Richard and Raj discuss Palliative care
Richard and Raj discuss some of the History of Statistics, and how it informs the practice of EBM today.
Richard and Raj discuss how patients can be involved in the process of generating evidence, from determining patient centered outcomes to prioritizing types and goals of research.
Richard & Raj discuss decision making in EBM, and the tipping points that change clinical practice.
Richard & Raj discuss Overdiagnosis, starting with the difficulty of defining the term to the practical challenges in every day clinical practice.
Links on Overdiagnosis:
References:
1. Wilson JM, Jungner YG. [Principles and practice of mass screening for disease]. Bol Oficina Sanit Panam. 1968;65(4):281-393.
2. Mant D, Fowler G. Mass screening: theory and ethics. BMJ. 1990;300(6729):916-918. doi:10.1136/bmj.300.6729.916
Discussion Timestamps:
0:15 Population Health and Screening History
6:44 Population Health Math
11:41 Screening for Blood Pressure
13:36 Wilson Criteria Difficulty
15:09 Blood Pressure and Screening Programs
22:10 Prostate Cancer Screening
28:27 Colon Cancer Screening
30:06 Colonoscopy Higher Rates of Adenoma Detection
Richard and Raj discuss the potential future role of AI in EBM and medicine
James Mccormack, from https://therapeuticseducation.org/ , discusses personalized, one-agent-at-a-time approach to medication management.
He also has helped to create several decision based websites:
Overall CVD
Heart failure
Diabetes
https://decisionaid.ca/diabetes/
Richard and Raj discuss the history of Hypertension and how it lead up to modern day challenges of managing high blood pressure.
The NNT
Reference:
https://gpevidence.org/
richard and raj discuss the changing approach to managing diabetes over the years.
Richard and Raj discuss the role of meta-analysis in EBM, in light of the recent controversial cochrane report on masks (physical interventions) in respiratory infections.
Richard and Raj discuss personalized medicine in primary care
Richard and Raj discuss common challenges and errors that may occur in diagnostic reasoning.
Reference:
https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2923.2009.03507.x
Richard and Raj discuss the cognitive process of diagnosis, and reflect on the different ways physicians make diagnosis beyond the standard approaches taught in EBM.
Raj and Richard continue their discussion on Diagnosis
References:
BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b946 (Published 20 April 2009)Cite this as: BMJ 2009;338:b946
1. Lehman R, Tejani AM, McCormack J, Perry T, Yudkin JS. Ten Commandments for patient-centred treatment. Br J Gen Pract. 2015;65(639):532-533. doi:10.3399/bjgp15X687001
https://bjgp.org/content/65/639/532
2. Yudkin JS, Lipska KJ, Montori VM. The idolatry of the surrogate. BMJ. 2011;343(dec28 1):d7995-d7995. doi:10.1136/bmj.d7995
A discussion on Heart Failure, polypharmacy, and optimizing therapy with multiple medications.
