What's it Worth? A Journal Club Podcast

About What's it Worth? A Journal Club Podcast

Get into the weeds with us as we take deep dives into clinical trials and build the essential skills of evidence critique! This podcast is a tool for healthcare professions students and practitioners to sharpen their science sleuth skills, learn key concepts about study design, biostatistics, and application of evidence to clinical practice.

Publisher

Diana Langworthy

Category

health & fitness

Language

en

Explicit

No

First episode

13 Apr 2023

Latest episode

23 Sept 2026

Latest episodes

46 episodes in the feed.

1. 

   23 Sept 2026

   S4E11 - Letermovir vs Valganciclovir: A Noninferiority Trial in Kidney Transplant CMV

   Cytomegalovirus — or CMV — is one of those transplant complications that sits at the intersection of infectious diseases, immunosuppression, medication access, monitoring, and toxicity. In high-risk kidney transplant recipients, valganciclovir has long been a standard prophylaxis option, but its use can be limited by myelosuppression, renal dose adjustments, and real-world logistics. In this episode, host Dr. Diana Langworthy is joined by Erin Hellickson, PharmD and Alyson Prom, PharmD, inpatient solid organ transplant pharmacists at Fairview – East Bank Hospital. Together, they decode a 2023 JAMA randomized, noninferiority clinical trial comparing letermovir with valganciclovir for CMV prophylaxis in high-risk kidney transplant recipients. The clinical question: can letermovir provide similar CMV protection with less myelosuppression — and where might it fit in a complex transplant prophylaxis toolbox? Key Points CMV risk is highest in donor-positive/recipient-negative transplant recipients. Universal prophylaxis and preemptive monitoring each come with tradeoffs. Valganciclovir works, but myelosuppression and renal dose changes can complicate use. Letermovir offers a different CMV mechanism without the same renal dosing burden. Letermovir does not cover HSV or VZV, so prophylaxis decisions do not disappear. This trial used a double-masked, double-dummy noninferiority design. The 10% noninferiority margin, adherence patterns, and missing data approach are worth a closer look. Leukopenia, neutropenia, G-CSF use, resistance, and discontinuation rates shape the safety story. Does letermovir move from "alternative" to a future first-line prophylaxis option in kidney transplant — or is the answer still "it depends"? ----> Tune in to find out! Featured Study Limaye AP, Budde K, Humar A, Vincenti F, Kuypers DRJ, Carroll RP, Stauffer N, Murata Y, Strizki JM, Teal VL, Gilbert CL, Haber BA. Letermovir vs Valganciclovir for Prophylaxis of Cytomegalovirus in High-Risk Kidney Transplant Recipients: A Randomized Clinical Trial. JAMA. 2023;330(1):33-42. doi:10.1001/jama.2023.9106. Host & Guest Information Diana Langworthy, PharmD, BCPS | Associate Professor, University of Minnesota College of Pharmacy | Clinical Pharmacist, Inpatient Internal Medicine, M Health Fairview East Bank Hospital Erin Hellickson, PharmD | Inpatient Solid Organ Transplant Pharmacist, Fairview – East Bank Hospital Alyson Prom, PharmD | Inpatient Solid Organ Transplant Pharmacist, Fairview – East Bank Hospital Join the Conversation Have a study you'd like us to decode on a future episode? Email whatsitworthpodcast@gmail.com or share how you're navigating evidence in practice — I love hearing how clinicians and learners think through uncertainty. Or you can find me on my socials — check out my Beacons for links to my TikTok and LinkedIn: https://beacons.ai/diana.the.pharm.d.etective Additional References Kotton CN, Kumar D, Manuel O, Chou S, Hayden RT, Danziger-Isakov L, Asberg A, Tedesco-Silva H, Humar A; Transplantation Society International CMV Consensus Group. The Fourth International Consensus Guidelines on the Management of Cytomegalovirus in Solid Organ Transplantation. Transplantation. 2025;109(7):1066-1110. doi:10.1097/TP.0000000000005374. Kotton CN, Kumar D, Caliendo AM, et al.; The Transplantation Society International CMV Consensus Group. The Third International Consensus Guidelines on the Management of Cytomegalovirus in Solid-organ Transplantation. Transplantation. 2018;102(6):900-931. doi:10.1097/TP.0000000000002191. Humar A, Lebranchu Y, Vincenti F, et al. The efficacy and safety of 200 days valganciclovir cytomegalovirus prophylaxis in high-risk kidney transplant recipients. American Journal of Transplantation. 2010;10(5):1228-1237. doi:10.1111/j.1600-6143.2010.03074.x. Paya C, Humar A, Dominguez E, et al.; Valganciclovir Solid Organ Transplant Study Group. Efficacy and safety of valganciclovir vs oral ganciclovir for prevention of cytomegalovirus disease in solid organ transplant recipients. American Journal of Transplantation. 2004;4(4):611-620. doi:10.1111/j.1600-6143.2004.00382.x. Rissling O, Naik M, Brakemeier S, et al. High frequency of valganciclovir underdosing for cytomegalovirus prophylaxis after renal transplantation. Clinical Kidney Journal. 2018;11(4):564-573. doi:10.1093/ckj/sfx145.

2. 

   11 Aug 2026

   S4E10 - Watchman Vs. DOACs for Prevention of Stroke & Systemic Embolism

   Stroke prevention in atrial fibrillation is always a balancing act: reduce clot risk without causing unacceptable bleeding. For years, oral anticoagulants have been the cornerstone of that decision. But what happens when a device enters the conversation? In this episode, host Dr. Diana Langworthy is joined by Dr. Jen Osborn, cardiology clinical pharmacy specialist at UMMC East Bank Hospital and residency program director for the PGY2 Thrombosis and Hemostasis Management Residency. Together, they decode the CHAMPION-AF trial, a 2026 New England Journal of Medicine study comparing left atrial appendage closure with the Watchman FLX device versus NOAC therapy for stroke prevention in atrial fibrillation. The Watchman device is designed to close off the left atrial appendage, a site where blood can pool and clot in patients with atrial fibrillation. But device-based stroke prevention is not as simple as "procedure instead of blood thinner." Patients still need antithrombotic therapy after implantation, and the procedure itself carries risks. So how should clinicians interpret a noninferiority trial comparing a permanent device to long-term anticoagulation? Key Points Atrial fibrillation creates a long-term need to balance stroke prevention and bleeding risk. The left atrial appendage (LAA) occlusion device (brand name Watchman) offers a non-medication approach to left atrial appendage closure. CHAMPION-AF compared the LAA occlusion device (brand name Watchman FLX) with direct acting oral anticoagulants or DOACs (also referred to in the episode as Novel Oral Anticoagulants or NOACs) therapy in patients considered candidates for anticoagulation. We discuss why noninferiority trials require careful attention to margins, event rates, and analysis populations. We explore why procedure-related bleeding, post-device antithrombotic therapy, and crossover matter. We consider where pharmacists fit in optimizing DOAC selection, dosing, adherence, and bleeding risk mitigation. Does CHAMPION-AF expand the role of left atrial appendage closure — or do the details make the story more complicated? ----> Tune in to find out! Featured Study Doshi SK, Kar S, Nair DG, et al.; CHAMPION-AF Investigators. Left Atrial Appendage Closure or Anticoagulation for Atrial Fibrillation. New England Journal of Medicine. Published online March 28, 2026. doi:10.1056/NEJMoa2517213. Host & Guest Information Diana Langworthy, PharmD, BCPS | Associate Professor, University of Minnesota College of Pharmacy | Clinical Pharmacist, Inpatient Internal Medicine, M Health Fairview East Bank Hospital Jen Osborn, PharmD | Cardiology Clinical Pharmacy Specialist, UMMC East Bank Hospital | Residency Program Director, PGY2 Thrombosis and Hemostasis Management Residency Join the Conversation Have a study you'd like us to decode on a future episode? Email whatsitworthpodcast@gmail.com or share how you're navigating evidence in practice — I love hearing how clinicians and learners think through uncertainty. Or you can find me on my socials — check out my Beacons for links to my TikTok and LinkedIn: https://beacons.ai/diana.the.pharm.d.etective Additional References Joglar JA, Chung MK, Armbruster AL, et al. 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: A report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. Published online November 30, 2023. doi:10.1161/CIR.0000000000001193. The guideline upgraded left atrial appendage occlusion devices to a Class 2a recommendation for patients with long-term contraindications to anticoagulation. Lip GYH, Banerjee A, Boriani G, et al. Antithrombotic Therapy for Atrial Fibrillation: CHEST Guideline and Expert Panel Report. Chest. 2018;154(5):1121-1201. doi:10.1016/j.chest.2018.07.040. CHEST recommends oral anticoagulation for patients at high stroke risk, including CHA₂DS₂-VASc ≥2 in males or ≥3 in females. Holmes DR, Reddy VY, Turi ZG, et al.; PROTECT AF Investigators. Percutaneous closure of the left atrial appendage versus warfarin therapy for prevention of stroke in patients with atrial fibrillation: A randomised non-inferiority trial. Lancet. 2009;374(9689):534-542. doi:10.1016/S0140-6736(09)61343-X. This original Watchman trial randomized 707 patients 2:1 to left atrial appendage closure versus warfarin. Holmes DR Jr, Kar S, Price MJ, et al. Prospective randomized evaluation of the Watchman Left Atrial Appendage Closure device in patients with atrial fibrillation versus long-term warfarin therapy: The PREVAIL trial. Journal of the American College of Cardiology. 2014;64(1):1-12. doi:10.1016/j.jacc.2014.04.029. PREVAIL was designed to further assess Watchman safety and efficacy after PROTECT AF identified a periprocedural safety hazard. Ray WA, Chung CP, Stein CM, et al. Association of Rivaroxaban vs Apixaban With Major Ischemic or Hemorrhagic Events in Patients With Atrial Fibrillation. JAMA. 2021;326(23):2395-2404. doi:10.1001/jama.2021.21222. In Medicare beneficiaries 65 years or older with atrial fibrillation, rivaroxaban initiation was associated with higher major ischemic or hemorrhagic events compared with apixaban.

3. 

   28 Jul 2026

   S4E9 - Anxiety Treatment Rankings: What a Network Meta-Analysis Can and Can't Tell Us

   Welcome back to What's it Worth? In this episode, we tackle treatment options for a common mental health concern - anxiety. Your host, Dr. Diana Langworthy, is joined by Dr. Lucas Kosobuski, an inpatient pharmacist at St. Luke's in Duluth with prior experience providing ambulatory care services in an inpatient substance use treatment program. Together, they decode a 2025 systematic review and network meta-analysis comparing medications for anxiety disorders, including Silexan, a proprietary oral lavender oil preparation. As over-the-counter options gain attention, clinicians and patients are left with important questions: How strong is the evidence? What does "acceptable" really mean? And when a supplement ranks favorably in a network meta-analysis, how much confidence should we have? Key Points This systematic review and network meta-analysis evaluated anxiolytic medications across multiple anxiety disorders. The study included 100 randomized controlled trials and more than 28,000 patients. Silexan was represented by a much smaller subset of the overall evidence base in this paper. We discuss the difference between generalized anxiety disorder and situational/short term anxiety. We break down what a network meta-analysis can — and cannot — tell us and why definitions in these studies matter SO much! Is Silexan a meaningful option for anxiety, or is the ranking stronger than the evidence behind it? ———> Tune in to find out! Episode Study Müller TJ, Künzi A, Heitlinger E, et al. Comparative efficacy and acceptability of anxiolytic drugs for the treatment of anxiety disorders: a systematic review and network meta-analysis. Eur Arch Psychiatry Clin Neurosci. 2026;276:1879–1894. doi:10.1007/s00406-025-02082-0 Host & Guest Information Diana Langworthy, PharmD, BCPS | Associate Professor, University of Minnesota College of Pharmacy | Clinical Pharmacist -Inpatient Internal Medicine, M Health Fairview East Bank Hospital Lucas Kosobuski, PharmD | Inpatient Pharmacist, St. Luke's, Duluth | Prior ambulatory care experience in an inpatient substance use treatment program Join the Conversation Have a study you'd like us to decode on a future episode? Email whatsitworthpodcast@gmail.com or share how you're navigating evidence in practice — I love hearing how clinicians and learners think through uncertainty. Or you can find me on my socials — check out my Beacons for links to my TikTok and LinkedIn: https://beacons.ai/diana.the.pharm.d.etective Additional References National Institute for Health and Care Excellence. Generalised anxiety disorder and panic disorder in adults: management. NICE Clinical Guideline CG113. Last updated June 15, 2020. Bandelow B, Allgulander C, Baldwin DS, et al. World Federation of Societies of Biological Psychiatry guidelines for treatment of anxiety, obsessive-compulsive and posttraumatic stress disorders – Version 3. Part I: Anxiety disorders. World J Biol Psychiatry. 2023;24(2):79-117. doi:10.1080/15622975.2022.2086295. Kasper S, Gastpar M, Müller WE, et al. Lavender oil preparation Silexan is effective in generalized anxiety disorder — a randomized, double-blind comparison to placebo and paroxetine. Int J Neuropsychopharmacol. 2014;17(6):859–869. doi:10.1017/S1461145714000017. Woelk H, Schläfke S. A multi-center, double-blind, randomised study of the lavender oil preparation Silexan in comparison to lorazepam for generalized anxiety disorder. Phytomedicine. 2010;17(2):94–99. doi:10.1016/j.phymed.2009.10.006. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR. 5th ed., text rev. Washington, DC: American Psychiatric Association Publishing; 2022. doi:10.1176/appi.books.9780890425787.

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Public platform figures. Ratings count people who left a rating, not total listeners.

Apple Podcasts (US)

5.0 / 5

10 ratings

Spotify

4.4 / 5

13 ratings

Podcast Authority Score: 30 / 100

A composite of feed quality, social presence, YouTube performance and engagement. Read the methodology.

Quality

31

Social presence

0

YouTube

0

Engagement

71

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