Richard Lehman on Evidence Based Medicine
By Richard Lehman & Raj Mehta
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@raj_mehta
Richard Lehman on Evidence Based MedicineOct 17, 2022
E23: EBM & Palliative Care
Richard and Raj discuss Palliative care
E22: A brief history of statistics
Richard and Raj discuss some of the History of Statistics, and how it informs the practice of EBM today.
E21: Patients' Role in Generating Evidence
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.
E20: Tipping Points in EBM
Richard & Raj discuss decision making in EBM, and the tipping points that change clinical practice.
E19: Overdiagnosis
Richard & Raj discuss Overdiagnosis, starting with the difficulty of defining the term to the practical challenges in every day clinical practice.
Links on Overdiagnosis:
E18: Screening and Population Health
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
E17: EBM & AI
Richard and Raj discuss the potential future role of AI in EBM and medicine
E16: James Mccormack on Applying Evidence and the "One Agent at a Time" approach
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/
E15: EBM & Hypertension
Richard and Raj discuss the history of Hypertension and how it lead up to modern day challenges of managing high blood pressure.
E14: NNT
The NNT
E13: GP Evidence & Web-based Aids for Shared Decision Making
Reference:
https://gpevidence.org/
E12: EBM & Diabetes
richard and raj discuss the changing approach to managing diabetes over the years.
E11: EBM’s over-reliance on meta-analysis
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.
E10: What works for the Individual Patient?
Richard and Raj discuss personalized medicine in primary care
E9: Errors in Diagnostic Reasoning
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
E8: The Cognitive Process of Diagnosis
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.
E7: Diagnosis (Part 2)
Raj and Richard continue their discussion on Diagnosis
E6. Diagnosis (Part I)
References:
Diagnostic strategies used in primary care.BMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b946 (Published 20 April 2009)Cite this as: BMJ 2009;338:b946
E5: 10 Commandments for patient-centered treatment
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
E4. CHF: Optimizing Drug Combinations vs Risks of Polypharmacy
A discussion on Heart Failure, polypharmacy, and optimizing therapy with multiple medications.
E3. Resuscitating EBM
Is EBM dead? This was a common claim the 2010's, but the response to the Covid pandemic lends some optimism that EBM is has some life yet! Join us as RIchard discusses the rise of EBM from 90's to the 2020s.
E2. Shared Decision Making
Richard discussed the concept and complexity of making shared decisions with patients. Or as he prefers to describe it, a "shared understanding of medicine".
E1 Medicine before EBM
Richard Lehman discusses the practice of primary care before EBM, and why EBM was necessary for medical practice to progress into a new era.
E.0 Welcome to the Podcast!
Introduction to the podcast, where Richard Lehman and Raj Mehta discuss EBM topics.