Medicine and Science from The BMJ

Tackling racism in the NHS

For decades research has shown that discrimination, harassment, and exclusion are pervasive experiences for staff from black and minority ethnic (BME) backgrounds in the National Health Service.In this podcast, the authors of a recent analysis article in The BMJ talk about the evidence for discrimination, what the NHS has done and is doing, and what has worked to promote equality in the wider world.Read their full analysis at:http://www.bmj.com/content/351/bmj.h3297

Should doctors recommend homeopathy?

A recent review by the Australian National Health and Medical Research Council concluded that “there are no health conditions for which there is reliable evidence that homeopathy is effective”, but Europe currently spends €1bn annually on such remedies - often at the recommendation of doctors.
So a recent head to head debate in The BMJ asks, should doctors recommend homeopathy? Peter Fisher, director of research, Royal London Hospital for Integrated Medicine argues yes, and Edzard Ernst, emeritus professor of complementary medicine at the University of Exeter argues no.
Read their full arguments:
http://www.bmj.com/content/351/bmj.h3735

Rheumatic fever - diagnosis and treatment

Many doctors may believe that acute rheumatic fever is a disease of the past, but it's estimated that, worldwide, there are 500,000 new annual cases, and that 15 million have chronic rheumatic heart disease.
Rachel Helena Webb, paediatric infectious diseases specialist at the Starship Children’s Hospital in Auckland, joins us to discuss diagnosis and management of this condition.
Read the full clinical review:
http://www.bmj.com/content/351/bmj.h3443

Tarnished GOLD - diagnosing COPD

Read the full analysis:
http://www.bmj.com/content/351/bmj.h3021
The prevalence and mortality of chronic obstructive pulmonary disease (COPD) is increasing globally.
However, Martin Miller, honorary professor of medicine at the University of Birmingham, and Mark Levy, GP with a special interest in respiratory medicine, argue that the GOLD (Global Initiative for Obstructive Lung Disease) criteria used for diagnosis may be leading to misdiagnosis.

GI bleeding, slow to diagnose, slow to treat

The National Confidential Enquiry into Patient Outcome and Death (NCEPOD) has been examining the treatment of acute GI bleeds in England's NHS.
Two of the authors, Martin Sinclair, consultant surgeon, and Simon McPherson, consultant vascular radiologist, join us to talk about their findings.
Read the full report:
http://www.ncepod.org.uk/gih.htm
Read The BMJ news story:
http://www.bmj.com/content/351/bmj.h3488

The trials and tribulations of peer review

Bias and peer review are of universal importance to all those that produce scholarly work. Fiona Godlee and Rob Tarr, editors in chief of The BMJ and JNIS respectively, share their insights and experience on these highly topical issues with Joshua Hirsch.
Read the related paper: http://jnis.bmj.com/content/early/2015/04/17/neurintsurg-2015-011781.full

How GPs can help carers looking after patients with

By 2050 an estimated 135 million people worldwide will have dementia. Of all chronic diseases, dementia is one of the most important contributors to dependence and disability.
In this part of a 2-part podcast, Sue, who cared for her mother who had dementia, and Louise Robinson, GP and professor of primary care at Newcastle University, join us to discuss what GPs can do to support carers.
Listen to part 1 of the podcast:
https://soundcloud.com/bmjpodcasts/diagnosis-and-management-of-dementia
Read the full clinical review:
http://www.bmj.com/content/350/bmj.h3029

Time to target older women for cervical cancer screening?

Cervical screening programmes in many countries stop at around the age of 65 and much of the focus is often on younger women. However, comparatively little attention has been given to older women despite the fact that they account for about a fifth of cases each year and half of deaths.
In this podcast Susan Sherman, a senior lecturer in psychology at Keele University, and Esther Moss, consultant gynaecological oncologist at University Hospitals of Leicester NHS Trust, argue that the upper age limit for cervical screening needs revisiting and call for awareness campaigns to target older as well as younger women.
Read the full analysis:
http://www.bmj.com/content/350/bmj.h2729

Diagnosis and management of dementia

By 2050 an estimated 135 million people worldwide will have dementia. However, increasing evidence showing that dementia may be preventable.
In this part of a 2-part podcast, Sue, who cared for her mother who had dementia, and Louise Robinson, GP and professor of primary care at Newcastle University, join us to discuss how to diagnose and manage the condition.
Listen to part 2 of the podcast:
https://soundcloud.com/bmjpodcasts/how-gps-can-help-dementia-carers
Read the full clinical review:
http://www.bmj.com/content/350/bmj.h3029

QOF, what is it good for?

Martin McShane, medical director of long term conditions at NHS England, questions the validity of the Quality and Outcomes Framework and suggests how it should change in the future.
Read the related article:
http://www.bmj.com/content/350/bmj.h2540