Critical appraisal skills have really become as important as the use of a stethoscope or the ability to write a legible prescription. However, I know that the thought of reviewing an RCT can seem like an insurmountable task and in fact will put many people into a heavy coma. 

Because of that I thought you might be interested in a “mini” book that I’ve just published through the iBook store. 

It is entitled “How to Critically Appraise an RCT in 10 Minutes” – you should be able to see the link to the book below. It is only readable on a 2nd generation iPad or higher.

This ebook will hopefully show you an approach that gets at 95% (I made that number up) of what you need to read and look for when it comes to analyzing an RCT. The ebook has interactive figures and some audio commentary to help you through the content. The book is free on the iBook store.

As this is the first edition I would LOVE feedback on how to make it better. THANKS

You can find it at the iBooks store by going to the following link

How to Critically Appraise an RCT in 10 Minutes

In episode 171, we finally finish answering, or at least trying to, listener questions. We talk about growth hormone, tramadol, and cardiovascular risk and then realize it is all for naught as we also find out that most published research findings are false. That being the case we go back and erase the previous 170 podcasts.

Show notes

1) Oral growth hormone secretagogue

J Clin Endocrinol Metab 2009;94:1198-206

2) Tramadol for osteoarthritis

Cochrane review CD005522

3) Why most published research findings are false

PLoS Med 2005 

Dear TEC podcast listeners – please tell us what you think and you just might win a free iPad!

We’ve been doing the TEC podcast for 3 1/2 years (now over 5500 minutes of pure listening “pleasure”) and we thought it was finally time to get some specific feedback from our listeners.

We have created a survey which should hopefully take you less than 10 minutes to complete. We want to find out what you think about the podcast, what impact it has had on your practice and what changes could be made to improve the TEC podcast experience.

To thank you for doing this we plan to select one lucky survey responder and send then a free iPad so PLEASE let us know what you think!!!

SURVEY LINK

https://www.surveymonkey.com/s/QMSMPVN

In episode 170, James and Mike continue their quest to answer the questions of the universe but fail and barely give answers to the podcast listener enquiries. We talk about thiazides and potassium, constipation, hazard a definition of hazard ratios and as always rant and rave about the lipid hypothesis or lack thereof.

Show notes

NONE

In episode 169, Mike and James get back to listener questions. Our listeners lead us down the garden path and we end up talking about bladder irritants, riboflavin for migraine prophylaxis, placebo, and as always low doses. Mike rebels by taking a high dose of obecalp which leads to some very strange side effects.

Show notes

1) Is caffeine a bladder irritant?

Urol Ann 2011:3:14-8

JAMA 2004;291:986

2) Riboflavin in migraine prophylaxis

Neurology 1998;50:466-70

Headache 2004;44:885-90

Cephalgia 2010;30:1426-34

J Child Neurol 2008;23:1300-4

3) Tools for practice

Are antihypertensive medications effective for migraine prophylaxis?

Antidepressants for preventing headaches: Which work and how well?

4) Placebo effect 

Cochrane library CD003974 

5) Low dose

CMAJ 2011;183:65–9

In episode 168, Mike and James welcome back the returning Bruce Arroll who helps us out with the painful issue of how to diagnosis, treat and prevent gout. We crystallize the evidence and stick a needle into the beliefs about diet and colchicine dose. At the end we all go out to celebrate and drink milk and wine because neither are associated with developing gout.

Show notes

1) A Diagnostic Rule for Acute Gouty Arthritis in Primary Care Without Joint Fluid Analysis

Arch Int Med 2010;170:1120-6

2) Tools For Practice

Is colchicine an effective alternative to NSAIDs for the treatment of acute gout?

3) Moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout

N Engl J Med 2004;350:1093-103

4) Febuxostat vs allopurinol

N Engl J Med 2005; 353:2450-2461

In episode 167, we welcome back Bruce Arroll who, as he commonly does, helps us talk about common conditions and in this case it is the common cold. We discuss common diagnoses, common treatments and uncommonly, we pretty much agree with everything he has to say about this common ailment. 

Show notes

1) Intranasal zinc for the common cold

J Prim Health Care 2009;1:134-9

2) Phenylpropanolamine and stroke

N Engl J Med 2000;343:1826-32

3) Rapid response – letter BMJ on rebound from nasal decongestants

http://www.bmj.com/rapid-response

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

Ann Intern Med 1997;127:788-95

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