A lifetime of insights - patient care, philosophy, history, and grappling with how evidence based medicine (EBM) should impact the practice of medicine. Find us on Twitter: @RichardLehman1 @raj_mehta
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E23: EBM & Palliative Care
33:09
33:09
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33:09
Richard and Raj discuss Palliative care
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E22: A brief history of statistics
36:32
36:32
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36:32
Richard and Raj discuss some of the History of Statistics, and how it informs the practice of EBM today.
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E21: Patients' Role in Generating Evidence
33:50
33:50
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33:50
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.
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E20: Tipping Points in EBM
36:22
36:22
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36:22
Richard & Raj discuss decision making in EBM, and the tipping points that change clinical practice.
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Richard & Raj discuss Overdiagnosis, starting with the difficulty of defining the term to the practical challenges in every day clinical practice. Links on Overdiagnosis: https://www.bmj.com/content/344/bmj.e3502 https://academic.oup.com/jnci/article/102/9/605/894608
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E18: Screening and Population Health
35:16
35:16
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35:16
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 …
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Richard and Raj discuss the potential future role of AI in EBM and medicine
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E16: James Mccormack on Applying Evidence and the "One Agent at a Time" approach
38:27
38:27
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38:27
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 cvdcalculator.com Heart failure https://hfmedchoice.com/ Diabetes https://decisionaid.ca/diabetes/…
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Richard and Raj discuss the history of Hypertension and how it lead up to modern day challenges of managing high blood pressure.
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The NNT
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E13: GP Evidence & Web-based Aids for Shared Decision Making
32:51
32:51
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32:51
Reference: https://gpevidence.org/
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richard and raj discuss the changing approach to managing diabetes over the years.
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E11: EBM’s over-reliance on meta-analysis
39:06
39:06
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39:06
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.
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E10: What works for the Individual Patient?
42:14
42:14
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42:14
Richard and Raj discuss personalized medicine in primary care
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E9: Errors in Diagnostic Reasoning
41:45
41:45
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41:45
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
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E8: The Cognitive Process of Diagnosis
37:09
37:09
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37:09
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.
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Raj and Richard continue their discussion on Diagnosis
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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
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E5: 10 Commandments for patient-centered treatment
41:27
41:27
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41:27
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 https://www.bmj.com…
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E4. CHF: Optimizing Drug Combinations vs Risks of Polypharmacy
42:39
42:39
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42:39
A discussion on Heart Failure, polypharmacy, and optimizing therapy with multiple medications.
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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.
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E2. Shared Decision Making
33:19
33:19
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33:19
Richard discussed the concept and complexity of making shared decisions with patients. Or as he prefers to describe it, a "shared understanding of medicine".
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Richard Lehman discusses the practice of primary care before EBM, and why EBM was necessary for medical practice to progress into a new era.
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Introduction to the podcast, where Richard Lehman and Raj Mehta discuss EBM topics.
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