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Talk Evidence

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Talk Evidence covid-19 update - Research on vaccine safety, treatment for dementia

In this week's Talk Evidence, Joe Ross, BMJ editor and professor at Yale again joins Helen Macdonald to talk about emerging evidence on Covid-19.They also welcome to the podcast Juan Franco, family physician in Buenos Aires, and professor at the Instituto Universitario Hospital Italiano, and new editor-in-chief of BMJ Evidence Based Medicine.This week, the team bring you updates on;Post-covid syndrome in individuals admitted to hospital with covid-19 - how are people with long covid faring.Finally published research from Scandinavia on the risk of thrombotic events after administration of the Oxford-AstraZeneca vaccine - how big is the risk, and what does that mean for the overall benefit of that vaccine.How difficult the UK population found it to understand and stick to the rules with our test, trace and isolate system - and some of the questions that this raises for this public health approach.and finally, research that showed non-drug interventions are as good as pharmaceuticals at treating people with depression and dementia - and the holistic effect that alleviating depression can have.Full reading listAyoubkhani, Daniel, Kamlesh Khunti, Vahé Nafilyan, Thomas Maddox, Ben Humberstone, Ian Diamond, and Amitava Banerjee. 2021. “Post-Covid Syndrome in Individuals Admitted to Hospital with Covid-19: Retrospective Cohort Study.” BMJ 372 (March): n693.https://www.bmj.com/content/372/bmj.n693Pottegård, Anton, Lars Christian Lund, Øystein Karlstad, Jesper Dahl, Morten Andersen, Jesper Hallas, Øjvind Lidegaard, et al. 2021. “Arterial Events, Venous Thromboembolism, Thrombocytopenia, and Bleeding after Vaccination with Oxford-AstraZeneca ChAdOx1-S in Denmark and Norway: Population Based Cohort Study.” BMJ 373 (May): n1114.https://www.bmj.com/content/373/bmj.n1114Smith, Louise E., Henry W. W. Potts, Richard Amlôt, Nicola T. Fear, Susan Michie, and G. James Rubin. 2021. “Adherence to the Test, Trace, and Isolate System in the UK: Results from 37 Nationally Representative Surveys.” BMJ 372 (March): n608.https://www.bmj.com/content/372/bmj.n608Watt, Jennifer A., Zahra Goodarzi, Areti Angeliki Veroniki, Vera Nincic, Paul A. Khan, Marco Ghassemi, Yonda Lai, et al. 2021. “Comparative Efficacy of Interventions for Reducing Symptoms of Depression in People with Dementia: Systematic Review and Network Meta-Analysis.” BMJ 372 (March): n532.https://www.bmj.com/content/372/bmj.n532

47mins

14 May 2021

Rank #1

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Talk Evidence - children and covid, varients of concern, ivormectin update

The evidence geekery continues, and this week Helen Macdonald and Duncan Jarvies are joined again by Joe Ross, The BMJ's US research editor, and professor of medicine and public health at Yale.This week we update you on treatment - the WHO's guidelines for covid and ivermectin, and why they're not ready to recommend it's use in treatment, and prophylactic anticoagulation treatment.We hear about two papers from the UK and Switzerland which look at children and covid, and we pick up on varients of concern and long covid.Reading list.Association between living with children and outcomes from covid-19: OpenSAFELY cohort study of 12 million adults in Englandhttps://www.bmj.com/content/372/bmj.n628Clustering and longitudinal change in SARS-CoV-2 seroprevalence in school children in the canton of Zurich, Switzerland: prospective cohort study of 55 schoolshttps://www.bmj.com/content/372/bmj.n616Risk of mortality in patients infected with SARS-CoV-2 variant of concern 202012/1: matched cohort studyhttps://www.bmj.com/content/372/bmj.n579Early initiation of prophylactic anticoagulation for prevention of coronavirus disease 2019 mortality in patients admitted to hospital in the United States: cohort studyhttps://www.bmj.com/content/372/bmj.n311Editorial - Prophylactic anticoagulation for patients in hospital with covid-19https://www.bmj.com/content/372/bmj.n487Living with Covid19 – Second review - Informative and accessible health and care researchhttps://evidence.nihr.ac.uk/themedreview/living-with-covid19-second-review/

32mins

2 Apr 2021

Rank #2

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Talk Evidence - Inside the JCVI, and the key to grading evidence

In a slightly different talk evidence, Helen Macdonald and Duncan Jarvies are bringing you a couple, of in depth interviews,Firstly, Anthony Harnden, GP, academic and member of the UK's Joint Committee on Vaccination and Immunisation takes us inside their decision making, and explains what evidence they look at, how they assess it, and what the next year of vaccination may look like.Also in this episode, Gordon Guyatt, one of the founders of EBM, joins us to talk about Grade - the framework in which evidence for guidelines can be assessed - and explains why the most important thing is not the RCTs, but being very clear about what the guideline is supposed to achieve.https://www.gov.uk/government/groups/joint-committee-on-vaccination-and-immunisation https://www.gradeworkinggroup.org/

55mins

12 Mar 2021

Rank #3

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Talk Evidence - re-hospitalistion for covid-19, remote hypertension intervention

The evidence geekery continues, and this week Helen Macdonald and Duncan Jarvies are joined by Joe Ross, The BMJ's US research editor, and professor of medicine and public health at Yale.This week we pick up on a preprint in medRxiv, which has been attracting attention on social media - it tries to look at the longer term effects of covid hospitalisation.Joe explains why he thinks propensity matching can be summarised as "doing your best".Finally, as more and more care moves remotely, we discuss a trial on a digital intervention to help manage poorly controlled hypertension remotely.Reading list:Epidemiology of post-COVID syndrome following hospitalisation withcoronavirus: a retrospective cohort studyhttps://www.medrxiv.org/content/10.1101/2021.01.15.21249885v1.full.pdfHome and Online Management and Evaluation of Blood Pressure (HOME BP) using a digital intervention in poorly controlled hypertension: randomised controlled trialhttps://www.bmj.com/content/372/bmj.m4858

41mins

12 Feb 2021

Rank #4

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Talk Evidence - Lateral flow tests update, not the best public health approach

In this episode of Talk Evidence, Jon Deeks, professor of biostatistics at the University of Birmingham, returns to the pod with an update on lateral flow tests - and why the government plan for using them in asymptomatic screening for covid-19 doesn't follow the science.We're also joined by Allyson Pollock, clinical professor of public health at Newcastle University, and author of a recent editorial in The BMJ about asymptomatic transmission of SARS-CoV-2. She explains why she thinks supporting social isolation is the missing piece of our approach to tackling the pandemic.Covid-19 INNOVA testing in schools: don’t just test, evaluatehttps://blogs.bmj.com/bmj/2021/01/12/covid-19-innova-testing-in-schools-dont-just-test-evaluate/Asymptomatic transmission of covid-19https://www.bmj.com/content/371/bmj.m4851

42mins

16 Jan 2021

Rank #5

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A (non-systematic) evidence review of 2020

As 2021 hoves into view, we look back at a year of extraordinary evidence.Helen Macdonald is joined by Joe Ross, one of The BMJ's research editors, as well as a researcher at Yale.They discuss the way in which clinical pre-prints have become an important part of the research ecosystem, especially during the pandemic, and pick up on some of the non-coronavirus things you might have missed in the deluge of data.

36mins

3 Jan 2021

Rank #6

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Talking Christmas evidence - how Christmas research is chosen

If you've had time to digest this year's Christmas edition of The BMJ, you might have wondered how those papers get into The BMJ.Well in this Talk Evidence podcast, Helen Macdonald, UK research editor at The BMJ talks to two of her research team colleagues, John Fletcher and Tim Feeney, as they talk through why they chose their favourite papers.Toxicological analysis of George’s marvellous medicinehttps://www.bmj.com/content/371/bmj.m4467Does medicine run in the family—evidence from three generations of physicians in Swedenhttps://www.bmj.com/content/371/bmj.m4453The time to act is nowhttps://www.bmj.com/content/371/bmj.m4143

39mins

28 Dec 2020

Rank #7

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Talk evidence covid-19 update - poor public messaging, and vaccine approval data

The vaccines are being rolled out - but approval is still on an emergency basis, and the evidence underpinning those decisions is only just becoming available for scrutiny.In this podcast we talk to Baruch Fischhoff, professor at Carnegie Mellon University and expert on public health communication about how that messaging should be done.Peter Doshi, associate editor at The BMJ, and vaccine regulation researcher also joins us to talk about the data now released on the vaccine trials - what questions does it raise, and what are the next steps for researching safety.For more on The BMJ's covid-19 coverage www.bmj.com/coronavirus

46mins

11 Dec 2020

Rank #8

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Talk evidence covid-19 update - uncertainty in treatment, uncertainty in prevention

Uncertainty abounds - even as we get better data on treatments, with the big RCTs beginning to report, and new trials on masks, the evidence remains uncertain, in both the statistical realm (confidence intervals crossing 0) and in what to do in the face of that continuing lack of clear effect.As always Helen Macdonald and Duncan Jarvies are looking at the evidence, and this week are joined by John Brodersen, professor of general practice at the University of Copenhagen.Helen talks to Bram Rochwerg, methodology lead on the WHO treatment guidelines for covid, about why their latest review has stopped recommending remdesivir for covid-19 treatment.John tells us about the Danmask study - what question it was actually trying to answer.We also discuss the ways in which there is a tendency to express certainty where there is none, and why distrusting simple solutions to complex problems is a good rule of thumb.Reading list:A living WHO guideline on drugs for covid-19https://www.bmj.com/content/370/bmj.m3379Covid-19’s known unknownshttps://www.bmj.com/content/371/bmj.m3979Effectiveness of Adding a Mask Recommendation to Other Public Health Measures to Prevent SARS-CoV-2 Infection in Danish Mask Wearershttps://www.acpjournals.org/doi/10.7326/M20-6817

33mins

21 Nov 2020

Rank #9

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Talk evidence covid-19 update - talking risk, remdesivir, and relevant research

In this talk evidence covid-19 update, we’re taking on risk - how do you figure out your individual risk of dying from the disease? Try QCovid, but remember that it’s figuring out your risk back in April.When it comes to talking about risk, very few people actually engage with the number, so Alex Freeman from the Winton Centre for Risk and Evidence Communication at the University of Cambridge joins us to describe their research into more effective ways of presenting it.Huseyin Naci, from the London School of Economics, returns to the podcast to talk to us about the problems of pulling all the trial data together, and where covid-19 has made people work together most effectively in tackling that issue.Reading list;Living risk prediction algorithm (QCOVID) for risk of hospital admission and mortality from coronavirus 19 in adultshttps://www.bmj.com/content/371/bmj.m3731Repurposed antiviral drugs for COVID-19 –interim WHO SOLIDARITY trial resultshttps://www.medrxiv.org/content/10.1101/2020.10.15.20209817v1Producing and using timely comparative evidence on drugs: lessons from clinical trials for covid-19https://www.bmj.com/content/371/bmj.m3869.full

41mins

30 Oct 2020

Rank #10