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PODCAST

Questioning Medicine

Questioning Medicine

Join Andrew on a medical rollercoaster as we ask a medical question and answer it based on recent published papers.

health & fitness medicine

All Episodes

10:28

Episode 361: 260. METHODS MONDAY-- EVENT RATE

Questioning Medicine ·

2025/01/13

Methods Monday --- Accuracy of Event Rate and Effect Size Estimation in Major Cardiovascular Trials: A Systematic Review | Cardiology | JAMA Network Open | JAMA Network During the design of a randomized clinical trial (RCT), estimation of the expected event rate and effect size is a key component to calculating the sample size. Overly optimistic estimation of event rates and effect sizes may lead to underpowered trials. If you expect 1 event per 100 people and you are looking for 5 events

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7:43

Episode 360: 259. Urinary Retention Evaluation and...

Questioning Medicine ·

2025/01/10

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2821168A team of researchers set out to change that by developing a comprehensive algorithm.The process involved a multidisciplinary panel of 11 expertss with extensive experience in managing urinary retention. These experts evaluated about 100 clinical scenarios to create an initial flow sheet. The algorithm was then refined through interviews with 33 frontline clinicians from various specialties.So, what does this new algorithm

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5:55

Episode 359: 258. Oral Antibiotics and Risk of...

Questioning Medicine ·

2025/01/03

https://jamanetwork.com/journals/jama/article-abstract/2822097Design, Setting, and Participants Nested case-control study using population-based linked administrative datasets among adults aged 66 years or older who received at least 1 oral antibiotic between 2002 and 2022 in Ontario, Canada. Cases were those who had an emergency department (ED) visit or hospitalization for serious cADRs within 60 days of the prescription, and each case was matched with up to 4 controls who did

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6:47

Episode 358: 257. Twice-Yearly Lenacapavir or Daily...

Questioning Medicine ·

2024/12/30

https://www.nejm.org/doi/full/10.1056/NEJMoa2407001ConclusionsNo participants receiving twice-yearly lenacapavir acquired HIV infection. HIV incidence with lenacapavir was significantly lower than background HIV incidence and HIV incidence with F/TDF. Among 5338 participants who were initially HIV-negative, 55 incident HIV infections were observed: 0 infections among 2134 participants in the lenacapavir group (0 per 100 person-years; 95% confidence interval [CI], 0.00 to 0.19), 39

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5:37

Episode 357: 256. Medications for alcohol-use...

Questioning Medicine ·

2024/12/27

Allaudeen N et al. Medications for alcohol-use disorder and follow-up after hospitalization for alcohol withdrawal: A multicenter study. J Hosp Med 2024 Dec; 19:1122. (https://doi.org/10.1002/jhm.13458) Hospital admission for alcohol withdrawal is a problem when it comes to readmission. They just come back--- In this retrospective study of ≈600 patients (96% men) admitted for alcohol withdrawal at 19 Veterans Affairs hospitals during 1 year (2018–2019), researchers evaluated prescription

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6:47

Episode 356: 255. Real-world use of glucocorticoids...

Questioning Medicine ·

2024/12/23

Real‐world use of glucocorticoids and clinical outcomes in adults hospitalized with community‐acquired pneumonia on medical wards - Malecki - 2024 - Journal of Hospital Medicine - Wiley Online Library This was a retrospective cohort study of 11,500 patients with CAP who were admitted to general medicine units in 7 Canadian hospitals, researchers compared outcomes for patients who received systemic corticosteroids. Patients were excluded if they were admitted to the intensive care units or

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8:29

Episode 355: 254. 2024 ESC Guidelines for the...

Questioning Medicine ·

2024/12/20

2024 ESC guidelines propose a simple new BP categorization:Non-elevated: less than 120/70 mm Hg in the office (pharmacological treatment is not recommended). Elevated: 120 to 139/70 to 89 mm Hg (pharmacological treatment is recommended for some, depending on cardiovascular disease [CVD] risk and follow-up BP measurements). Hypertension: 140/90 mm Hg or greater (confirmation and prompt pharmacological treatment is recommended). lifestyle interventions are particularly critical for

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7:08

Episode 354: 253. Centralized Colorectal Cancer...

Questioning Medicine ·

2024/12/18

Question Does adding centralized mailed fecal immunochemical testing and patient navigation to usual care improve colorectal cancer (CRC) screening in US federally qualified health centers? pragmatic randomized clinical trial was conducted Patients were enrolled and randomly assigned to usual care alone (control group) or intervention (2,001 participants per group). Intervention participants received mailed screening outreach materials including an introductory letter, FIT kit packet with

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11:01

Episode 353: 252. 2.4 Million to Prevent 4...

Questioning Medicine ·

2024/12/13

Packer M et al. Tirzepatide for heart failure with preserved ejection fraction and obesity. N Engl J Med 2024 Nov 16; [e-pub].https://doi.org/10.1056/NEJMoa2410027 In the industry-funded SUMMIT trial (NCT04847557), investigators examined cardiovascular outcomes of tirzepatide — an agonist of glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 receptors — over a longer period in patients with HFpEF and obesity. The 731 study participants had elevated filling pressures or an

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6:13

Episode 352: 251. Safety of Triptans in Patients Who...

Questioning Medicine ·

2024/12/12

Wang Z et al. Safety of triptans in patients who have or are at high risk for cardiovascular disease: A target trial emulation. Mayo Clin Proc 2024 Nov; 99:1722. (https://doi.org/10.1016/j.mayocp.2024.03.023) How unsafe are triptans triptans — the mainstays of migraine therapy — are vasoactive, the U.S. FDA considers them to be contraindicated in patients with cardiovascular (CV) disease or elevated CV risk. many patients with migraine (including those with CV disease) request triptans

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9:11

Episode 351: 250. STROKE part 3 CME

Questioning Medicine ·

2024/11/29

STROKE part 3 CME

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17:36

Episode 350: 249. STROKE - LA closure, alteplase vs...

Questioning Medicine ·

2024/11/27

CME FOR FREEE

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36:00

Episode 349: 248. Stroke- UIA, CHAD-VASC, HAS-BLED,...

Questioning Medicine ·

2024/11/26

CME --- Stroke- UIA, CHAD-VASC, HAS-BLED, SPARC, PFO

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6:08

Episode 348: 247. Early diagnostic paracentesis...

Questioning Medicine ·

2024/11/22

Beran A et al. Early diagnostic paracentesis improves outcomes of hospitalized patients with cirrhosis and ascites: A systematic review and meta-analysis. Am J Gastroenterol 2024 Nov; 119:2259. (https://doi.org/10.14309/ajg.0000000000002906) BOTTOM LINE (if you don’t like to read)- While it might not be fun to have the conversation with the ER provider saying you NEED A DIAGNOSTIC PARACENTESIS PRIOR TO THE PATIENT COMING TO THE FLOOR, just remember that every 33 times we have that

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8:59

Episode 347: 246. Acupuncture vs Sham Acupuncture...

Questioning Medicine ·

2024/11/21

Acupuncture vs Sham Acupuncture for Chronic Sciatica From Herniated Disk: A Randomized Clinical Trial | Complementary and Alternative Medicine | JAMA Internal Medicine | JAMA Network In a randomized trial, acupuncture reduced pain and disability better than a sham procedure did. In this trial from China, 216 adults (mean age, 51) were randomized to undergo 10 sessions of acupuncture or sham procedures during 4 weeks. All patients had moderate-to-severe unilateral leg pain attributed to

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7:05

Episode 346: 245. Duration of benefit and risk of...

Questioning Medicine ·

2024/11/20

And now a secondary analysis of the trial focused on the timing of major ischemic events and the potential tradeoffs of benefits and risks,------ maybe there is magic sauce where the benefit is drastically greater than risk and vice versa! Guan L et al. Duration of benefit and risk of dual antiplatelet therapy up to 72 hours after mild ischemic stroke and transient ischemic attack. Neurology 2024 Oct 8; 103:e209845. (https://doi.org/10.1212/WNL.0000000000209845) The goal is less ischemic

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16:37

Episode 345: 244. CORRECTED ACOI question and answer

Questioning Medicine ·

2024/11/15

The full podcast -- not sure why the last one cut off early. Question and answer from ACOI

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5:09

Episode 344: 343. Arm position and blood pressure...

Questioning Medicine ·

2024/11/08

Liu H et al. Arm position and blood pressure readings: The ARMS crossover randomized clinical trial. JAMA Intern Med 2024 Oct 7; [e-pub]. (https://doi.org/10.1001/jamainternmed.2024.5213) study replicated some of the “real-world” shortcuts that often occur when we check BP, such as measuring BP while the patient is sitting up on an exam table.===In this U.S. trial of 133 adults, researchers assessed the effect of nonstandard arm positions on BP readings by measuring each patient's BP in

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8:58

Episode 342: 341. Methods Monday! What is the...

Questioning Medicine ·

2024/11/04

Stopping Trials Early for Benefit: Insights From Recent Pivotal Trials in Chronic Kidney Disease - ScienceDirect There are 4 major reasons why trials might be stopped early: 1) unequivocal benefit; 2) unacceptable harm; 3) futility; and 4) administrative reasons (enrollment or funding concerns). trials stopped early for benefit tend to overestimate benefit, a phenomenon referred to as random-high. trials that stopped early, especially those with <500 events, fail to provide reliable

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38:16

Episode 341: 340. ACOI -- Vitamin D and Calcium Made...

Questioning Medicine ·

2024/10/30

You get the CME knowledge without the CME payment!

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363 results

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