Time to rethink GP's advice on weightloss, and ticagrelor data doubts
Last December, The BMJ published an investigation into the 2009 PLATO trial - exposing serious problems with that study’s data analysis and reporting. Our follow up investigation has shown that those data problems extend to other key supporting evidence in AstraZeneca’s initial application to regulators.
Peter Doshi, senior editor in the BMJ’s Investigations unit, and Rita Redberg, cardiologist and Professor of Medicine at UCSF and former editor of JAMA Internal Medicine, join us to explain what this means for scientific integrity, and trust in the FDA's approval processes.
Also in this episode. A group of international authors are arguing that weightloss advice given in primary care might actually be doing more harm than good - it’s ineffective and potentially reinforces damaging stigma.
To explain why they came to that conclusion we're joined by Juan Franco editor in chief of BMJ EBM, and a practicing GP in Germany, and Emma Grundtvig Gram, from the Centre for General Practice at the University of Copenhagen
Reading list
Doubts over landmark heart drug trial: ticagrelor PLATO study
Ticagrelor doubts: inaccuracies uncovered in key studies for AstraZeneca’s billion dollar drug
Beyond body mass index: rethinking doctors’ advice for weight loss
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The plan for NHS league tables is bad, and will lead to unintended consequences
In this episode, we hear about ketamine addiction. It's in the news, but the rise in addiction amongst young people in the UK has caused concern for some time. Irene Guerrini and Nicola Kalk, both addiction psychiatrists from the National Addiction Centre, join us to explain why its become a problem.
In November 2024 Wes Streeting, the UK’s health and social care minister, announced that he was planning to introduce league tables for hospitals - and would be linking managers' pay and continued employment to those outcomes.
Richard Lilford, from the University of Birmingham, Timothy Hofer, from the University of Michigan, and Ian Leistikow, an inspector at the Dutch Health and Youth Care Inspectorate, join us to explain why this is a bad idea.
Non-prescribed ketamine use is rising in the UK
Hospital league tables, targets, and performance incentives should be used with care
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Wellness industry lies, and preventative AI evaluation
Devi Sridhar's new book “How Not to Die (Too Soon) - The Lies We’ve Been Sold, and the Policies That Could Save Us” is focussing on the way wellness culture ignores the societal context in which health is really created. As a trained personal trainer and professor of global public health, Devi's straddling both of those worlds, and joins us to talk about how she would tackle our lowering life expectancy.
Also, John Downey, from the Centre of Health Technology at Peninsula Medical School, and Martha Lee from NHS Devon Integrated Care Board, have written about Plymouth's "Living Lab" - which has been set up to test how health tech can actually work in the real world, but also (importantly, critically) how it can be properly evaluated and integrated into the NHS and social care.
Reading list
How Not to Die (Too Soon)
Harnessing predictive prevention to shift elderly care from hospital to community in England
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Conflict in South Asia, and simplifying GRADE.
Recent escalations in the ever simmering tension between India and Pakistan brought us closer to conflict - conflict between two nuclear powers.
For a long time doctors have campaigned for nuclear disarmament, and Chris Zielinski, president of the World Association of Medical Editors, makes the case for returning WHO's mandate to measure the potential impact of nuclear war.
Also the militarization of the region is detrimental to the health and wellbeing of the populations in both India and Pakistan. co-chairs of The BMJ's South Asia editorial board, Sanjay Nagral and Zulfiqar Butta, explain why a focus on the daily material and health needs of citizens is the way to change political rhetoric in the region.
Gordon Guyatt, distinguished professor at McMaster University, was one of the people responsible for starting GRADE - which is a structured system for assessing the quality of evidence in systematic reviews and clinical practice guideline. Gordon thinks that process has become too complicated - so he’s now championing “Core GRADE”. He joins us to explain why.
Reading list
Ending nuclear weapons, before they end us
Why Core GRADE is needed: introduction to a new series in The BMJ
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Malaria free China, an academic medicine revolution, and retracted data's impact
China was declared malaria free in 2021 - and we'll hear how persistence was key to their success, and what new technologies are available to help the rest of the world become malaria free, from Regina Rabinovich, director of the Malaria Elimination Initiative at the Barcelona Institute for Global Health.
Sonia Saxena, professor of primary care at Imperial College London, and Miguel O’Ryan, dean of the medical faculty of the University of Chile join Kamran to talk about what broke academic medicine, and why it's time for a revolution.
New research shows that data from retracted papers is still having an alarming effect on clinical practice. Chang Xu, Hui Liu, and Fuchen Liu from the Naval Medical University in Shanghai, and Suhail Doi from Qatar University, join us to talk about their study which has maped retracted papers impact on systematic reviews and clinical guidelines.
Reading list
Malaria control lessons from China
Vision 2050: a revolution in academic medicine for better health for all
Investigating the impact of trial retractions on the healthcare evidence ecosystem (VITALITY Study I)
- An example of the BMJ's approach to updating metaanalysis after a study retraction
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