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In episode 161, James and Mike finally get to the end of a very long series about how do a quick critical appraisal of an RCT. We talk about evaluating the harms found in the study and then discuss how to put the findings into context for an individual patient. At the end we conclude that the only well done and important studies to ever be published are the ones we have done and we leave it at that.

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In episode 160, Mike and James continue to tackle the issue of critical appraisal head on with an even more common-sense approach than the last episode. We talk about ignoring much of the text in the study, how to look at baseline characteristics and how to decipher the information provided in the outcomes table.

Show notes

The ACCORD study

N Engl J Med 2008; 358:2545-59

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In episode 159, Mike and James decide to tackle the issue of critical appraisal head on with a common-sense approach. We talk about why we need to do critical appraisal, how to save time by doing a quick scan of the abstract and how to search, identify, and deal with potential sources of bias. At the end we critique each other and find out that we are both packed full of bias but also loaded with high quality outcomes. 

Show notes

1) The ACCORD study

N Engl J Med 2008; 358:2545-59

In this second very special episode our good friend Bruce Arroll comes back to discuss all sorts of issues around insomnia. We learn all about the evidence and an interesting and very effective treatment that uses the concept of restriction of time in bed. Both of us fall asleep during the podcast but at the end realize it in no way interfered with the content.

Check out our new iPad app released to day MyStudies – www.mystudies.org. The app and 10 studies are free – hopefully it will give you enough of an idea of what we have created. To get all the studies requires a subscription. I would love it if you would check it out and support us – this is only a 1.0 version and we have lots of plans for updates in the future. I would also love feedback as to how to improve the app. I co-created it with the same guy who made the awesome iPhone/iPad app MedCalc. If you think it is useful PLEASE let all your friends and colleagues know. Thanks.

You want to use evidence in your clinical practice from the landmark studies – those studies that change practice. Your patient comes in and asks you about the latest greatest study. How can you quickly and easily get all that information? Let MyStudies help.

You are at a presentation and you start to wonder if the presenter is really telling you everything you need to know about a study. Did they just present relative numbers? Did they only present the benefits with no mention of harms? Did they come up with conclusions that don’t really match the results? MyStudies can help.

As a student/resident on rounds did you feel hopeless when someone asked you about the HOPE trial? Did you ever have to prove what was in the PROVE-IT study? Should you care what the CARE trial showed? Did not knowing the results of the TNT trial make you want to explode?

Have you wanted to enthusiastically let everybody know about the GUSTO trial? MyStudies is there for you.Have you ever had to make a presentation and not have time to look up all the studies and make slides to show the results? MyStudies was designed to help you with all this as well. MyStudies brings the results of hundreds of the major clinical studies to your fingertips.

We have done the work for you – all you have to do now is look at the results. 

In this very special no-Mike episode, James gets together with our good friend and colleague Bruce Arroll from New Zealand who capably sits in to fill Mike’s shoes which Mike actually left in New Zealand last year. We discuss impetigo, otitis externa, chronic supporative otitis media and eczema and decide that the old drugs are still very useful.

Show notes

1) Impetigo

Cochrane Library

2) Otitis externa

Cochrane Library

3) Beta-lactam versus beta-lactam-aminoglycoside combination therapy in immunocompetent patients with sepsis

BMJ 2004;328:668–72

4) Beta-lactam versus beta-lactam-aminoglycoside combination therapy in cancer patients with neutropenia

Cochrane Library

 5) Chronic supporative otitis media

Cochrane Library

In episode 158, Mike and James work under very distressing conditions (no microphones, colds, Bubonic plague) and discuss the issue of which thiazide should you choose. Evidence, personal experience and values swirl continually through the diatribe. At the end the stress becomes so significant that they both develop high blood pressure and decide to take high dose reserpine.

Show notes
1) Is hydrochlorothiazide the best thiazide diuretic for hypertension?

Tools for Practice

2) COLD-FX

CBC marketplace expose

We’ve been having some troubles updating/switching our website although it should still be doing most of what it is supposed to do. If you are having any issues with getting podcasts, paying for a premium membership, or anything else please contact us at

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Thanks in advance.

In episode 157, James and Mike discuss the latest study of H pylori eradication in patients with functional dyspepsia. We discuss what to do in patients who come in with dyspeptic symptoms and when to scope, when to test, when to treat, when to say you aren’t taking any new patients. At the end we decide, to bring in another Mike (Kolber) for a future podcast to help put the whole issue into its proper perspective.

Show notes

1) Helicobacter pylori eradication in functional dyspepsia

Arch Intern Med 2011;171:1929-36

In episode 156, Mike and James inject a large dose of therapeutics into yet another PREMIUM podcast. We discuss steroid injections for trochanteric pain and which pain medication is safer for long-term use in osteoarthritis. At the end James and Mike offer to send the listeners lidocaine to dull the pain associated with listening to their latest offerings.

Show notes

1) Corticosteroid injections for trochanteric bursitis 

Ann Fam Med 2011;9:226-34

2) Fluoroscopy bursa injection vs injection by landmark

BMJ 2009;338:b1088 doi:10.1136/bmj.b1088

3) Steroid vs shock wave vs exercise

Am J Sports Med 2009;37:1981-90

4) Are corticosteroid injections effective in the management of lateral epicondylitis (tennis elbow)?

Tools For Practice

5) Osteoathritis pain – NSAIDs or narcotics – which is safer?

Arch Intern Med 2010;170:1968-78