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Sensible Medicine

Sensible Medicine Authors and Editors

Common sense and original thinking in bio-medicine A platform for diverse views and debate www.sensible-med.com

science medicine

All Episodes

45:27

Cifu, Prasad, Mandrola

Sensible Medicine ·

2024/05/27

A spirited discussion of craziness in medicine This is a public episode. If you’d like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

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6:19

Friday Reflection #39: What to Expect When You Are Aging

Sensible Medicine ·

2024/05/17

MM is 94 years old. Her only active medical issues are hypertension and vitamin D deficiency. She takes only 20 mg of lisinopril and 1000 units of vitamin D3 each day. She has no cognitive decline and gardens every day if the Chicago weather allows. Her Friday afternoon appointment is the doctor’s last of the week.Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber.I’ve already written a reflection on four things patients have

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39:31

A Novel Approach to AF Ablation

Sensible Medicine ·

2024/05/16

A few short words about our conversation: Two decades have passed and electrophysiologists have learned little about how to ablate atrial fibrillation. Now, and then, we simply ablate circles around the orifices of the pulmonary veins. This works reasonably well. But we don’t—exactly—know why it works. For instance, some patients have total elimination of AF, but when they are restudied, they have reconnection of PV activity. Observations like these suggest there is something else happening with our

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41:51

Video version of our podcast

Sensible Medicine ·

2024/05/11

We discuss the state of medical education, Harvard music video, causal language at JAMA and more This is a public episode. If you’d like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

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41:51

Cifu, Mandrola, Prasad

Sensible Medicine ·

2024/05/10

Video will be available to paid subscribers This is a public episode. If you’d like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

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22:48

A Discussion with Dr. Dena Zeraatkar regarding...

Sensible Medicine ·

2024/04/30

Gosh was this a great conversation about her recent paper on specification curve analysis of nutritional observational studies. Here is Dr. Zeraatkar’s bio:Dena Zeraatkar, PhD is an Assistant Professor in the Departments of Anesthesia and Health Research Methods, Evidence, and Impact (HEI) at McMaster University. She earned her doctoral degree at McMaster University in the Health Research Methodology graduate program. Following her doctoral training, she pursued postdoctoral training at Harvard

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10:03

Friday Reflection 38: Yesterday’s Solutions; Today’s...

Sensible Medicine ·

2024/04/12

The Thomas Sowell quote, “On closer scrutiny, it turns out that many of today's problems are a result of yesterday's solutions” has been ringing in my head a lot lately. This is a public episode. If you’d like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

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44:05

Yet Another Excellent Explainer About P-Values in...

Sensible Medicine ·

2024/04/04

Gosh was I lucky to speak with Professor Erik Van Zwet from Leiden University in the Netherlands. He is the first author on a recent NEJM Evidence paper looking at more than 23,000 trials in the Cochrane Database. (I linked to an URL that should get by the paywall.) There are technical aspects of this paper. We hit on some (not a lot) of them. The gist of it though is really important when we look at evidence. Erik did an excellent job of explaining P-values, trial power, and, at the end, we discuss

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8:08

Friday Reflection 37: Why I Teach (acceptable and...

Sensible Medicine ·

2024/03/08

Why have I been committed to medical education? Some of the reasons are admirable but not terribly novel. Others are a bit hard to admit, but just as true. This is a public episode. If you’d like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

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7:55

Friday Reflection 36: Why Don’t Doctors Want to See...

Sensible Medicine ·

2024/02/02

Friday Reflection 35: Why Don’t Doctors Want to See Patients?I was asked “Why is it that doctors don’t want to see patients?” and I could not answer the question. Fourteen months later, here is my response. This is a public episode. If you’d like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

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7:40

New Austrian Study Shows Boosters do NOT reduce...

Sensible Medicine ·

2024/01/25

This is a public episode. If you’d like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

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49:08

Math Professor Ben Recht and I Discuss P-values and...

Sensible Medicine ·

2024/01/18

Ben Recht is a professor at UC Berkeley. You know, the place that has all those parking spaces for the Nobel laureates. He understands the innards of math. And that is exactly why he explained that doctors who use evidence don’t have to get bogged down in technicalities. I reached out to Ben to discuss a complicated but provocative statistical paper in NEJM evidence. But we mostly talk basics. Ben writes at his Substack arg min This is a public episode. If you’d like to discuss this with other

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19:13

A discussion with the primary investigator of the...

Sensible Medicine ·

2023/12/22

As many of you know, I have long argued (unsuccessfully until now) for a placebo-controlled trial of AF ablation. One group gets the ablation; the other gets a placebo or sham procedure. This way we can sort out the placebo-resistant effect of the ablation. Finally, here is the first report of one. Dr. Malcolm Finlay is an electrophysiologist at St Bartholomew hospital in London UK and primary investigator of the study. They recently published their feasibility study for AF ablation vs placebo. The

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50:55

Mandrola and Prasad are back

Sensible Medicine ·

2023/12/17

This is a public episode. If you’d like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

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49:42

Mandrola and Prasad are back

Sensible Medicine ·

2023/12/17

This is a public episode. If you’d like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

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9:18

Friday Reflection 35: Four Who Fired Me

Sensible Medicine ·

2023/12/15

These patients did the right thing leaving my care. We were wrong for each other, or I had given what I had to offer (at the time) and it was not enough. That does not lessen the feeling that I failed. This is a public episode. If you’d like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

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7:49

Friday Reflection 32: The Trauma of Not Dying Alone

Sensible Medicine ·

2023/11/03

They say dying alone is sad. They also say we all die alone. There is trauma to not dying alone as well. This is a public episode. If you’d like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

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35:38

Soren Diederichsen on Atrial Fibrillation Screening

Sensible Medicine ·

2023/11/01

If you care about AF you will love this conversation. Soren has some interesting ideas about what AF is now vs what AF was in the past. Here are some links:The LOOP Study (which was non-significant). Effects of Atrial Fibrillation Screening According to N-Terminal Pro-B-Type Natriuretic Peptide: A Secondary Analysis of the Randomized LOOP StudySeverity and Etiology of Incident Stroke in Patients Screened for Atrial Fibrillation vs Usual Care and the Impact of Prior Stroke: A Post Hoc Analysis of the

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53:18

Andrew Foy has a Different Conclusion on a Big JAMA...

Sensible Medicine ·

2023/10/23

The study in question is a randomized clinical trial looking at the Million Hearts Model. This model paid health care organizations to assess and reduce CV risk. Obviously, this is an important goal. Heart disease, specifically, atherosclerotic vascular disease, is a leading killer of humans. Any reduction of heart disease should have a benefit on both a person and a population. But paying health systems to do specific things is a policy intervention. Even though a policy, like this one, makes

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5:35

Friday Reflection 31: Senses, Memories, and Medicine

Sensible Medicine ·

2023/10/20

Friday Reflection 31: Senses, Memories, and MedicineMedical training introduced me to a whole menu of smells -- both diagnostic tools and reminders of times in my career. This is a public episode. If you’d like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe

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