In episode 166, James and Mike battle the issue of low dose statins, high dose statins and also traffic noise to try to figure if we should consider high doses of statins. We discover that bigger is better but that a lot bigger ends up being just a little bit better.
Show notes
1) Tools For Practice
How does high dose statin compare to low dose in people with heart disease?
In episode 165, Mike and James talk about how should we diagnose type 2 diabetes and should we use A1c, FPG or OGTT or a magic crystal ball. At the end we come to the conclusion that you need to realize the vagueness of the diagnosis so you can be specific in your recommendations.
Show notes
1) Tools For Practice
Hemoglobin A1c for the diagnosis of Type II Diabetes
2) ESRD and Blindness risk
In episode 164, Mike and James finally get to another PREMIUM episode and boy is it ever premium. We discuss the latest HDL raising drugs, ASA after a DVT, and a new meta-analysis of metformin. With our usual skill, alacrity and boyish charm we give all our premium listeners their monies worth with practice changing evidence.
Show notes
1) Dalcetrapib (HDL raising) study stopped due to no benefit
2) Genetic HDL – no reduction in heart disease
Lancet doi:10.1016/S0140-6736(12)60312-2
3) WARFASA – Aspirin for Preventing the Recurrence of Venous Thromboembolism
4) A new metformin meta-analysis – is it good or bad?
PLoS Med 9(4): e1001204. doi:10.1371/journal.pmed.1001204
In episode 163, Mike and James race to the end of their in-depth look at critical appraisal and as they get to the end their final kick is at some of the problems seen with meta-analyses. We discuss examples of how meta-analyses sometime go wrong and we do our best to make them right – with varying degrees of success.
Show notes
1) Glucose lowering meta-analysis
Ann Intern Med 2009;151:394-403
2) Beta-blocker meta-analysis
3) PSA screening
BMJ 2010;341:c4543 doi:10.1136/bmj.c4543
3) Statin meta-analyses on mortality effect in primary prevention
RR 0.88 (0.81-0.96)
Arch Intern Med 2010;170:1024-31
RR 0.91 (0.83-1.01)
Arch Intern Med 2005;165:725-30
RR 0.86 (0.76 -0.99)
Arch Intern Med 2006;166:2307-13
RR 0.92 (0.84-1.01)
J Am Coll Cardiol 2008;52:1769-81
RR 0.93 (0.87-0.99)
4) Back pain meta-analysis
THE NUTRITION PROPOSITION BOOK
Check it out at nutritionproposition.com and think about picking up a copy on Amazon. All the evidence you ever wanted about nutrition and the only nutrition book that won’t tell you what to eat.
This pragmatic trial is now recruiting in BC. Make a difference and get involved with pragmatic trials (www.pragmatictrials.ca)
