TEC: Evidence Based Therapeutics
Therapeutics Education Collaboration
Medication Mythbusters – Home of the Best Science (BS) Medicine Podcast

Episode 2: Evidence does not equal decision-making

In our second session we discuss the philosophy of calculating risk and the many factors that influence the application of these numbers. We each calculate risk using our personal preference for risk estimators and discuss the mystery of why these numbers are not the same. “Treating” asymptomatic patients and instituting preventive interventions taken for a life time does not require great haste.

Show Notes

Canadian Cardiovascular Society Risk Calculator

12 points =10% risk in 10 years (of non-fatal MI or coronary death)

Risk factors Points
Age 3
Total cholesterol 6
BP 1
Smoke 0

Can J Cardiol 2006;22(11):913-27

Our 45 y/o 10-year risk

10 year chance of CVD
Overall CVD 14.1%
CHD 12.3%
MI 6.4%
Stroke 1.2%
Death of CVD 2.0%
Death for CHD 2.0%

Episode 1: Philosophy, guidelines and the truth

In this first session we offer a slightly long introduction (but not long enough to reach REM sleep). We present Mr. Guy Lines, a 45 year old male with a number of risks for cardiovascular, who we will consider over the next number of sessions on primary prevention. We lay the rocky groundwork of future podcasts; touching on patient values, the arbitrary nature of guidelines, discussing risks, the asymptomatic ‘sick’ patient, and the art (or enigma) of applying the evidence.

Show Notes

Hippocrates would be proud?

Mr G. Lines is a 45 year old male in for his “periodic” health exam. He describes himself as happy and healthy Aside from reminding him to wear a seatbelt, floss regularly, etc, you find…

  1. He is relieved to hear routine rectal exams don’t start until age 50
  2. His BP is 146/85 today (you took it twice hoping it would be below 140)
  3. His BMI=29 and his WC=98 cm
  4. His Lipids: Total Cholesterol = 6.8/265, HDL = 1.0/39, LDL = 4.9/191, Trig = 2/312
  5. His Blood Sugar = 6.4/115
  6. He is not a smoker

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