Welcome to the festive talk evidence, giving you a little EBM to take you into the new year. As always Duncan Jarvies is joined by Helen Macdonald (resting GP and editor at The BMJ) and Carl Heneghan (active GP, director of Oxford University’s CEBM and editor of BMJ Evidence) This month: (2.00) Helen look back at a Christmas article, which investigates a very common superstition in hospitals. (7.55) Carl has his pick of the top 100 altimetric most influential papers of the year. (12.40) We find out all about the preventing overdiagnosis conference which happened earlier in December. (34.15) Helen has her annual rant about misogeny in medicine. Reading list: Q fever—the superstition of avoiding the word “quiet” as a coping mechanism https://www.bmj.com/content/367/bmj.l6446 Altimetric Top 100 https://www.altmetric.com/top100/2019/ Fiona Godlee’s keynote at Preventing Overdiagnosis https://www.preventingoverdiagnosis.net/ Gender differences in how scientists present the importance of their research: observational study https://www.bmj.com/content/367/bmj.l6573
Chapter 1: What is the main topic discussed in this episode?
Welcome back to a particularly Christmassy Talk Evidence, your monthly dive into the world of EBM. As always, we're bringing you some top science, this time looking back through the last year, as well as in the Christmas BMJ.
Chapter 2: What superstition is explored in the Christmas article?
I'm Duncan Jarvis, multimedia editor for the BMJ, and as always, I'm joined by your favourite EBM nerds. Helen, can you introduce yourself?
I'm Helen MacDonald, UK Research Editor at the BMJ and a resting GP.
We've stuck with resting now.
What does it mean to be a resting GP?
Chapter 3: What are the highlights of the top 100 altimetric papers of the year?
That's ridiculous.
It means you spend too much time being a mum and editing to do any clinical work.
Look, there's a dire need for GPs back on the front line.
I'm happy to come back at any time. They make it easy.
Chapter 4: What insights were shared from the Preventing Overdiagnosis conference?
It is impossible to get back.
That's a whole other rant, I feel like. Maybe not for this podcast. Carl, can you introduce yourself?
Yes, I'm Carl Hennigan. I'm Editor-in-Chief of BMJ Evidence-Based Medicine, an academic and not a resting GP, an active GP who's working in urgent care over the holiday period. Thank you. Just to get something.
Just get your little violin out.
Yeah, just to get some love out there and people think, oh, poor you.
I know. Your kids are expecting some good Christmas presents this year because of that.
No, it's because, actually, the NHS are the only people who email me and tweet me on a daily basis saying, well, sending me nice messages saying, can you work this weekend?
There you go. So it's the festive period and after a long year of evidence, or maybe in some cases elections, lack of evidence, we're going to take a look at Christmas and I'll look back over the altmetric top 100 papers. So Helen, in this festive period, how superstitious are you feeling?
Yes. Well, I've got a great research paper for you guys this week, which is from the BMJ's Christmas edition, which is where everything is a bit unusual. So good science, slightly quirky questions. And I have a paper called Q Fever. Can you guess what this is about?
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Chapter 5: What issues surrounding misogyny in medicine are discussed?
It's about something I can't do.
Something I can't do.
Be quiet.
Yeah, that's very difficult for me. I'll try.
So these authors say that saying quiet is about the worst thing that you can do at work. And they say Adam Kay, ex-junior doctor, says in his book, say the Q word to a doctor and you are all but performing an incantation summoning up the sickest people in the world to your hospital. And I certainly remember being told off a lot in hospital.
I have a very small brain circuit between my thoughts and my mouth. And the word quiet did used to come out of my mouth quite a lot. So this looks at whether saying the word quiet out loud increases your clinical workload. And this is done by a rather glorious collection of lab clinicians. And a secondary aim of this paper was
which is nonetheless very important, is to answer the question, what does a medical microbiologist actually do?
So just to say this is done by the microbiology team at Lancashire Teaching Hospitals and NHS Foundation Trust. And there's a very sweet photo of them. There is.
I have to say, it is really written well, this. And I was slightly astounded when it... You might chuckle out loud when you read it. At the end of the introduction, it says, "...a secondary aim of the trial was to answer another mystery of the medical world, what medical microbiologists actually do." And that's a question that I think is actually unanswerable by research.
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Chapter 6: How does saying 'quiet' impact clinical workload according to the research?
I find that a bit depressing. It's the things people actually care about, I suppose.
Well, I think it's interesting, and we've been looking into this, whether the problem is now is that in selecting research, we're starting to skew to these new type of issues like all metrics because they get you this instant hit in the news, the blogs, the Twittersphere.
and so editors are starting to choose this more often and we're actually taking a bit of a look at this at the moment so we'll come back to you in the future but i think it may be skewing the choice of articles so it becomes a self-fulfilling prophecy that you're more likely to see this stuff because actually it's more likely to get this high alt metric that might not actually bear out though in the citation so we don't understand the impact i think they are correlated
yeah but whether the impact in future decisions about it changes in healthcare and guidelines be interesting to see because there are not many of what i consider the important systematic reviews or randomized control trials in this top 100 because there's lots of observational studies in there perhaps it also relates to as science becomes increasingly open to the public what topics the public can easily identify with and tweet and engage with and blog about themselves as well
Or maybe what they're actually interested in, you know, ivory tower, academics working away and actually people just want to know what's good to eat.
Should I eat fish?
Yeah, easy. Great. Well, there you go. So that's two things. One thing to start doing, which is some exercise. And one thing to stop doing, which is worrying about saying it's quiet. So, as we record this, Carl, you have just come back from Sydney.
Can I get my violin out? Because Carl's just come back from Sydney at the Preventing Overdiagnosis conference. And I didn't go, but Carl did. Carl's been in the sunshine.
Well, was there any sunshine? All those bushfires? Have you seen photos of Sydney recently? Somebody's got to do it, haven't they?
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