Questioning Medicine

Kanwal F, et al. Clinical care pathway for the risk stratification and management of patients with metabolic dysfunction–associated steatotic liver disease. Gastroenterology 2026 Jul; 171:164. DOI: 10.1053/j.gastro.2026.01.047. PubMed   - MASLD screening and treatment recommendations.  CT detected substantially more cardiac thrombi than TTE  Nio SS, et al. Diagnostic yield of cardiac CT to detect cardiac thrombi in patients with acute ischemic stroke (AIS of HEARTS). Stroke 2026 Aug; 57:2408. DOI: 10.1161/STROKEAHA.126.055575. PubMed  Lee KK, et al. Targeted use of computed tomographic coronary angiography in acute chest pain. N Engl J Med 2026 Aug 29; [e-pub]. DOI: 10.1056/NEJMoa2608903. PubMed  CTCA did not reduce MI or cardiac death after MI was ruled out Bundgaard H, et al. Response-tailored or standard-duration antibiotic treatment for infective endocarditis. N Engl J Med 2026 Aug 28; [e-pub]. DOI: 10.1056/NEJMoa2607887. PubMed Relapse of infection was significantly more common when antibiotics stopped early https://www.sciencedirect.com/science/article/pii/S073646792200347X  -- you don’t need magnesium when you replace potassium

we unpack whether rivaroxaban followed by aspirin improves thromboprophylaxis after hip and knee arthroplasty, put oral GLP-1 therapy orforglipron head-to-head with dapagliflozin for type 2 diabetes, and examine new evidence on venous thromboembolism after mechanical restraint in psychiatric hospitals. We also translate updated pediatric functional-constipation guidance, the newest ACG recommendations for colonic diverticulitis, and real-world data on blood-pressure control and mortality among U.S. veterans—then finish with a practical look at whether a lumbar belt can truly ease nonspecific low-back pain.Shivakumar S, et al. Rivaroxaban then aspirin vs. aspirin alone after total hip or knee arthroplasty. N Engl J Med 2026 Jul 12; [e-pub]. DOI: 10.1056/NEJMoa2603649. PubMed https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(26)00800-7/abstract https://pubmed.ncbi.nlm.nih.gov/42393373/ Welch M, et al. Orforglipron compared with dapagliflozin in adults with type 2 diabetes and inadequate glycaemic control with metformin (ACHIEVE-2): A multicentre, randomised, non-inferiority, open-label, phase 3 trial. Lancet 2026 Jul 11; 408:125. DOI: 10.1016/S0140-6736(26)00800-7. PubMed Viuff JH, et al. Venous thromboembolism after mechanical restraint in psychiatric hospitals: Population based cohort and self-controlled case series study. BMJ 2026 Jul 1; 394:e100016. DOI: 10.1136/bmj-2026-100016. PubMed Gordon M, et al. European Society for Paediatric Gastroenterology, Hepatology and Nutrition/North American Society for Pediatric Gastroenterology, Hepatology and Nutrition guidelines for treatment of functional constipation in children aged 0–18 years. J Pediatr Gastroenterol Nutr 2026 May 20; [e-pub]. DOI: 10.1002/jpn3.70447. PubMed Peery AF, et al. ACG clinical guideline: Colonic diverticulitis. Am J Gastroenterol 2026 Jul; 121:1549. DOI: 10.14309/ajg.0000000000004047.  Yamada M, et al. Blood pressure control and mortality among US veterans. Hypertension 2026 Apr 7; [e-pub]. DOI: 10.1161/HYPERTENSIONAHA.125.25787.  Grange L, et al. Lumbar belt for nonspecific low back pain: A randomized clinical trial. JAMA Netw Open 2026 Aug 3; 9:e2629793. DOI: 10.1001/jamanetworkopen.2026.29793. PubMed

Does a Coronary Artery Calcium (CAC) scan still earn its place in modern cardiovascular prevention? This podcast cuts through the headlines to examine the recent research, challenge overconfident conclusions, and put CAC testing under the microscope alongside the PREVENT risk equation.Each episode brings a sharp, evidence-first look at what calcium scoring can—and cannot—tell us about heart-attack risk. We unpack study methods, question the assumptions behind new publications, and ask the practical questions clinicians and patients actually need answered: When does CAC meaningfully change care? Who benefits most? And in an era of PREVENT, does a scan add actionable information beyond the numbers?Clear-eyed, clinically grounded, and never afraid to interrogate the data, this is the podcast for anyone who wants the real value of CAC—not just the latest claim.

OMED lecture on how to understand medical stats

CME