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April 8th, 2016

Podcast 201: The NFL’s concussion-research flaws

(1 votes, average: 5.00 out of 5)

A conversation with Dr. Ira Casson (who served on the National Football League’s committee on mild traumatic brain injury and co-authored several of its studies on MTBI) reveals that it may be impossible to assess the value of its six-season study. Despite the author’s defense of the methods used to conduct the research, there’s room for skepticism, both in the light of a New York Times story reporting that over 10% of such injuries may have gone unreported and the study’s assumption that all teams reported all injuries.

We asked the League to make the studies’ first author available for this conversation, and they declined.

 

March 25th, 2016

Podcast 200: Sorting out the results of breast biopsy

(1 votes, average: 5.00 out of 5)

Most of the time, pathologists agree with each other about breast biopsy results — especially when the biopsy is negative or indicates invasive cancer. However, the biopsies that fall between those two extremes — that is, atypia and ductal carcinoma in situ — make for tough conversations with patients.

This week’s guest, Alexander Borowsky, has written an editorial (with Laura Esserman) about the problem, and he offers advice to clinicians about conveying diagnostic uncertainty. Their editorial also calls into question the words used to describe breast biopsy results, pointing out that a report of “ductal carcinoma” in situ has a way of making people reach for their scalpels — not always wisely.

The editorial accompanies a study in the Annals of Internal Medicine that examines precision of biopsy diagnoses.

(One aspect of the editorial we never got to discuss in the podcast was its citation of “Car Talk,” on the question how uncertainties feed into each other. That’s worth a link, given below.)

Annals of Internal Medicine editorial (subscription required)

Annals study (free abstract)

Car Talk episode (start listening at the 17 min, 45 sec mark)

March 15th, 2016

Podcast 199: Rethinking what medical journals do

(2 votes, average: 4.50 out of 5)

There’s change in the air about science publishing, and Harlan Krumholz, the founding editor of the journal Circulation: Cardiovascular Quality and Outcomes, thinks it’s time to reimagine the whole concept of what a journal is and what it does.

He poured his ideas into an editorial, “The End of Journals,” which he published as he approached the end of his editorship. We finally caught up with him weeks later (he’s elusive) and talked about those ideas.

(As this podcast was being readied for posting, the New York Times published an account of Nobel laureate Carol Greider’s posting of work on bioRxiv. She celebrated by tweeting under #ASAPbio.)

March 10th, 2016

Podcast 198: Three laws that could reduce U.S. firearm mortality

(No Ratings Yet)
m-16 and candle

M-16 and candle, 1968

Implementing universal background checks for gun purchases, for ammunition purchases, and mandating firearm identification could dramatically lower U.S. mortality attributable to firearms, our guest says.

In the Lancet, Dr. Bindu Kalesan and her colleagues examined state gun laws associated with the lowest mortality rates and concluded that if three of those laws were implemented at the national level, rates would drop by over 90%.

Lancet article (free abstract)

March 4th, 2016

Podcast 197: A dissent on sepsis

(5 votes, average: 3.60 out of 5)

The authors of the new sepsis definitions encouraged “debate and discussion,” and an editorial in Chest was quick to provide it.

The editorialist, Dr. Steven Simpson, is worried about missing some cases if consideration of SIRS (the systemic inflammatory response syndrome) is tossed out of the definition.

Chest editorial (free PDF available if you scroll down that landing page)

Last week’s interview on the new defintions (free)

 

February 27th, 2016

Podcast 196: Sepsis redefined

(4 votes, average: 2.50 out of 5)

We have Edward Abraham, Dean of Wake Forest School of Medicine, with us to talk about the new definitions of sepsis and septic shock. He wrote an editorial in JAMA that puts the changed definitions into perspective for clinicians. Listen in.

Editorial in JAMA (free)

JAMA paper with new definitions (free)

NEJM Journal Watch coverage (free)

 

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