Welcome back Rounds Table Listeners! This week Mike and John review clinical aspects of COVID-19 management and review the latest data on treatment options. We hadn’t come up with a Good Stuff item at the time of recording, but since then this incredible video came out of a boy singing the #youcanbeABCs — it is…
Tag: Evidence Based Medicine
Episode 12 – Rapid Fire Treatment Options for COVID-19
Welcome back Rounds Table Listeners! This week we are going back to our Rapid Fire Format to review two papers looking at new data on treatment options for patients with COVID-19. Is Remdesivir effective in the treatment of COVID-19? https://www.nejm.org/doi/full/10.1056/NEJMoa2007764 Is Lopinavir-ritonavir effective in the treatment of COVID-19? https://www.nejm.org/doi/full/10.1056/NEJMoa2001282 And for The Good Stuff….…
Episode 10 – Interview with Dr. Sholzberg on COVID coagulopathy
Welcome back Rounds Table Listeners! This week we interviewed Dr. Michelle Sholzberg to discuss coagulopathy associated with COVID-19. Dr. Sholzberg is a clinical hematologist with a focus on bleeding and is the Medical Director of the Coagulation Laboratory at St. Michael’s Hospital in Toronto, Ontario, Canada. She is also the Co-Director of the Hematology-Oncology Clinical…
Episode 8 – Rapid Fire: COVID-19 Part 2
Welcome back Rounds Table Listeners! This episode we discuss two recently published papers related to COVID-19. 1. What is the incidence and significance of cardiac injury in patients with COVID-19 https://jamanetwork.com/journals/jamacardiology/fullarticle/2763524 2. The clinical course and risk factors for mortality in a multi-centre cohort of inpatients with COVID-19 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fulltext And for the good stuff: 1. Calgary distillers and…
Episode 7 – Rapid Fire COVID-19
Welcome back Rounds Table Listeners! This episode, we’re focusing on 2 papers recently released related to COVID-19. 1. Our first paper provides an overview of the clinical characteristics of a sample of patients admitted to hospital with COVID-19. https://www.nejm.org/doi/full/10.1056/NEJMoa2002032 2. The second paper provides timely data to identify factors associated with ARDS among adults diagnosed with COVID-19.…
Can an essential medicines list fix drug coverage gaps?
IgG tests promise to reveal food sensitivities. But are they science or science-ish?
Primary care quality improvement: Is data the future?
Why aren’t new health care models studied more?
‘An imperfect tool’: The controversy over whether BMI is the best measure of obesity
When Travis Saunders went for his regular physical a few years ago, a nurse calculated his Body Mass Index (BMI). At 24.5, it was at the high end of normal, and she told him to “watch his weight.” “I just kind of smiled and nodded,” he says. As an obesity researcher, Saunders knew that since…
Is wisdom teeth removal really warranted?
In her 20s, Nancy Fornasiero’s dentist told her that her wisdom teeth should come out. They were impacted, which means they were stuck below the gums because they didn’t have enough room. She was warned that the teeth were more prone to decay and infection than other teeth, and that they should be removed before…
Why are mental health disorders and addictions treated separately?
According to statistics from the Centre for Addiction and Mental Health, at least 20% of people with a mental illness also have a substance use problem. To Peter Selby, chief of the addictions program at the Centre for Addiction and Mental Health, this number is very conservative. Laura Calhoun, provincial medical director of addiction and mental…
Health care system is failing people with alcohol addiction, say experts
It’s one of the biggest health issues Canadians face. It’s responsible for 7% of all premature deaths in this country. The direct health system costs amount to three billion dollars a year. But its most devastating impacts are felt by those with the condition and their families. If excessive alcohol consumption didn’t jump to your…
Confused about the mixed messages on sunscreen safety?
Are patients being informed about prostate cancer screening risks?
Get screened. It could save your life. Don’t get screened. There’s no evidence that screening saves lives. Get tested in your 40s. Wait until you’re 55. Get the test every year. Every four years is enough. When it comes to screening for prostate cancer, the messages from doctors, major medical organizations and media campaigns are…
Should Canadian communities continue to fluoridate water?
Water fluoridation has been hailed as one of the top ten great public health achievements of the 20th century by the U.S. Centers for Disease Control. Yet, in the past five years, dozens of Canadian communities have stopped adding fluoride to the municipal water supply, including Calgary, Waterloo, Windsor and Saint John. Inspired by online…
Decision aids: why hasn’t this proven, patient-centred practice caught on?
Health care has supposedly entered an era of patient involvement, where important medical decisions are shared between doctors and patients. But many believe that the reality in Canadian health care falls well short of this ideal. Complex medical decisions can prove difficult for patients, who are often faced with dizzying amounts of information about benefits and risks,…
Controversy over closing rural hospitals
Hymns, protests, and arrests – that’s what happened when the Fort Erie, Ont. community rallied against a planned conversion of their local hospital’s emergency room to an urgent-care centre. It didn’t work, and in 2009, it seemed their fears were realized when a teenager died after she was in a car crash and had to be…
What Canada can learn from Sweden’s health registry system
In 2007, a group of Canadian cardiologists found themselves in a unique position. New – and expensive – implantable cardiac defibrillators were being used by fewer than a dozen doctors. And the Institute for Clinical Evaluative Sciences was offering to help them create a registry that would track outcomes for five years. Soon, they had the largest registry…
How Norway’s innovative library made high-quality health information free for everyone
If you’re looking for evidence-based health information in Canada, a lot depends on who – and where – you are. A physician in a teaching hospital? No problem. But family doctors in rural areas, nurses or physiotherapists have a much harder time accessing up to date materials. And the general public is more likely to find…
The surprising science behind evidence-based hospital design
Rahel Yetbarek sits with her feet up, looking out onto the city and the large swath of treed land that surrounds the freeway below her. The nurse is taking in the view over her lunch break, from the 10th floor rooftop garden at Bridgepoint, a Toronto hospital. Nearby, a few patients do the same. The…
Integrative cancer care in Canada: curiosity and cautions
Joanne MacPhail was diagnosed with breast cancer in 1993 at the age of forty three. At that time, her treatment included two surgeries, as well as a lengthy course of chemotherapy that had profound physical and emotional side effects. MacPhail details how she sought out reflexology, therapeutic touch and massage therapies to help her cope with side…
Should HPV vaccination programs be expanded to boys?
Vaccination programs are based on the old adage that an ounce of prevention is worth a pound of cure. Since 2007 Canada has had a vaccination program for the Human Papillomavirus (HPV) administered to girls, although the age of vaccination varies by province: Grade 5 in Alberta and Grade 8 (with catch up until Grade…
Medical marijuana: what doctors need to know about Canada’s new rules
Herbal marijuana is not an approved drug in Canada, but court rulings have required reasonable access to a legal source of marijuana when authorized by a physician. On April 1st, Canada’s current regulatory system for medical marijuana will be replaced entirely by a new set of rules. These new regulations will have important implications for…
Buyer beware – no quick fix for concussion symptoms
The world is watching athletes in Sochi compete in sports such as hockey and downhill skiing. Concussion poses a risk, not only to the highly trained individuals competing in the Olympics, but also to ordinary Canadians who play sports occasionally. Concussions are the result of a blow to the head, and are the most common…
Evidence-based hospital nurse staffing: the challenges
Should clinical practice guidelines consider value for money?
In Canada, doctors’ associations regularly incorporate new evidence about medications into clinical practice guidelines that are intended to influence patient care. The Ontario Ministry of Health and Long-Term Care reviews the same evidence to decide which medications it will pay for, and often comes to different conclusions. This results in doctors recommending medications which are…
Did mammography save her life?
Some breast cancers detected by screening mammography are cured and would have led to death had they not been detected early. Other breast cancers detected by screening can be treated just as effectively if diagnosed later, may not have needed treatment at all, or may be so advanced that treatment does not prevent death from…
Interpreting randomized trial evidence around mammography
The Canadian Task Force on Preventive Health Care recently released recommendations about screening for breast cancer. These recommendations have been criticized by some because they emphasize the results of randomized trials. This article explores the advantages and limitations of randomized trial evidence regarding screening mammography. The recent recommendations by the Canadian Task Force on Preventive…
Presenting the benefits of mammography
The results of research on screening for breast cancer with mammography can be presented in ways that make the benefits seem larger or smaller Similarly, the benefits can be described as avoiding deaths from breast cancer or avoiding deaths from any cause Part of the debate about the benefits of screening mammography may be related…