In episode 385, James and Mike invite Tim Caulfield (author, professor and lawyer) yet again to talk about the marketing and evidence around stem cell therapies. Low and behold the evidence pales in comparison to the hype. At the end Tim states – “science is hard” – enough said.

1) Is Gwenyth Paltrow wrong about everything?

2) A user’s guide to cheating death

3) Televised medical talk shows–what they recommend and the evidence to support their recommendations: a prospective observational study

BMJ. 2014 Dec 17;349:g7346. doi: 10.1136/bmj.g7346

4) The evolution of policy issues in stem cell research: an international survey

Stem Cell Rev. 2012 Dec;8(4):1037-42. doi: 10.1007/s12015-012-9404-5

5) Reassessing direct-to-consumer portrayals of unproven stem cell therapies: is it getting better?

Regen Med. 2013 May;8(3):361-9. doi: 10.2217/rme.13.15

6) International Society for Stem Cell Research

7) Polar Extremes in the Clinical Use of Stem Cells

N Engl J Med. 2017 Mar 16;376(11):1075-1077. doi: 10.1056/NEJMe1701379

8) How Anecdotal Evidence Can Undermine Scientific Results

9) Exploiting science? A systematic analysis of complementary and alternative medicine clinic websites’ marketing of stem cell therapies

BMJ Open 2018;8:e019414. doi:10.1136/ bmjopen-2017-019414

In episode 384, James and Mike invite Tim Caulfield (author, professor and lawyer) to talk about the marketing of personalized medicine. We find out that most of the marketing is absurd. We also figure out that personalized medicine is being done all the time but it rarely if ever requires knowledge of any genetic testing results.

1) Is Gwenyth Paltrow wrong about everything?

2) A user’s guide to cheating death

3) Shattuck lecture–medical and societal consequences of the Human Genome Project

N Engl J Med 1999;341:28-37

4) Representing a “revolution”: how the popular press has portrayed personalized medicine

Genet Med 2018 Jan 4. doi: 10.1038/gim.2017.217

5) Personalized genetic risk counseling to motivate diabetes prevention: a randomized trial

Diabetes Care 2013 Jan;36(1):13-9. doi: 10.2337/dc12-0884

6) Genetic determinants of common obesity and their value in prediction.

Best Pract Res Clin Endocrinol Metab. 2012 Apr;26(2):211-26. doi: 10.1016/j.beem.2011.11.003.

7) Effectiveness of testing for genetic susceptibility to smoking-related diseases on smoking cessation outcomes: a systematic review and meta-analysis

Tob Control 2012 May;21(3):347-54. doi: 10.1136/tc.2011.042739

8) Differences in Weight Loss Between Persons on Standard Balanced vs Nutrigenetic Diets in a Randomized Controlled Trial

Clin Gastroenterol Hepatol. 2015 Sep;13(9):1625-1632.e1. doi: 10.1016/j.cgh.2015.02.044

9) Gene Environment Risk Assessment and Colorectal Cancer Screening in an Average Risk Population: A Randomized, Controlled Trial

Ann Intern Med. 2014 Oct 21; 161(8): 537–545.

10) Lifestyle Advice Combined with Personalized Estimates of Genetic or Phenotypic Risk of Type 2 Diabetes, and Objectively Measured Physical Activity: A Randomized Controlled Trial

PLoS Med. 2016 Nov 29;13(11):e1002185. doi: 10.1371/journal.pmed.1002185. eCollection 2016 Nov

11) Born Fat: The Relations Between Weight Changeability Beliefs and Health Behaviors and Physical Health

Health Educ Behav. 2016 Jun;43(3):337-46. doi: 10.1177/1090198115602266. Epub 2015 Sep 8

12) The impact of communicating genetic risks of disease on risk-reducing health behaviour: systematic review with meta-analysis

BMJ. 2016 Mar 15;352:i1102. doi: 10.1136/bmj.i1102

13) Gene-lifestyle interaction and type 2 diabetes: the EPIC interact case-cohort study

PLoS Med. 2014 May 20;11(5):e1001647. doi: 10.1371/journal.pmed.1001647. eCollection 2014 May

14) Why Are Some Population Interventions for Diet and Obesity More Equitable and Effective Than Others? The Role of Individual Agency

PLoS Med. 2016 Apr 5;13(4):e1001990. doi: 10.1371/journal.pmed.1001990. eCollection 2016 Apr

In episode 383, James and Mike go over the IMPACT trial that looks at triple inhaler therapy for patients with COPD. We talk about how, unfortunately, the impact is not that impactful and then put all the results into context with the issues of placebo, patents and cost. 

Show Notes

1) Once-Daily Single-Inhaler Triple versus Dual Therapy in Patients with COPD 

N Engl J Med 2018;378:1671-80

2) Price Comparison of Commonly Prescribed Pharmaceuticals in Alberta 2018

Cost document

In episode 382, Mike and James and Gary Bloch decide to try to solve the problem of poverty. While we get somewhere, it becomes clear that it might take more than just doing a 30-minute podcast. Who would have thought? Nonetheless, we hope that some of the things we discuss will inspire others to continue the battle against this extremely important health issue.

Show notes

1) Butler-Jones  D. Chief Public Health Officer’s report on the state of public health in Canada. Addressing health inequalities. Ottawa, ON: Government of Canada; 2008. 

2) The Clinical Tool on Poverty

CFPC Poverty Tools

3) A novel income security intervention to address poverty in a primary care setting: a retrospective chart review

BMJ Open 2017;7:e014270

4) Building a Foundation to Reduce Health Inequities: Routine Collection of Sociodemographic Data in Primary Care. 

J Am Board Fam Med 2016;29:348-55

5) Framework for building primary care capacity to address the social determinants of health

Can Fam Physician 2017;63:e476-e482

6) What is the impact on individual health of services in general practice settings which offer welfare benefits advice?

Health Soc Care Community 2006;14:1–8

7) UK Social Prescribing – evidence 

8) Taking action on the social determinants of health in clinical practice: a framework for health professionals

CMAJ 2016;188:E474–83

In episode 381, Mike and James invite Gary Bloch to talk in detail about the impact of poverty on health, and more importantly what can we do about it for our patients. In particular, we start to discuss a very useful clinical tool for dealing with poverty in primary care.

Show notes

1) Butler-Jones  D. Chief Public Health Officer’s report on the state of public health in Canada. Addressing health inequalities. Ottawa, ON: Government of Canada; 2008. 

2) The Clinical Tool on Poverty

CFPC Poverty Tools

3) A novel income security intervention to address poverty in a primary care setting: a retrospective chart review

BMJ Open 2017;7:e014270

4) Building a Foundation to Reduce Health Inequities: Routine Collection of Sociodemographic Data in Primary Care. 

J Am Board Fam Med 2016;29:348-55

5) Framework for building primary care capacity to address the social determinants of health

Can Fam Physician 2017;63:e476-e482

6) What is the impact on individual health of services in general practice settings which offer welfare benefits advice?

Health Soc Care Community 2006;14:1–8

7) UK Social Prescribing – evidence 

8) Taking action on the social determinants of health in clinical practice: a framework for health professionals

CMAJ 2016;188:E474–83

In episode 380, James and Mike continue celebrating their 10th podcasting anniversary with Tina K and Mike K and the silly studies and confusion continue to escalate.

Show notes

1) A randomized trial to assess the potential of different beverages to affect hydration status: development of a beverage hydration index.

Am J Clin Nutr 2016;103:717–23

2) Commercial features of placebo and therapeutic efficacy

JAMA 2008;299:1016-7 

3) Gender Roles and Pressure to be Truthful: The Bogus Pipeline Modifies Gender Differences in Sexual but Not Non-sexual Behavior

Sex Roles 2013;68:401–14

4) Kissing reduces allergic skin wheal responses and plasma neurotrophin levels

Physiology & Behavior 2003;80:395– 8

5) Longer Contact Times Increase Cross-Contamination of Enterobacter aerogenes from Surfaces to Food

Appl Environ Microbiol doi:10.1128/AEM.01838-16

6) Unskilled and unaware of it: how difficulties in recognizing one’s own incompetence lead to inflated self-assessments

J Pers Soc Psychol 1999;77:1121-34

7) Sexual Activity before Sports Competition: A Systematic Review

Front Physiol 2016;7:246. doi: 10.3389/fphys.2016.00246. eCollection 2016.

8) From junior to senior Pinocchio: A cross-sectional lifespan investigation of deception

Acta Psychol 2015;160:58-68

9) The Relationships Among Height, Penile Length, and Foot Size

Sexual Abuse 1993;6:231-5

10) Honey bee sting pain index by body location

PeerJ 2014;2:e338

11) Can Sexual Intercourse Be an Alternative Therapy for Distal Ureteral Stones? A Prospective, Randomized, Controlled Study.

Urology 2015;86:19-24

Evaluation of the efficacy of sexual intercourse in expulsion of distal ureteric stones.

Int Urol Nephrol 2017;49:27–30

12) The effect of acute increase in urge to void on cognitive function in healthy adults

Neurourology and Urodynamics 2011;30:183–7

In episode 379, James and Mike celebrate their 10th podcasting anniversary and bring in Tina K and Mike K to help alert the listeners to some exceedingly important studies that many listeners may have missed over the years.

Show notes

1) Beano and flatulence

J Fam Pract 1994 39:441-5

2) Mandatory Snack Consumption

Obesity 2007;15:673-85

3) CoQ10 changes CoQ10 levels

BioFactors 1999;9:315–8

4) Reusable shopping bags and food cross-contamination

Food Protection Trends 31:508-13

5) Length matters – am I normal?

BJU Int 2015;115:978–86

6) Country music and suicide

Social Forces 1992;71:211-8

7) Intractable Hiccups and DRM

Ann Emerg Med 1988;17:872

8) Women, men and thinking clearly

Arch Sex Behav 2012;41:1051–6

9) Alcohol and unprotected sex

Addiction 2012;107:51-9 

In episode 378, James, Tina and Mike go over the latest antidepressant meta-analysis from the Lancet. We talk about the fact that antidepressants do work, but importantly, what does “work” mean. Most importantly, we talk about what questions about antidepressants are not answered by this meta-analysis. At the end we put everything (to do with antidepressants) into its proper context.

Show notes

1) Effectiveness of antidepressants

BMJ 2018; 360 doi: https://doi.org/10.1136/bmj.k1073

2) Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis

Lancet. 2018 Feb 20. pii: S0140-6736(17)32802-7. doi: 10.1016/S0140-6736(17)32802-7

In episode 377, Mike and James finally get to the end of looking at all the available cannabinoid evidence and we continue to discuss how the evidence could be used in the context of a shared-decision making process.

Show notes

Simplified guideline for prescribing medical cannabinoids in primary care 

Canadian Family Physician 2018;64:111-20

Cannabinoid short summary

Cannabinoid patient summary

In episode 376, Mike and James take all the best available evidence around cannabinoid use and put the evidence into the concept of a shared-decision making guideline. Shocking as it may seem, shared-decision making is rarely a part of most guidelines but we show how valuable it can be to keep this concept in focus when it comes to giving suggestions for the use of many treatments.

Show notes

Simplified guideline for prescribing medical cannabinoids in primary care 

Canadian Family Physician 2018;64:111-20

Cannabinoid short summary

Cannabinoid patient summary