Medicine and Science from The BMJ

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

Is the FDA really too slow?

The FDA faces perpetual criticism that it is too slow in it’s approval process for getting drugs to market, but one former FDA employee Tom Marciniak, and one professor, Victor Serebruany from Johns Hopkins University have analysed that process and disagree.
Tom Marciniak has been a commentator on the approval process, both critical of industry and the FDA in The BMJ - and in this interview he talks about that process, his new analysis, and how he thinks we could be more sure about the safety and efficacy of drugs coming onto the market.
Read this full analysis:
http://www.bmj.com/content/357/bmj.j2867

”For the public good, not for careers” - Iain Chalmers and Doug Altman on research waste

Twenty years ago the statistician Doug Altman railed against, “The Scandal of Poor Medical Research,” in an editorial in The BMJ.
10 years later, Iain Chalmers and Paul Glaziou calculated that costs $170 billion annually in wasted research grants.
In this podcast, recorded at Evidence Live, we spoke to Altman and Chalmers about their campaigns to improve the design, conduct, and reporting of clinical trials, and why that level of waste still occurs.
Reward Alliance - http://rewardalliance.net/
Equator Network - http://www.equator-network.org/
Research publication audit "Getting our house in order" - http://bmjopen.bmj.com/content/6/3/e009285

Dementia prevalance in 2040

The Alzheimer’s society, in the UK, predicts that if the rates of dementia remain constant there’ll be 1.7 million people in the country living with the condition by 2050. We also know that things like improvements in cardiovascular health are changing those rates.
New research published on bmj.com attempts to model what the outcomes of those changing factors might be, and Sara Ahmadi - Abhari, a research associate in the Department of Epidemiology and Public Health at the University College London, joins us to discuss that model.
Read the open access research:
http://www.bmj.com/content/358/bmj.j2856

Transhealth - how to talk to patients about pronouns

Two articles published on the bmj.com aim to help doctors treat patients who request support with their gender identity.
Firstly a practice pointer on how to refer to gender clinic, and secondly a What Your Patient Is Thinking article about trans people's experiences in the healthcare system.
In this podcast, two of the authors of that patient experience article, Emma-Ben and Reubs, join us to discuss identity, pronouns and what genderqueer means.
I am your trans patient
http://www.bmj.com/content/357/bmj.j2963
Gender dysphoria: assessment and management for non-specialists
http://www.bmj.com/content/357/bmj.j2866