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June 22nd, 2015

Clinical Conversation 177: Can We Deliver NICEly?

(1 votes, average: 5.00 out of 5)

Neel Shah wrote a Perspective essay in the New England Journal of Medicine earlier this month on the U.K.’s NICE recommendation that encourages wider acceptance of home delivery and midwifery. The question is, could it work in the U.S.?

For the audio-oriented Clin Con audience we’ve adapted a video conversation that took place on Medstro (https://medstro.com/groups/nejm-group-open-forum/discussions/112). There, Dr. Shah and other clinicians discuss the problems U.S. obstetricians and U.S. mothers-to-be face. The Medstro forum is now finished, but the discussions back and forth over the course of its 10-day run are still available at the URL above.

Running time: 32 minutes

June 12th, 2015

Podcast 176: HPV Vaccine — How many doses are needed to confer protection?

(No Ratings Yet)

Running time: 19 minutes

We talk with Dr. Cosette Wheeler about a new Lancet Oncology paper that offers follow-up on two major trials of HPV-16/18 vaccines.

The analysis adds more data to the suspicion that although three doses of vaccine are optimal, two or even one may offer substantial protection. Wheeler is very cautious on this point, however, and insists that the goal must be to deliver three doses to every recipient. In the U.S., HPV vaccine courses are completed less than half the time.

Lancet Oncology abstract

June 3rd, 2015

Podcast 175: “Understanding Value-Based Healthcare” — A Discussion with the Authors of an Important New Book

(6 votes, average: 3.83 out of 5)

Running time: 26 minutes

“Understanding Value-Based Healthcare,” published in April by McGraw-Hill is today’s focus.

Drs. Christopher Moriates, of the University of California, San Francisco; Vineet Arora, of the University of Chicago; and Neel Shah of Harvard Medical — the book’s authors — discuss its straightforward approach to valuing patient outcomes foremost.

The discussion ranges over their reasons for writing the book, their attempt to reach the broader audience concerned with healthcare costs, and their recommendations for taking action locally.

Here’s a link to the authors’ Costs-of-Care website, where you will find information on ordering the book.

September 9th, 2014

Podcast 174: PARADIGM and Heart Failure

(7 votes, average: 3.57 out of 5)

The PARADIGM-HF trial of LCZ696 — a novel compound that both blocks the renin-angiotensin system with an ARB component and blocks neprilysin’s degradation of natriuretic peptides — increased survival in heart failure by some 20% relative to enalapril. It seems to be a big deal, and the trial’s two principal authors have agreed to talk about their work and its larger meaning.

Running time: 15 minutes

Other links:

The study in the New England Journal of Medicine (free)

NEJM Journal Watch coverage of the study (free)

August 29th, 2014

Podcast 173: Sensible Sodium Levels in View at Last

(6 votes, average: 3.83 out of 5)

Running time: 9 minutes

In the light of the New England Journal of Medicine‘s recent publication three papers on sodium intake and its implications for cardiovascular disease, blood pressure, and excess mortality, we thought we’d speak again with Dr. Jan Staessen, who surprised a lot of people 3 years ago with a paper in JAMA warning against population-wide sodium reductions. His research showed that cutting sodium intakes to levels recommended by the U.S. Dept. of Agriculture was associated in his cohort with an increase in cardiovascular risk.

Dr. Staessen kindly agreed to serve as our guide through the new NEJM research.

LINKS:

The 2011 Staessen interview

Physician’s First Watch coverage of the new NEJM studies

 

July 30th, 2014

Podcast 172: Listening for the Diagnosis, a Conversation with Danielle Ofri

(16 votes, average: 2.81 out of 5)

Running time: 15 minutes

Dr. Danielle Ofri, author and internist (as well as an aspiring cellist), is writing a book about how patients and clinicians hear each other. Our discussion centers on that, and on her request that you contact her if you can put her in touch with great diagnosticians (and maybe even their patients).

If you have any suggestions about this or other matters, please contact me here: jelia@nejm.org.

Dr. Ofri may be contacted at her website: http://danielleofri.com

 Here’s a link to our 2009 interview with Ofri.

Clinical Conversations

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