Here's a podcast I've just done with Damian Tarnopolsky from the Narrative-Based Medicine Lab in Toronto. He's a very good interviewer and it's short and to the point (21mins). At the end I talk about AI-enhanced narrative medicine. www.youtube.com/playlist?lis...

I’ve said it before and I’ll say it again (and again and again…). An integrated team is necessary but not sufficient to deliver coordinated care- let alone care that aligns with patient goals and priorities, minimises the burden of treatment and enables people to live well.

We need humility to engage with AI. My latest column, just out @bmj.com www.bmj.com/content/391/...

We are a long way indeed from systematically collecting and acting on the voices of patients. Abolishing Healthwatch and handing responsibility for its work to ICBs (which are themselves undergoing massive reorganisation) is in my own view a very bad move indeed by DHSC.

A lot of crap research is being done with the microbiome. At the heart of much of the research is fundamentally unreliable data.

Read the publications here: Living clinical practice guideline (The BMJ): pubmed.ncbi.nlm.nih.gov/40813129/ Living SR + network meta-analysis (The BMJ): pubmed.ncbi.nlm.nih.gov/40813122/ Living SR of prognostic models (BMJ Medicine): pubmed.ncbi.nlm.nih.gov/40832127/

"Evidence itself never gives us the answer what to do. It's evidence in the context of values and preferences." Professor Gordon Guyatt talks to The BMJ about the challenges of evidence based medicine and introduces the Core GRADE system @guyattgh.bsky.social www.youtube.com/watch?v=433J...

Ahoy! Learn about the importance of randomisation through history in my library at www.jameslindlibrary.org. For example, read how the GISSI trials embedded patient and public health oriented randomised trials into the Italian health service 40 years ago www.jameslindlibrary.org/articles/emb...

It is very weird indeed. How anybody could think of calling jam jelly and eating it with ground nut paste.

Nice blog highlighting total vacuity in The Plan. Its lack of originality may be pardonable, but its lack of substance is not. These ideas have been around for 105 years. Lessons may perhaps have been learned. No evidence of that here.

Treatment burden= the work that NHS staff ask/demand of patients in order to optimally manage their clinical condition(s). It’s a *big issue* for patients and we don’t talk about it enough. For people with multiple LTCs it can outweigh the benefits afforded by seeing clinical teams…

I've just been having some exchanges across on the Musk site which have warmed my heart. Saying to those of you who never go there now, the old Twitter is not yet dead. It may even be coming back to life while its proprietor is away licking his self-inflicted wounds.

If your business model only works because you're allowed to do crimes, you don't have a business. www.theguardian.com/business/202...

May 13 2025: 10th anniversary of death of Dave Sackett. Read extended questions & answers he prepared shortly before his death to describe his multiple careers, importance of fair tests and evidence-based medicine www.jameslindlibrary.org/sackett-dl-2... @cebmoxford.bsky.social #EBM #EBHC #Cochrane

Brilliant video - www.youtube.com/watch?si=5BP... Generative AI will massively improve care for ill people. Doctors may survive as operatives, mediators and humans to talk to: the rest will be done much better by machines.

Medicine will, and should, be carried out with the universal help of intelligent and compassionate machines in the hands of patients. Machines that know what they are doing and learn from everything they do. While this is already beginning to happen, the rest is simply falling apart.

The government was wrong to cut winter fuel payments. It was wrong to keep the 2-child benefit cap. It was wrong to slash disability benefits. Pushing people into poverty is the wrong thing to do. The right thing to do is redistribute wealth and power so that everyone can live in dignity.

The effects of teaching strategies on learning to think critically in primary and secondary schools: an overview of systematic reviews #AndyOxman @sarahros.bsky.social f1000research.com/articles/13-...

Most decision making in healthcare is informed by clinician biases. There are lots of reasons for this, one of them being that nobody can keep up with the rapidly evolving evidence base. To quote @richard-lehman.bsky.social we need reliable AI driven satnav to inform decision making processes.

Also let's not forget Olga Nethersole's role in setting up the People's League for Health - a pioneer of patient activism on behalf of impoverished pregnant women. A Victorian/Edwardian actress of formidable presence crying out for good biographer. Lived from 1860s to 1950s. @reinarz.bsky.social

Volume 108 on Dealing with Uncertainty in and through the History of Medicine now out in Brill’s Clio Medica series. brill.com/display/titl...

Ahoy!If you'd like to read more from Dave Sackett, try the article he wrote for me in 2015 about why he became a clinical trialist www.jameslindlibrary.org/articles/why...

Once you start looking, it’s tramlines not guidelines everywhere. Inexorably leads to overdiagnosis and overtreatment.

The UK nuclear "deterrent" will expire within months without US tech support and components - likely to be withdrawn by Trump. So many layers of insanity here. It's also an opportunity to sign the UN Treaty on the Prohibition of Nuclear Weapons, like most countries. But don't hold your breath.

🟠 How It Was Created: An international panel—patients, clinicians & methodologists—developed these guidelines using the GRADE approach. (4/6) This initiative shows how MAGIC & @bmj.com are advancing trustworthy clinical guidance. Editorial: www.bmj.com/content/388/... (6/6)

Looking for new sources of clinical evidence to help you make smarter decisions about patient treatment? On 25 Feb @juliantreadwell.bsky.social of @bristoluni.bsky.social reveals how the GP Evidence website can be the goldmine of information you're looking for. @stokemacca.bsky.social #learning

Paper out on digitally-driven stress, strain, and suffering in UK GP To harness tech’s benefits, practices need to be *change-ready*: have strong working relations, time and resource to make informed decisions RE what tech and when (for the local staff/patient context) and the capacity to implement

I feel sad and angry about the UK government's decision not to sign the statement from the AI Action Summit. Not because I think it presents a rare new hope, but because they have decided to follow Trump and Musk. blogs.lse.ac.uk/politicsandp...

If you stand very still right now, you can feel it. A slow awakening, reaching, uncurling, every tiny thing flickering back to life. The birds are singing a little louder, and the light from longer days stretches into all the shadows. Everything lies just ahead of us, around the next corner.

Hardly any healthcare interventions are ‘rolled out’. Nothing much can be adopted at ‘pace and scale’. This much I know from 42 years in healthcare Anyone who uses these terms doesn’t understand the tensions and dynamics of change in social systems.

So the new BMJ Digital Health and AI journal is now accepting submissions bmjdigitalhealth.bmj.com/pages/about. Also both @maxi-macki.bsky.social and I are on the editorial board as Associate Editors so you know it's a cool place for your research to hang out

Two brilliant young novelists met up in the last year of Queen Victoria's reign to write a dizzying satire on the stupidities of imperialism. Their subject: the takeover of Greenland.

This looks like it will be fantastic @hetanshah.bsky.social

Just been QOFd- a wholly unedifying experience which I left feeling (as per Carolyn Chew Grahams research) ‘a passive object of biomedical surveillance’. If you really do want people to become engaged in managing their health NHSE, please give us our notes and reform QOF (as starters for 10) 😊

Mandatory "prevention" is swallowing up skilled time and imposing an impossible load on those trying to help ill people, i.e. GPs. So thrilled to be on the authorship of this plea for a restoration of balance and due roles: www.bmj.com/content/388/...

bjgplife.com/rebalancing-... A completely lovely review of my book by the legendary Richard Lehman. £2.49 on Kindle, priced to be accessible to almost everyone. (I’m relying on Spielberg or Redford or Lady Gaga to pick up the film rights) 😉.

Good to see you all. Happy Christmas!

🤩 Hands-on workshop on MAGICapp coming up in January 2025! Register through the QR code Objectives: Demonstrate/discuss the value of creating guidelines in a digital guideline platform for improved authoring efficiency and increased dissemination opportunities. Learn the basics of using MAGICapp

Hello All. Just to say that all the podcasts Jens and I have recorded are now available on Spotify- including the most recent one with Bob Klaber on cultures of kindness. Just look for’Fighting for the Soul of General Practice’. Thank you all

We are hiring a tech lead! We build high impact national health data infrastructure that is open, productive, and beautiful - like our OpenSAFELY - in a truly mixed team, where software developers and researchers all share skills, status, knowledge, and best practice! my.corehr.com/pls/uoxrecru...

I love this view of beautiful Bakewell, and perhaps never more so than on quiet winter mornings. Just a jumble of dreaming, higgledy-piggledy rooftops, the smoke coiling up lazily from the chimneys to meet the mist rolling down from the hills, and beneath it all, the murmuring, oblivious river.

I am generally really bad at small talk and the “getting to know you chat” - but I love hero origin stories. I find it so fascinating to hear how people ended up where they did doing what they do. I also love it when ppl find out I have a geography BA & my first job was primary care commissioning 😂

A book that needs to be part of every doctor's lifelong learning. Huge riches hinted at in my little review, which is mostly about uncertainty in general practice: bjgplife.com/the-art-of-u... @marydixonwoods.bsky.social @johnlauner.bsky.social

A farewell to autumn as we move on, the final splashes of colour now fading in the woods. This was a perfectly still morning, no haste or pressure, no noise but the rush and bubble of water. I stayed long after I'd taken the shot, just watching and listening and breathing it all in. #peakdistrict

Looking forward to joining the @thisinstitute.bsky.social (directed by @marydixonwoods.bsky.social) THIS Space conference to chat with @xiaoliu.bsky.social Brian Chapman, and Niels Peek about the challenges (and opportunities) of responsible data science and healthcare innovation. See you online.

The debate on assisted dying has been, on the whole, thoughtful and considered. It’s complex and important. I do wonder whether those opposing assisted dying are, sometimes, holding onto a degree of medical paternalism of a bygone era.

Those just wanting explanations of the terms used when discussing health-AI, can use: www.owkin.com/a-z-of-ai-in... Owkin commissioned & did the artwork, I wrote all the text. Each concept (e.g., LLM) has a short lay explanation, a detailed technical explanation, & further reading. Enjoy.

Maybe too controversial a point for gentle BlueSky, but I think the whole of medical civilisation as we know it is going to be swept aside by generative AI. We'll all be made aware of how badly we've been doing things all our lives. And I welcome that.