that report. Read more: http://www.bmj.com/content/355/bmj.i5455
Oct 28, 2016•20 min
Middle East respiratory syndrome (MERS) is an acute viral respiratory tract infection caused by the novel betacoronavirus. Cases have been limited to the Arabian Peninsula and its surrounding countries, and to travellers from the Middle East or their contacts. The clinical spectrum of infection varies from no symptoms or mild respiratory symptoms to severe, rapidly progressive pneumonia, acute respiratory distress syndrome, septic shock, or multiorgan failure resulting in death. In this podcast ...
Oct 21, 2016•20 min
Elizabeth Pisani, visiting senior research fellow at King's College London, collects data on sex workers and injecting drug users in low and middle income countries. For years she has been sharing her data, and joins us to explain why she went from being protective of her research to to making it freely available - and talk about some of the practicalities of keeping participants anonymous. Read the full analysis: http://www.bmj.com/content/355/bmj.i5295
Oct 11, 2016•22 min
Independent contractor status creates unnecessary stress, argues Azeem Majeed, GP partner and professor of primary care at Imperial College London. Laurence Buckman, GP partner and former head of the BMA GP committee, values his autonomy and distance from a non-benign employer. Read the full head to head: http://www.bmj.com/content/355/bmj.i5064 We also hear from former columnist and current partner in a federated practice, Des Spence, who thinks that the days of small GP surgeries are numbered....
Oct 07, 2016•17 min
The Preventing Overdiagnosis conference is part of The BMJ's campaign against Too Much Medicine. Helen Macdonald clinical editor for The BMJ was at the conference, and talked to some of the key speakers there about what they believe the key issues are, and what's being done to roll back the harms of too much medicine. http://www.bmj.com/too-much-medicine http://www.preventingoverdiagnosis.net/
Oct 06, 2016•50 min
Globally each year more than 30 000 people become living kidney donors. Living kidney donation is constantly evolving, with new ways of pooling donors and recipients to maximise opportunity. With increased numbers, there is increasing information regarding the long term outcomes associated with donation. Pippa Bailey, clinical lecturer in renal medicine at the University of Bristol, and Aisling Courtney, consultant nephrologist at Belfast City Hospital join us to explain who can donate, to whom,...
Sep 23, 2016•19 min
In a clinical trial, we usually think of risk in terms of the new active compound - will it have unwanted effects. However, two analyses in The BMJ are concerned about the risk associated with the control arm. Robin Emsley is a professor of psychiatry at Stellenbosch University in South Africa, he and colleagues have written about the risk associated with forgoing treatment in patients with schizophrenia. Read the full analysis: http://www.bmj.com/content/354/bmj.i4728 Jonathan Mendel, lecturer ...
Sep 16, 2016•19 min
Alastair Matheson, independant consultant and former ghostwriter, describes how the pharmaceutical publications industry seeks to legitimise ghostwriting by changing its definition while deflecting attention from wider marketing practices in academic publishing. Read his full analysis: http://www.bmj.com/content/354/bmj.i4578
Sep 09, 2016•12 min
Oversimplification and lack of evidence stigmatise people with mental illness and impede prevention efforts, says Simon Wessley, professor of psychiatry at King's College London, in an editorial published on thebmj.com. Read the full editorial: http://www.bmj.com/content/354/bmj.i4869
Sep 08, 2016•11 min
Lily was diagnosed at 14 years old with stage four Hodgkin's lymphoma and received six rounds of chemotherapy and two weeks of radiotherapy. She survived but now lives with the long term effects of that therapy - and joins us to discuss how it has impacted her quality of life. We're also joined by Saif Ahmad and Thankamma Ajithkumar, oncologists from Cambridge University Hospitals NHS Foundation Trust, who give advice for generalists on late effects of anticancer chemotherapy that may affect qua...
Sep 08, 2016•24 min
The United Nation's Millennium Development Goals, and the subsequent Sustainable Development Goals, define premature mortality as being a death under the age of 70. As demographic change means more people are living longer than this, Peter Lloyd-Sherlock, professor of social policy and international development at the University of East Anglia, argues that this will lead to discrimination against older people. Read the full analysis: http://www.bmj.com/content/354/bmj.i4514
Sep 02, 2016•12 min
