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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

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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54:17

Sudden cardiac death and arrhythmias in athletes

Sensible Medicine ·

2023/10/18

Sudden cardiac death due to ventricular rhythm disturbances are rare but highly public. It’s strange and curious because you don’t expect healthy athletes to suffer serious cardiac issues. Recently three prominent athletes have survived sudden cardiac death. Christian Erikson, a Danish soccer player, Damar Hamlin, an American football player and Bronny James, son of Lebron James. These high-profile cases have highlighted the issue of sudden cardiac death of athletes. Dr. Dorian has published

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54:55

Prasad's lecture gets cancelled/ Cifu Gets COVID

Sensible Medicine ·

2023/10/16

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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35:12

New Podcast -- Discussion with Rita Redberg and...

Sensible Medicine ·

2023/10/05

Angela Lu is training to be a physician. She’s interested in public policy. As a third year medical student, she teamed up with established leaders to ask a unique question regarding public disclosure of financial relationships. When the Centers for Medicare & Medicaid Services (CMS) issues National Coverage Determinations (NCDs) for services or products, they mean business. Such decisions have huge implications. You cannot go against them. Think #HighConsequences.CMS studies the evidence and

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64:50

Foy and Mandrola Talk Coronary Calcium and a New...

Sensible Medicine ·

2023/09/27

Andrew Foy rejoins the Sensible Medicine podcast. We talk first about coronary artery calcium. Andrew is an expert in this area. We have co-written our case against CAC scoring for any cause in the American Family Physician. It’s had little effect as CAC scoring is running rampant. Sensible Medicine is a reader-supported publication. To receive new posts and support our work, consider becoming a free or paid subscriber.The second part of our conversation centers on a big med-ed project Andrew is

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40:03

Foy and Mandrola Discuss AF, AF-Ablation,...

Sensible Medicine ·

2023/09/19

This week, I talk with Andrew Foy, who is an academic cardiologist at Penn State University in Hershey, PA. Andrew is one of the smartest voices in medicine today. We start with the REMEDIAL trial, published recently in JAMA. Ablation vs Meds. Primary endpoint—depression and anxiety. One of the main issues was the control arm—namely that there was no sham control. We referenced this useful review paper on placebo and nocebo effects in cardiology, from Brian Olshansky. Our second topic was the FRAIL

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48:39

Coumadin beats DOAC, ECMO fails, When RCTs needed,...

Sensible Medicine ·

2023/09/11

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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9:17

Friday Reflection 29: The Totally Predictable Doctor...

Sensible Medicine ·

2023/09/08

AC is a 56-year-old man brought to the emergency room by ambulance for a trauma evaluation after a bicycle crash.Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber.I’ve tried to stay away from the reflections that end up being part of the “doctor-as-patient” genre.[i] Books, TV shows, and movies are filled with these stories.[ii] A doctor gets sick or injured, spends time as a patient, and then authors a piece with a

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51:59

Sensible Medicine x Vaccine Curious: Tracy Beth Høeg...

Sensible Medicine ·

2023/08/29

Sensible MedicineSensible Medicine x Vaccine Curious Cross Podcast on the USA vs Denmark, vaccines, etc:Show notes by Dovid Y Rimmer, Tracy Beth Høeg and Christine Stabell Benn* Benn, Høeg. Regarding becoming a medical skeptic. Hoeg: anonymous blog - exercise during pregnancy. Benn: Vitamins, sex differences, and vaccines.* Differences in pandemic response between Denmark v. California - school reopening, masks.* USA recommends boosters (yearly) for Children, Denmark does not recommend vaccinating

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11:17

Friday Reflection 28: Four of the Things Patients...

Sensible Medicine ·

2023/08/25

Although it is unoriginal to point out that doctors learn from our patients, here are a few lessons so powerful, so extrapolatable, that I forever associate them with an individual. 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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42:44

Mandrola & Prasad on Republicans and COVID outcomes,...

Sensible Medicine ·

2023/08/23

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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46:39

A Conversation with Professor Robert Yeh

Sensible Medicine ·

2023/08/20

Here is the profile for Harvard Professor Robert (Bobby) Yeh. His most recent Circulation paper: Bringing the Credibility Revolution to Observational Research in Cardiology. We referenced a paper by Professor Miguel Hernan: The C-Word: Scientific Euphemisms Do Not Improve Causal Inference From Observational DataPaper referenced on left ventricular assist devices: Comparative Effectiveness of Percutaneous Microaxial Left Ventricular Assist Device vs Intra-Aortic Balloon Pump or No Mechanical

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