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richard-lehman.bsky.social

@richard-lehman.bsky.social
194 followers 29 following 29 posts
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Francesca H. Dakin @francescadakin.bsky.social · 22/01/2026
Very proud to see our paper on the unintended consequences of digitalisation on GP staff wellbeing making number 6 in the #BJGPTop10!
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Alf Collins @alfcollins.bsky.social · 21/01/2026
Great article re: patients using AI. Given the evidence that a) clinical training drains doctors of empathy, and b) doctors can’t possibly keep all relevant evidence in their heads, there’s a big shift emerging and doctors need to ride with it. cc @glynelwyn.bsky.social , @johnlauner.bsky.social
even.cc
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richard-lehman.bsky.social @richard-lehman.bsky.social · 26/01/2026
This is a fabulous trio of articles. A delight for all interested in the progress of medicine. But what trials have done the most HARM in medicine? Send us your pet hates.
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Octopus.ac @octopus-ac.bsky.social · 26/01/2026
It is now possible to embed video within the main text of your Octopus publications. We heard that this was important for, e.g., video methods, artistic performances, sign language and behavioural studies. Your video has to be hosted on Vimeo first. That is because of privacy and cookies settings.
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Frank Harrell @f2harrell.bsky.social · 19/12/2025
Doug Altman - an eternal inspiration for all medical statisticians and non-statistician medical researchers. #StatsSky #Statistics
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James Lind Library @jameslindlibrary.bsky.social · 17/12/2025
Listen in as @richard-lehman.bsky.social and @raj-mehta.bsky.social explore why it took so long for fair tests of treatments to develop, and the transition from anecdotal and authority-based decisions to empirical methodologies in the 18th and 19th centuries. www.jameslindlibrary.org/blogs/the-fi...
jameslindlibrary.org
Podcast: The first steps towards Evidence-Based Medicine - The James Lind Library
This video covers the first section of the James Lind Library essays, exploring why it took so long for fair assessments of medical treatments to develop.
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John Launer @johnlauner.bsky.social · 28/11/2025
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...
youtube.com
NBM Talks: Podcast from the Narrative-Based Medicine Lab - YouTube
NBM Talks is a podcast from the Narrative-Based Medicine Lab at Continuing Professional Development, Temerty Faculty of Medicine, University of Toronto. List...
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Alf Collins @alfcollins.bsky.social · 23/11/2025
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.
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John Launer @johnlauner.bsky.social · 19/11/2025
We need humility to engage with AI. My latest column, just out @bmj.com www.bmj.com/content/391/...
bmj.com
John Launer: We need humility to engage with AI
Like almost every doctor, I’ve had to get to grips with artificial intelligence (AI). In some ways this has felt like going through the classic stages of loss and grief. First there’s denial (“It hasn...
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Alf Collins @alfcollins.bsky.social · 14/11/2025
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.
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Frank Harrell @f2harrell.bsky.social · 16/11/2025
A lot of crap research is being done with the microbiome. At the heart of much of the research is fundamentally unreliable data.
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MAGIC Evidence Ecosystem Foundation @magicevidence.bsky.social · 22/08/2025
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/
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The BMJ @bmj.com · 30/07/2025
"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...
youtube.com
GRADE the trustworthiness of evidence | Prof. Gordon Guyatt
YouTube video by The BMJ
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James Lind Library @jameslindlibrary.bsky.social · 18/08/2025
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...
jameslindlibrary.org
The James Lind Library - The James Lind Library
The James Lind Library uses material from history to illustrate the development of research methods for evaluating treatments.
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richard-lehman.bsky.social @richard-lehman.bsky.social · 17/07/2025
It is very weird indeed. How anybody could think of calling jam jelly and eating it with ground nut paste.
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richard-lehman.bsky.social @richard-lehman.bsky.social · 08/07/2025
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.
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Alf Collins @alfcollins.bsky.social · 18/06/2025
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…
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richard-lehman.bsky.social @richard-lehman.bsky.social · 11/06/2025
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.
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Rosamundi @rosamundi.bsky.social · 08/06/2025
If your business model only works because you're allowed to do crimes, you don't have a business. www.theguardian.com/business/202...
theguardian.com
Bidders demand Thames Water granted immunity over environmental crimes
Exclusive: ‘Ransom note’ requests would leave Environment Agency unable to prosecute company or management
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James Lind Library @jameslindlibrary.bsky.social · 13/05/2025
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
jameslindlibrary.org
Sackett DL (2015) - The James Lind Library
Extended questions and answers prepared by Dave Sackett shortly before his death in 2015, edited by Brian Haynes.
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richard-lehman.bsky.social @richard-lehman.bsky.social · 13/05/2025
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.
youtube.com
Yes, Doctors: AI Will Replace You
YouTube video by Sheriff of Sodium
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richard-lehman.bsky.social @richard-lehman.bsky.social · 08/05/2025
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.
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Jeremy Corbyn @jeremycorbyn.bsky.social · 06/05/2025
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.
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Thomas Agoritsas @thomasagoritsas.bsky.social · 04/05/2025
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-...
f1000research.com
F1000Research Article: The effects of teaching strategies on learning to think critically in primary and secondary schools: an overview of systematic reviews.
Read the latest article version by Andrew D. Oxman, Allen Nsangi, Laura Martínez García, Margaret Kaseje, Laura Samsó Jofra, Daniel Semakula, Heather Munthe-Kaas, Sarah E. Rosenbaum, at F1000Research.
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Alf Collins @alfcollins.bsky.social · 28/03/2025
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.
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richard-lehman.bsky.social @richard-lehman.bsky.social · 28/03/2025
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
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Jonathan Reinarz @reinarz.bsky.social · 25/03/2025
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...
brill.com
Dealing with Medical Uncertainty in and through the History of Medicine
"Dealing with Medical Uncertainty in and through the History of Medicine" published on 10 Mar 2025 by Brill.
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James Lind Library @jameslindlibrary.bsky.social · 17/03/2025
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...
jameslindlibrary.org
Why did I become a clinician-trialist? - The James Lind Library
The seeds of iconoclasm In 1956 I went to the University of Illinois College of Medicine to be taught how to become a physician. Despite the College’s well-deserved reputation, a ...
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Neal Maskrey @stokemacca.bsky.social · 21/03/2025
Once you start looking, it’s tramlines not guidelines everywhere. Inexorably leads to overdiagnosis and overtreatment.
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John Launer @johnlauner.bsky.social · 09/03/2025
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.
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MAGIC Evidence Ecosystem Foundation @magicevidence.bsky.social · 20/02/2025
🟠 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)
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PrescQIPP CIC @prescqipp.info · 18/02/2025
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
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Francesca H. Dakin @francescadakin.bsky.social · 14/02/2025
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
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Rachel Coldicutt @rachelcoldicutt.bsky.social · 12/02/2025
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...
Whether "open, inclusive, transparent, ethical, safe, secure and trustworthy" Al is even possible is another matter altogether, but it will be very interesting to see which governments sign up to the ambition to achieve it - and which decide to stay toughing it out in the arena in the hope of delivering a beat down to their opponents.
If the only possible future for global Al is extractive and divisive, the pursuit of dominance will result in painful and costly real-world conflict - the very opposite of the "national renewal" that Starmer hopes
these technologies will bring about.
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Peaklass @peaklass.bsky.social · 08/02/2025
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.
A curving lane with grass growing in the middle, stretching away under trees and between hedges. The sun is rising through the trees directly ahead, lighting the lane.
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Alf Collins @alfcollins.bsky.social · 05/02/2025
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.
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Jess Morley @jessrmorley.bsky.social · 29/01/2025
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
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richard-lehman.bsky.social @richard-lehman.bsky.social · 28/01/2025
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.
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Mary Dixon-Woods @marydixonwoods.bsky.social · 28/01/2025
This looks like it will be fantastic @hetanshah.bsky.social
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Alf Collins @alfcollins.bsky.social · 27/01/2025
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) 😊
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richard-lehman.bsky.social @richard-lehman.bsky.social · 21/01/2025
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/...
bmj.com
Sacrificing patient care for prevention: distortion of the role of general practice
Expansion of preventive clinical recommendations in primary care has had the unintended consequence of destabilising this foundation of the healthcare system, argue Minna Johansson and colleagues Fo...
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Neal Maskrey @stokemacca.bsky.social · 16/12/2024
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) 😉.
bjgplife.com
Rebalancing Medicine by Neal Maskrey
Rebalancing Medicine can seem an impossible task. This book describes, often from personal experience, how the political fashions of the last decades first facilitated and then debilitated the essenti
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richard-lehman.bsky.social @richard-lehman.bsky.social · 23/12/2024
Good to see you all. Happy Christmas!
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MAGIC Evidence Ecosystem Foundation @magicevidence.bsky.social · 20/12/2024
🤩 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
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Rupal Shah @rooshah.bsky.social · 19/12/2024
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
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Ben Goldacre @bengoldacre.bsky.social · 18/12/2024
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...
my.corehr.com
Job Details
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Peaklass @peaklass.bsky.social · 06/12/2024
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.
A view of the town of Bakewell on a misty, winter morning. The river Wye runs in front of the houses at the bottom of the frame, and then the houses rise up along the hillside, smoke blooming from the chimneys.
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Jess Morley @jessrmorley.bsky.social · 06/12/2024
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 😂
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