Medicine and Science from The BMJ

Mendelian randomisation - it’s a technique that uses the chance distribution of genes in a population, combined with big data sets, to investigate causative relationships.
But there are a lot of questions we have in The BMJ about how the technique works - the association between genes and apparently non-biologically mediated behaviours, how much the strict rule of not claiming causation based on observational data has actually been overturned, and general confusion about how the non-methodologists amongst us can read these studies.
Neil Davies and George Davey Smith from University of Bristol, and Michael Holmes from the University of Oxford, join us to explain how the technique works, where it can be applied, and what readers should look out for when they're trying to assess the quality of a mendelian randomisation study.
Read their full research methods and reporting paper:
https://www.bmj.com/content/362/bmj.k601

It’s been quite a year for the NHS - it just turned 70, had a winter crisis like never before, got over junior doctor strikes, but then was hit by a series of scandals about breast screening, and now opiate prescriptions.
At the same time, we’ve seen demonstrations in favour of the service and even widespread public backing for more money. So how do all of these things mix into the way in which the British public view the NHS?
In this podcast, Ben Page - chief exec of Ipsos MORI, the polling company, joins us to discuss the fluctuations in public opinion.
Read the provocation:
https://www.bmj.com/content/361/bmj.k2663
More NHS at 70 coverage:
https://www.bmj.com/nhs-at-70

This week influential Editor-in-Chief of JAMA Internal Medicine Dr Rita Redberg joins Ray for a wide ranging conversation on all things health. A Professor at the University of California San Francisco and high profile contributor to The Washington Post and New York Times, Rita is also a practising cardiologist who loves to see patients. She says that ‘being a doctor is really a privilege’.
Together, Ray and Rita canvas many topics including shared decision making between doctors and patients, the tricky territory of medical device approvals, the controversy surrounding both statins and CT scans, and the implications of not including enough women in clinical trials.

Doctors and the farming industry are often blamed for overuse of antibiotics that spurs the growing problem of antimicrobial resistance - but the professions are using different methods to combat resistance and reduce overuse.
In this roundtable, we bring medics and vets together to discuss the problem - where antibiotic resistance arises, how resistance genes propagate through the environment and between countries, and what non-drug approaches can be used to reduce the need for antibiotics.
Sandy Trees, Vet Record editor in chief, and retired veterinary surgeon
Stuart Reid, principal of the Royal Veterinary College
Jenny Bellini, cattle and dairy vet, Friars Moor Livestock Health in Dorset
Peter Hawkey, professor of clinical and public health bacteriology, University of Birmingham
Tim McHugh, professor of medical microbiology at University College London
Emmanuel Wey, consultant in infection, Royal Free Hospital, London

Getting feedback from people who use NHS services is essential to
assessing their value - and improving their quality. Hospitals and general practices widely post information about patient's satisfaction with their services on their websites, but approach tells us little about how feedback changes things on the ground .
In this podcast, James Munro, former doctor and academic and current CEO of Care Opinion, explains how their online platform works, how Trusts are using it as a quality improvement tool, and how health systems can capitalise on the learning potential of this large scale data collection.
This is part of the series of interviews with people who are making partnership between health professional and patients work in the real world. Listen to Katherine Cowen, from the James Lind Alliance, talk about how to broker an agreement about research priorities. https://soundcloud.com/bmjpodcasts/katherine-cowan-reaching-a-priority

Wendy Burn is a consultant old age psychiatrist, and new president of the Royal College of Psychiatrists. Her work on dementia has given her an affinity for the neurobiological basis of psychiatry - and her tenure at the college is seeing a move to wards this neurobiological model in the teaching of the profession.
In this interview she talks about her work, how the profession is changing, and why she thinks Kanye can be a model for mental health.

Ray Moynihan is a senior research assistant at Bond University, a journalist, champion of rolling back too much medicine, and host of a new series “The Recommended Dose” from Cochrane Australia.
In the series, Ray has talked to some of the people who shape the medical evidence that underpin healthcare around the world - the series aim is to elucidating their worldview, and how their thinking shapes their work.
Over the next couple of months, we’ll be co-publishing the series - so keep an ear out for those interviews in your podcast feed.

At evidence live this year, one of the sessions was about the work of Evidence Aid - and their attempt to bring high quality evidence to the frontline of a humanitarian crisis.
In that situation, it’s very difficult to know what will work - a conflict, or even immediately post-conflict situation is characterised by chaos - and merely doing something is vital. But though each situation is unique, sharing what’s worked elsewhere can be key to maximising the help given to vulnerable people.

At Evidence Live this year, the focus of the conference was on communication of evidence - both academically, and to the public. And part of that is the role that investigative journalism has to play in that.
At the BMJ we’ve used investigative journalistic techniques to try and expose wrong doing on the part of government and industry - always in collaboration with clinicians and researchers.
To explain a bit more about the world of journalism and campaigning, we're joined by to Shelley Jofre - from the BBC, Jet Schouten - from Radar, Kath Sansom - who started the online sling the mesh campaign & Deb Cohen, former investigations editor at The BMJ.

Don Berwick, president emeritus of the Institute of Healthcare Improvement, and former Administrator of the Centers for Medicare and Medicaid Services.
In this conversation he discusses how he went from being a paediatrician to running Medicare for Obama, how we can create headroom in stressed systems, and breaking the rules to make things better for patients and staff.
Quality improvement series: