BS Medicine Podcast

Hosted by James McCormack and Mike Allan .

These podcasts promote healthy skepticism and critical thinking, with the majority presented in a case-based format.

Recommended Listening

Episode 440: Putting the FUN in Fungi: Toenail onychomycosis treatments

In episode 440, Mike and James yet again invite Adrienne to go over all the evidence for treating toenail onychomycosis.  We find that ~ 40% more people get better on oral treatments than on placebo. For topicals the number is closer to 10%. Topicals should likely only be used if there is <40% nail involvement. Show notes Tools For Practice...


Episode 439: Taking a hard look at the evidence: PDE5 inhibitors in erectile dysfunction

In episode 439, Mike and James invite Adrienne to take us through the impressively large amount of evidence for the PDE5 inhibitors for erectile dysfunction. We find that the NNTs are 2-3 for the not clearly defined endpoint of successful intercourse. There is a 20% absolute increase in adverse effects but almost no one stops using these medications because of these effects. Go figure....


Episode 437: Injecting evidence into Platelet-Rich Plasma (PRP) injections

In episode 437, Mike and James invite Joey Ton to help us work through all the evidence around Platelet-Rich Plasma (PRP) injections for tendinopathies. The best evidence for Achilles tendinopathy, lateral epicondylitis, and rotator cuff tendinopathy shows no difference in pain, function or return to sport when PRP is compared to dry needling or saline. Show notes...


Episode 436: Hydrochlorothiazide and squamous cell skin cancer – what we know

In episode 436, Mike and James invite Samantha Moe to help us work through the recent evidence suggesting that hydrocholorothiazide is associated with squamous cell skin cancer. We go over all the numbers and talk about how we use cohort data to figure out if an association needs to influence our clinical practice. As always it is tricky. Show notes...


Episode 435: Unwrapping the subclinical hypothyroidism enigma

In episode 435, Mike and James unravel the evidence around thyroid testing. We talk about an approach to deal with the lack of research and the variation in the measurement of TSH and many other things. At the end we both complain of fatigue, dry skin, puffy eyes, anxiety and depression – and immediately get a TSH test. Show notes 1) Tools for Practice...


Episode 433: Yes, more diabetes trials

In episode 433, Mike and James get all sweet on the latest diabetic trials from 2019. We provide the results, the critique and the context and we do it all with our usual level of charm and wit – which is by all accounts at a level similar to the size of the effect that many diabetes medications have on CVD events.  Show notes...