Medicine and Science from The BMJ

Preventing Overdiagnosis 2017 - Rita Redberg

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 work of Rita Redberg, professor of clinical medicine, and a working cardiologist, at UCSF, and editor of JAMA internal medicine who joins us to discuss why less is more.

Preventing Overdiagnosis 2017 - Stacy Carter on the culture of overmedicalisation

In this interview from Preventing Overdiagnosis 2017 (preventingoverdiagnosis.net) Stacy Carter, associate professor at Sydney Health Ethics - and the author of a recently written BMJ essay the ethical aspects of overdiagnosis, joins us to talk about how the cultural context of medicine seeps into our decision making processes and affects how people conceptualise the risks of too much medicine.
Read Stacy's full essay:
http://www.bmj.com/content/358/bmj.j3872

What’s driving overdiagnosis?

This week the annual Preventing over diagnosis conference is happening in Quebec, Canada. The conference is put together with a wide range of partners, including The BMJ, and aims to tackle the some of the problems of Too Much Medicine.
To kick off our content for the conference, this week we’ve published an article looking at some of the drivers - and hence potential solutions for over diagnosis.
Two of the authors of that paper. Thanya Pathirana, and Ray Moynihan, both from Bond University’s Centre fro Research in Evidence Based Practice, join us to discuss.

Helping Bereaved people

Loss of a loved one can be very painful. When seeking support, some people turn to their doctor. Because of their pivotal role in the community, physicians can provide excellent support for bereaved people and can often direct them to additional resources.
Katherine Shear, a physician, and Stephanie Muldberg, a bereaved mother, join us to discuss how grief can play out in the consultation, and explain the importance of doctors acknowledging the death of a patient's loved one.
Read their full practice article:
http://www.bmj.com/content/358/bmj.j2854

Auditing the transparency policies of pharma

If you’ve listened to more than one of our podcasts, you’ll probably be aware of the problem of the opacity of clinical trial data - trials which are conducted by never see the light of day, or results within those trials which are never published.
Pharmaceutical companies have their own policies on what they are willing to make public, when, and for the first time a new audit, published on bmj.com, collates and analyses those policies.
To discuss that study I’m joined by two of the authors - Ben Goldacre, senior clinical research fellow at, and Carl Heneghan, director of, Oxford's Centre for Evidence Based Medicine.
Read the full audit:
http://www.bmj.com/content/358/bmj.j3334

Mike Richards has ”never been politically interfered with”

Mike Richards is well known in the UK - former Cancer Tzar, he now heads up the Care Quality Commission - regulator of all health and social care services, and therefore the body responsible for inspecting hospitals and GP practices.
In this interview, BMJ’s head of news and views, Rebecca Coombes went to the CQC’s headquarters in London, and spoke to Mike Richards - who defends the record of hospital inspection on his watch.
This is an edited version of the interview - read the full write up:
http://www.bmj.com/content/358/bmj.j3567

”For the first time in 15 years the quitting rate has gone up” - ecigarettes smoking cessation

It’s been 10 years since electronic cigarettes hit the shelves in a big way - and since there controversy has reigned about their health effects - are they less unhealthy than smoking traditional tobacco cigarettes, and will they increase nicotine dependence?
Its to that last point that new research, published on BMJ.com is looking into - specifically, do e-cigarettes help people quit tobacco?
Professor Shu-Hong Zhu, Director of the Center for Research & Intervention in Tobacco Control at the university of California San Diego joins us to discuss what effect ecigarettes have had, at a population level, on smoking cessation rates.
Read the open access research:
http://www.bmj.com/content/358/bmj.j3262

What’s going on with life expectancy?

The increase in life expectancy in England has almost “ground to a halt” since 2010 and austerity measures are likely to be a significant contributor.
In this podcast Michael Marmot, director at University College London’s Institute of Health Equity, joins us to discuss what might be causing that drop off, and why a decrease in early life chances is particularly problematic.
Read more about the report:
http://www.bmj.com/content/358/bmj.j3473

Biomarkers - miracle or marketing?

The BMJ has been campaigning for an end to “too much medicine” - the pernicious effect of marketing on the range of tests and treatments that doctors offer patients - tests and treatments which are motivated by the financial reward to the system, than the health of the individual.
A new analysis on BMJ.com takes a look at what’s happening in the the first part of that - testing. New biomarkers for disease, and new ways of monitoring, have the potential to diagnose disease more quickly, but is the hype backed by science?
Bjorn Hoffman professor of medical ethics at Norwegian University of Science and Technology and one of the authors of that article doesn’t think so - and joins us on the podcast to discuss.
Read the full analysis:
http://www.bmj.com/content/358/bmj.j3314

James Kinross and Chris Hankin WannCry about NHS IT

Earlier this year, the WannaCry ransomeware attack took control of computers in 40 NHS trusts, blocking access to the data held on them.
This wasn’t the first time that NHS computers had been infected by malware, but it brought the danger of cyber attack into the consciousness of doctors and patients.
In this podcast we hear from two people who have been thinking hard about cyber security in the NHS - James Kinross, a surgeon and lecturer at Imperial College London, and Chris Hankin, director of Imperial’s Institute for Security Science and Technology.
Read the analysis:
http://www.bmj.com/content/358/bmj.j3179