The whole thing was a farce why are you not speaking out?

The podcast for evidence based medicine - where research, guidance and practice are debated and demystified

Talk Evidence

40 LỜI KHAI THỊ TÔN SƯ - TT. Thích Tuệ Hải

睡眠的礼物

From Dusk Till Dawn, Pt. 27

Sleep Satisfaction

From Dusk Till Dawn, Pt. 26

Music for Peaceful Dreams, Pt. 1

It's October's Talk Evidence, and  that means the autumn is upon us including those autumnal viruses. Here in the UK covid is on the rise, and Joe Ross is looking at some research on how good those elusive lateral flows are at detecting infection among people with symptoms of covid.

Juan will give us an update on the covid inquiry, the collection of analysis articles The BMJ is publishing looking at the interface of evidence and policy in our decisions about how to handle the pandemic.

Since the pandemic moral among clinicians in many health systems has fallen even further, workloads have spiralled. Coupled with other problems with workforce planning and investment in health and healthcare, this is increasing burnout -  with a consequential impact on patient care. Helen will tell us about new research which is trying to put some numbers to how much clinican burnout effects patient outcomes

Finally, we're turning to a very clinical topic that we don't often cover in Talk Evidence - oncology, and some interesting insights into clearance margins in cancer surgery.


Reading list

Diagnostic accuracy of covid-19 rapid antigen tests with unsupervised self-sampling in people with symptoms in the omicron period
https://www.bmj.com/content/378/bmj-2022-071215

Guided by the science? Questions for the UK’s covid-19 public inquiry
https://www.bmj.com/content/378/bmj.o2066

 
Associations of physician burnout with career engagement and quality of patient care
https://www.bmj.com/content/378/bmj-2022-070442

Margin status and survival outcomes after breast cancer conservation surgery
https://www.bmj.com/content/378/bmj-2022-070346

Talk Evidence - Inquiring about covid, burnout, and marginal data

Restful Sleep

Drifting Off Music for Restful Sleep, Pt. 1

It's almost time for the Christmas edition of the BMJ to hit your doormats, and in this festive edition of Talk Evidence we're going to be talking Christmas research.

Joining Helen and Juan, we have Tim Feeney, BMJ research editor and researcher into Surgical outcomes at Boston University.

In this episode we'll be hearing about the health of footballers, and if a career in the sport predisposes Swedish players to substance use disorders. We'll hear about the performance of BMJ’s editors, when it comes to assessing the impact of a paper. We'll find out if AI algorithms can pass UK radiology exams, misinformation and a belief that everything causes cancer, and finally, some tips from BMJ’s statisticians to set the world right

Talking evidence at Christmas

In this week's episode, we're focusing on covid and the ongoing crisis in the NHS.

Helen Macdonald, Juan Franco and Joseph Ross cast their evidence seeking eyes over research into outcomes as well as the workload of doctors.

Firstly, Joe tells us about a new big data study into longer term outcomes after mild covid-19, how those ongoing symptoms relate to long covid, and how often they resolve themselves.

Juan looks back to his homeland to see what Argentina which was very early to offer children vaccinations against covid-19. He tells us how a new study design can help understand how effective different combinations of vaccines were.

Joe has a Danish registry paper, which links people's employment status after a MI, explains how that gives us an insight into morbidity following that event.

Helen looks at a new analysis which outlines the concept of "time needed to treat" - a measure of how much time it would take a clinician to actually carry out a guideline - and you'd be surprised how much GP time would be swallowed by a "brief" intervention to reduce inactivity in their patients.

Finally, the data on excess mortality in the UK has been up for debate recently - our health minister calling into question the Office of National Statistic's data. We hear from Nazrul Islam, Associate professor of medical statistics, advisor to the ONS and BMJ research editor, who has some bad news for him.

Reading list:
Long covid outcomes at one year after mild SARS-CoV-2 infection
https://www.bmj.com/content/380/bmj-2022-072529

Effectiveness of mRNA-1273, BNT162b2, and BBIBP-CorV vaccines against infection and mortality in children in Argentina, during predominance of delta and omicron covid-19 variants
https://www.bmj.com/content/379/bmj-2022-073070


Guidelines should consider clinicians’ time needed to treat
https://www.bmj.com/content/380/bmj-2022-072953

Expanding the measurement of overdiagnosis in the context of disease precursors and risk factors
https://ebm.bmj.com/content/early/2023/01/10/bmjebm-2022-112117

Excess deaths associated with covid-19 pandemic in 2020
https://www.bmj.com/content/373/bmj.n1137.abstract

Talk Evidence - excess deaths, the ONS, and the healthcare crisis

In this episode of Talk Evidence, Helen Macdonald is joined by Juan Franco and Joe Ross, to bring you the newest evidence in The BMJ.

First, chronic pain. As prescribers move away from opioids, Juan finds an overview of systematic reviews asking whether anti-depressants might help. 

Joe finds new research on the link between six healthy lifestyle markers and cognitive decline. 

Helen looks at a trial to reduce prescribing among older people with suspected urinary tract infection or UTI.

Juan has a nuanced take on the updated evidence on masks to reduce the spread of respiratory viruses. 

Finally, an international group of researchers traced the health claims made about infant formula milk back to the evidence or lack of it 

Reading list:
Efficacy, safety, and tolerability of antidepressants for pain in adults
https://www.bmj.com/content/380/bmj-2022-072415

Association between healthy lifestyle and memory decline in older adults
https://www.bmj.com/content/380/bmj-2022-072691

Effect of a multifaceted antibiotic stewardship intervention to improve antibiotic prescribing for suspected urinary tract infections in frail older adults 
https://www.bmj.com/content/380/bmj-2022-072319

Physical interventions to interrupt or reduce the spread of respiratory viruses
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD006207.pub6/full

Health and nutrition claims for infant formula
https://www.bmj.com/content/380/bmj-2022-071075

Talk Evidence - masks, chronic pain, and baby milk formulae claims

Speeches of 2023-03-15

001 - TaTaiDatPhongLamXangLamBayLaiBiXungHienVuongTH

In this month’s Talk Evidence, Helen Macdonald, Juan Franco and Joseph Ross are back to talk us through some of the latest research, 

They’ll talk about pay-for-perfomance schemes, and whether the data they routinely collect is measuring outcomes or  tickboxes. They’ll also talk about a new analysis published on bmj.com which suggests ways in which that data could be better.


We’re also by Huseyin Naci, associate professor of health policy at the London School of Economics and Political Science, who will tell us about proposed changes to drug regulation in the UK - and we discuss research which has linked speedier regulatory approval to more adverse advents in post marketing studies.

Finally, we talk about point of care apps. The availability of medical information in the clinic has changed practice, but how good is that information? We hear about research which has evaluated those point of care apps (including BMJ’s Best Practice app) and rates them against different criteria.


Reading list

Estimated impact from the withdrawal of primary care financial incentives on selected indicators of quality of care in Scotland 
https://www.bmj.com/content/380/bmj-2022-072098
How can we improve the quality of data collected in general practice?
https://www.bmj.com/content/380/bmj-2022-071950#


UK to give “near automatic sign off” for treatments approved by “trusted” regulators
https://www.bmj.com/content/380/bmj.p633


Smartphone apps for point-of-care information summaries
https://ebm.bmj.com/content/early/2023/03/14/bmjebm-2022-112146

Talk Evidence - automatic approval, evidence apps, and pay for performance data

Helen Macdonald, Juan Franco, and Joe Ross are back with our monthly update on the world of evidence based medicine.

This episode delves into new methodologies which can use observational data to emulate trial data.  We discuss a new systematic review and meta-analysis of RCTs for surgical treatment of sciatica.  There is elaboration and explanation of the CONSORT Harms 2022 statement - and we'll be asking if it goes far enough. Finally, the old chestnut of surrogate endpoints in cancer treatment trials - are benefits communicated to patients accurately?

Reading list;
Nirmatrelvir and risk of hospital admission or death in adults with covid-19: emulation of a randomized target trial using electronic health records - https://www.bmj.com/content/381/bmj-2022-073312

Surgical versus non-surgical treatment for sciatica
https://www.bmj.com/content/381/bmj-2022-070730


CONSORT Harms 2022 statement, explanation, and elaboration
https://www.bmj.com/content/381/bmj-2022-073725

Funders crack down on unpublished clinical trials—but is it enough?
https://www.bmj.com/content/381/bmj.p840

Communication of anticancer drug benefits and related uncertainties to patients and clinicians
https://www.bmj.com/content/380/bmj-2022-073711

Talk Evidence - cloning, reporting, and disseminating

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Rene Pareja to discuss recent the cervical cancer management updates. Dr. Pareja is a gynecologist-oncologist at Astorga Oncology Clinic in Medellín and the National Cancer Institute in Bogotá, Colombia. He is a reviewer for more than 20 specialty journals and is an Associate Editor for IJGC. He is the author of ten book chapters and more than 80 publications in peer-reviewed journals, and at IGCS 2021 he received an award for Community Advancement in Resource-Limited Settings.

Highlights:
 - There is controversy in offering minimally invasive approaches to women with early-stage cervical cancer and tumors less than 2 cm.
 - The role of surgical staging remains controversial because guidelines still recommend it, despite evidence of a negative prospective randomized controlled trial.
 - Intermediate risk factors after a radical hysterectomy need to be re-evaluated in a very well designed prospective randomized trial, with modern radiotherapy techniques and updated inclusion criteria.

Cervical Cancer Management Updates with Rene Pareja

5. Евангелие От Йоан. Глава Шеста И Седма - Г. Томалевски.MP3

1 August 2023, Theater im Palais, Leonhardstraße 19, 8010 Graz

zone expérimentale basel

Clara Giner Franco, bass flute 
Manca Dornik, accordion  
Pietro Elia Barcellona, double bass

‘’Eros concerns the other in strong sense, namely, what cannot be encompassed by the regime of the ego.’’*
- 
Byung-Chul Han

Throughout the composing process I deeply hesitated  to write any words about the piece. This uneasiness was not caused by the complicatedness of the questions and intentions behind the piece. Rather, it was their inner contradictions and radical dispositions which made articulating them so difficult. They seemed to me very irrational, erratic and reactive to be helpful  to the listener throughout the listening process. 

However, at first the piece was motivated to explore perceptual roots of erotic experience caused by an encounter with the other or  one's own otherness. Unfortunately, the exploration did not  succeed. Rather it turned out to be a confrontation with the agony of Eros who is burning in the inferno of the same.

Ankara, 12.04.2023
*Han Byung-Chul et al. The Agony of Eros. MIT Press 2017.

Eros therefore Psyche (or not an Oriental rug) (2023) for bass flute, accordion and double bass

DawgNation Daily -- the daily podcast for Georgia Bulldogs fans

Beginning of the show: A look at an old comment from one of Alabama's best players that explains why Saturday is much more than just another football game for these two teams.

15-minute mark: I discuss the emergence of Kendall Milton and Milton's comment from earlier in the week about the intensity of UGA's practices leading into the SEC championship game.

25-minute mark: Former UGA WR Terrence Edwards joins the show.

40-minute mark: I take a look at other SEC headlines including the latest transfer rumors and reports regarding some of the league's QBs.

50-minute mark: CBS Sports' Brad Nessler joins the show to discuss the final SEC game airing on the network.

End of show: I award some Golden Shoe winners and share the Gator Hater Countdown.

Talk Evidence - Inquiring about covid, burnout, and marginal data

BMJ talk medicine

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