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

Talk Evidence

In this week's Talk Evidence, Joe Ross, BMJ editor and professor at Yale again joins Helen Macdonald to talk about emerging evidence on Covid-19.

They also welcome to the podcast Juan Franco, family physician in Buenos Aires, and professor at the Instituto Universitario Hospital Italiano, and new editor-in-chief of BMJ Evidence Based Medicine.

This week, the team bring you updates on;

Post-covid syndrome in individuals admitted to hospital with covid-19 - how are people with long covid faring.

Finally published research from Scandinavia on the risk of thrombotic events after administration of the Oxford-AstraZeneca vaccine - how big is the risk, and what does that mean for the overall benefit of that vaccine.

How difficult the UK population found it to understand and stick to the rules with our test, trace and isolate system - and some of the questions that this raises for this public health approach.

and finally, research that showed non-drug interventions are as good as pharmaceuticals at treating people with depression and dementia - and the holistic effect that alleviating depression can have.


Full reading list
Ayoubkhani, Daniel, Kamlesh Khunti, Vahé Nafilyan, Thomas Maddox, Ben Humberstone, Ian Diamond, and Amitava Banerjee. 2021. “Post-Covid Syndrome in Individuals Admitted to Hospital with Covid-19: Retrospective Cohort Study.” BMJ  372 (March): n693.
https://www.bmj.com/content/372/bmj.n693


Pottegård, Anton, Lars Christian Lund, Øystein Karlstad, Jesper Dahl, Morten Andersen, Jesper Hallas, Øjvind Lidegaard, et al. 2021. “Arterial Events, Venous Thromboembolism, Thrombocytopenia, and Bleeding after Vaccination with Oxford-AstraZeneca ChAdOx1-S in Denmark and Norway: Population Based Cohort Study.” BMJ  373 (May): n1114.
https://www.bmj.com/content/373/bmj.n1114

Smith, Louise E., Henry W. W. Potts, Richard Amlôt, Nicola T. Fear, Susan Michie, and G. James Rubin. 2021. “Adherence to the Test, Trace, and Isolate System in the UK: Results from 37 Nationally Representative Surveys.” BMJ  372 (March): n608.
https://www.bmj.com/content/372/bmj.n608

Watt, Jennifer A., Zahra Goodarzi, Areti Angeliki Veroniki, Vera Nincic, Paul A. Khan, Marco Ghassemi, Yonda Lai, et al. 2021. “Comparative Efficacy of Interventions for Reducing Symptoms of Depression in People with Dementia: Systematic Review and Network Meta-Analysis.” BMJ  372 (March): n532.
https://www.bmj.com/content/372/bmj.n532

Talk Evidence covid-19 update - Research on vaccine safety, treatment for dementia

In this Talk Evidence, Helen Macdonald, Joe Ross and Duncan Jarvies discuss what's going on in the world of EBM.

Firstly, a while ago on the podcast, we concluded that excess mortality would be the best way to measure the impact of the pandemic - and now a new paper looks at different country's excess mortalitites over the past year. We're joined by author Nazrul Islam Physician-Epidemiologist at the University of Oxford (and a research editor for The BMJ) to talk about why comparisons may still not be sensible.

Read the full research here - https://www.bmj.com/content/373/bmj.n1137

The Delta variant is dominating headlines, and infections in the UK now - but until recently the Alpha one was ascendent, and new research has helped characterise how the mortality rate of that variant differed from previous viruses.  We discuss how that research was done.

Read the full research - https://www.bmj.com/content/372/bmj.n579

GP data in the UK - the planned cut-off for granting access to your GP data for researchers has been extended, but there are still a lot of questions remaining. Helen has tried to find out some basic answers, and is still confused.

Finally, the FDA has approved a new drug for treatment of dementia - and researchers (and the FDA's own panel of experts) are up in arms. Joe Ross tells us why he thinks the decision was the wrong one, and why patients may be harmed because of it. 

https://edition.cnn.com/2021/06/17/opinions/biogen-alzheimers-drug-opinion-ramachandra-ross/index.html

Talk Evidence - GP data, excess mortality and FDA approval

The 19th of July in the UK saw the relaxation of covid rules that have been in place for 18 months - social distancing requirements in venues, mask wearing in public will no longer be legally mandated.

There are a lot of questions about what this will mean for the pandemic, and in this episode of Talk Evidence Helen MacDonald, Joe Ross and Duncan Jarvies are joined by Iain Buchan, professor of public health in Liverpool, who has been involved in 2 key studies on covid transmission. 

Firstly, lateral flow tests - the big questions has been how well do they work in the wild - and how well do they have to work, to be useful in test trace and isolate? Iain tells us about new research into the innova test.

Secondly, events - the football has shown that events can still be a big source of transmission, and the UK government put in place a number of trial events, all carefully monitored by public health researchers - Iain tells us about one nightclub test in Liverpool, and what we can glean from it.

Reading list;

Performance of the Innova SARS-CoV-2 antigen rapid lateral flow test in the Liverpool asymptomatic testing pilot: population based cohort study
https://www.bmj.com/content/374/bmj.n1637

The UK government's events programme
https://www.gov.uk/government/publications/events-research-programme-phase-i-findings/events-research-programme-phase-i-findings#findings
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/979461/S1195_Science_framework_for_opening_up_group_events.pdf

Effect of the covid-19 pandemic in 2020 on life expectancy across populations in the USA and other high income countries: simulations of provisional mortality data
https://www.bmj.com/content/373/bmj.n1343

Optimizing Therapy to Prevent Avoidable Hospital Admissions in Multimorbid Older Adults (OPERAM): cluster randomised controlled trial
https://www.bmj.com/content/374/bmj.n1585

Efficacy, acceptability, and safety of muscle relaxants for adults with non-specific low back pain: systematic review and meta-analysis
https://www.bmj.com/content/374/bmj.n1446

Talk Evidence - Freedom Day

In this month's Talk Evidence, Helen Macdonald and Joe Ross are back with a wry look at the world of Evidence Based Medicine.

They give us a round up of real world data emerging to address various uncertainties about vaccinations against covid

Helen has an update on NHS Digital’s project to extract GP coding for planning of healthcare and research, and talks to Natalie Banner from Understanding Patient Data, to find out what the public really cares about.

Finally, as routine care must go on a clinical review on cardiovascular disease in older adults introduces us to geroscience.


Reading list

Vaccines;
Effectiveness of BNT162b2 and mRNA-1273 covid-19 vaccines against symptomatic SARS-CoV-2 infection and severe covid-19 outcomes in Ontario, Canada: test negative design study - https://doi.org/10.1136/bmj.n1943 

Effectiveness of the CoronaVac vaccine in older adults during a gamma variant associated epidemic of covid-19 in Brazil: test negative case-control study -  https://doi.org/10.1136/bmj.n2015

Associations of BNT162b2 vaccination with SARS-CoV-2 infection and hospital admission and death with covid-19 in nursing homes and healthcare workers in Catalonia: prospective cohort study
https://doi.org/10.1136/bmj.n1868

Risk of thrombocytopenia and thromboembolism after covid-19 vaccination and SARS-CoV-2 positive testing: self-controlled case series study - https://doi.org/10.1136/bmj.n1931 

CVD
Cardiovascular care of older adults - https://doi.org/10.1136/bmj.n1593

Talk Evidence - real world vaccine data, GP records and CVD

This week our regular panelists, Helen Macdonald and Joe Ross, are joined by Juan Franco, editor in chief of BMJ Evidence Based Medicine - to take a primary care focussed look at what's been happening in the world of evidence.

On this week’s episode. 
As kids go back to school, winter bugs surge and pressure mounts on health services we look at two trials which aimed to use reduce antibiotic prescribing for respiratory tract infections in nursing homes and primary care

Juan brings us an update on prescribing medicinal cannabis for pain, based on a recent BMJ rapid recommendation article and linked systematic review and meta-analysis

And finally, in covid news, how likely are you to be admitted or die from covid after one or two SARS-CoV 2 vaccinations?

Reading list
Effect of C reactive protein point-of-care testing on antibiotic prescribing for lower respiratory tract infections in nursing home residents - https://www.bmj.com/content/374/bmj.n2198

Procalcitonin and lung ultrasonography point-of-care testing to determine antibiotic prescription in patients with lower respiratory tract infection in primary care - https://www.bmj.com/content/374/bmj.n2132

Medical cannabis or cannabinoids for chronic pain - https://www.bmj.com/content/374/bmj.n2040

Risk prediction of covid-19 related death and hospital admission in adults after covid-19 vaccination - https://www.bmj.com/content/374/bmj.n2244

Talk Evidence - testing for respiratory tract infections, cannabis for pain, & covid outcomes

In this month’s Talk evidence, we’re going back to our roots and avoiding covid - so sit back and listen to Helen Macdonald and Joe Ross discuss a new nutrition study to prevent fractures in older adults by eating dairy, and a meta-analysis which helps you choose pain relief medications for management of osteoarthritis.

We’ll hear from Steven Woloshin about the virtual Overdiagnosis conference, and why he’s so excited about a new category in the National Library of Medicine.

Finally, we have a study on urinary retention and risk of cancer that has been over 25 years in the making.


Reading list;

Effect of dietary sources of calcium and protein on hip fractures and falls in older adults in residential care
https://www.bmj.com/content/375/bmj.n2364

Effectiveness and safety of non-steroidal anti-inflammatory drugs and opioid treatment for knee and hip osteoarthritis
https://www.bmj.com/content/375/bmj.n2321

To access the webinars Steven was talking about.
https://www.preventingoverdiagnosis.net/

Acute urinary retention and risk of cancer
https://www.bmj.com/content/375/bmj.n2305

Podcast listener survey. Please let us know how we could improve the podcasts for you, and your specialty - https://linktr.ee/BMJsurvey

Talk Evidence - Bones, nutrition, pain relief, and overdiagnosis.

The BMJ has special criteria for considering Christmas research: first it should make you laugh, and then it should make you think. 

In this festive episode of the Talk Evidence podcast, our regular panel of Helen Macdonald and Joe Ross are again joined by Juan Franco,
editor in chief of BMJ Evidence Based Medicine. 

They’ll give you a peek into what makes for good Christmas research, and why what may seem silly on the surface has a deeper meaning.

Talking Christmas Evidence 2021

In the first Talk Evidence of 2022, we'll be asking about the evidence for isolation - now that isolation periods are being reduced, or even stopped in the event of a negative lateral flow test, we'll find out what data that's based on, and if it's appropriate. 

Vaccinations and treatments for covid-19 have been the one major success story of the pandemic, but that doesn't mean we should abandon the principles of openness and transparency when it comes to scrutinising the data - we'll hear what access to the data which underlies regulatory approval could do now.

Finally, the impacts of climate change were set out in a WHO report in November last year - and recent weather seems to underline their conclusions. We'll discuss new evidence linking the environment and health, and ask what clinicians can do with that.

Reading list:
Mitigating isolation: The use of rapid antigen testing to reduce the impact of self-isolation periods
https://www.medrxiv.org/content/10.1101/2021.12.23.21268326v1.full.pdf

Covid-19 vaccines and treatments: we must have raw data, now
https://www.bmj.com/content/376/bmj.o102

WHO report: Climate change and health
https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health

Ambient heat and risks of emergency department visits among adults in the United States: time stratified case crossover study
https://www.bmj.com/content/375/bmj-2021-065653

Residential exposure to transportation noise in Denmark and incidence of dementia: national cohort study
https://www.bmj.com/content/374/bmj.n1954

Long term exposure to low level air pollution and mortality in eight European cohorts within the ELAPSE project: pooled analysis
https://www.bmj.com/content/374/bmj.n1904

Talk Evidence - isolation periods, openness, and environmental impacts

In this episode of Talk Evidence, Helen Macdonald, the BMJ’s research integrity editor is joined by Joe Ross, US research editor, and Juan Franco, editor in chief of BMJEBM, to talk about all things evidence.

Joe gives us an update about covid, including new research on safety of the vaccine  Association between covid-19 vaccination, SARS-CoV-2 infection, and risk of immune mediated neurological events
https://www.bmj.com/content/376/bmj-2021-068373

Juan updates us on a potential new prophylactic for recurrent UTIs, Methenamine hippurate, which could be an alternative to antibiotics.
Alternative to prophylactic antibiotics for the treatment of recurrent urinary tract infections in women
https://www.bmj.com/content/376/bmj-2021-0068229

Helen tells us about some research which evaluates the way in which intersecting identities combine to make students experience of medical school more difficult.
Marginalized identities, mistreatment, discrimination, and burnout among US medical students
https://www.bmj.com/content/376/bmj-2021-065984

Covid vaccine safety, Methenamine hippurate, and intersectionality

Helen Macdonald, The BMJ's research integrity editor is back with another episode, and this week is joined by Joe Ross, professor of medicine and public health at Yale, and US research editor for The BMJ, and Juan Franco, editor in chief of BMJ EBM, and Professor at the  Instituto Universitario Hospital Italiano de Buenos Aires

In this episode they discuss;

The US supreme court looks set to overturn Roe v Wade, creating a patchwork of abortion provision across the U.S.  We consider the role which evidence might play in documenting how health is affected by that decision, and whether medical evidence is being used at all in the debate.

We'll give you a quick update on treatment for Covid-19

We know that trials are needed for new treatments, but in the face of an exponentially growing amount of observational data, is it time for a shift in that certainty? Joe tells us about his research into whether trials and observational studies of three drugs in covid produce the same answer? 

And finally, treatment variation - it's one of the things that helped kick-start the EBM revolution, but there's still much to learn. Juan describes some new research which examines how countries stack up when you compare their handling of and outcomes of a common condition such as a myocardial infarction.

Reading list;

Navigating Loss of Abortion Services — A Large Academic Medical Center Prepares for the Overturn of Roe v. Wade
https://www.nejm.org/doi/full/10.1056/NEJMp2206246.

A living WHO guideline on drugs for covid-19
https://www.bmj.com/content/370/bmj.m3379

Agreement of treatment effects from observational studies and randomized controlled trials evaluating hydroxychloroquine, lopinavir-ritonavir, or dexamethasone for covid-19
https://www.bmj.com/content/377/bmj-2021-069400

Variation in revascularisation use and outcomes of patients in hospital with acute myocardial infarction across six high income countries
https://www.bmj.com/content/377/bmj-2021-069164

Talk Evidence - evidence in Roe vs Wade, MI treatment variation, and tribal methodologies

In this episode, Juan Franco, editor in chief of BMJ EBM, and Helen Macdonald, The BMJ's research integrity editor, sit down to discuss what's new in the world of evidence.

Firstly, last week they went to the first EBM Live conference for two years - and report back on what happened when the evidence community got back together.

We have two research papers looking at knees and shoulders, and finding out about the balance of risks and benefits.

In covid news, we're still finding new symptoms associated with infection, 2.5 years after the pandemic started. We'll also hear how complex it is to research vaccine efficacy now.

Reading list:
Smell and taste dysfunction after covid-19 https://www.bmj.com/content/378/bmj.o1653

Serious adverse event rates and reoperation after arthroscopic shoulder surgery
https://www.bmj.com/content/378/bmj-2021-069901

Viscosupplementation for knee osteoarthritis
https://www.bmj.com/content/378/bmj-2022-069722

Waning effectiveness of BNT162b2 and ChAdOx1 covid-19 vaccines over six months since second dose
https://www.bmj.com/content/378/bmj-2022-071249

Talk Evidence - shoulders, knees, and woes

In this week's episode, Joe Ross, professor of medicine at Yale, and The BMJ's US research editor, and Juan Franco, researcher at Heinrich-Heine-Universität and editor in chief of BMJ EBM are in the hot-seat.

They will discuss new research on the effectiveness of antidepressants - based on all the individual patient data submitted to the FDA between 1979 and now. 

We'll take a look at a study of industry sponsorship of cost effectiveness analysis, and seeing similar patters of publication bias to RCTs.

And finally we'll be talking about new research on the ongoing, and emergent pandemics - covid and monkeypox.

Reading listResponse to acute monotherapy for major depressive disorder in randomized, placebo controlled trials submitted to the US Food and Drug Administration: individual participant data analysis
https://www.bmj.com/content/378/bmj-2021-067606)
 
Using individual participant data to improve network meta-analysis projects
https://ebm.bmj.com/content/early/2022/08/10/bmjebm-2022-111931 
 
Industry sponsorship bias in cost effectiveness analysis: registry based analysis
https://www.bmj.com/content/377/bmj-2021-069573
 
Clinical features and novel presentations of human monkeypox in a central London centre during the 2022 outbreak https://www.bmj.com/content/378/bmj-2022-072410
 
Effectiveness of a fourth dose of covid-19 mRNA vaccine against the omicron variant among long term care residents in Ontario, Canada:
https://www.bmj.com/content/378/bmj-2022-071502

Talk Evidence - a new way of understanding antidepressant effectiveness

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

In this month's Talk Evidence, Helen Macdonald, The BMJ's research integrity editor, is joined again by Juan Franco, editor in chief of BMJ EBM, and Joe Ross, US research editor. 

They're straying beyond the pages of The BMJ, and discussing an NEJM paper about colonoscopy for colorectal cancer screening. 

We have a listener request, asking about evidence for England's " NHS Diabetes Prevention Programme" - what do we know about how lifestyle interventions work at a population level? Juan puts on his Cochrane hat to answer the query.

We stay with diabetes, and Joe tells us about his research trying to see if routinely collected observational data could be used to match the outcomes of an RCT into drug treatments. 

Finally, Helen updates us about what she's been doing about a case of plagiarism in one of BMJ's journals - and what that means for researchers who are writing in multiple journals about their work.

Reading list

Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death
https://www.nejm.org/doi/full/10.1056/NEJMoa2208375

Emulating the GRADE trial using real world data: retrospective comparative effectiveness study
https://www.bmj.com/content/379/bmj-2022-070717

Expression of concern about content of which Dr Paul McCrory is a single author
https://bjsm.bmj.com/content/early/2022/10/11/bjsports-2022-106408eoc

Talk Evidence - Diabetes data, colonoscopies, and researchers behaving badly

In this month's episode, Helen Juan and Joe delve into the clinical - with a new review of endometriosis, and why the difficulty in diagnosis has lead to a dearth of evidence and attention on the condition.

Joe tells us about a risk prediction tool that could be useful in helping to mitigate some of the problems of antihypertensive treatments.

We're also having a geek out about a group of papers we've published lately, on how well evidence is created, maintained, and diseminated.

Reading list;


Development and external validation of a risk prediction model for falls in patients with an indication for antihypertensive treatment: retrospective cohort study
https://www.bmj.com/content/379/bmj-2022-070918

Pathophysiology, diagnosis, and management of endometriosis
https://www.bmj.com/content/379/bmj-2022-070750


Effective knowledge mobilisation: creating environments for quick generation, dissemination, and use of evidence
https://www.bmj.com/content/379/bmj-2022-070195

Consistency of covid-19 trial preprints with published reports and impact for decision making: retrospective review 
https://bmjmedicine.bmj.com/content/1/1/e000309

Changing patterns in reporting and sharing of review data in systematic reviews with meta-analysis of the effects of interventions: a meta-research study from the REPRISE project
https://www.medrxiv.org/content/10.1101/2022.04.11.22273688v2

Talk Evidence - endometriosis, falling, and better EBM

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

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

BMJ talk medicine