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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

40:53

This Fortnight in Medicine XII

Sensible Medicine ·

2025/11/05

Effects of Intensive Blood Pressure Control in Patients With Frailty: A Post Hoc Analysis From ESPRIT* Lowering systolic blood pressure to less than 120 mm Hg versus less than 140 mm Hg in patients with high cardiovascular risk with and without diabetes or previous stroke: an open-label, blinded-outcome, randomised trial* Reduction of Antihypertensive Treatment in Nursing Home ResidentsPolysaccharide Conjugate Vaccine against Pneumococcal Pneumonia in Adults* A trial to evaluate the safety and

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51:13

This Fortnight in Medicine XI

Sensible Medicine ·

2025/10/22

Total cholesterol and all-cause mortality by sex and age: a prospective cohort study among 12.8 million adults* The Ideal Cholesterol Level ... Depends...And Cannot Be Determined From Observational StudiesStructured vs Self-Guided Multidomain Lifestyle Interventions for Global Cognitive Function: The US POINTER Randomized Clinical Trial* Can We Please Stop Asking if Crossword Puzzles Prevent Dementia? This is a public episode. If you'd like to discuss this with other subscribers or get access to

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50:52

This Fortnight in Medicine X

Sensible Medicine ·

2025/10/08

Two papers this week, with a bunch of articles that we referenced in the conversation. Also, the last Fortnight podcast was accidentally posted behind a paywall. It is now up and free to listen to. My apologies.Sensible Medicine is reader-supported. If you appreciate our work, consider becoming a free or paid subscriber.Folinic acid improves verbal communication in children with autism and language impairment: a randomized double-blind placebo-controlled trial* Folate Receptor Alpha Autoantibodies

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34:11

This Fortnight in Medicine IX

Sensible Medicine ·

2025/09/24

We go all observational this week. A look at data suggesting the safety of GLP-1s and a re-examination of data on patient/doctor race concordance/discordance (a topic Adam said we should not study, and then John forces him to).GLP-1 Receptor Agonists and Cancer Risk in Adults With ObesityPhysician–patient racial concordance and newborn mortalityOriginal, 2020 article: Physician–patient racial concordance and disparities in birthing mortality for newborns This is a public episode. If you'd like to

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8:09

Friday Reflection 53: Eradicating the Very Important...

Sensible Medicine ·

2025/09/19

NT is a 55-year-old man admitted to the general medicine service with cellulitis of his left leg. When the attending sees him the morning after admission, he notices the patient’s “Medical Center Trustee” hospital ID on his bedside table. After gathering a history and examining the leg, the attending leaves the room. In the hallway, he crosses paths with the hospital president, who is there to make a “social call”. She smiles and says to the attending, “Don’t let anything bad happen.”Sensible

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8:27

Friday Reflection 52: The Three Worst Phone Calls of...

Sensible Medicine ·

2025/09/12

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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45:22

This Fortnight in Medicine VIII

Sensible Medicine ·

2025/09/10

Last week, John was at the European Society of Cardiology conference in Madrid, and Adam was at the Preventing Overdiagnosis 2025 International Conference in Oxford. A conversation about what we learned.Digitoxin in Patients with Heart Failure and Reduced Ejection FractionBeta-Blockers Post-MI: A Clear Clinical MessageAspirin in Patients with Chronic Coronary Syndrome Receiving Oral AnticoagulationHow does decontextualised risk information affect clinicians’ understanding of risk and uncertainty in

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39:46

This Fortnight in Medicine VII

Sensible Medicine ·

2025/08/27

Metformin for Treatment of Knee Osteoarthritis in Patients With Overweight or ObesityOnce-Weekly Semaglutide in Persons with Obesity and Knee OsteoarthritisSemaglutide or Tirzepatide and Optic Nerve and Visual Pathway Disorders in Type 2 Diabetes 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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6:26

Friday Reflection 50: The Look

Sensible Medicine ·

2025/08/15

TR is a 72-year-old woman, a retired executive, who had been in excellent health until she began experiencing exertional dyspnea and palpitations. After waiting out the symptoms for about a month, she called and made an appointment to see her primary care doctor. The day before her appointment, she awoke unable to move her entire right side. With difficulty, she reached for her phone and called her daughter. Her daughter was unable to understand her and called 911.This Substack is reader-supported

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35:06

This Fortnight in Medicine VI

Sensible Medicine ·

2025/08/13

A “manel” reviewing trials and studies that explore the benefits and harms of hormone replacement therapy.The Women’s Health Initiative* Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial* The Women's Health Initiative Randomized Trials and Clinical Practice: A Review* The Women’s Health Initiative Hormone Therapy Trials: Update and Overview of Health Outcomes During the Intervention and

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33:03

This Fortnight in Medicine V

Sensible Medicine ·

2025/07/30

Primary Articles* As-Needed Albuterol–Budesonide in Mild Asthma* Early versus Later Anticoagulation for Stroke with Atrial FibrillationReferenced Articles * Albuterol–Budesonide Fixed-Dose Combination Rescue Inhaler for Asthma* Stopping Randomized Trials Early for Benefit and Estimation of Treatment Effects: Systematic Review and Meta-regression Analysis This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit

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35:39

This Fortnight in Medicine (IV)

Sensible Medicine ·

2025/07/16

Primary articles discussed:* First myocardial infarction: risk factors, symptoms, and medical therapy* Oral vs Extended-Release Injectable Naltrexone for Hospitalized Patients With Alcohol Use DisorderA Randomized Clinical TrialArticles referenced:* Pharmacotherapy for Alcohol Use Disorder: A Systematic Review and Meta-Analysis* General health checks in adults for reducing morbidity and mortality from disease: Cochrane systematic review and meta-analysis This is a public episode. If you'd like to

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10:40

Friday Reflection 49: The Patients of 12 Reisman

Sensible Medicine ·

2025/07/11

A visit brings back the memories of patients and the lessons they taught. 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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40:24

This Fortnight in Medicine (Episode III)

Sensible Medicine ·

2025/07/02

No association between preprocedural fasting and witnessed pulmonary aspiration: A systematic review and meta-analysisHere are a couple of other older articles to give you the history of preprocedural fasting. Reducing the Risk of Acid Aspirations During Cesarean SectionFasting from midnight — the history behind the dogmaCT Angiography, Healthy Lifestyle Behaviors, and Preventive Therapy This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes,

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38:11

This Fortnight in Medicine (Episode II)

Sensible Medicine ·

2025/06/18

This Substack is reader-supported. If you appreciate our work, consider becoming a free or paid subscriber.Clinical Validation of a Circulating Tumor DNA–Based Blood Test to Screen for Colorectal CancerIf you want a deeper dive into cancer screening, we have covered the topic a lot on Sensible Medicine. There is a video debate Vinay, John, and Adam had about colon cancer screening. We also posted two follow-up articles for that debate. Adam has written six different articles about screening.The

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37:09

This Fortnight in Medicine

Sensible Medicine ·

2025/06/04

We are beginning a new series today. John and Adam will discuss a couple of articles we found interesting. Please let us know your thoughts. This week:Phase 3 Trial of Semaglutide in Metabolic Dysfunction–Associated SteatohepatitisTiotropium Initiation and Dementia Risk in Chronic Obstructive Pulmonary Disease 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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83:33

Ask Us Anything

Sensible Medicine ·

2025/05/17

This is a long one! 83 minutes. This is the second podcast in which we answer questions from a our “ask us anything” post. We recorded this one before our most recent podcast — kind of like Abbey Road and Let it Be — so we were still graced by Vinay’s presence. In fact, we recorded it in his studio. We still have about a half dozen questions to answer; we will cover those on an upcoming podcast. Enjoy. This is a public episode. If you'd like to discuss this with other subscribers or get access to

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37:03

Vinay at FDA; what's next for Sensible Medicine; ask...

Sensible Medicine ·

2025/05/08

John and Adam discuss our hopes for Vinay’s tenure at the FDA and how we intend to keep Sensible Medicine a vibrant place on Substack, a place where we will continue to showcase a range of ideas and opinions about all things bio-medicine. We also answer some of the questions from our recent “ask us anything” post. 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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18:41

How Not to Get Fooled by the Medical Literature -...

Sensible Medicine ·

2025/04/30

The most common question we get asked is: is there a course on how to become better at critically reading medical research. Well, now there is!This is the first of 9 videos that we recorded as part of a course on clinical appraisal, and there will be many more to come. We call our class: How Not to Get Fooled by the Medical Literature. These are topics that each of us teaches separately, but, here, for the first time, we teach them together, and the whole is more than the sum of the parts.The

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6:59

Friday Reflection 48: Linguistics, Diagnosis, and...

Sensible Medicine ·

2025/03/07

FH is a 66-year-old woman who comes in for an urgent visit because she has been feeling woozy for two days. She is very anxious, almost distraught, because she thinks these symptoms are the same as the ones that her sister had before she died of a hemorrhagic stroke.Sensible Medicine is a reader-supported publication. If you appreciate our work, consider becoming a free or paid subscriber.A few years ago, a team building exercise was proposed at a meeting I was attending. To say I hate team building

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