Questioning Medicine

Andrew is by himself and trying to struggle through the harsh Florida winter. The question today is should steroids, more specifically prednisolone, be given to those with alcoholic hepatitis? A quick look at the evidence and even go back to some original research from the 70's! Before you hit play can you guess what the music for this alcoholic podcast is going to be?

Andrew is back to being by himself. When you get out questioned in questioning medicine its time for a podcast update. This episode briefly touches on the granulocyte colony stimulating factor and is this $5000 dollar drug worth the price tag or just an expensive Tylenol?

Boy bands from the 80's might have helped you survive childhood, but now they escort in a new era of non-contact HPV testing. Andrew discusses the potential option for women to do their own testing privately, while Joe ponders the trade off between time spent doing the exam vs a patient-centered discussion on health goals. The music video featuring Andrew has been delayed by "BigPharma".

Andrew and Joe discuss the new guidelines or guidance on using the pap smear with HPV for cervical cancer screening in low risk women. Andrew learns 80's rock trivia and Joe gives level C- evidence. More to come on the final episode of our quest to limit the use of a speculum to evidence based medicine.

A rebroadcast as we start a three part series to destroy the speculum. No matter your field if you have a wife, daughter, or mother this applies to you! DONT FORGET TO WRITE A REVIEW!

Our Best Shot of the year. Joe continues to defrost from the frozen Rockies while Andrew is just getting warmed up on his dig into the newest reports on Tamiflu and the annual influenza vaccine. What do Chuck Norris, Pat Benatar, Joel Topf, and Jake Dodge and Detroit Auto Workers all have in common? Tune in and find out!

Another Hospital Medicine discussion: Joe continues to defrost from his month in the frozen west, He BLOWs Andrews mind with a nugget from medical school and Andrew turns his nose up to some of the original evidence surrounding avoidance of Beta Blockers in ACS. What is a discussion surrounding blow without mentioning Whitney Houston, Scarface and other memorable moments in research.

What do Questioning Medicine and Charlie Brown have in common? Neither one as ever made a field goal in a football game and neither one likes a hoax!In this episode Joe practices his french. Andrew is now clear of ebola. The discussion around prostate evidence is addressed. Some of the comments from the medpage post are answered. http://www.medpagetoday.com/HematologyOncology/ProstateCancer/47939 However, most importantly the intro and exit music by ZDoggMD will keep a smile on your face even if you still believe in the digital rectal exam (maybe).

With winter storms brewing up north it's hard to know if the 'ice ice baby' is due to your thyroid or the weather. In this episode Andrew is still being screened for Ebola but Joe manages to make it through the podcast in a hazmat suit. Part 2 of the thyroid discussion leads to guidelines, errors of the test, and treatment.

The Dr James McCormack from BS Medicine joins QMed and helps us enlighten listeners about some of the great and terrible evidence in DM. Revelations regarding symptom management and risks surrounding this disease spectrum. Lift your spirits and recharge your Evidence Based Medicine soul! COMMENT! EMAIL! TWEET!

Andrew and Joe snorkel into the data on TSH testing. Breaking down the test, the patient, the benefits and risks of treatment. Just enough to get you hungry for part 2.

Andrew is back from his 21 day isolation for r/o Ebola, turns out it was just subclinical Post Testing Stress Disorder. Andrew and Joe discuss the concept of "pre" disease and common lab testing errors and POC testing.

An overview of a few studies and information regarding inpatient and outpatient testing. "The first principle of solid wisdom is discretion.." --Norman MacDonald. A little discussion on understanding where we most commonly go awry in ordering tests. Joe admits to ordering a test that did not change practice (off air) and describes rounding from a computer.

Bottoms up on the last discussion on fluids and a review of a few of the trials that contribute to the current mindset in EBM. Andrew creates his own "Mike Tyson Theory of fluids" and Joe subscribes to Dr Joel Topf's (@kidney_boy) delivery service for home-made NaCl (IVF). Joe goes off the deep end...or rather ...into the deep end with his mind...and mouth wide open.

A quick discussion one the topic of which patient to give which fluid. Review of studies from the 90s to 2014 with demographics including pre/post Operative, Septic patient and even Rattus Rattus. (the sewer kind, not the courtroom kind)

Hard topic and difficult discussion continues about reasonable intervention and evaluation of therapy for osteoporosis. Andrew starts right off with his personal recommendation on the screening of low risk patients.

Hard hitting discussion on the evidence on soft bones and the best screening and treatment options. This episode was broken into two parts because Joe needed to run a full NIH Stroke Scale on Andrew mid episode. Turns out, that is his baseline.

Who and when to test. Dose and frequency along with route of administration of Vitamin D are discussed along with 12 studies of outcomes and complications/benefits of each. Joe discovers Andrew is below average....In Vitamin D but well above average in screening for Vitamin D deficiency! None of our discussions constitute medical advice. These are intended to promote Doctor / Patient discussions on best available evidence and allow for informed decision making in that setting. Our views are our own and not those of our employers or affiliates.

You might be outside the guidelines soon. Joe and Andrew discuss the newest recommendations from ACP regarding bimanual/pelvic exams. Andrew can't hold it any longer and breaks into song for the first time. Joe doesn't.

Don't celebrate just yet, the confidence intervals aren't all the way over the line. Andrew gives yet another history lesson on the improvements in Diabetes and runs over some of the recent talk about Diabetes as he takes Joe to school in diabetes diagnosis and monitoring. Andrew and Joe continue to set a precedence of pew pew on over zealous abstracts and being negative nancys in general.