Recent Posts


November 15th, 2019

Podcast 242: Tranexamic acid saves lives after traumatic bleeds

(2 votes, average: 2.00 out of 5)

Tranexamic acid, which frustrates clot dissolution, has been shown to reduce death from intracranial bleeding in a large international placebo-controlled trial — “CRASH-3.”

Ali Raja and Joe Elia host a lively chat with Ian Roberts, the co-chair of the trial’s writing committee, who, in addition to chastising the hosts’ seeming fascination with P-values, recounts a story from early in his training that first stirred his devotion to preventing bleeding-related death after trauma.

NEJM Journal Watch Emergency Medicine summary of CRASH-3

CRASH-3 report in The Lancet

Ian Roberts explains CRASH-3 on YouTube to collaborators in Malaysia

Roberts presents CRASH-3 results at World Congress on Intensive Care on YouTube

Running time: 23 minutes

November 7th, 2019

Podcast 241: Talking about guns with patients

(4 votes, average: 3.25 out of 5)

Running time: 18 minutes

In California, Garen Wintemute and his group find evidence that people are willing to discuss gun safety with their clinicians, especially when there may be danger of harm present. That willingness extends across gun owners and non-owners. So why aren’t more clinicians doing it?

The findings appear in Health Affairs.

Links to the article & further resources:

Health Affairs article

Wintemute’s essay in Annals of Internal Medicine on gun violence

Another Annals article on preventing gun-related death and injury


November 1st, 2019

Podcast 240: Overuse of statins for primary prevention of cardiovascular events

(8 votes, average: 3.88 out of 5)

Running time: 23 minutes

Paula Byrne set out to understand what the available data tell us about how many people are taking statins for primary prevention — and how much good is it likely doing them?

Also, how do you discuss their possible harms and benefits with patients?


Paula Byrne and colleagues’ analysis in The BMJ

Kausik Ray meta analysis in JAMA Internal  Medicine

Kausik Ray 2010 Clinical Conversations interview

NEJM Journal Watch General Medicine comparison of statin guidelines

October 25th, 2019

Podcast 239: Talking with veterans

(No Ratings Yet)

Running Time: 18 minutes

Veterans Day will be here soon, and this episode introduces you to Patrick Tripp, a writer and radiation oncologist. He’s taken conversations with some of his patients and published thumbnail profiles of several in a remarkable essay in the London Review of Books (that’s right, it’s not a medical journal).

The patients all happened to be veterans of the war in Vietnam. There are no biomedical insights here — or are there? At the very least, you are reminded that the people in the exam room all have stories to tell, and if you have the luxury of listening to them you may just learn more about their true chief complaint.

Patrick Tripp’s London Review of Books essay


October 18th, 2019

Podcast 238: Preparing for the unthinkable chaos of a mass-casualty event

(2 votes, average: 5.00 out of 5)

Running time: 21 minutes

A white paper from the Office of the Assistant Secretary for Preparedness and Response (ASPR) advises clinicians, health planners, and emergency responders that the old ways of responding to mass casualty events no longer hold. Wounded people arrive in Ubers and Lyfts at hospitals that are unprepared to be trauma centers. It’s best to practice (sending out an email to the staff doesn’t count) so that everyone in the hospital knows what to do and where to go when chaos strikes.

Ali Raja and Joe Elia talk with Paul Biddinger, one of the contributors to “Mass Casualty Trauma Triage: Paradigms and Pitfalls.”

And by the way, you may think you know how to use a tourniquet, but you probably don’t. Follow the link (below) to Stop the Bleed.



October 10th, 2019

Podcast 237: U.S. health spending — where is the outrage?

(3 votes, average: 3.67 out of 5)

Running time: 18 minutes

JAMA has just published an analysis of the latest findings regarding waste in the nation’s $3.5 trillion annual health “co-pay.” And with 25% of that — some eight hundred billion dollars — characterized as wasted, you’d think there would be stacks of competing cost-saving proposals to consider, especially regarding administrative costs. There aren’t.

An editorial comment on all this by our guest, Don Berwick, reminds us that one person’s wasteful spending is another’s lavish income. The question is, with all that money left on the table, what are we foregoing as a country?

Dr. Berwick has thoughts, and he kindly agreed to share them with us.

JAMA article by Shrank et al.

JAMA editorial by Berwick


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