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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

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All Episodes

45:36

This Fortnight in Medicine XVIII

Sensible Medicine ·

2026/01/28

No video this week — we had a bit of a computer meltdown — but two interesting articles.As always, thanks for listening. If you have articles you would like us to cover, please send us a suggestion at sensiblemedicine2022@gmail.com.This Substack is reader-supported. If you appreciate our work, consider becoming a free or paid subscriber. 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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7:27

Friday Reflection 56: Comments that Stuck

Sensible Medicine ·

2026/01/23

In a lifetime of possible memories, only some are accessible. There are a few comments — made by mentors, co-residents, and patients — that have lingered and shaped my medical practice. 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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39:51

When to treat (or not treat) a high cholesterol

Sensible Medicine ·

2026/01/18

I was shocked at the comments on this post. Many people, some of them I know to be smart, thought I was nuts for suggesting two middle-aged women who had isolated high LDL-C needn’t take meds because their calculated 10-year risk was less than 3% What shocked me is that our guidelines suggest treatment with statins when 10-year risk is ≥ 7.5%. You may not know this but clinicians are supposed to consider cholesterol (and BP) based on overall risk, which include things like age, blood pressure,

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45:04

This Fortnight in Medicine XVII

Sensible Medicine ·

2026/01/14

Medical Management and Revascularization for Asymptomatic Carotid StenosisVagus nerve-mediated neuroimmune modulation for rheumatoid arthritis: a pivotal randomized controlled trialWe spent quite a bit of time talking about blinding. This is the table on the adequacy of blinding from the supplement. It does seem like blinding was less than perfect. 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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82:35

This Fortnight in Medicine XVI

Sensible Medicine ·

2025/12/31

We try to answer the remainder of your AUA questions. We will be back in the new year with more article discussions!Here are a few of the things we referenced.GDMT Bugs Me: A bit of a rant against the standard of careA Plan to Refocus Primary CareSacrificing patient care for prevention: distortion of the role of general practiceThe Great Colonoscopy DebateArthroscopic Partial Meniscectomy versus Sham Surgery for a Degenerative Meniscal Tear This is a public episode. If you'd like to discuss this

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60:40

This Fortnight in Medicine XV

Sensible Medicine ·

2025/12/17

We cover questions from Amy J, Benjamin Hourani, Diana Stiles Friou, Chris Costas, Errol Laurie, Jim Healthy, Elizabeth Fama, Never Dull, Rod Rodriguez, Ellison Burns, David Araujo, and George.We have more to come!One nice reference I found while looking into some of the topics:DMSO Is Not a Cure-All. But the FDA’s Panic Over It Birthed a Myth 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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33:51

This Fortnight in Medicine XIV

Sensible Medicine ·

2025/12/03

Vascular and inflammatory diseases after COVID-19 infection and vaccination in children and young people in England: a retrospective, population-based cohort study using linked electronic health recordsComparison of an Initial Risk-Based Testing Strategy vs Usual Testing in Stable Symptomatic Patients With Suspected Coronary Artery Disease: The PRECISE Randomized Clinical Trial 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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44:10

This Fortnight in Medicine XIII

Sensible Medicine ·

2025/11/19

European Study of Prostate Cancer Screening — 23-Year Follow-upAssociation Between Baseline Diastolic Blood Pressure and the Efficacy of Intensive vs Standard Blood Pressure–Lowering TherapyFurther Reading* Effects of intensive blood-pressure control in type 2 diabetes mellitus* A Randomized Trial of Intensive versus Standard Blood-Pressure ControlSensible Medicine is 100% reader-supported. If you appreciate our work, consider becoming a free or paid subscriber. This is a public episode. If you'd

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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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