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What's it Worth? A Journal Club PodcastS3E2 (#19.1) - Seeing the forest for the trees in Hypertrophic Cardiomyopathy with the SEQUOIA TrialJoin us for a Double Header with the Minnesota Twins! No, we haven't converted to a sports podcast... I have PGY1 Residents (who are identical twins), Kane and Mckay Carstens joining me for back-to-back journal critiques! The first article, the SEQUOIA trial, was conducted to determine the efficacy and safety of aficamten, a novel cardiac myosin inhibitor, in patients with obstructive Hypertrophic Cardiomyopathy (HoCM). Let's get into the weeds to see the forest for the trees - what is aficamten's possible place in therapy for HoCM? Key Points Hypertrophic Cardiomyopathy (HCM) is one of the most c...2025-04-2327 minWhat's it Worth? A Journal Club PodcastS3E3 (#19.2) - Under Pressure! Portal hypertension showdown between carvedilol and classical non-selective beta blockersEpisode 2 of the Double Header with the Minnesota Twins! The first article, the SEQUOIA trial, was discussed in the preceding episode with Mckay Carstens... did you guess correctly for which twin was speaking? He's passing the baton to his brother Kane to discuss management of portal hypertension in patients with cirrhosis. We're looking back in time with a retrospective study that investigated whether carvedilol showed more effectiveness compared with classical NSBBs to prevent decompensation in patients with cirrhosis. Stick with us to see if the weight of portal hypertension is lifted in this cohort and explore the role of se...2025-04-2335 minWhat's it Worth? A Journal Club PodcastS3E1 (#18) - To Stay or Not To Stay with VKAs: Comparison of VKA or switch to DOAC in frail elderly patients with AFibWelcome to What’s it Worth! Join your host, Dr. Diana Langworthy and student guest host, Meade Avery, as we walk the tightrope of anticoagulation in elderly patients with Atrial Fibrillation (AFib). We'll be reviewing an article that evaluated frail, elderly patients with AFib and compared maintaining INR guided warfarin with switching to a direct acting oral anticoagulant (DOAC). Come along as we decide To Stay or Not To Stay with VKAs! Key Points Atrial fibrillation leads to an increased risk of stroke/systemic embolism (SSE) and maintenance anticoagulation is indicated for patients at elevated risk Gui...2025-03-0557 minWhat's it Worth? A Journal Club PodcastS2E6 (#17) - Decoding Estimands and GLP-1 Agonist Effectiveness in the PIONEER 4 StudyWelcome to What’s it Worth! Join your host Dr. Diana Langworthy, with student co-host Rachel Cohen, as we hit the design dictionary to decode statistical language and simplify estimands and populations. Our expert guest for this episode is Dr. Kylee Funk, Assoiate Professor and Ambulatory Care Pharmacist. We're discussing a trial that compared oral semaglutide with subcutanous liraglutide, GLP-1 agonists, for the treatment of type 2 diabetes. Key Points Non-inferiority (NI) trials are indicated when there are other effective treatment options or where it would be unethical to expose a group to placebo NI marg...2024-12-0536 minWhat's it Worth? A Journal Club PodcastS2E5 (#16) - REDUCE the use of Beta Blockers? Comparison of beta blocker vs no beta blocker after acute MI with preserved EF.Welcome to What’s it Worth! Join your host Dr. Diana Langworthy as we record live with our 2nd year Pharmacy Students for their EBP Pulse Check! We're exploring whether or not we should REDUCE our use of beta blockers in post MI patients who have a preserved ejection fraction by critiquing the REDUCE-AMI trial (NEJM 2024). Our expert guest for this episode is Dr. Anne Schullo-Feulner, Clinical Professor at the University of Minnesota College of Pharmacy and Cardiology Clinical Specialist at Methodist Hospital in St. Louis Park, MN. We discuss key concepts related to interpretation of results and how we ca...2024-10-1039 minWhat's it Worth? A Journal Club PodcastS2E4 (#15): Informed Choices: Exploring Cannabis and Maternal Outcomes in PregnancyWelcome to What’s it Worth! Join your host Dr. Diana Langworthy and guest host Rachel Cohen (PharmD Candidate, 2025) as we take a look at how cannabis affects pregnancy outcomes. Our guest, Dr. Ann Philbrick, PharmD, BCACP, will share her expertise with the current state of cannabis use and what it looks like to see patients who use cannabis in pregnancy. Key Points Existing evidence regarding cannabis in pregnancy has focused primarily on neonatal/fetal outcomes leaving a gap in maternal outcomes Discussions about the safety of cannabis are more common as more sta...2024-09-0735 minWhat's it Worth? A Journal Club PodcastS2E3 (#14) - Can I Have Some More Power Please? Apixaban vs Warfarin for AFib in HemodialysisWelcome back to What’s it Worth! Join your hosts, Dr. Diana Langworthy and P4 Garrison Avery, as we discuss the RENAL-AF trial comparing apixaban vs warfarin in hemodialysis patients. These authors aimed to assess safety and efficacy in one of the first prospective trials comparing DOACs with warfarin in hemodialysis patients. Ever read a trial that didn't enroll their goal number of patients? Let's dig into patient recruitment considerations in trials and also pragmatic applications to medication selection, and properties of drugs that can be cleared by hemodialysis with real pharmacokinetic data to support! Key Points...2024-05-0636 minWhat's it Worth? A Journal Club PodcastS2E2 (#13) - What's the Brass Tacks on MAESTRO-NASH?Welcome back to What’s it Worth! Join your hosts, Dr. Diana Langworthy and Garrison Avery, student PharmD, as we evaluate the 52 week reported outcomes of the ongoing Resmetirom Phase 3 trial. This trial is our first look at a medication currently seeking FDA approval to halt and reverse NASH and liver fibrosis. We also discuss Bonferroni statistical analysis, patients excluded from the trial, and bias in language. Key Points The FDA accelerated approval process might get your pharmacist-spidey senses going, but is it a concern? Non-alcoholic steatohepatitis (NASH) is the most seve...2024-04-0837 minWhat's it Worth? A Journal Club PodcastS2E1 (#12) - Beating Benzos? Phenobarbital versus benzodiazepines in severe alcohol withdrawal syndrome.Did you miss us? We're back for Season 2 of What’s it Worth! Join your host, Dr. Diana Langworthy, and co-host Garrison (Griest) Avery (back at the end of his APPE year for some more EBP fun!), as they find out if phenobarbital is beating benzos in severe alcohol withdrawal! CI-WAt all the fuss is about in season two as we PAWSS and reflect on where single-site retrospective results and clinical takeaways can meet! Key Points Alcohol withdrawal syndrome is a complex process involving acute imbalances in excitatory and inhibitory neurotransmitters in the CNS that...2024-03-1943 minWhat's it Worth? A Journal Club Podcast[BONUS] S1E11 - Pegfilgrastim Equivalence Chronicles: Is The Margin Razor Thin?Welcome to What’s it Worth - BONUS episode #2! Join your host Dr. Diana Langworthy and a come-back by P4 student co-host Marina Fahim as we get biosimilar! Our expert guest for this episode is Dr. Hannah Berg, Formulary Management Pharmacist at United Healthcare. We're discussing a trial that aimed to determine whether pegfilgrastim biosimilars were considered statistically equivalent to the pegfilgrastim originator product. Biosimilars have the potential to offer cost-savings for patients requiring these expensive agents as they can introduce market competition and a potentially cheaper alternative to originator products. This bonus episode also coincides with a Jour...2023-11-2234 minWhat's it Worth? A Journal Club Podcast[BONUS] S1E10 - The Scoop on Poop! Fecal Microbiota Therapy for Reducing Recurrence of CDiff InfectionsWelcome to What’s it Worth - a BONUS episode! Join your host Dr. Diana Langworthy and a come-back by P4 student co-host Garrison Griest as we get the scoop on poop! Our expert guest for this episode is Dr. Jen Ross, Antimicrobial Stewardship Clinical Pharmacist at M Health Fairview East and West Bank Hospitals. We're discussing a trial that evaluated the efficacy of a new orally administered fecal microbiota transplant capsule - SER-109. This episode coincides with a Journal Club assignment that students in my Evidence Based Practice course completed last week - Hello PHAR6782 Students! Grea...2023-11-2141 minWhat's it Worth? A Journal Club PodcastS1E9 - Co-Primary Clues: Zavegepant's Journey in Migraine ManagementWelcome to What’s it Worth! Join your host Dr. Diana Langworthy as we co-mingle with co-primary clues! Our expert guest for this episode is Dr. Natalie Heinrich, Medication Therapy Management Clinical Pharmacist in Neurology at M Health Fairview. We're discussing a trial evaluated the efficacy of zavegepant, a novel CGRP antagonist for nasal administration, for the treatment of acute migraine attack. Join us as we discuss the key points of co-primary outcomes, populations and power. Key Points Migraine disease affects 1 in 6 Americans and is a leading cause of disability Triptan medications have been used...2023-11-0626 minWhat's it Worth? A Journal Club PodcastS1E8 - ATTACK-ing Non-Inferiority Trials and Margins: Sulbactam-Durlobactam for Acinetobacter InfectionsWelcome to What’s it Worth! Join your host Dr. Diana Langworthy, & co-host Marina Fahim, as we ATTACK the critique of a non-inferiotiy study design. Our expert guest for this episode is Dr. Betsy Hirsch, Assoiate Professor and Infectious Diseases Translational Researcher. We're discussing a trial that compared a new beta-lactam antibiotic, sulbactam/durlobactam, with colistin for the treatment of Acinetobacter baumannii infections. Join us as we discuss the key points of a non-inferiority trial design as we determine what this article is worth! Key Points Non-inferiority (NI) trials are indicated when there are othe...2023-10-0454 minWhat's it Worth? A Journal Club PodcastS1E7 - Breaking Down Delphi: A qualitative implementation study on clinical pharmacist impactWelcome to What’s it Worth! Join your host, Dr. Diana Langworthy and co-host Chelsea Bolier, PharmD, as we break down Delphi and learn more about analyzing qualitatitve data. We're joined this month by Dr. Joel Farley, PhD and Dr. Pamela Phelps, PharmD, FASHP - two experts in the arena of determining the impact of clinical pharmacy services. Key Points Determining the impact of clinical pharmacist interventions is a complex and site specific process The Delphi (or modified Delphi) process is intended for use to answer a qualitative research question through consensus building among experts A...2023-09-1135 minWhat's it Worth? A Journal Club PodcastS1E6 - Going Retro to Tackle Confounding: Assessing Risk of SBP from PPI use in CirrhosisWelcome to What’s it Worth! Join your hosts, Dr. Diana Langworthy & Garrison Griest as we go retro to tackle confounding variables! We'll be reviewing an article that aimed to determine the risk of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis who are using proton pump inhibitors (PPIs). Key Points Retrospective studies produce more opportunities for confounding variables to impact study results Proton pump inhibitors are widely used and overused for acid reflux disease and have been associated with several risks Odds ratios calculated for retrospective cohort studies determine associations between an intervention and...2023-08-1141 minWhat's it Worth? A Journal Club PodcastS1E5 - Seeing composite outcomes CLEAR-ly: Bempedoic acid versus placebo for preventing Major Adverse Cardiovascular Outcomes08Welcome to What’s it Worth! Join your hosts, Dr. Diana Langworthy, Nathan Uk, and Garrison Griest as we walk you through composite outcomes with the CLEAR trial - a comparison of bempedoic acid versus placebo for preventing major adverse cardiovascular events (MACE) in patients who cannot tolerate statin therapy. We're joined by Dr. Chrystian Pereira, PharmD, BCACP, an ambulatory care pharmacist at the Smiley's Family Medicine Clinic in South Minneapolis, MN. Key Points Statins play a key role in prevention of major cardiovascular events (MACE), yet not all patients tolerate them Bempedoic acid may hav...2023-07-0544 minWhat's it Worth? A Journal Club PodcastS1E4 - TBD on CBD?: A placebo-controlled RCT of CBD in COVID-19Welcome to What’s it Worth! Join your hosts, Dr. Diana Langworthy, Nathan Uk, and Garrison Griest as we take on the evidence behind a trending treatment for COVID-19. Our guest, Dr. Ann Philbrick, PharmD, BCACP, will share her expertise with medical cannabis products to help figure out what is TBD about CBD in COVID-19. Key Points Cannabidiol (CBD) has some purported anti-inflammatory properties from in-vitro studies and was investigated to prevent progression of COVID-19 to moderate or severe disease Pharmacists can use their EBP skills to serve as information experts to prevent progression of inf...2023-06-0540 minWhat's it Worth? A Journal Club PodcastS1E3 - Strength in Numbers: Understanding event driven power with the STRONG-HF trialWelcome to What’s it Worth! Join your host, Dr. Diana Langworthy as we’re strengthening our EBP skills in power and subject allocation with the STRONG-HF trial - a prospective, randomized, open-label study comparing high-intensity titration to guideline-directed medical therapy vs usual cares in patients with recent heart failure exacerbations. Special guest - Dr. Christian Bell, PharmD and PGY1 Pharmacy Practice Resident at M Health Fairview. Key Points Critique of subject allocation in clinical trials helps practitioners understand key balancing characteristics between study groups Evaluating the outcomes to determine clinical relevance is key in determining how t...2023-05-0840 minWhat's it Worth? A Journal Club PodcastS1E1 - The Power of Rates and Flows: Aggressive vs. moderate hydration in acute pancreatitisWelcome to What’s it Worth! Join Dr. Diana Langworthy, Garrison Griest, and Nathan Uk for our first episode where we go down the WATERFALL and take a deep dive into the details of a prospective, open-label trial comparing aggressive and moderate fluid resuscitation strategies in the initial treatment of acute pancreatitis. Key Points Aggressive fluid resuscitation has historically been preferred in the treatment of acute pancreatitis There is conflicting evidence as to whether aggressive or moderate resuscitation is the safest and most effective approach in patients with acute pancreatitis Statistical power is an important concept to...2023-04-2433 minWhat's it Worth? A Journal Club PodcastS1E2 - Taking the Pain out of Feasibility Trials: A pilot study evaluating medical cannabis for cancer-related painBONUS EPISODE! We're dropping Episode 2 early so you have even more journal critique music to your ears. Welcome back to What’s it Worth! Today we soar through the topics of pilot studies, medical cannabis, and cancer related pain. We are joined by Dr. Kirollos Hanna, Director of Pharmacy at Minnesota Oncology, as we attempt to take the pain out of assessing feasibility trials. Key Points Pilot studies are conducted to determine whether a large-scale trial would be feasible Cancer-related pain can be challenging to manage and additional approaches to multimodal pain management are nee...2023-04-1347 min