In episode 449, Mike and James invite Danielle Perry and Joey Ton to go over our osteoarthritis systematic review. We talk about all the evidence around exercise, steroid injections, SNRIs, oral NSAIDs, glucosamine, topical NSAIDs, chondroitin, viscosupplementation, oral opioids, acetaminophen. In fact, the magnitude of benefit is exactly in this order – exercise highest, acetaminophen lowest.

Show notes 

PEER Umbrella Systematic Review of Systematic Reviews: Management of Osteoarthritis in Primary Care

Can Fam Phy 2020 Mar;66(3):e89-e98.

In episode 448, Mike and James go over all the evidence around masks for preventing viral respiratory infections in healthcare workers. We find that surgical masks and N95 masks provide similar protection against viral infections. Unfortunately we have no evidence for COVID-19.

Show notes 

Tools for Practice

Unmasking the evidence around masks for healthcare workers

COVID Webinar

May 7

The COVID-19 Pivot: Rapid evidence reviews with the PEER team

In episode 447, Mike and James invite Tina and Mike to talk about a really important topic – is there asymptomatic transmission of COVID-19? The simple answer is yes. Have a listen and hear about all the data and the numbers.

Show notes 

Tools for Practice

Stealth style transmission? Covert data on COVID-19

In episode 446, Mike and James invite Mike and Tina to talk about all things COVID. In this podcast we look at what are the presenting symptoms, the clinical course and the risk factors for mortality.  

Show notes 

Tools for Practice

A rushed introduction to an uninvited guest

In episode 445, Mike and James wade into the evidence-free zone (pretty much) around assessing dyspnea over a telephone/video conference. We talk about the Roth score, respiratory rate, fever, and patient self-rating of dyspnea. Have a listen and see what we found.

Show notes

The BMJ

Covid-19: a remote assessment in primary care

In episode 444, James and Mike wade into the evidence quagmire around hydroxychloroquine and COVID-19.  The bottom line is the evidence will likely be different around the time you listen to the podcast. So listen quickly.

Show notes

1)Tools for Practice

Hydroxychloroquine with or without azithromycin for COVID-19

2) Efficacy of hydroxychloroquine in patients with COVID-19: results of a randomized clinical trial

In episode 443, James and Mike continue with Mike Kolber and we discuss the evidence around electronic cigarettes and their use for smoking cessation. Overall, the podcast ends up being smoking hot in so many ways.

Show notes

Tools for Practice

Electronic Cigarettes – Hoot that helps, hurts, or just hype?

In episode 442, James and Mike welcome back Mike Kolber to discuss all the evidence around biosimilars. The issue is exactly the same one we have had for decades with the question around brand name versus generic medications. Tune in and find out the answer.

Show notes

Tools for Practice

It’s all in the details… or is it? Biosimilars versus biologics for inflammatory conditions

In episode 441, James and Mike revisit the problem with guidelines. We talk about recent writings on the issues around guidelines. We discuss the main problems and believe it or not we give advice and suggestions for how to make them better.

Show notes

1) Health Affair

Fixing Clinical Practice Guidelines

2) Evidence vs Consensus in Clinical Practice Guidelines

JAMA 2019 Jul 19. doi: 10.1001/jama.2019.9751

3) The future of guidelines: Primary care focused, patient oriented, evidence based and simplified

Maturitas 2017;95:61-62

In episode 440, Mike and James yet again invite Adrienne to go over all the evidence for treating toenail onychomycosis.  We find that ~ 40% more people get better on oral treatments than on placebo. For topicals the number is closer to 10%. Topicals should likely only be used if there is <40% nail involvement.

Show notes

Tools For Practice

Putting the FUN in Fungi: Toenail onychomycosis treatments

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