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Medication Mythbusters – Home of the Best Science (BS) Medicine Podcast

Episode 165: Diagnosing type 2 diabetes – as much magic as science

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

Ann Intern Med 1997;127:788-95

Episode 164: PREMIUM Stuff you really need to know about HDL, ASA and metformin

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

Roche news release 

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

N Engl J Med 2012;366:1959-67

4) A new metformin meta-analysis  – is it good or bad?

PLoS Med 9(4): e1001204. doi:10.1371/journal.pmed.1001204

 

Episode 163: How to analyse a meta-analysis and at the end not need analysis – PART II

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

Lancet 2005;366:1545–53

3) PSA screening

BMJ 2010;341:c4543 doi:10.1136/bmj.c4543

3) Statin meta-analyses on mortality effect in primary prevention 

BMJ 2009;338:b2376

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

Cochrane CD000335

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BIG ANNOUNCEMENTS

THE NUTRITION PROPOSITION BOOK HAS JUST BEEN RELEASED

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.

 

THE MEME CONFERENCE – Making Evidence Matter For Everyone

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Our annual primary care evidence-based conference is BACK. The MEME conference is happening May 27/28 live and virtual in beautiful Vancouver, BC. Sure hope you can join us.

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