Best Science Medicine Podcast - BS without the BS: Recent Episodes
James McCormack
The Best Science (BS) Medicine Podcast is a weekly presentation where practitioners can get evidence-based drug therapy content that is practical, entertaining and promotes healthy scepticism. In essence, we are the Medication Mythbusters. We present information that is useful and relevant to physicians, pharmacists, nurses, physician assistants and other health professionals, and that can easily be incorporated into day-to-day practice. The podcast is presented by Dr. James McCormack, Professor in the Faculty of Pharmaceutical Sciences at the University of British Columbia and Dr Michael Allan, Associate Professor in the Department of Family Practice at the University of Alberta. For more about us and to get the show notes for each episode, visit our website at www.bsmedicine.com or www.medicationmythbusters.com
In episode 625, Mike K and James invite Danielle Perry and Tony Nickonchuk to the podcast to talk about the evidence around blood pressure measurement techniques. You might be surprised by what does and does not influence blood pressure measurements. Check out the podcast.
Show Notes
Tools For Practice
Blood Pressure Measurement Technique: Meaningful mistakes or minor details?
In episode 624, James and Mike K invite Tony Nickonchuk to go over all the new evidence we have for the PCSK9 inhibitors. First, we discuss whether or not the evidence addresses the issue of primary versus secondary prevention. We then give you all the numbers and the context you need to allow you to discuss these with your patients.
Show Notes
Tools For Practice
PCSK9 Inhibitors: Cardiovascular prevention panacea or pricey pokes?
PEIP Conference Oct 16-17, 2026
In episode 623, Jamie and James invite Samantha Moe back again to talk about the never-ending debate as to what is the target for systolic blood pressure. We look at the evidence and then try to put it into a reasonable context because at best the evidence is always nuanced. But at least you will now know the numbers.
Show Notes
Tools For Practice
Less than 140, 130, or 120? Counting down to the optimal systolic blood pressure target.
In episode 622, Jamie and James invite Émélie Braschi back again to talk about if we should be using inhalers that combine corticosteroids and beta-agonists as rescue inhalers. We go over the best available evidence and then try to put the findings into context.
Show Notes
Tools For Practice
Bronchodilator with Benefits? Budesonide-formoterol rescue inhaler for asthma
In episode 621, Tina, James and Mike K talk about the evidence around whole-body MRIs. We discuss how many abnormalities are found, how many cancers are actually found, and finally the lost opportunity costs. You need to know these numbers to talk to your patients about the value or lack thereof of doing this test.
Show Notes
Tools For Practice
Whole-Body MRI for Cancer Screening: Many findings, little benefit update
MEME conference May8/9 2026 in Vancouver
In episode 612, Tina and James chat with Samantha Moe about the use of a recently approved non-hormonal medication being used for vasomotor symptoms in menopause. We go over the 3 available trials and show you the numbers, talk about the limitations and then put the results into the context of hormone and other non-hormonal treatments.
Show Notes
Tools For Practice
Turn Down the Heat, Part II! Can fezolinetant improve vasomotor symptoms in menopause?
In episode 611, Tina and James talk with Samantha Moe about the use of betablockers and other medications for essential tremor. There is some evidence – much of it from the 1970s, but also some more recent publications. We do our best to tease out all the numbers you need to help you with your recommendations.
Show Notes
Tools For Practice
Meds for Essential Tremor: Steady solution or shaky science?
In episode 610, Jamie and James chat with Jennifer Young about yet another Vitamin D Tools for Practice. We look at what happens to mortality, CVD and cancer when Vitamin D supplements are compared to placebo. The results may surprise you – or maybe not if you have listened to previous BS Medicine Podcasts on this seemingly never-ending topic.
Show Notes
Tools For Practice
Vitamin D and Mortality – Don’t bet your life on it!
Vitamin D and Respiratory Tract Infections: Does the sun’s vitamin chase the cold?
In episode 609, Jamie and James chat with Jennifer Young about what the evidence says around exercise for fibromyalgia. Unfortunately, the evidence and the way it is presented is somewhat limited but nonetheless we do put it into context to help you and your patients make decisions.
Show Notes
1) Tools For Practice
Use the soft touch for buckle fractures?
https://cfpclearn.ca/tfp396/
2) PEIP Conference Edmonton October 17-18, 2025
https://www.peipconference.ca
In episode 608, Tina and James invite Jennifer Young back again to the podcast to go over the evidence we have for a simple but important question around buckle fractures – does treating with a soft bandage versus a rigid splint/cast produce different clinical outcomes? The answer is quite clear around what we should do. Check out what we found.
Show Notes
1) Tools For Practice
Use the soft touch for buckle fractures?
2) PEIP Conference Edmonton October 17-18, 2025
In episode 607, Tina and James invite Caitlin Finley to go over what the group found with regard to the best available evidence around surgical frenotomy. We look at the effect the surgery has on breast pain, self-reported breastfeeding improvement, and infant weight gain. Tune in as you might be impressed with the absolute benefits.
Show Notes
1) Tools For Practice
Trying Tongue-Tie Treatment: Does Frenotomy Fix Feeding Frustrations?
2) PEIP Conference Edmonton October 17-18, 2025
THE CASE
It is Friday, the end of a long and busy week and a sunny weekend is calling you. Your tasks this afternoon includes seeing some patients who have complex comorbidity and have been booked in for medication reviews. Next up is a longstanding patient, aged 76 who is on 14 different medication, for several different conditions, 2 more drugs than she was on just 3 months ago. How does this feel? Perhaps a bit daunting? Perhaps the clinician isn’t confident they know what to do about this polypharmacy although they have a gut feeling that this many drugs in an older person could be a problem. Perhaps they feel that this review is a dull chore, or that any attempt to reduce medications will be resisted by the patient and cause criticism from the specialist teams who are involved in her care. Perhaps they feel alone and that other people are not working on reducing medications
Show Notes
- The Mechanics of Tackling Overprescribing and Problematic Polypharmacy Health Innovation Network (HIN) document which includes the evidence base, the car analogies, and practical advice for both clinicians and care boards/systems
- Health Innovation Network Polypharmacy: getting the balance right programme
- Resources to support patients having a Structured Medication Review
- Aural Apothecary Podcast
- Consultation skills for optimising medication: A DExTruS approach to personalising drug treatments
- MedStopper
THE CASE
You have just seen James aged 37 about an ankle sprain. He says he also wants to ask about an exercise test. He has just got a new job and the company have offered him a cut price “Private medical well man appointment which includes tests that your own GP doesn’t do including an Exercise ECG”. James says “It costs £75 Do I need an exercise ECG and why don’t GPs offer this?”
Show Notes
1) Screening: Evidence and Practice 2nd edition
2) UK National Screening Committee
3) Canadian Task Force on Preventive health care
Breast cancer tools
Prostate cancer tools
In episode 598, James and Mike continue to talk with David Gardner about the issue of insomnia. We discuss his latest, very cool, Your Answers When Needing Sleep (YAWNS NB) randomized clinical trial. YAWNS was a pragmatic, open-label, minimum-contact, RCT where people with long-term use of benzodiazepines and current or past insomnia were randomly allocated to different mailed behavior change interventions or no intervention. They found that in people who got the intervention more of them stopped or reduced the dose of their benzodiazepines and more improved their sleep. Tune in for the numbers for this simple intervention.
Show Notes
The YAWNS NB trial
Booklets: order booklets via the Resource Centre
Sleepwell, a research and knowledge translation program based out of Dalhousie University in Halifax, includes tools, resources, and recommendations for patients, the public, and health care professionals.
Some features and resources to explore are:
Sleepwell stories (patient and health care professional video and written accounts)
Clinicians – short videos on how to use get what you need from the website for patient care, and CBT-I training options
Sleepwell recommends – vetted reviews and recommendations for self-help CBT-I programs
Sleeping pills – content to motivate and facilitate safely ending long-term use of sedatives
Tools – sleep diary, online sleep calculator (with guidance for time-in-bed restriction therapy), behaviour change tools (CBTi vs. Sleeping Pills)
Zopiclone’s residual effects on actual driving performance in a standardized test: a pooled analysis of age and sex effects in 4 placebo-controlled studies
Clin Ther 2014 Jan 1;36(1):141-50. doi: 10.1016/j.clinthera.2013.11.00
In episode 597, James and Mike invite David Gardner to talk in depth about the issue of insomnia. We talk about triggers, precipitating factors, acute and chronic insomnia, and chronic use of sleeping pills. We discuss Cognitive Behavioral Therapy for Insomnia (CBT-I) and how his team has developed a comprehensive website, Sleepwell, that provides patients and clinicians with great tools and recommendations for the self-care of chronic insomnia. Mike stays awake for the whole podcast and James only has a brief nap.
Show Notes
Sleepwell, a research and knowledge translation program based out of Dalhousie University in Halifax, includes tools, resources, and recommendations for patients, the public, and health care professionals.
Visit https://mysleepwell.ca/
Some features and resources to explore are:
Sleepwell stories (patient and health care professional video and written accounts)
Clinicians – short videos on how to use get what you need from the website for patient care, and CBT-I training options
Sleepwell recommends – vetted reviews and recommendations for self-help CBT-I programs
Sleeping pills – content to motivate and facilitate safely ending long-term use of sedatives
Tools – sleep diary, online sleep calculator (with guidance for time-in-bed restriction therapy), behaviour change tools (CBTi vs. Sleeping Pills)
In episode 595, Mike and James invite Jennifer Young back to talk about the use of combined oral contraceptives for heavy menstrual bleeding (benign etiology) and see if they improve patient outcomes. They do! Have a listen to get all the numbers and see how they compare to using levonorgestrel-containing intrauterine devices or NSAIDs.
Show notes
Tools for Practice
1) How to Slow the Flow: Combined oral contraceptives
2) How to Slow the Flow: Tranexamic acid for heavy menstrual bleeding
3) How to Slow the Flow: Levonorgestrel intrauterine systems for heavy menstrual bleeding
4) How to Slow the Flow: NSAIDs for Heavy Menstrual Bleeding
In episode 594, Mike and James invite Samantha Moe back to talk about the use of the RSV vaccine in pregnancy. The only way to have an informed conversation around this vaccine is to know the numbers. If you listen to the whole podcast, you’ll get all the numbers available to date.
Show notes
Tools for Practice
1)Bumpin’ Up the Protection? RSV Vaccine in Pregnancy
2) Preventing RSV Infections in Infants
3) Preventing RSV in the elderly
In episode 593, Mike and James invite Samantha Moe back to talk about a newer agent for osteoporosis. So, if you want to know all the evidence for romosozumab, tune in and all will be revealed about the benefits and harms.
Show notes
1) Tools for Practice
Tony Romo-sozumab: Winning touchdown in osteoporosis or interception for the loss?
2) FRAX site for Canada
In episode 589, Mike and James invite Jennifer Young back to the podcast again to talk about a topic that Mike absolutely loves – Vitamin D for everyone. Tune in to hear about all the latest, and the older, evidence. Do you agree we should remove the question mark from the podcast title?
Show notes
1) Tools for Practice
Vitamin D and Fracture Prevention: Not what it’s cracked up to be?
In episode 588, Mike and James invite Émélie Braschi back to the podcast to discuss another tricky area – insulin in type 2 diabetes and how to use it. Do we need to give it once a day, twice a day or maybe no times a day? Tune in to hear about all the evidence.
Show notes
1) Tools for Practice
Strategies for initiating insulin in type 2 diabetes
In episode 587, Mike and James invite Adrienne Lindblad back to the podcast to go over all the evidence we have for the oral GLP-1 weight loss medications. You know you are going to get lots of questions about these medications so tune in to find out all the numbers around the benefit and potential harms – and cost.
Show notes
1) Tools for Practice
Mission Slimpossible Part 2: Oral GLP-1 agonists for weight loss
In episode 586, Mike and James invite Émélie Braschi back to the podcast to talk about the tricky issue of how to deal with a potential penicillin allergy. Believe it or not there are a couple of RCTs looking at this issue. These two trials compared oral challenge alone to skin testing followed (if negative) by oral challenge. The results may allow you to change your practice in a good way. Tune in and find out why.
Show notes
Tools for Practice
It’s time to challenge penicillin allergy labels!
In episode 584, Mike and James invite Tina Korownyk back to the podcast to talk about the evidence for amyloid-targeting monoclonal antibodies in mild cognitive impairment or Alzheimer’s dementia. Unfortunately, the evidence shows these medications don’t seem to have a clinically important effect and do have some harms. Have a listen as we give you all the numbers so you will be able to properly discuss these medications with your patients.
Show notes
Tools for Practice
Remind me, do medications that target brain amyloid improve my dementia?
In episode 583, Mike and James continue to go over the issues associated with using CVD risk calculators. We talk about some of the limitations, how to think about the results and explain the risks and benefits to patients.
Show notes
PEER Simplified Cardiovascular Decision Aid
Incorporation of Shared Decision-Making in International Cardiovascular Guidelines, 2012-2022
JAMA Network Open. 2023;6(9):e2332793. doi:10.1001/jamanetworkopen.2023.32793
Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalizations in Get With The Guidelines
Am Heart J 2009;157:111-7.e2
Agreement among cardiovascular disease risk calculators
Circulation. 2013;127:1948–1956
In episode 582, Mike and James go over the issues associated with using CVD risk calculators. We talk about where the numbers come from, what they mean, what their limitations are, how to think about them and how to use them. So have a listen as it may decrease your risk but it will definitely increase your understanding.
Show notes
1) PEER Simplified Cardiovascular Decision Aid
https://decisionaid.ca/cvd/
2) Incorporation of Shared Decision-Making in International Cardiovascular Guidelines, 2012-2022
JAMA Network Open. 2023;6(9):e2332793. doi:10.1001/jamanetworkopen.2023.32793
3) Lipid levels in patients hospitalized with coronary artery disease: an analysis of 136,905 hospitalizations in Get With The Guidelines
Am Heart J 2009;157:111-7.e2
4) Agreement among cardiovascular disease risk calculators
Circulation. 2013;127:1948–1956
In episode 581, Mike and James invite Mike Kolber back to the podcast for the umpteenth time – this time we talk about a topic we haven’t discussed before – acute diverticulitis. Historically, if a person has diverticulitis they were given antibiotics BUT do they really do anything? We look at all the evidence and the results may surprise you.
Show notes
Tools for Practice
Antibiotics or no antibiotics for acute diverticulitis, that is the question!
In episode 580, Mike and James invite Jennifer Young to talk about the treatment of pityriasis rosea. Believe it or not there are 2 simple treatments that seem to work really quite well. Tune in to hear what works and how well they work.
Show notes
Tools for Practice
(A)dressing the Christmas Tree? Therapies for pityriasis rosea
In episode 579, Mike and James invite Nicholas Dugré back to the podcast to talk about the evidence around the benefits and harms of a new class of medications for the acute treatment of episodic migraines. Ubrogepant is an oral calcitonin gene-related peptide antagonist. In this case, amazing as it may sound, there are triple the number of systematic reviews than there are RCTs. Nonetheless, we go over all the evidence and at the end of the podcast you’ll know what the world knows about these agents.
Show notes
Tools for Practice
Oral Calcitonin Gene-related Peptide Antagonists: A painfully long name for the acute treatment of migraines
In episode 578, Mike, James and Jennifer Potter try to answer the question, in patients with dementia, how safe and effective are stimulants, antidepressants, and antipsychotics for treating apathy? We look at the evidence for methylphenidate, antipsychotics, and antidepressants so tune in to find out if any of these treatments have any sort of effect in this very difficult to treat condition.
Show notes
Tools for Practice
Making a difference in indifference? Medications for apathy in dementia
In episode 577, Mike and James invite Jennifer Young to join us to go over all the evidence around how best to close punch biopsies, lacerations and incisions. We go over all the evidence for sutures (absorbable/nonabsorbable), skin glue, and tape. We look at cosmesis, patient satisfaction, and infection rates so have a listen and find out what we found.
Show notes
Tools for Practice
Looking for Closure: Managing simple excisions or wounds efficiently
In episode 576, James, Mike, and Jamie continue to review the evidence for acne treatments. In this podcast, we examine if antibiotics work and we find they do have an effect. Check out the podcast for all the numbers.
Show notes
Tools for Practice
Facing the Evidence in Acne, Part II: Oral Antibiotics
Tools for Practice
Is less more with isotretinoin and acne?
Alberta Medication Costs
In episode 575, James and Mike invite Jamie Falk back to the podcast to help us sift through all the evidence for using oral contraceptives and spironolactone to treat acne. We find that they actually do work. We go over all the numbers for the benefits and harms. Have a listen.
Show notes
Tools for Practice
Facing the Evidence in Acne, Part I: Oral contraceptives and spironolactone in females
In episode 574, James and Mike invite Jennifer Young back to the podcast to help us yet again look at the evidence for cranberries and the prevention of UTI’s. Unfortunately, there is a problem with the evidence as there is a high risk-of-bias from potential publication bias, small studies, and unblinding. However, if we look past some of these biases, cranberry products might be worth a try. But have a listen and see what the evidence says.
Show notes
1) Tools for Practice
Any berry good solutions to preventing UTIs: Cranberries?
2) MAKING EVIDENCE MATTER for EVERYONE CONFERENCE
Vancouver
May 24/25, 2024
In episode 573, James and Mike invite Jamie Falk back to the podcast to help us simplify all the evidence around using antipsychotics for difficult to treat depression. They do seem to “work”, but you really need to know the numbers around what “work” means. At the end of the podcast, you will!
Show notes
1) Tools for Practice
Overcoming Resistance: Antipsychotics for difficult to treat depression
2) MAKING EVIDENCE MATTER for EVERYONE CONFERENCE
Vancouver
May 24/25, 2024
In episode 572, James and Mike invite Samantha Moe back to the podcast to go over the evidence around the safety and effectiveness of the monoclonal antibodies used to reduce the risk of respiratory syncytial virus (RSV) infections in infants. We go over all the numbers for hospitalizations and death so you can make evidence-informed decisions.
Show Notes
1) Tools for Practice
Preventing RSV Infections in Infants
2) MAKING EVIDENCE MATTER for EVERYONE CONFERENCE
Vancouver
May 24/25, 2024
https://hectalks.com
In episode 570, James and Mike finish their trilogy on statistics. We take what we discussed in the previous podcasts and go through a couple of examples that will hopefully solidify what all the terms and numbers really mean.
Show Notes
1) Sensible Medicine
Doing statistics can be difficult but understanding them can be fairly simple
2) Analysis of 567,758 randomized controlled trials published over 30 years reveals trends in phrases used to discuss results that do not reach statistical significance
PLoS Biol 2022: e3001562. https:// doi.org/10.1371/journal.pbio.3001562
In episode 569, James and Mike continue to go over what statistics really show – we focus on what inferential statistics can and cannot do, what a p value means and more importantly what it doesn’t mean. And yes we try to keep all this stat stuff on a realistic and practical level – easier said than done.
Show Notes
Sensible Medicine
Doing statistics can be difficult but understanding them can be fairly simple
In episode 568, James and Mike go over what statistics really show – and importantly what they don’t show. We go over the terms and nuances and hopefully put them all into a simple context. Statistics are not just in medicine – they are in much of what you do every day – so you really do need to understand them.
Show Notes
Sensible Medicine
Doing statistics can be difficult but understanding them can be fairly simple
In episode 567, Mike and James revisit the old topic of industry influence on health care providers. We go over the issues, the nuances and some of the latest evidence around the interactions, the influence, and patient perceptions.
Show Notes
1) Industry Evidence Handout
2) MAKING EVIDENCE MATTER for EVERYONE CONFERENCE
Vancouver
May 24/25, 2024
Home
In episode 551, James and Mike invite Danielle Perry back to the podcast to talk about the best available evidence for the use of statins in people 65 and over. As you’ll hear, we have lots of evidence so all you need to know is what it says. Then, you can have an evidence-based discussion with all your people in this age category. After that discussion, your patient can make a decision one way or another and that means both of you win and you don’t have to care what guidelines say about this topic. Check it out.
Show notes
Tools for Practice
Statins in Older Adults
CFPC Learn
PEIP conference Oct 20-21 2023
In episode 551, James and Mike invite Danielle Perry back to the podcast to talk about the best available evidence for the use of statins in people 65 and over. As you’ll hear, we have lots of evidence so all you need to know is what it says. Then, you can have an evidence-based discussion with all your people in this age category. After that discussion, your patient can make a decision one way or another and that means both of you win and you don’t have to care what guidelines say about this topic. Check it out.
Show notes
Tools for Practice
Statins in Older Adults
CFPC Learn
PEIP conference Oct 20-21 2023
In episode 549, James and Mike invite Blair MacDonald to the podcast for the first time and we talk about a topic that we haven’t really covered to-date. We discuss the evidence around what happens to the risk of pancreatitis when we use triglyceride-lowering medications (fibrates, statins, niacin, omega-3s) in patients with hypertriglyceridemia. Have a […]
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, however, it is very important you know what it is and what it is not.
Show Notes
Placebo handout
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 also what dose and duration.
Show Notes
1) Tools For Practice
Clear, not cloudy: Antibiotic options for uncomplicated urinary tract infections
MEME medical conference
hectalks.com
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 here first, eggs are not as bad for you as smoking. Tune in to find out why.
Show Notes
The Nutrition Proposition
Book website
Amazon Link
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 vaccination for the prevention of cardiovascular events
2) Annual MEME conference – Vancouver May 12/13, 2023
REGISTER NOW
3) CFPC Learn
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 for Practice
Asymptomatic bacteriuria in the elderly: Don’t drug the bugs?
2) Annual MEME talk Vancouver May 12/13, 2023
REGISTER NOW
3) CFPC Learn
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 because of the statin.
Show Notes
Tools for Practice
Wouldn’t Bet On it: What is the risk of muscle symptoms on statins?
https://gomainpro.ca/wp-content/uploads/tools-for-practice/1676944827_tfp334_statinmsk.pdf
Annual MEME talk Vancouver May 12/13, 2023
REGISTER NOW
CFPC Learn
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 the details.
Show Notes
Tools for Practice
Come Spy with Me: Continuous glucose monitoring in diabetes
Annual MEME talk Vancouver May 12/13, 2023
REGISTER NOW
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 dose of topical nitroglycerin.
Show Notes
Tools for Practice
Topical Anal Fissure Treatments – getting to the bottom of it
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 practice.
Show Notes
Tools for Practice
Coughing up the evidence: Bronchodilators or inhaled steroids for post-infectious cough
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 to “improve” future podcasts – so please continue to listen to see if that happens and give us feedback – although we also resolved to ignore all feedback so who knows what will happen. Happy Holidays Everyone!!
Show Notes
Tools for Practice
Resolving New Year’s Resolutions
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…
This content is for members only. Visit the site and log in/register to read.
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 to do is look at a person’s drivers license.
Show Notes
The Absolute CVD Risk/Benefit Calculator
Don’t Be Unheard – an educational medical musical parody of the iconic song We Are The World by USA for Africa.
YouTube Link
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 into testing. Have a listen so you can get all the numbers and use them tomorrow in your practice.
Show Notes
Tools for Practice
To Treat or Not Treat Uncomplicated UTIs
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) […]
In episode 520, James and Mike delve into the delicious area of ultra-processed food. We review all the best available evidence and try to put it into a digestible format. At the end we put a cherry on top to make it even more appetizing/interesting. Show Notes The Nutrition Proposition 1) Book website nutritionproposition.com 2)Amazon […]
In episode 519, Mike and James ask Jen Potter back to the podcast to talk about a common primary care question around oral contraceptives and breast feeding. We review the best available evidence which unfortunately we find out is not the highest quality. Nonetheless, we go over the numbers and then come up with useful, […]
In episode 518, Mike and James get Samantha to go through all the evidence we have for restricting lactose-containing foods in children with acute diarrhea. While we find out that looking at this evidence is at best tricky, it seems like reducing or diluting formula may provide a reasonable benefit. Listen to the podcast for […]
In episode 518, Mike and James get Samantha to go through all the evidence we have for restricting lactose-containing foods in children with acute diarrhea. While we find out that looking at this evidence is at best tricky, it seems like reducing or diluting formula may provide a reasonable benefit. Listen to the podcast for […]
In episode 516, James and Mike invite Nicolas Dugré to the podcast yet again, and this time we talk about the evidence around the latest long-acting implantable reversible contraception. As always, we talk about the efficacy, the harm and all the rest of the issues around the use of these forms of contraception. Show Notes […]
In episode 515, James and Mike invite Allison Paige to the podcast for the first time. Alli takes us through all the evidence around a combination product (naltrexone/bupropion) for weight loss. We talk about all the numbers we have for benefit, harm and cost and we put this agent into the context of the other […]
In episode 514, James and Mike invite Betsy Thomas to the podcast for the first time. We look at a very common condition that many of us have at some point in our lives – allergic rhinosinusitis. We go over the best available evidence for the oral antihistamines and try to figure out which one […]
In episode 513, James and Mike invite Emelie Braschi to the podcast for the first time. We go over the best available evidence around the treatment of BPH and focus on the combination therapy of alpha-blockers and 5-alpha reductase and find as for many things there is an improvement in symptoms but also an increase […]
In episode 512, James and Mike finish going over the best available evidence around drinking alcohol. We look at what evidence says about the “red-wine” theory and the French Paradox. We also look at the evidence around alcohol and surrogate markers, and atrial fibrillation. We also examine the effect of social drinking on emotion and […]
In episode 511, James and Mike go on a binge and dissect the best available evidence around alcohol – more specifically 0-3 drinks a day. We look at what is a “drink” and then dive into one of the largest reviews of alcohol ever done. We explore what that evidence suggests about the harms and […]
In episode 509, James, Mike and Tina finish talking about our new clinical practice guideline on chronic pain. We focus on the top questions we all have in chronic pain and also discuss the best available evidence for the many different medications we use for chronic pain. Show Notes PEER simplified chronic pain guideline: Management […]
In episode 508, James and Mike ask Tina to come in and talk about our new clinical practice guideline on chronic pain. We focus on the best available evidence which shows that physical activity is key (except for neuropathic pain). We also go over the role for psychological interventions and the problem with opioids. Show […]
In episode 507, James and Mike and Adrienne continue the discussion about our new clinical practice guideline on pain. We discuss the evidence for the treatments used for back pain and neuropathic pain and give you all the numbers and the nuances. Show Notes PEER simplified chronic pain guideline: Management of chronic low back, osteoarthritic, […]
In episode 506, James and Mike invite Adrienne Lindblad to discuss our latest clinical practice guideline on the management of chronic low back, osteoarthritic, and neuropathic pain in primary care. In this episode we describe the development process and then highlight the best available evidence, including both benefits and harms, for chronic osteoarthritis treatments. We […]
In episode 505, James and Mike invite nephrologists Samira Farouk and Matthew Sparks to discuss the tricky issue of albuminuria – who to monitor, what to monitor and who to treat. We spend a lot of time dribbling and end up deciding that nothing is a slam dunk, so stay until the end for a real buzzer beater.
Show Notes
1) ACR variability
AJKD 2013;62:1095–1101
2) Kidney Failure Risk Equation
3) Albumin Handout
4) American Journal of Kidney Disease Blog
5) NephMadness
6) May 27/28. 2022 The MEME conference – Making Evidence Matter For Everyone
In episode 504, James and Mike invite Jen Potter back to the podcast to talk about whether or not intrauterine devices for preventing pregnancy can be used beyond the recommended duration of use. It seems one can defer IUD replacement for at least up to 12 months. Have a listen and see what you think.
Show Notes
1) Tools for Practice
Can It Stay or Must It Go? Extended Use of Intrauterine Devices
2) The Aural Apothecary Podcast – check it out
3) The MEME Conference – Make Evidence Matter for Everyone
4) CFPC Learn – Continuing Professional Development made by and for family physicians
In episode 503, James and Mike explore the evidence around water for a variety of different health outcomes. How much do we need and does it matter where we get it from? The only thing we know is that 8 glasses a day is wrong.
Show Notes
Coming soon
In episode 502, James, Mike Kolber and Tony Nickonchuk get together to talk about the easy question (just kidding) of COVID vaccines for children and adolescents. We discuss the best evidence we could find around efficacy and adverse effects in these age groups and hopefully give enough context so that you go from murky to somewhat less cloudy as to what we know and don’t know about this topic.
Show Notes
1) Tools for Practice
CO-KID: Covid vaccine for kids
2) Effectiveness of BNT162b2 Vaccine against Critical Covid-19 in Adolescents
January 12, 2022 DOI: 10.1056/NEJMoa2117995
3) Effectiveness of Pfizer-BioNTech mRNA Vaccination Against COVID-19 Hospitalization Among Persons Aged 12–18 Years — United States, June–September 2021
4) Effectiveness of BNT162b2 (Pfizer-BioNTech) mRNA Vaccination Against Multisystem Inflammatory Syndrome in Children Among Persons Aged 12–18 Years — United States, July–December 2021
James and Mike celebrate their 500th, YIKES, podcast episode. You get to hear the entire intro song (Some People) written and recorded by Pete McCormack. We talk about the history of the podcast, thank a lot of people, and talk about the key messages and the philosophy we have tried to impart over the years. We then discuss a few cases that bring all these ideas into focus. THANKS SO MUCH FOR LISTENING and going on this journey with us. We have had a blast.
Show Notes
Pete McCormack’s Website
Tools for Practice
PEER Evidence
In episode 499, James and Mike invite Tina back again to discuss the evidence we have for dieting to lose weight and the impact of that on osteoarthritis knee pain. Overall, there isn’t a lot of evidence but some observational data suggests a benefit Unfortunately the relatively small weight loss achieved from most diets in RCTs did not demonstrate a difference on OA pain.
Show Notes
Tools for Practice
No Gain, No Pain? – What is the effect of diet-induced weight loss on osteoarthritis-related knee pain?
In episode 498, James and Mike invite Tina back yet again to talk about all the evidence we have for using compression stockings in patients with chronic lower limb edema. The NNT for recurrent cellulitis is pretty good (listen to find out the actual number) on the “NNT scale”.
Show Notes
Tools for Practice
Under Pressure: Compression stockings for recurrent cellulitis?