I think it’s entirely plausible that a podcast with a good sized following could lead to detectable, broader changes in practice--especially if it gives attention to studies that otherwise wouldn’t get it, and if listeners are in position to spread practice patterns. Media attention has been shown to sway practice patterns, presumably through influence on patients and doctors alike; Curbsiders obviously would impact doctors more. I’d be curious to see if there were practice pattern changes in the data when the podcast covered an *older* study, so that we could attribute changes to the podcast rather than other news coverage of a new study. We did something similar here looking at oral minoxidil for hair loss after some old studies got new attention in the New York Times: https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2804659
Hotcakes (the journal club version of Curbsiders that covers recently published literature) could provide another interesting comparator. By definition the studies discussed are new. Most of what's discussed on other episodes is older. I suspect the oral iron example is somewhat unique.
I think also contributing to the rapid spread was the contrarian spirit of certain people in internal medicine (e.g., "Well, actually...ALLHAT used Chlorthalidone"). As in, "Well, actually...iron is better absorbed QOD." Thus QOD dosing became a shibboleth of that type of contrarian practice -- until *now*, when what you show is that daily dosing is the contra-contrarian practice. I cannot wait to counter the residents with *these* data while precepting. :)
I think it’s entirely plausible that a podcast with a good sized following could lead to detectable, broader changes in practice--especially if it gives attention to studies that otherwise wouldn’t get it, and if listeners are in position to spread practice patterns. Media attention has been shown to sway practice patterns, presumably through influence on patients and doctors alike; Curbsiders obviously would impact doctors more. I’d be curious to see if there were practice pattern changes in the data when the podcast covered an *older* study, so that we could attribute changes to the podcast rather than other news coverage of a new study. We did something similar here looking at oral minoxidil for hair loss after some old studies got new attention in the New York Times: https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2804659
Hotcakes (the journal club version of Curbsiders that covers recently published literature) could provide another interesting comparator. By definition the studies discussed are new. Most of what's discussed on other episodes is older. I suspect the oral iron example is somewhat unique.
I think also contributing to the rapid spread was the contrarian spirit of certain people in internal medicine (e.g., "Well, actually...ALLHAT used Chlorthalidone"). As in, "Well, actually...iron is better absorbed QOD." Thus QOD dosing became a shibboleth of that type of contrarian practice -- until *now*, when what you show is that daily dosing is the contra-contrarian practice. I cannot wait to counter the residents with *these* data while precepting. :)
I couldn't agree more. And I love your use of shibboleth here. It perfectly encapsulates what I aimed to capture with #5 above.