Evidence Based Medicine Podcast
Science Podcasts
Each episode will go through a landmark clinical trial that has shaped medicine as we know it. We will go through all the big and important studies that have made the practice of medicine what it is today, the ones that have formed the basis of our guidelines and the ones we should all probably know about to improve the care of our patients. This podcast aims to keep you up to date with the scientific medical literature, so that you can learn about the most important studies, learn the evidence behind the common medications you use and the new medications on the market. It is set for beginners so you don't have to know anything about statistics or have done research. It's even suitable for those that hated evidence based medicine and journal clubs during medical school. Good for medical students and good for exams study on the go.
Location:
Australia
Description:
Each episode will go through a landmark clinical trial that has shaped medicine as we know it. We will go through all the big and important studies that have made the practice of medicine what it is today, the ones that have formed the basis of our guidelines and the ones we should all probably know about to improve the care of our patients. This podcast aims to keep you up to date with the scientific medical literature, so that you can learn about the most important studies, learn the evidence behind the common medications you use and the new medications on the market. It is set for beginners so you don't have to know anything about statistics or have done research. It's even suitable for those that hated evidence based medicine and journal clubs during medical school. Good for medical students and good for exams study on the go.
Twitter:
@DrAronov
Language:
English
Website:
http://www.ebmpodcast.com/
Email:
drdan@ebmpodcast.com
Episodes
#24 Chlorhexidine versus Iodine – The Battle of the Antiseptics
2/1/2018
By Dr. Daniel Aronov Daniel is available for talks, workshops or seminars Before any sort of surgery, its routine to clean the skin with antiseptic. The point is to kill the microorganisms on the skin and so hopefully reduce the chance of infection. The two most common preoperative skin antiseptics are povidone-iodine and chlorhexidine. Both of these come in an alcoholic or aqueous preparation. So which is better for preventing wound infections? Iodine or chlorhexidine? And does it matter...
Duration:00:20:02
#23 Dust mite avoidance for asthma
11/28/2017
Dr. Daniel Aronov Does dust mite avoidance improve asthma? Asthmatics are commonly advised to do things to reduce dust mites in their environment: vacuum regularly, wash the curtains, avoid soft toys, wash bed linen regularly, etc. This is because there is a strong association between asthma and house dust mite allergy: Around 65% of asthmatics are also allergic to house dust mites (on skin prick testing) and it seems that higher exposures to house dust mite allergens are associated with...
Duration:00:13:53
#22 Subclinical hypothyroidism in pregnancy
11/19/2017
Dr. Daniel Aronov A pregnant woman has come to you for her first antenatal appointment. She’s perfectly healthy with no signs or symptoms of thyroid disease. You arrange the gamut of blood tests: full blood exam, blood group, HIV, etc., but do you also check her Thyroid Stimulating Hormone levels (TSH) to screen for thyroid problems? And if she ends up having subclinical hypothyroidism, do you treat it? This week we look at the evidence, the guidelines and the history to try and answer...
Duration:00:19:35
#21 Steroids for acute urticaria
11/13/2017
By Dr. Daniel Aronov A patient presents with acute urticaria (hives) and after your comprehensive assessment, you decide to give them an antihistamine. But do you also give them a corticosteroid? Maybe some prednisolone to speed up the recovery from their hives? It’s a pretty common practice, in a study of one emergency department in Italy, 93% of those presenting with acute urticaria where treated with steroids on top of their antihistamine. But does it actually add any benefit on top of...
Duration:00:17:42
#20 Evidence Based Pearls for Respiratory Tract Infections
11/8/2017
Dr. Daniel Aronov This episode is a live broadcast from a lecture given at the Royal Australian College of General Practitioners conference. It is a collection of my favourite evidence-based clinical pearls for the most common presentation in primary care: respiratory tract infections. We'll cover antibiotics for otitis media, sore throat and bronchitis, steroids for sore throat, Tamiflu, treatments for cough and a few other random things in between. To watch this talk with the slides head...
Duration:00:49:29
#19 Does high cholesterol CAUSE cardiovascular disease?
11/2/2017
This episode takes a deep dive into the evidence for and against the lipid hypothesis. The lipid hypothesis states that abnormal blood cholesterol levels cause cardiovascular disease. But is this true? Does high LDL ("bad cholesterol") and/or low HDL ("good cholesterol") actually CAUSE cardiovascular disease or is it just an association? This episode was recorded live from a General Practitioner conference. To view the presentation with the slideshow visit: www.youtube.com/DrDanMD
Duration:01:03:57
#18 Which antihypertensive is best? The ALLHAT trial
10/11/2017
The ALL-HAT trial is by far the most important clinical trial ever done in the management of hypertension. It answers the question: Which class of antihypertensive medication is the best for reducing cardiovascular disease? And it is the definitive source for the answer. They randomised a whopping 42,000 patients to get one of the four antihypertensive medications: an ACE-inihibitor, a calcium channel blocker, a thiazide or an alpha-blocker. The ACE-inihibitor they used was lisinopril, the...
Duration:00:22:16
#17 Honey for cough
10/4/2017
By Dr. Daniel Aronov On average, children get about 8 upper respiratory tract infections per year. Most of which involve a cough which can be a nuisance. It can ruin the child’s sleep and the parents sleep and it can also be very distressing for the parents. A survey found that one of the common fears about their child’s cough is that they may die from asphyxiation. It’s no wonder then, that we spend a fortune on cough medications. In Australia alone, we spend $67 million per year on over...
Duration:00:20:49
#16 The best way to quit smoking according to science
9/26/2017
By Dr. Daniel Aronov 14.5% of Australian adults smoke cigarettes - this is down from 22.4% at the turn of the century. The rates are similar in the US but much higher across Europe - with an average closer to 30%. There’s pretty much nothing we can do for a smoking patient that would improve their health as much as getting them to quit smoking would. So how do we do it? Firstly, are you more likely to quit successfully if you stop it “cold turkey”, or is it better to stop gradually?...
Duration:00:17:32
#15 Preventing allergies – the LEAP study
9/18/2017
There’s no doubting that allergies are on the rise. We know it because when we were in school it was pretty rare, but for kids in school nowadays its all too common. The United States, who have been collecting data on the rates of peanut allergy over time, found that in 1997, 0.4% of people reported peanut allergy, and this had tripled by 2008 to 1.4%. Currently, it’s around 2%. Medicine has done a complete 360 in the way that it thinks about allergies and it’s all thanks to the LEAP...
Duration:00:15:45
#14 Evidence for low fat diet and decreasing saturated fat – PURE Study
9/12/2017
Almost all guidelines are recommending that we should reduce dietary fats and restrict saturated fats. The PURE study has called to question these recommendations and in this episode, we explore the evidence. It's very hard to find a guideline that does not recommend reducing total fat and saturated fat intake: The Australian Heart foundation guidelines The heart association guidelines The Australian dietary guidelines The RACGP and Diabetes Australia diabetes guidelines The American Heart...
Duration:00:19:25
#13 Lowering cholesterol with evolocumab and cardiovascular risk
9/5/2017
There’s a new cholesterol lowering drug in town and its ability to lower cholesterol is like nothing we’ve ever seen before. It’s called Evolocumab, (trade name Repatha) but is it any good at reducing cardiovascular disease? This week, we delve into the FOURIER trial - a humongous randomised controlled trial that will answer this question. Development of Evolocumab Evolocumab is a monoclonal antibody PCSK9 inhibitor. It's actually an interesting story how this drug came to be. A group in...
Duration:00:17:49
#12 Magnesium for Leg Cramps
8/29/2017
Night time leg cramps are very common and can ruin sleep. One study surveyed 490 veterans and found that 60% of them had suffered from night time leg cramps and 1/4 of those had them regularly. A lot of people use magnesium to ease their nocturnal cramps and they often swear by them, but do they actually work? This week, we delve into the evidence of magnesium for leg cramps. A study published in JAMA in May of 2017 has tried to answer this question. Methods This was a randomised, double...
Duration:00:09:17
#11 Antibiotics for Otitis Media with Paul Glasziou
8/23/2017
Otitis media, or middle ear infection, is a very common issue. It is the second most common reason for a child to see a GP and is the most common reason antibiotics are prescribed to children. According to a large Australian database called the BEACH data, 80% of kids with otitis media are prescribed an antibiotic. The dilemma A study was published in the NEJM in December of 2016 by Hoberman, et al., that compared 10 days of amoxycillin/clavulanate to 5 days for treating kids with acute...
Duration:00:13:35
#10 Likelihood of chronic opioid use after first prescription
8/7/2017
Opioid addiction has been increasingly recognised as a public health crisis: Deaths from prescription painkillers have now surpassed the deaths from heroin. Opioid use disorder has risen 500% from 2010 to 2016 in the USA For the first time in history, the Surgeon General sent a letter to every single doctor in America. That’s over 2 million doctors! And the letter was a summary of the recommendations on opioid prescribing from the CDC. This clearly points to the importance of this issue....
Duration:00:10:20
#8 Does Ezetimibe IMPROVE-IT?
7/24/2017
Introduction The reason doctors like to lower their patients cholesterol is to decrease their risk of developing cardiovascular disease. There is no point decreasing cholesterol levels if it has no impact on cardiovascular disease. Ezetimibe (Zetia, Ezetrol or Vytorin when in combination with simvastatin), was on the market for 13 years before the manufacturers finally published a study to assess whether it actually had any benefit for cardiovascular disease. This was called the IMPROVE-IT...
Duration:00:17:21
#7 Testosterone Trials – Should we treat age related testosterone deficiency?
7/18/2017
Background Testosterone levels seem to naturally decline as men age. There has been an enormous rise in the amount of testing and treatment of this natural decline in testosterone. Testosterone clinics have been popping up all over the place and promise that treatment will restore energy, improve depression, increase libido and enhance overall well-being. In America, the direct to consumer advertising about low T is everywhere- on television, radio, magazines and billboards. There has been...
Duration:00:29:09
#6 Medication to speed up kidney stone passage
7/10/2017
Calcium channel blockers and alpha blockers are both smooth muscle relaxants and so could theoretically relax the smooth muscle of the ureter and speed up the passage of kidney stones. Given that kidney stones can take several weeks to pass and often are rated as 10/10 pain, treatments to speed up the passage of stones would be greatly welcomed. A Cochrane meta analysis in 2014 found 32 studies, making a total of 5864 patients with kidney stones, and showed that alpha blockers, mainly...
Duration:00:16:51
#5 Caesarian Section versus Vaginal Delivery for Breech Presentation – The Term Breech Trial
7/4/2017
For show notes including all the results for this trial: http://www.ebmpodcast.com/breech The Term Breech Trial is one of the most important clinical trials in the history of obstetrics and has changed the way we manage breech presentation across the world. The term breech trial was as randomised controlled trial comparing planned caesarian section to planned vaginal delivery for management of breech presentation at term. 2088 pregnant women, who were presenting in a breech presentation at...
Duration:00:17:53
#4 Wart is the best treatment for warts?
6/26/2017
This episode delves into the highest quality trial ever done on the treatment for warts. This randomised controlled trial published in the CMAJ compared cryotherapy with liquid nitrogen to salicylic acid wart creams to doing nothing. 250 patients were recruited in primary care and follows up for 13 weeks, The primary outcome was complete resolution of the wart by that time. The bottom line was that for plantar warts there was no difference between cryotherapy, salicylic acid cream or doing...
Duration:00:09:52