Medicine and Science from The BMJ
Episodes
neoadjuvant treatment for breast cancer - not living up to the promise
11 Jan 2018
Contributed by Lukas
Neoadjuvant chemotherapy for breast cancer is a new strategy that was introduced towards the end of the 20th century with the aim of reducing tumour s...
Winter pressures - ”You run the risk of dropping the ball”
10 Jan 2018
Contributed by Lukas
Winter pressures on NHS services have kicked in a little bit earlier than usual. So here to discuss that, and also the issue of how local NHS leaders ...
Suspect, investigate, and diagnose acute respiratory distress syndrome
03 Jan 2018
Contributed by Lukas
Acute respiratory distress syndrome was first described in 1967 and has become a defining condition in critical care. Around 40% of patients with ARDS...
Hope is important - early psychosis for the non-specialist doctor
31 Dec 2017
Contributed by Lukas
Psychosis often emerges for the first time in adolescence and young adulthood. In around four out of five patients symptoms remit, but most experience...
Cats, dogs, and biomarkers of ageing.
15 Dec 2017
Contributed by Lukas
The notion that animal companionship might be linked to human health can be traced to ancient writings and, with the first population based study cond...
Small, medium, or a pint of wine?
14 Dec 2017
Contributed by Lukas
Wine glasses come in a range of sizes, but the average wine glass in the UK today can hold almost ½ a litre. That wasn’t always the case - and a n...
Taking the temperature of 37°C
13 Dec 2017
Contributed by Lukas
Average body temperature is 37°C, right? That was the conclusion of Carl Wunderlich in his magnum opus, The Course of Temperature in Diseases - Wun...
Manflu - are men immunologically inferior?
12 Dec 2017
Contributed by Lukas
Manflu, the phenomenon that men experience the symptoms of viral illness more than woman, is usually used with derision - but a new review, published ...
I thought I wasn’t thin enough to be anorexic
10 Dec 2017
Contributed by Lukas
Assessing young people with possible eating disorders can be complex for a variety of reasons. Building a therapeutic relationship with a young person...
Early detection of eating disorders
10 Dec 2017
Contributed by Lukas
Assessing young people with possible eating disorders can be complex for a variety of reasons. Building a therapeutic relationship with a young person...
Should all fetuses be monitored electronically during birth?
07 Dec 2017
Contributed by Lukas
Our latest H2H debate asks: Is continuous electronic fetal monitoring useful for all women in labour? Peter Brocklehurst is professor of women’s he...
”Obesity is the last thing it’s OK to discriminate on the basis of”
24 Nov 2017
Contributed by Lukas
We have a problem in obesity research — clinical trials continue to prioritise weight loss as a primary outcome and rarely consider patients’ expe...
Dieting, cardiovascular disease, cancer, and mortality
21 Nov 2017
Contributed by Lukas
We know that adults with obesity have an increased risk of premature mortality, cardiovascular disease, some cancers, type 2 diabetes, and many other ...
Antibiotic prescription course - an update
17 Nov 2017
Contributed by Lukas
In July, The BMJ published an analysis article called “The Antibiotic Course has had it’s day” - a provocative title that turned out the garner...
Is it time to scrap the UK’s mental health act?
17 Nov 2017
Contributed by Lukas
Unjust discrimination against people with mental ill health should be replaced with universal rules based on decision making ability, argues George Sz...
Three talks to good decision making
10 Nov 2017
Contributed by Lukas
The Three Talk Model of shared decision is a framework to help clinicians to think about how to structure their consultation to ensure that shared dec...
Education round up October 2017
31 Oct 2017
Contributed by Lukas
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 puttin...
Money for editors
27 Oct 2017
Contributed by Lukas
As journal editors, we’re aware of the fact that we have a role to play in scientific discourse - that’s why The BMJ has been so keen to talk abou...
The death of QOF?
26 Oct 2017
Contributed by Lukas
The Quality and Outcomes Framework (QOF) is one of the most ambitious pay-for-performance schemes introduced into any health system. It's now being sc...
70% rise in incidence of self harm in teenagers
19 Oct 2017
Contributed by Lukas
Half of adolescents who die by suicide have a history of self harm. And in the UK, the rates of adolescents who commit suicide jumped from 3.2, to 5.4...
Exercise in old age - ”we need kendo classes in Huddersfield”
18 Oct 2017
Contributed by Lukas
There's a crisis in old age care - not just in the UK, around the world, as population demographics shift, and the proportion of older people increase...
Sex in surgery
13 Oct 2017
Contributed by Lukas
New research published on bmj.com has evaluated how well women surgeons operate, when compared to their male colleagues - and shows that there is a ma...
Vinay Prasad - Cancer drugs from an oncologist point of view
13 Oct 2017
Contributed by Lukas
Last week we published some new research which showed that 2/3 of new cancer drugs approved by the European Medicines Agency - the drug regulator for ...
There’s no clear evidence that most new cancer drugs extend or improve life
05 Oct 2017
Contributed by Lukas
The majority of cancer drugs approved in Europe between 2009 and 2013 entered the market without clear evidence that they improved survival or quality...
Telephone consultations - no cost savings, but increased GP workload
28 Sep 2017
Contributed by Lukas
If you're a patient in the UK, increasingly, your first interaction with the healthcare system won't be the traditional face to fact chat with your do...
Selling off NHS silver?
27 Sep 2017
Contributed by Lukas
Should we welcome plans to sell off NHS land? The government seems likely to back the recommendations of Robert Naylor (national adviser on NHS prope...
What Choosing Wisely looks like in the UK
27 Sep 2017
Contributed by Lukas
Choosing Wisely was launched in the US, to much fanfare. Since then the movement has spread around the world, with successful chapters set up in Canad...
Diabetes remission - ”treating blood glucose, when the disease process is to do with body fat”
22 Sep 2017
Contributed by Lukas
In the UK - type 2 diabetes now affects between 5-10% of the population - and accounts for around 10% of our total NHS budget. For the individuals af...
The problems with peer review
19 Sep 2017
Contributed by Lukas
One of the hurdles that anyone who submits research or analysis to The BMJ has to deal with is peer review. The problems of the process, and some of...
HIV in pregnancy - ”without the big picture, people aren’t going to be able to take the medication”
15 Sep 2017
Contributed by Lukas
A new Rapid Recommendation from The BMJ suggests that for pregnant women, they may wish to avoid certain antiviral treatments for HIV. This recommen...
Googling depression
11 Sep 2017
Contributed by Lukas
In the USA, when googling "depression" patients will be presented with a link to the PHQ-9 screening test. Google has developed this in collaboration...
Nigel Crisp - The NHS isn’t just a cost to society, it’s a benefit
08 Sep 2017
Contributed by Lukas
If you google "The NHS" you'll see screaming headlines from the Daily Mail about cost and waste - debate in parliament is about how much of our GDP we...
The World Bank - creating a market in pandemic risk
01 Sep 2017
Contributed by Lukas
The world bank was set up in 1944. In the aftermath of the second world war, the institution was there to give loans to countries rebuilding after the...
The World Bank - the Global Financing Facility
01 Sep 2017
Contributed by Lukas
The world bank was set up in 1944. In the aftermath of the second world war, the institution was there to give loans to countries rebuilding after the...
The World Bank - trust funds
01 Sep 2017
Contributed by Lukas
The world bank was set up in 1944. In the aftermath of the second world war, the institution was there to give loans to countries rebuilding after the...
The World Bank - Universal Healthcare
01 Sep 2017
Contributed by Lukas
The world bank was set up in 1944. In the aftermath of the second world war, the institution was there to give loans to countries rebuilding after the...
The World Bank - why it matters for global health
01 Sep 2017
Contributed by Lukas
The world bank was set up in 1944. In the aftermath of the second world war, the institution was there to give loans to countries rebuilding after the...
Preventing Overdiagnosis 2017 - from theory to practice
24 Aug 2017
Contributed by Lukas
In our last podcast from Preventing Overdiagnosis 2017, we convened an impromptu roundtable of clinicians who are attending the conference to see how ...
Preventing Overdiagnosis 2017 - Citizen juries
19 Aug 2017
Contributed by Lukas
This week we’re at the over diagnosis conference in Quebec Canada, Preventing overdiangosis is a forum to discuss the harms associated with using u...
Preventing Overdiagnosis 2017 - Vinay Prasad
19 Aug 2017
Contributed by Lukas
The Preventing overdiagnosis conference covers how physicians, researchers and patients can implement solutions to the problems of over diagnosis and ...
Preventing Overdiagnosis 2017 - Rita Redberg
18 Aug 2017
Contributed by Lukas
This week we’re at the Preventing Overdiagnosis conference in Quebec Canada, The conference is a forum to discuss the harms associated with using u...
Preventing Overdiagnosis 2017 - Stacy Carter on the culture of overmedicalisation
17 Aug 2017
Contributed by Lukas
In this interview from Preventing Overdiagnosis 2017 (preventingoverdiagnosis.net) Stacy Carter, associate professor at Sydney Health Ethics - and th...
What’s driving overdiagnosis?
16 Aug 2017
Contributed by Lukas
This week the annual Preventing over diagnosis conference is happening in Quebec, Canada. The conference is put together with a wide range of partners...
Helping Bereaved people
03 Aug 2017
Contributed by Lukas
Loss of a loved one can be very painful. When seeking support, some people turn to their doctor. Because of their pivotal role in the community, physi...
Auditing the transparency policies of pharma
28 Jul 2017
Contributed by Lukas
If you’ve listened to more than one of our podcasts, you’ll probably be aware of the problem of the opacity of clinical trial data - trials which ...
Mike Richards has ”never been politically interfered with”
28 Jul 2017
Contributed by Lukas
Mike Richards is well known in the UK - former Cancer Tzar, he now heads up the Care Quality Commission - regulator of all health and social care serv...
”For the first time in 15 years the quitting rate has gone up” - ecigarettes smoking cessation
27 Jul 2017
Contributed by Lukas
It’s been 10 years since electronic cigarettes hit the shelves in a big way - and since there controversy has reigned about their health effects - a...
What’s going on with life expectancy?
21 Jul 2017
Contributed by Lukas
The increase in life expectancy in England has almost “ground to a halt” since 2010 and austerity measures are likely to be a significant contribu...
Biomarkers - miracle or marketing?
18 Jul 2017
Contributed by Lukas
The BMJ has been campaigning for an end to “too much medicine” - the pernicious effect of marketing on the range of tests and treatments that doct...
James Kinross and Chris Hankin WannCry about NHS IT
14 Jul 2017
Contributed by Lukas
Earlier this year, the WannaCry ransomeware attack took control of computers in 40 NHS trusts, blocking access to the data held on them. This wasn’...
Is the FDA really too slow?
11 Jul 2017
Contributed by Lukas
The FDA faces perpetual criticism that it is too slow in it’s approval process for getting drugs to market, but one former FDA employee Tom Marcinia...
”For the public good, not for careers” - Iain Chalmers and Doug Altman on research waste
07 Jul 2017
Contributed by Lukas
Twenty years ago the statistician Doug Altman railed against, “The Scandal of Poor Medical Research,” in an editorial in The BMJ. 10 years later...
Dementia prevalance in 2040
05 Jul 2017
Contributed by Lukas
The Alzheimer’s society, in the UK, predicts that if the rates of dementia remain constant there’ll be 1.7 million people in the country living wi...
Transhealth - how to talk to patients about pronouns
30 Jun 2017
Contributed by Lukas
Two articles published on the bmj.com aim to help doctors treat patients who request support with their gender identity. Firstly a practice pointer ...
Childhood IQ and cause of death
29 Jun 2017
Contributed by Lukas
Findings from a range of prospective cohort studies based around the world indicate that higher intelligence in children is related to a lower risk of...
The Evidence Manifesto - it’s time to fix the E in EBM
23 Jun 2017
Contributed by Lukas
"Too many research studies are poorly designed or executed. Too much of the resulting research evidence is withheld or disseminated piecemeal. As the ...
Stress at work
16 Jun 2017
Contributed by Lukas
Stress is one of the leading causes of work absence, recently overtaking back-pain, and an increasing part of a GPs workload. However good quality evi...
”The interest of diesel drivers over the interest of the public” - tackling air pollution
15 Jun 2017
Contributed by Lukas
Air pollution is a truly damaging environmental insult to the human body. The numbers of premature deaths, in the UK alone, that can be attributed to...
How to build a resillient health system
08 Jun 2017
Contributed by Lukas
The 2014 west African Ebola epidemic shone a harsh light on the health systems of Guinea, Liberia, and Sierra Leone. While decades of domestic and int...
Your brain on booze
07 Jun 2017
Contributed by Lukas
A new study on BMJ.com, examines the effect of moderate drinking on brain structure. We know that heavy drinking has a deleterious effect on our brai...
Future Earth - linking health and environmental research
02 Jun 2017
Contributed by Lukas
The rapid changes in the global environment have led many scientists to conclude that we are living in a new geological epoch—the Anthropocene—in ...
Government and evidence
02 Jun 2017
Contributed by Lukas
We're creating a manifesto for better evidence. The centre for Evidence Based Medicine at the University of Oxford, and the BMJ, are asking what are t...
50% of delirium is hypoactive - how to spot it
26 May 2017
Contributed by Lukas
Available data suggest about 50% of delirium is hypoactive; this and the mixed motor subtype account for 80% of all cases of delirium. It can be more...
Helping patients with complex grief
18 May 2017
Contributed by Lukas
Each individual’s grief process is unique, when confronted with the death of a loved one, most people experience transient rather than persistent di...
NHS must “get its act together” to secure cash for new buildings
15 May 2017
Contributed by Lukas
NHS hospitals must be willing to dispose of surplus land to help convince the Treasury to invest in new premises that are fit for purpose, the head of...
Education Round - Exercising too much, microbiome, suicide and translation
15 May 2017
Contributed by Lukas
The BMJ publishes a lot of educational articles, and in an attempt to help you with your CPD, we have put together this round-up. Our authors and edit...
The magic of shared decision making
09 May 2017
Contributed by Lukas
Adoption of shared decision making into routine practice has been remarkably slow, despite 40 years of research and considerable policy support. In ...
Drug promotion, prescription, and value
04 May 2017
Contributed by Lukas
Pharma companies say that money spent on promotion is essential to educate doctors about the best drugs - but when a medical student asked Joseph Ross...
How established biologics become less safe
28 Apr 2017
Contributed by Lukas
Biologics have revolutionised healthcare for some conditions - but have been expensive because of the multistep manufacturing processes required to cr...
“I had two herniated discs in my back, and I was still running” - addicted to exercise
27 Apr 2017
Contributed by Lukas
It’s been called “the universal panacea” - exercise has a positive effect on almost all health measures, and governments are actively campaignin...
The evidence manifesto - better trials, better use of trial data
21 Apr 2017
Contributed by Lukas
We're creating a manifesto for better evidence. The centre for Evidence Based Medicine at the University of Oxford, and the BMJ, are asking what are ...
Assessing and treating an electrical injury
13 Apr 2017
Contributed by Lukas
Thankfully, electrical injuries are relatively uncommon - but that means that lack of evidence regarding the management of patients who have been elec...
”We’re kicking the can down the road” - how to get agreement on the future of the NHS
12 Apr 2017
Contributed by Lukas
Our latest debate asks whether there should be a Royal Commission (a high level enquiry, with statutory powers) into the future of the NHS. A high le...
Fighting inequality, corruption, and conflict - how to improve South Asia’s health
11 Apr 2017
Contributed by Lukas
The BMJ has published a series of articles, taking an in-depth look at health in South Asia. In this collection, authors from India, Pakistan, Nepal, ...
STPs - who, what, why, when, where.
07 Apr 2017
Contributed by Lukas
The NHS Delivery Plan - setting out what’s in store of the English NHS in the coming years, has been delivered by Simon Stevens the chief executive....
High integrity child mental healthcare
06 Apr 2017
Contributed by Lukas
Around 1 in 10 children and young people worldwide have mental health difficulties that substantially affect their lives. Child mental health service...
What is high integrity healthcare?
31 Mar 2017
Contributed by Lukas
This week, a new series starts in The BMJ - the aim is to rethink how hospitals, clinics, community services and public health work - with the aim of ...
”Watching the world through a clear fog” - recognising depersonalisation and derealisation
31 Mar 2017
Contributed by Lukas
Transient symptoms of depersonalisation and derealisation - feeling detached from the world, and feeling as if you are watching events at a remove - a...
American healthcare - what next?
29 Mar 2017
Contributed by Lukas
For seven years, Republicans have vowed to repeal the Affordable Healthcare Act (Obamacare), and that promise took a central place in President Trump'...
Dying on the canal
24 Mar 2017
Contributed by Lukas
Lady-Jacqueline Aster lives on a 72 foot canal boat. She's been diagnosed with adrenocortical cancer, and is receiving palliative care and is planning...
Education round up - HIV testing, legal highs and care for relatives of the dying
17 Mar 2017
Contributed by Lukas
The BMJ publishes a lot of educational articles, and in an attempt to help you with your CPD, we have put together this round-up. Our authors and edi...
Identifying a viral rash in pregnancy
17 Mar 2017
Contributed by Lukas
Viral exanthema can cause rash in a pregnant woman and should be considered even in countries that have comprehensive vaccination programmes. Measles...
Nuffield Summit 2017 - Reducing Demand
16 Mar 2017
Contributed by Lukas
As the NHS strains under pressure from rising patient activity, an ageing population, and financial constraints, The BMJ hosted a discussion on how cl...
Emergency care plans at the end of life
08 Mar 2017
Contributed by Lukas
When a person’s heart or breathing stops and the cause is reversible, immediate cardiopulmonary resuscitation (CPR) offers a chance of life. However...
Should malaria be eradicated?
07 Mar 2017
Contributed by Lukas
The World Health Organization, the Roll Back Malaria Partnership, and the United Nations, all have a vision of a malaria-free world. The world has alr...
Palliative care is about life, not death
03 Mar 2017
Contributed by Lukas
Scott Murray, professor of primary palliative care at the University of Edinburgh, has written, and talked in this podcast before, about the benefits ...
Community acquired pneumonia in children
02 Mar 2017
Contributed by Lukas
In 2015, community acquired pneumonia (CAP) accounted for 15% of deaths in children under 5 years old globally and 922 000 deaths globally in childr...
The inadequacy of the UK’s childhood obesity strategy
02 Mar 2017
Contributed by Lukas
The UK government published its report Childhood Obesity: a Plan for Action, in August 2016. A new analysis article takes them to task for the inadequ...
Low intensity pulsed ultrasound - no difference for bone healing
24 Feb 2017
Contributed by Lukas
A new rapid recommendation had concluded that LIPUS makes no different to patients experience of bone healing, and therefore shouldn't be used. In th...
How people die remains in the memory of those who live on - supporting the relatives of the dying
21 Feb 2017
Contributed by Lukas
All doctors, irrespective of their specialty or the setting in which they work, will care for patients who die. Around half of all deaths occur in hos...
Helping patients with medically unexplained symptoms
17 Feb 2017
Contributed by Lukas
Persistent physical symptoms are common and include those symptoms that last at least three months and are insufficiently explained by a medical condi...
US Surgeon General - “For far too long addiction has been looked at as a moral failing”
15 Feb 2017
Contributed by Lukas
Vivek Murthy, the US surgeon general, has highlighted prescription opioid misuse as a serious public health problem. In this podcast, Richard Hurley...
Should all American doctors be using electronic medical records?
19 Jan 2017
Contributed by Lukas
Evidence shows using electronic health records can increase efficiency, and reduce preventable medical errors - but only if they are used properly. Ho...
Expanding your mind about novel psychoactives
19 Jan 2017
Contributed by Lukas
The use of novel psychoactive substances is increasing, however there is little information about what these are, and how they work. Dr Derek Tracy,...
Big Data - what effect is it going to have on EBM
19 Jan 2017
Contributed by Lukas
http://evidencelive.org/manifesto/ The BMJ, and the Centre for Evidence Based Medicine in Oxford have long collaborated to document the problems with...
Gluten free on the NHS
13 Jan 2017
Contributed by Lukas
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 ava...
Surrogate outcomes distorting medicine
06 Jan 2017
Contributed by Lukas
Surrogate endpoints are commonly used in clinical trials to get quicker results, however Michael Baum, emeritus professor at University College London...
Nanny state knows best
03 Jan 2017
Contributed by Lukas
State regulation is necessary for safety, says Simon Capewell, professor of public health and policy at the University of Liverpool. Richard Lilford,...
Christmas 2016 - War
23 Dec 2016
Contributed by Lukas
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 seco...
Christmas 2016 - truth, post truth, nothing like the truth
22 Dec 2016
Contributed by Lukas
In response to the turmoil of 2016, with political campaigns being run on, and won on, misinformation - many commentators are disparing that we’ve ...