Medicine and Science from The BMJ

At BMA house, we convened a group of world experts in shared decision making. Inspired by the Salzburg Global Summit meeting we discussed the background, practical challenges, and how to engage patients with their health The participants were: Fiona Godlee , editor in chief, BMJ Angela Coulter , director of global initiatives, Foundation for Informed Medical Decision Making Albert Mulley , co-founder, Foundation for Informed Medical Decision Making, and director, Dartmouth Center for Health Care Delivery Science Glyn Elwyn, research professor with an interest in shared decision making, Cardiff University Muir Gray , chair of the Information Standard, Department of Health, and co-editor (with Gerd Gigerenzer of the new book Better Doctors, Better Patients, Better Decisions: Envisioning Health Care 2020 Marion Collict, national programme manager, shared decision making, NHS (UK’s National Health System) Alf Collins , consultant in pain medicine, Taunton and Somerset NHS Foundation Trust, and national clinical lead for Co-Creating Health Margaret McCartney , writer and GP Anu Dhir , junior surgical trainee and co-signatory of the Salzburg Statement Gerd Gigerenzer , director, Center for Adaptive Behaviour and Cognition, Max Planck Institute for Human Behaviour Lisa Schwartz , professor of medicine, Dartmouth Medical School, author (with Steve Woloshin (see below)) of Know Your Chances available free online. Steve Woloshin , professor of medicine, Dartmouth Medical School “e-Patient Dave” deBronkart , co-chair, Society for Participatory Medicine Tessa Richards , analysis editor, BMJ Sue Ziebland , research director of the Health Experiences Research Group and a reader in qualitative health research, Department of Primary Health Care, University of Oxford

This week’s podcast is a summary of the shared decision making round table - looking at it’s history, practicalities of implementation and how to get patients involved. The full round table can be found on bmj.com/podcasts.

Should we screen for prostate cancer? A study published on bmj.com suggests that it doesn’t improve survival rates, and could lead to over treatment. Gabriel Sandblom, of the Karolinska Institute, tells us about his research. Also, James Ritter, emeritus professor of pharmacology at King’s College London, explains the As in the ABCD of hypertension treatment.

Information abounds in our burgeoning knowledge economy, but how much is useful - let alone essential? Martin Dawes from the University of British Colombia tells us about the hierachy of evidence. Also this week, data journalist and author of Information is Beautiful, David McCandless, talks to us about the power and the pitfalls of graphically representing data.

Regulation of genetic testing kits is difficult, so how do we start to control this growing market? Christine Hauskeller, from the ESRC Centre for Genomics in Society at the University of Exeter, discusses her idea for an international standard which will help consumers make the right choices. Also this week, management of type 2 diabetes could be improved using an “artificial pancreas”. Roman Hovorka, principal research associate at the Institute of Metabolic Science, University of Cambridge, describes his new intelligent system for insulin delivery.

The problems associated with arsenic in drinking water have been known for some time, but new research published in the BMJ helps quantify that risk with respect to cardiovascular disease. Yu Chen, New York University School of Medicine, joins us to discuss her research. Also this week, requests for travel information for pregnant women are on the increase, but the available information is patchy. Lucy Chappell, a lecturer at Kings College London School of Medicine and one of the authors of a new clinical review on the subject, joins us in the studio to talk about the evidence and how to assess risk.

What are the health impacts of cold homes and fuel poverty? Michael Marmot, professor of epidemiology and public health at University College London, talks about findings of the report he co- authored for environmental charity Friends of the Earth. BMJ editor in chief Fiona Godlee and deputy editor Trish Groves talk about the BMJ Group’s evidence to the UK parliamentary science and technology select committee inquiry into peer review.

Richard Peto, renowned epidemiologist at Oxford University, won the BMJ Group lifetime achievement award this week. We hear from him about his work, and some of impact it has had. Also this week, Martin Thornhill, from the University of Sheffield, talks about his research, which shows the effect of a change to NICE guidance on antibiotic prophylaxis for endocarditis.

In this week’s podcast Babatunde Osotimehin, executive director of the UN population fund, joins us in the studio to talk about climate change and reproductive rights. Also, Barry Taylor from the University of Otago in New Zealand, describes his research into the link between sleep, BMI, and body fat in children.

In this week’s podcast Trish Groves talks to Marzio Babille, UNICEF representative in Chad, about the country with the lowest immunisation rates in the world. Sophie Cook finds out from Davor Jurkovic, from University College Hospital London, about clinical signs of ectopic pregnancy that may be easy to miss.