E19: Overdiagnosis

Richard and Raj discuss Palliative care

Richard and Raj discuss some of the History of Statistics, and how it informs the practice of EBM today.

Richard and Raj discuss how patients can be involved in the process of generating evidence, from determining patient centered outcomes to prioritizing types and goals of research.

Richard & Raj discuss decision making in EBM, and the tipping points that change clinical practice.

Richard & Raj discuss Overdiagnosis, starting with the difficulty of defining the term to the practical challenges in every day clinical practice. Links on Overdiagnosis: https://www.bmj.com/content/344/bmj.e3502 https://academic.oup.com/jnci/article/102/9/605/894608

References: 1. Wilson JM, Jungner YG. [Principles and practice of mass screening for disease]. Bol Oficina Sanit Panam. 1968;65(4):281-393. 2. Mant D, Fowler G. Mass screening: theory and ethics. BMJ. 1990;300(6729):916-918. doi:10.1136/bmj.300.6729.916 Discussion Timestamps: 0:15 Population Health and Screening History 6:44 Population Health Math 11:41 Screening for Blood Pressure 13:36 Wilson Criteria Difficulty 15:09 Blood Pressure and Screening Programs 22:10 Prostate Cancer Screening 28:27 Colon Cancer Screening 30:06 Colonoscopy Higher Rates of Adenoma Detection

Richard and Raj discuss the potential future role of AI in EBM and medicine

James Mccormack, from https://therapeuticseducation.org/ , discusses personalized, one-agent-at-a-time approach to medication management.   He also has helped to create several decision based websites:   Overall CVD cvdcalculator.com Heart failure https://hfmedchoice.com/ Diabetes https://decisionaid.ca/diabetes/

Richard and Raj discuss the history of Hypertension and how it lead up to modern day challenges of managing high blood pressure.

The NNT