In episode 548, James and Mike invite Betsy Thomas back to the podcast to talk about whether or not measuring lipoprotein(a) or apolipoprotein B improves cardiovascular risk prediction in a meaningful way over and above using standard risk factors. Many guidelines are now recommending we should do these measurements but is this an evidence-based recommendation? […]

In episode 547, James and Mike invite Jessica and Scott back again to talk about whether or not COPD patients seen in primary care are like the people studied in the large COPD trials. We talk about how to focus care on the people who are most likely to benefit from therapy. There are lots […]

Episode 546: Who provides chronic disease management? In episode 546, James and Mike invite Jessica Kirkwood and Scott Garrison to talk about a new study they published looking at what proportion of common chronic medical conditions such as hypertension, diabetes and COPD are handled by family physicians, specialists, and nurse practitioners manage. We find that […]

In episode 545, James and Mike invite Samantha Moe back again to the podcast to talk about whether or not statins increase the risk of dementia or worsening of cognitive scores. I forgot the answer so you will have to listen to the podcast. Show Notes Tools for Practice Forget about it? Statins and the […]

In episode 544, James and Mike invite Samantha Moe to the podcast to talk about whether or not PPIs improve crying, fussiness, irritability, or regurgitation attributed to feeds. If you’ve ever used PPIs for this condition, you may be surprised by the results. Show Notes 1) Tools for Practice Crying babies: Can proton pump inhibitors […]

In episode 543, James and Mike invite Tina Korowynk and Jennifer Young to discuss their recent paper where they talk about the evidence around comprehensive primary care that is led by a family physician. We find out family physician care improves patient outcomes such as mortality, decreased emergency department visits, hospitalizations, readmissions, and health care […]

In episode 542, James and Mike finish their discussion around placebo. We then talk about tips and tricks for how to best use the knowledge about the placebo group effect when it comes to day-to-day decisions of choosing, stopping and starting medications/treatments. Show Notes Placebo handout

In episode 541, James and Mike get into a powerful discussion of placebo. We talk about the evidence around placebo, the placebo effect, the placebo group effect/response and we try to put it all into the context of clinical practice. The bottom line is the placebo effect is likely not what you think it is, […]

In episode 540, James and Mike invite Jennifer Young to go over all the evidence we have for what antibiotics to choose for bladder infections. The evidence clearly shows that the antibiotics we have been using for decades are still the drugs of choice. Tune in and find out which one you should choose and […]

In episode 538, James and Mike discuss the great (but pretty much silly) egg controversy. We go over the best available evidence for eggs which is at best not great. We talk about the cohorts, the effect of eggs on cholesterol and much more. At the end we conclude definitively that, and you heard it […]

In episode 537, Mike and James invite Ricky Turgeon back to the podcast to talk about the impact of the influenza vaccination on cardiovascular events in both primary and secondary prevention. The best evidence is in secondary prevention. Tune-in to hear the numbers. Show Notes 1) Tools for Practice A Jab for Your CAD: Influenza […]

In episode 536, Mike and James talk about 4 questions – Is any bacteriuria associated with altered mental state? – Does treating ASB improve/prevent clinical outcomes? – Does treating ASB improve altered mental state? – Do antibiotic reduction interventions for ASB affect patient outcomes? Tune in to find out the answers. Show Notes 1) Tools […]

In episode 535, Mike and James work through all the evidence and come up with the definitive (in our minds) answer as to whether or not statins cause muscle symptoms. They likely do in 1% of people, but if you have muscle symptoms when you are on a statin it is very unlikely it is […]

In episode 534, Mike and James bring Jamie Falk to go through all the evidence for continuous glucose monitors that use subcutaneous sensors. There certainly seems to be evidence of benefit for T1DM but when it comes to T2DM the evidence for a benefit is not clear at all. Have a listen to get all […]

In episode 532, Mike and James bring Mike Kolber in to chat about potential treatments for anal fissures. We discuss the evidence for topical nitroglycerin, topical calcium channel blockers and topical Vitamin E. At the end we provide guidance that will blow your head off – or maybe we were all using too high a […]

In episode 531, Mike and James chat with Samantha Moe yet again. In this podcast we go over all the best evidence for whether or not inhalers help with post-infectious cough in adults without asthma. The evidence is miles/kilometres from being overwhelming but we do our best give you numbers you can use in your […]

In episode 530, Mike and James welcome Samantha Moe back to the podcast to do an end of the year podcast. In this podcast we discuss the evidence around New Year’s resolutions. We discuss what are the most popular types of resolutions and which are more likely to be kept. At the end we resolve […]

In episode 529, Mike and James welcome Mike Kolber back to the podcast and we discuss all the best available around the use of tranexamic acid for acute adult trauma and acute GI bleed. It seems to have an effect in one of these. Tune in to find out the numbers. Show Notes 1) Tools […]

In episode 528, James and Mike go through the logic and math around CVD risk estimates with regard to repeat cholesterol measurements. We discuss the impact remeasuring cholesterol has on CVD risk estimates and show that re-measuring every 5-10 years provides minimal if any value when it comes to making treatment decisions. All you need […]

In episode 527, Mike and James continue their urinary tract infections “trilogy and more” discussions. In this podcast, we look at the evidence around whether or not we need to use antibiotics to treat uncomplicated symptomatic urinary tract infections. We talk about the evidence for NSAIDs and antibiotics and we also delve a little bit […]

In episode 526, Mike and James go PREMIUM yet again, although it takes a while – so stay till the end. We go over the latest research on low sodium in heart failure, Vitamin D for preventing COVID, and multivitamins for doing anything. Show Notes 1) Reduction of dietary sodium to less than 100 mmol […]

In episode 525 – part two of our series on weight – James and Mike talk about how best to measure “weight” – and waste circumference, and hip -to-weight ratio and so on. We show that there is very little reason to measure much else other than actual weight. We also look at the evidence […]

In episode 524 – the first of a 2-part series about weight – James and Mike talk about why people wish to lose weight, the words we use to describe weight, the obesity paradox, all the cohort evidence around weight and mortality/cardiovascular disease/depression/osteoarthritis/fractures, and in a nice juxtaposition do it while eating rum and raisin […]

In episode 523, James and Mike invite Jennifer Young to the podcast for the first time to help us go over all the evidence around diagnosing symptomatic uncomplicated urinary tract infections in adult women. We also delve into the “fun“ world of likelihood ratios – believe it or not, they are REALLY useful. So hang […]

In episode 521, James and Mike invite Caitlin Finley to the podcast for the first time to talk about a very common primary care topic – recurrent UTIs. We discuss the frequency of recurrence and look at the evidence for many of the different strategies used to reduce the chance of recurrence. Show Notes 1) […]