Medicine and Science from The BMJ

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 putting their recommendations into practice. In this new monthly audio round-up The BMJ’s clinical editors discuss what they have learned, and how they may alter their practice. In this edition, GP Cat Chatfield, psychiatric trainee Kate Addlington and Gas...

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 about the way in which scientific knowledge is constructed, through our Evidence Manifesto. We also know that money has influence in the scientific literature - which is why we have a zero tolerance policy for financial conflicts of interest in our education...

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 scrapped by bits of the NHS, and is under reform elsewhere. Martin Marshall, GP and professor of Health Improvement at University College London, thinks it's time to rethink the experiment. He joins us to discuss how we got here, what we've learned, an...

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 per 100 000 between 2010 and 2015. The national suicide prevention strategy recently expanded its scope by aiming to reduce self harm rates as a common precursor to suicide. Therefore it's important that we have an accurate measure of rates of self...

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 - there's a worry about who's going to look after them, and how much is it going to cost? However, a new analysis on bmj.com says this picture need not be so gloomy - they say that encouraging exercise in older people could save billions - by keepin...

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 marginal improvement in patient outcomes. To discuss how that was studied, and what the findings mean, we're joined by Chris Wallis, a resident at the University of Toronto, and Raj Satkunasivam, a urologic-surgeon and assistant professor at the Housto...

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 Europe - didn’t have any evidence of improved life expectancy or quality of life. In this interview, Vinau Prasad, ematologist-oncologist and Assistant Professor of Medicine at the Oregon Health and Sciences University, explains how we came to accept...

The majority of cancer drugs approved in Europe between 2009 and 2013 entered the market without clear evidence that they improved survival or quality of life for patients, finds a study published by The BMJ today. Even where drugs did show survival gains over existing treatments, these were often marginal. To discuss that, we're joined by Huseyin Naci, assistant professor of health policy at the...

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 doctor - instead you'll have a telephone consultation. The prevalence of these telephone consultations is increasing, and being promoted by CCGs and private companies who administer them - usually as a cost saving measure. Now new research published on...

Should we welcome plans to sell off NHS land? The government seems likely to back the recommendations of Robert Naylor (national adviser on NHS property and estates) to raise capital by selling off inefficiently used assets, but Kailash Chand (GP) worries that services could be threatened and that public consultation is lacking. Read the Head To Head article: https://www.bmj.com/content/358/bmj.j4...

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 Canada, Australia Brazil, Italy, Japan, new Zealand - and most recently the UK. The campaigns have not been without criticism – from how individual recommendations were chosen, to the way in which patients have been involved. In this podcast, we're joined...

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 affected, treatments are effective at helping control glucose levels - however, the sequela associated with the disease - vascular problems, and a life expectancy that’s 6 years shorter - are still an issue. However, for some, remission seems to be a po...

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 the potential solutions, was a big part of the Peer Review Congress which took place last week. In this interview, Sophie Cook, The BMJ's UK research editor, talks to Lisa Bero, who’s a professor of evidence based medicine at Sydney University, and sp...

A new Rapid Recommendation from The BMJ suggests that for pregnant women, they may wish to avoid certain antiviral treatments for HIV. This recommendation differs from the WHO's, and to discuss why that is, and what makes that difference important, we're joined by Reed Siemieniuk, a physician and methodologist from McMaster University, and Alice Welbourn, campaigner for gender and sexual and repro...

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 with the National Alliance on Mental Illness - and Ken Duckworth, the alliance's medical director, debates the merits of this approach with Simon Gilbody, from the Department of Health Sciences at the University of York. Also joining this podcast is...

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 should be spending - and each year, hospital trusts go cap in hand to ask for more funding. Against this backdrop, a new analysis, and a first in a series, published on bmj.com, looks at what it takes to have sustainable healthcare - and cruically,...

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 conflict. Their first loan went to France - but with stipulations about repayment that set a tone for future funds. A new series, authored by Devi Sridhar, and her team from the University of Edinburgh, and published on bmj.com, looks at where the W...

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 conflict. Their first loan went to France - but with stipulations about repayment that set a tone for future funds. A new series, authored by Devi Sridhar, and her team from the University of Edinburgh, and published on bmj.com, looks at where the W...

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 conflict. Their first loan went to France - but with stipulations about repayment that set a tone for future funds. A new series, authored by Devi Sridhar, and her team from the University of Edinburgh, and published on bmj.com, looks at where the W...

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 conflict. Their first loan went to France - but with stipulations about repayment that set a tone for future funds. A new series, authored by Devi Sridhar, and her team from the University of Edinburgh, and published on bmj.com, looks at where the W...

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 conflict. Their first loan went to France - but with stipulations about repayment that set a tone for future funds. A new series, authored by Devi Sridhar, and her team from the University of Edinburgh, and published on bmj.com, looks at where the W...

In our last podcast from Preventing Overdiagnosis 2017, we convened an impromptu roundtable of clinicians who are attending the conference to see how some of the big themes that were discussed at the conference are going to impact their everyday practice. Joining us were; Jessica Otte - Family physician from Canada David Warriner - Cardiologist from the UK. Jack O’Sullivan - Junior doctor from Aus...

This week we’re at the over diagnosis conference in Quebec Canada, Preventing overdiangosis is a forum to discuss the harms associated with using uncertain methods to look for disease in apparently healthy people - and is part of the BMJ’s too much medicine campaign. One of the ways in which the public’s attitudes and wishes around health is measured are citizen or community juries - set up in a s...

The Preventing overdiagnosis conference covers how physicians, researchers and patients can implement solutions to the problems of over diagnosis and overuse in healthcare. If you’re a doctor on twitter, you’ve probably come across our guest - Vinay Prasad, assistant prof. of medicine at Oregon Health and Science University, and author of the book Ending Medical Reversal.

This week we’re at the Preventing Overdiagnosis conference in Quebec Canada, The conference is a forum to discuss the harms associated with using uncertain methods to look for disease in apparently healthy people - and is part of the BMJ’s too much medicine campaign. The literature on overdiagnosis has mostly been published since 2013 - partly because of The BMJ, but in large part because of the w...