Medicine and Science from The BMJ

Christmas 2016 - Health and happiness

21 Dec 2016

Contributed by Lukas

Underneath all of our civilisation and science, we’re still primates - and the connection between patient and doctor can be reinforced by simply tak...

Christmas 2016 - ideologies and moralities

16 Dec 2016

Contributed by Lukas

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...

Education round up - November

07 Dec 2016

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...

Caring for renal transplant patients

02 Dec 2016

Contributed by Lukas

Renal transplantation improves quantity and quality of life compared with chronic dialysis. A UK general practice with 8000 patients will have around ...

Margaret McCartney wants to fix the NHS

28 Nov 2016

Contributed by Lukas

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...

Evidence for vitamin D supplimentation

25 Nov 2016

Contributed by Lukas

Despite high quality systematic reviews reporting ineffectiveness, many guideline groups continue to recommend vitamin D supplementation (with or with...

Blinding the randomisation

18 Nov 2016

Contributed by Lukas

Allocation concealment - blinding which arm of a trial a patient is randomised to - is being questioned in an analysis published on thebmj.com. David...

What to do after a concussion

18 Nov 2016

Contributed by Lukas

Concussion is a clinical diagnosis made after a head injury with consequent associated signs, symptoms, and neurological or cognitive impairment (info...

Non-drug treatments for chronic insomnia

17 Nov 2016

Contributed by Lukas

Between 13 & 33% of the adult population have regular difficulty in getting to sleep, or staying asleep. It's important to recognise the difference be...

Cancer drugs, survival, and ethics

11 Nov 2016

Contributed by Lukas

Despite considerable investment and innovation, chemotherapy drugs have had little effect on survival in adults with metastatic cancer. In this podc...

Advertising junk food to children

04 Nov 2016

Contributed by Lukas

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 fr...

Research before researching

04 Nov 2016

Contributed by Lukas

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, ...

Rapid Recs - patient preference in heart valve replacement

01 Nov 2016

Contributed by Lukas

In patients with symptomatic severe aortic stenosis but at lower risk of perioperative death, how do minimally invasive techniques compare with open s...

Catherine Calderwood’s realistic medicine

28 Oct 2016

Contributed by Lukas

Catherine Calderwood has been chief medical officer for Scotland since March 2015 - her first CMO report, which she titled “Realistic Medicine” ha...

Middle East respiratory syndrome

21 Oct 2016

Contributed by Lukas

Middle East respiratory syndrome (MERS) is an acute viral respiratory tract infection caused by the novel betacoronavirus. Cases have been limited t...

Beyond data sharing - ”It was me who got my research team out of jail... that’s my data”

11 Oct 2016

Contributed by Lukas

Elizabeth Pisani, visiting senior research fellow at King's College London, collects data on sex workers and injecting drug users in low and middle in...

Head to head - Should all GPs be NHS employees?

07 Oct 2016

Contributed by Lukas

Independent contractor status creates unnecessary stress, argues Azeem Majeed, GP partner and professor of primary care at Imperial College London. L...

Preventing Overdiagnosis In Barcelona

06 Oct 2016

Contributed by Lukas

The Preventing Overdiagnosis conference is part of The BMJ's campaign against Too Much Medicine. Helen Macdonald clinical editor for The BMJ was at t...

Living kidney donation

23 Sep 2016

Contributed by Lukas

Globally each year more than 30 000 people become living kidney donors. Living kidney donation is constantly evolving, with new ways of pooling dono...

The ethics of placebo

16 Sep 2016

Contributed by Lukas

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 ar...

Ghostwriting redefined

09 Sep 2016

Contributed by Lukas

Alastair Matheson, independant consultant and former ghostwriter, describes how the pharmaceutical publications industry seeks to legitimise ghostwrit...

Reprehensible, but the people carrying out atrocities have very low rates of mental disorders

08 Sep 2016

Contributed by Lukas

Oversimplification and lack of evidence stigmatise people with mental illness and impede prevention efforts, says Simon Wessley, professor of psychiat...

Late effects of anticancer chemotherapy: It’s hard to trust your body, after it’s betrayed you

08 Sep 2016

Contributed by Lukas

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 survi...

”It suggests that older people have a lower value in society” - Ageism in global development

02 Sep 2016

Contributed by Lukas

The United Nation's Millennium Development Goals, and the subsequent Sustainable Development Goals, define premature mortality as being a death under ...

Not just our ethical credibility as a profession, but our shared humanity

30 Aug 2016

Contributed by Lukas

"I say to all Australian doctors - young, old, the political and the apolitical - that on this depends not just our ethical credibility as a professio...

Education round up - ICE, examinations, and adherence

25 Aug 2016

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...

A maladaptive pathway to drug approval

19 Aug 2016

Contributed by Lukas

The European Medicines Agency (EMA) has embraced a new model of drug testing and marketing called “adaptive pathways”, allowing new drugs for “u...

Evidence for examination

16 Aug 2016

Contributed by Lukas

You may have spent hours practicing for your examination exams, but how evidence based are the techniques taught? Andrew Elder, a professor at the Un...

Likelihood ratios in diagnostic tests

16 Aug 2016

Contributed by Lukas

Andrew Elder, a professor at the University of Edinburgh talks about likelihood ratios in diagnostic testing, and how they’re helpful in thinking ab...

Poor adherence to antihypertensives

16 Aug 2016

Contributed by Lukas

It is estimated that 50% of patients who have what appears to be treatment resistant hypertension are actually not taking their drugs as prescribed. ...

Anticipatory care

05 Aug 2016

Contributed by Lukas

“How long have I got, doc” is a TV medical drama cliche - but like all cliches has it’s feet in real life - and it’s medicine’s attempt to...

Ivan Oransky watching retractions

29 Jul 2016

Contributed by Lukas

Ivan Oransky, co-founder of Retraction Watch and global editorial director at MedPage Today, discusses which areas of science are most affected by res...

How does maximizing shareholder value distort drug development?

28 Jul 2016

Contributed by Lukas

With the emergence of sofobuvir, a new direct acting antiviral, treatment for Hepatitis C infection is currently undergoing it's greatest change since...

What went wrong with care.data?

22 Jul 2016

Contributed by Lukas

Failures in implementation of data sharing projects have eroded public trust. In the wake of NHS England’s decision to close down its care.data pro...

You’ve been ICE’d

22 Jul 2016

Contributed by Lukas

We’re taught that patients' ideas, concerns, and expectations are central to a successful consultation, but has ICEing gone too far? A “What your...

Should we scrap the internal market in England’s NHS

15 Jul 2016

Contributed by Lukas

The "internal market" was created after the 1987 UK general election focused attention on inadequate funding in the NHS, long waiting lists for electi...

Treating hip osteoarthritis

08 Jul 2016

Contributed by Lukas

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 cons...

Having hip osteoarthritis

08 Jul 2016

Contributed by Lukas

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 cons...

PreP And public health

08 Jul 2016

Contributed by Lukas

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...

Can guidelines be reformulated to account for how doctors actually use information?

01 Jul 2016

Contributed by Lukas

Guidelines usually assume a rational comprehensive decision model in which all values, means, and ends are known and considered. In clinical encounter...

Evidence live - Emily Sena on closing the gap between clinical and basic science

24 Jun 2016

Contributed by Lukas

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 th...

Julia Beluz And Victor Montori - Journalists And doctors; separated by a common evidence

23 Jun 2016

Contributed by Lukas

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 ...

Epilepsy in pregnancy

21 Jun 2016

Contributed by Lukas

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 mater...

Caring for patients with delirium at the end of their life

14 Jun 2016

Contributed by Lukas

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 success...

”What has convinced me is the evidence” - why mandatory treatment for drug use is a bad idea

10 Jun 2016

Contributed by Lukas

Global evidence indicates that mandated treatment of drug dependence conflicts with drug users’ human rights and is not effective in treating addict...

Tell me a story

03 Jun 2016

Contributed by Lukas

How can asking patient to tell us their story improve healthcare? Helen Morant, content lead at BMJ, talks us through her project getting healthcare p...

Guidelines Not Tramlines

27 May 2016

Contributed by Lukas

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 ...

Uncovering the uncertainty on wound dressing

26 May 2016

Contributed by Lukas

There is insufficient evidence to know whether dressings reduce the risk of surgical site infection in closed primary surgical wounds. Jane Blazeby,...

Women and the Zika Virus

25 May 2016

Contributed by Lukas

Interviews from the Women deliver conference in Copenhagen. Donna McCarraher, director of reproductive, maternal, newborn and child health at FHI 360...

Abortion as a development issue

25 May 2016

Contributed by Lukas

Interviews from the Women deliver conference in Copenhagen. Catrin Schulte-Hillen, co-ordinator of reproductive health and sexual violence care at Me...

What are they on?

20 May 2016

Contributed by Lukas

This week, we look at medication reconciliation. Joshua Pevnick, health services researcher and hospital physician at Cedars-Sinai Hospital, LA, US, ...

The Weekend Effect - what’s (un)knowable, and what next?

20 May 2016

Contributed by Lukas

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 thi...

”Women deliver, and not only babies”

16 May 2016

Contributed by Lukas

Katja Iversen, CEO of Women Deliver, joins Rebecca Coombes to explain why the UN sustainable development goals are unachievable if we don't empower wo...

Travellers’ diarrhoea

13 May 2016

Contributed by Lukas

Travellers’ diarrhoea is one of the most common illnesses in people who travel internationally, and depending on destination affects 20-60% of the m...

”The information we get can be harmfull”; Informed consent is not a panacea

09 May 2016

Contributed by Lukas

Providing information to enable informed choices about healthcare sounds immediately appealing to most of us. But Minna Johansson, GP trainee and Ph...

The science of improvement

06 May 2016

Contributed by Lukas

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 ...

Medical error—the third leading cause of death in the US

04 May 2016

Contributed by Lukas

Medical error is not included on death certificates or in rankings of cause of death. Martin Makary, professor of surgery at Johns Hopkins University ...

Ecigarettes; ”...the risk is 5% of that caused by smoking”

29 Apr 2016

Contributed by Lukas

Nicholas Hopkinson, reader in respiratory medicine at Imperial College London, joins us to explain why a new report from the Royal College of Physicia...

BMJ roundtable: How to fix out of hours care

27 Apr 2016

Contributed by Lukas

The BMJ recently held a discussion between experts in the fields of general practice, emergency medicine, and paediatrics about the state of out of ho...

Bad with names

22 Apr 2016

Contributed by Lukas

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 t...

”The harm and the benefit of treatment is about the same” - cardiac screening for athletes

22 Apr 2016

Contributed by Lukas

Sudden cardiac death of young athletes needs to be avoided but does screening really help? Hans Van Braband, researcher at the Belgian Health Care Kno...

Doctors in spaaaaaace

15 Apr 2016

Contributed by Lukas

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 i...

The pattern of damage caused by Zika virus in the brains of 23 foetuses

14 Apr 2016

Contributed by Lukas

In February World Health Organization (WHO) declared the microcephaly epidemic in South America an international public health emergency. Today, the U...

”What’s the point in living, in a body I don’t want” - how the NHS treats trans people

11 Apr 2016

Contributed by Lukas

James Barrett, president of the British Association of Gender Identity Specialists, and Nina, a trans woman, join us to discuss how difficult it can b...

Budget decisions can decrease alcohol deaths in less than 18 months

08 Apr 2016

Contributed by Lukas

Alcohol consumption has been a perennial problem, but recently The economic downturn and rises in alcohol taxation seem to have stemmed the persistent...

Greenwing cast explain why they’re with the junior doctors

08 Apr 2016

Contributed by Lukas

Abi Rimmer, BMJ careers reporter, talks to the cast of hospital comedy Greenwing, who explain why they're supporting junior doctors on the picket line...

Why the junior doctors are striking again

08 Apr 2016

Contributed by Lukas

Abi Rimmer, BMJ Careers reporter, talks to junior doctors on the picket line at Northwick Park Hospital. Read her report: http://bmj.co/1qydmFq

Plan, do, study, act

08 Apr 2016

Contributed by Lukas

Plan, do, study, act cycles, or PDSA cycles, are the basis of many quality improvement projects, they're a model to trial changes and feed the lessons...

Mistakes were made

08 Apr 2016

Contributed by Lukas

The Francis report, the Berwick report, the Keogh review - all of these have highlighted how important learning from mistakes is in healthcare. Repor...

Médecins Sans Frontières’s Dunkirk spirit

31 Mar 2016

Contributed by Lukas

As France has moved in recent weeks to clear camps where migrants stay while trying to cross illegally into Britain, Médecins Sans Frontières has ju...

How and when to treat depression in pregnancy

24 Mar 2016

Contributed by Lukas

Depression in pregnancy affects up to 10% of women, a rate only slightly lower than in the postpartum period. Yet, as few as 20% of pregnant women wit...

Should doctors boycott working in Australia’s immigration detention centres?

24 Mar 2016

Contributed by Lukas

However well intentioned, working in detention centres amounts to complicity in torture, says David Berger, a district medical officer in emergency me...

Jeremy Hunt Interview

23 Mar 2016

Contributed by Lukas

Jeremy Hunt is a health secretary under pressure. In this exclusive interview with The BMJ’s editor in chief Fiona Godlee, the man who could soon be...

”I thought I was the worst person with type I...” - Self management of diabetes

14 Mar 2016

Contributed by Lukas

Nick Oliver, consultant diabetologist at Imperial Healthcare NHS Trust and Philippa Cooper, who has type I diabetes, join us to explain how structured...

”We’re pulling the rug out from under the feet of [GPs]”

14 Mar 2016

Contributed by Lukas

Gareth Iacobucci talks to Candace Imison, director of policy at The Nuffield Trust, about the problems facing GPs, and how primary care could be chang...

”It’s the workforce, stupid” - is the NHS workforce in crisis?

09 Mar 2016

Contributed by Lukas

As the junior doctors in England strike, concerns for the workforce are foremost in the minds of those running the NHS. A summary is available here: ...

Zika virus - ”it really felt like having bad sunburn, all over your body”

26 Feb 2016

Contributed by Lukas

“Juliet”, a woman living in London, was diagnosed with a mysterious illness in November 2015, Ian Cropley, a consultant in infectious disease from...

What is vaginal seeding - and is it safe?

23 Feb 2016

Contributed by Lukas

How should health professionals engage with this increasingly popular but unproved practice? Aubrey Cunnington, a consultant paediatrician from Imper...

Frontline NHS charges for migrants will harm the most vulnerable

19 Feb 2016

Contributed by Lukas

The Department of Health is proposing to extend charging for migrants into some NHS primary care services and emergency departments. Although the gov...

Time to end the federal ban on gun violence research funding

11 Feb 2016

Contributed by Lukas

In recent weeks, the firearms controversy has again lit up the media in the United States, with clarification that anyone engaged in the business of s...

Junior doctors second strike - from the picket line

10 Feb 2016

Contributed by Lukas

This week, junior doctors in England have taken industrial action for the second time in as many months after failing to reach agreement with the gove...

Stopping the overtreatment of malaria

05 Feb 2016

Contributed by Lukas

The Rapid diagnostic tests have the potential to reduce the overtreatment of malaria by 95%, but time and extensive logistical, behavioural, and techn...

The role of stenting in stable angina

05 Feb 2016

Contributed by Lukas

Iqbal Malik, consultant cardiologist at Imperial College Healthcare NHS Trust in London, joins Mabel Chew to discuss the role of angioplasty and sten...

Could campaigns like Dry January do more harm than good?

09 Jan 2016

Contributed by Lukas

Are you having a dry January? In this podcast Ian Gilmore, honorary professor at Liverpool University, and Ian Hamilton, a lecturer in the Department...

Exercise induced bronchoconstriction

09 Jan 2016

Contributed by Lukas

James Smoliga, from High Point University, North Carolina, and Ken Rundell, from The Commonwealth Medical College, Pennsylvania, join us to discuss ho...

CKD In the elderly - disease, or disease label

09 Jan 2016

Contributed by Lukas

Around half of people aged over 75 meet the diagnostic criteria for chronic kidney disease (CKD), but there is debate about what this means for patie...

Cancer screening - does it save lives?

08 Jan 2016

Contributed by Lukas

The claim that cancer screening saves lives is based on fewer deaths due to the target cancer. Vinay Prasad, assistant professor at Oregon Health and ...

Why are Dutch GPs happier than British ones?

08 Jan 2016

Contributed by Lukas

General practice is similar in the Netherlands and the UK yet it appeals far more to young Dutch doctors than to their British counterparts. In collab...

In search of the Christmas spirit

15 Dec 2015

Contributed by Lukas

Is the Christmas sprit divinely inspired, or does it reside within the body? Researchers from Denmark have tried to answer that age-old philosophical ...

The big (research) book of British teeth

15 Dec 2015

Contributed by Lukas

Despite what hollywood says, science has proven that British teeth are actually better than American. Richard Watt, head of the Research Department of...

Gunslingers gait

15 Dec 2015

Contributed by Lukas

A lot of attention has been paid to Russian president Vladimir Putin recently, but a group of researchers from The Netherlands are more interested in ...

Diagnosing COPD in primary care

04 Dec 2015

Contributed by Lukas

Francesca Conway, from the Department of Primary Care and Public Health at Imperial College London is co-author of an article on diagnosis of COPD. Sh...

The more you see, the more you eat

03 Dec 2015

Contributed by Lukas

Larger portions of food increase consumption. Theresa Marteau, director of the Behaviour and Health Research Unit at the University of Cambridge, join...

Sarah Wollaston - obesity, not a sugary drinks tax, is regressive

02 Dec 2015

Contributed by Lukas

The UK Parliament's Health Select Committee's recent report on childhood obesity says 1 in 5 children are obese by the time they leave school. The com...

The diagnosis and treatment of post-traumatic stress disorder

27 Nov 2015

Contributed by Lukas

PTSD may develop after exposure to exceptionally threatening or horrifying events. About 3% of the adult population has PTSD at any one time, and more...

The evidence on doctors strikes and patient harm

27 Nov 2015

Contributed by Lukas

Doctors considering strike action may worry about the effect on patients. David Metcalfe and colleagues examine the evidence and find that “patients...

Revisiting the bridge

13 Nov 2015

Contributed by Lukas

In the podcast, we’ll hear from Kevin Hines the survivor of such an attempt, and Alys Cole-King, a psychiatrist who wants to break down the stigma o...

Unexpected findings, with uncertain implications, in research imaging

13 Nov 2015

Contributed by Lukas

When healthy volunteers are scanned as part of a research project, unexpected findings, with uncertain implications, can be thrown up. Joanna Wardla...

This house believes that medicine is the best career in the world.

02 Nov 2015

Contributed by Lukas

Medicine has long been a rewarding career, but doctors say the profession needs to overcome the frustrations of working in the NHS to ensure it remain...

Diagnosis and treatment of diabetic ketoacidosis in adults

30 Oct 2015

Contributed by Lukas

Shivani Misra, clinical research fellow and specialist trainee in metabolic medicine from Imperial College London, joins us to discuss diagnosis and m...