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.
What's it Worth? A Journal Club Podcast
Claim This Podcastby Diana Langworthy
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42 episodes
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Podcast Overview
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.
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4/13/2023
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Recent Episodes
July 21, 2026
S4E8 - Is it Possible to Decouple Bleeding from Clotting? Insights from the AZALEA-TIMI 71 Trial (Factor XI Series Part 2 of 2)
<p data-path-to-node="4">In Part 2 of our back-to-back series on the novel frontier of Factor XI inhibition, host <strong data-path-to-node="4" data-index-in-node="89">Dr. Diana Langworthy</strong> and student co-hosts <strong data-path-to-node= "4" data-index-in-node="131">Caleb Nelson-Lange</strong> and <strong data-path-to-node="4" data-index-in-node="154">Tim Haas</strong> dive into the <strong data-path-to-node="4" data-index-in-node="177">AZALEA-TIMI 71</strong> trial.</p> <p data-path-to-node="5">Following our Part 1 discussion on the early termination of the OCEANIC-AF trial (asundexian), we turn our attention to <strong data-path-to-node="5" data-index-in-node= "120">abelacimab</strong>—a high-affinity, fully human monoclonal antibody that targets Factor XI. Unlike the small-molecule asundexian, abelacimab offers a unique pharmacokinetic profile with a once-monthly dosing potential. We explore safety outcomes of this novel agent.</p> <p data-path-to-node="6">The team also tackles a crucial Pharmacy Detective Moment: Why did the study use <strong data-path-to-node="6" data-index-in-node= "74">rivaroxaban</strong> as the comparator instead of apixaban? We discuss how this choice impacts the "Worth" of the findings...</p> <h3 data-path-to-node="7"><strong data-path-to-node="7" data-index-in-node="0">Key Takeaways</strong></h3> <ul> <li data-path-to-node="8,0,0">Factor XI sits at the intersection of the intrinsic and common pathways. By inhibiting it, can we stop pathologic thrombosis while leaving "protective" hemostasis intact?</li> <li data-path-to-node="8,0,0">Abelacimab (both 90mg and 150mg) achieved a staggering reduction in the primary outcome compared to rivaroxaban —<strong>a composite of major and clinically relevant non-major bleeding</strong>—with hazard ratios of <strong data-path-to-node="8,1,0" data-index-in-node= "201">0.33</strong> and <strong data-path-to-node="8,1,0" data-index-in-node="210">0.26</strong>, respectively.</li> <li data-path-to-node="8,1,0">Why rivaroxaban? We dissect the strategic selection of a once-daily Xa inhibitor with a known higher GI bleeding profile and how it influences the trial's dramatic safety margin.</li> <li data-path-to-node="8,4,0">Was the early termination a win for patients or a loss for long-term efficacy data? ---> <strong data-path-to-node="8,4,0" data-index-in-node= "89">Tune in to find out!</strong></li> </ul> <h3 data-path-to-node="9"><strong data-path-to-node="9" data-index-in-node="0">Featured Study</strong></h3> <p data-path-to-node="10">Ruff, C. T., Patel, S. M., Giugliano, R. P., Morrow, D. A., Hug, B., Kuder, J. F., Goodrich, E. L., Chen, S. A., Goodman, S. G., Joung, B., Kiss, R. G., Spinar, J., Wojakowski, W., Weitz, J. I., Murphy, S. A., Wiviott, S. D., Parkar, S., Bloomfield, D., & Sabatine, M. S. (2024). Abelacimab versus rivaroxaban in patients with atrial fibrillation. New England Journal of Medicine, 391(1), 21-33. <!----><!----><!----> <!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><a class="ng-star-inserted" href="https://doi.org/10.1056/NEJMoa2406674" target="_blank" rel= "noopener">https://doi.org/10.1056/NEJMoa2406674</a><!----><!----> <!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----></p> <h3 data-path-to-node="11"><strong data-path-to-node="11" data-index-in-node="0">Host</strong></h3> <p data-path-to-node="12"><strong data-path-to-node="12" data-index-in-node="0">Diana Langworthy, PharmD, BCPS</strong> | Associate Professor, University of Minnesota College of Pharmacy | Clinical Pharmacist, Inpatient Internal Medicine, M Health Fairview East Bank Hospital</p> <h3 data-path-to-node="13"><strong data-path-to-node="13" data-index-in-node="0">Student Co-Hosts</strong></h3> <p data-path-to-node="14"><strong data-path-to-node="14" data-index-in-node="0">Caleb Nelson-Lange</strong> | PharmD Candidate | Class of 2026 | University of Minnesota College of Pharmacy</p> <p data-path-to-node="15"><strong data-path-to-node="15" data-index-in-node="0">Tim Haas</strong> | PharmD Candidate | Class of 2028 | University of Minnesota College of Pharmacy</p> <h2 data-start="3538" data-end="3566"><strong data-start="3541" data-end="3566">Join the Conversation</strong></h2> <p>Have a study you'd like us to decode on a future episode?<br data-start="3625" data-end="3628" /> Email <strong data-start="3634" data-end="3667"><a class= "decorated-link cursor-pointer" rel="noopener" data-start="3636" data-end="3665">whatsitworthpodcast@gmail.com</a></strong> or share how you're navigating evidence in practice—I love hearing how clinicians and learners think through uncertainty.</p> <p>Or you can find me on my socials - Check out my Beacons for links to my TikTok and LinkedIn</p> <p>https://beacons.ai/diana.the.pharm.d.etective</p> <p><strong data-start="2266" data-end="2304">Additional References & Guidelines</strong></p> <ol> <li>Piccini, J. P., Patel, M. R., Steffel, J., et al. (2025). Asundexian versus apixaban in patients with atrial fibrillation. New England Journal of Medicine, 392(1), 23-32. <!----><!----><!----> <!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><a href="https://doi.org/10.1056/NEJMoa2411777">https://doi.org/10.1056/NEJMoa2411777</a></li> <li>Cohen, A. T., Hill, N. R., Luo, X., et al. (2024). A systematic review and network meta-analysis of the comparative safety of direct oral anticoagulants in patients with atrial fibrillation. Journal of Comparative Effectiveness Research, 13(2), 45-58. <!----><!----><!----> <!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><a href="https://doi.org/10.2217/cer-2023-0182">https://doi.org/10.2217/cer-2023-0182</a></li> <li>Joglar, J. A., Chung, M. K., Armbruster, A. L., et al. (2024). 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of patients with atrial fibrillation. Journal of the American College of Cardiology, 83(1), 109-279. <!----><!----><!----><!----><!----> <!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><a class="ng-star-inserted" href="https://doi.org/10.1016/j.jacc.2023.08.017" target="_blank" rel="noopener">https://doi.org/10.1016/j.jacc.2023.08.017</a></li> </ol>
July 14, 2026
S4E8.5 - What's it Worth? For Everyone. Are We Waiting Too Long for New Treatments?
<p><strong>In this What's It Worth? For Everyone episode, we're asking: Are we waiting too long for new treatments?</strong></p> <p>If you've ever heard about a promising new medication, peptide, or breakthrough therapy and wondered, "If it works so well, why isn't everyone using it yet?"—you're not alone.</p> <p>It can feel frustrating to hear about exciting discoveries while waiting years before they become part of routine healthcare.</p> <p>In this episode, we take you behind the scenes of the scientific process to explore what happens between an exciting idea and a treatment that is recommended for patients. Along the way, we use recent blood thinner research as a real-world example of why asking the right questions—and taking the time to answer them—matters.</p> <h2>Key Takeaways</h2> <ul> <li> <p>A promising scientific idea is not the same as a proven treatment.</p> </li> <li> <p>Clinical trials help researchers answer two critical questions: <strong>Does it work?</strong> and <strong>Is it safe?</strong></p> </li> <li> <p>Many exciting discoveries change as they are studied in larger groups of people.</p> </li> <li> <p>The goal of the scientific process is not to slow innovation—it is to help ensure new treatments provide meaningful benefits while minimizing harm.</p> </li> <li> <p>Progress in medicine depends on both curiosity and careful testing.</p> </li> </ul> <h2>Questions Worth Asking</h2> <p>Use these questions to help guide conversations with your healthcare team when you hear about a new treatment:</p> <ul> <li> <p>How strong is the evidence supporting this treatment?</p> </li> <li> <p>Has it been studied in people, or only in laboratory or animal studies?</p> </li> <li> <p>What are the known benefits?</p> </li> <li> <p>What are the known risks?</p> </li> <li> <p>How does it compare with treatments that are already available?</p> </li> <li> <p>Is this treatment appropriate for someone with my medical history?</p> </li> </ul> <p>New discoveries are exciting—and they are how medicine moves forward. But every promising idea deserves careful testing before it becomes routine care.</p> <p>The goal isn't simply to bring new treatments to patients faster. It's to bring forward treatments that have been shown to make a meaningful difference in people's lives.</p> <p>This episode is for educational purposes only and is not medical advice. It does not replace care from your own healthcare team.</p> <p><strong>🎙️Host:</strong> Diana Langworthy, PharmD, BCPS | Associate Professor at the University of Minnesota College of Pharmacy | Clinical Pharmacist in Adult Internal Medicine, Fairview East Bank Hospital</p> <hr /> <p>📬 Enjoyed this episode? Find more evidence-based content, podcast episodes, social media, and ways to connect at <strong><a href= "https://beacons.ai/diana.the.pharm.d.etective">https://beacons.ai/diana.the.pharm.d.etective</a></strong>.</p>
July 14, 2026
S4E8 - Why Efficacy Matters: Dissecting the Early Termination of Asundexian (Factor XI Series Part 1 of 2)
<p data-path-to-node="5">Welcome to Part 1 of our "What's it Worth?" deep dive into the next generation of anticoagulation. In this episode, host <strong data-path-to-node="5" data-index-in-node="121">Dr. Diana Langworthy</strong> and student co-hosts <strong data-path-to-node="5" data-index-in-node="186">Tim Haas</strong> and <strong data-path-to-node="5" data-index-in-node="163">Caleb Nelson-Lange</strong> take on the <strong data-path-to-node="5" data-index-in-node= "226">OCEANIC-AF</strong> trial.</p> <p id="p-rc_410d77c8c2ce12be-155" data-path-to-node="6"> <span data-path-to-node="6,0">This Phase 3, non-inferiority trial was designed to prove that the oral Factor XIa inhibitor, asundexian, could match the gold-standard apixaban in preventing stroke while significantly reducing bleeding.</span> <span data-path-to-node="6,2"><span class="citation-367">However, the trial took a dramatic turn when it was stopped early—not for safety, but for</span> <strong data-path-to-node="6,2" data-index-in-node="90"><span class= "citation-367">futility</span></strong> <span class= "citation-367"><strong>in efficacy</strong></span></span><span class= "citation-367 citation-end-367"><sup class="superscript" data-turn-source-index="1"><!----></sup><sup class="superscript" data-turn-source-index="1"><!----></sup><sup class="superscript" data-turn-source-index="1"><!----></sup> <sup class="superscript" data-turn-source-index="1"> <!----></sup></span><span data-path-to-node="6,4">. We unpack why asundexian failed to clear the non-inferiority hurdle and what this means for the "Factor XI hypothesis.</span></p> <p data-path-to-node="6">In this episode, we move past the excitement of a "bleeding-free" anticoagulant to look at the clinical necessity of efficacy. We explore the challenge of going head-to-head with apixaban—widely considered the safest and most effective agent in our current toolkit—and discuss whether the "Factor XI hypothesis" was flawed or if the bar was simply set too high for this specific molecule.</p> <p data-path-to-node="6"><strong data-path-to-node="8" data-index-in-node="0">Key Takeaways</strong></p> <ul> <li><span data-path-to-node="9,0,1,0"><span class= "citation-364">OCEANIC-AF was halted because asundexian was</span> <strong data-path-to-node="9,0,1,0" data-index-in-node= "140"><span class="citation-364">inferior</span></strong> <span class="citation-364">to apixaban for preventing stroke and systemic embolism</span></span><span class= "citation-364 citation-end-364"><sup class="superscript" data-turn-source-index="4"><!----></sup><sup class="superscript" data-turn-source-index="4"><!----></sup><sup class="superscript" data-turn-source-index="4"><!----></sup> <sup class="superscript" data-turn-source-index="4"> <!----></sup></span><span data-path-to-node="9,0,1,2">.</span> <!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----></li> <li id="p-rc_410d77c8c2ce12be-158" data-path-to-node="9,1,1"> <span data-path-to-node="9,1,1,0"><span class="citation-363">In this trial, asundexian went head-to-head with </span><strong data-path-to-node="9,1,1,0" data-index-in-node="69"><span class= "citation-363">apixaban</span></strong><span class="citation-363">, the current market leader for safety and efficacy</span></span><span class= "citation-363 citation-end-363"><sup class="superscript" data-turn-source-index="5"><!----></sup> <sup class="superscript" data-turn-source-index="5"> <!----></sup></span><span data-path-to-node= "9,1,1,2">. </span></li> <li id="p-rc_410d77c8c2ce12be-158" data-path-to-node="9,1,1"> <span data-path-to-node="9,3,1,0"><span class="citation-360">While asundexian showed numerical trends toward less bleeding, those gains were overshadowed by the increased risk of ischemic events compared to standard-of-care apixaban</span></span><span class= "citation-360 citation-end-360"><sup class="superscript" data-turn-source-index="8"><!----></sup><sup class="superscript" data-turn-source-index="8"><!----></sup><sup class="superscript" data-turn-source-index="8"><!----></sup> <sup class="superscript" data-turn-source-index="8"> <!----></sup></span><span data-path-to-node="9,3,1,2">.</span> <!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----></li> <li data-path-to-node="9,4,0">Is the Factor XI class dead on arrival, or was asundexian just the wrong molecule? ---> <strong data-path-to-node="9,4,0" data-index-in-node="88">Tune in to find out!</strong></li> </ul> <h3 data-path-to-node="10"><strong data-path-to-node="10" data-index-in-node="0">Episode Resources</strong></h3> <ul> <li><strong data-path-to-node="10" data-index-in-node="0">Link to the Coagulation Cascade:</strong> <a href= "https://www.bleeding.org/educational-programs/education/online-education/the-clotting-cascade"> https://www.bleeding.org/educational-programs/education/online-education/the-clotting-cascade</a></li> </ul> <h3 data-path-to-node="10"><strong data-path-to-node="10" data-index-in-node="0">Featured Study</strong></h3> <p id="p-rc_410d77c8c2ce12be-161" data-path-to-node="11"> <span data-path-to-node="11,0">Piccini, J. P., Patel, M. R., Steffel, J., Ferdinand, K., Van Gelder, I. C., Russo, A. M., ... & OCEANIC-AF Steering Committee and Investigators. (2025). Asundexian versus apixaban in patients with atrial fibrillation.</span> <span data-path-to-node= "11,2"><span class="citation-359">New England Journal of Medicine</span><span class="citation-359">,</span> <span class= "citation-359">392</span><span class="citation-359">(1), 23–32.</span></span> <span class= "citation-359 citation-end-359"><sup class="superscript" data-turn-source-index="9"><!----></sup><sup class="superscript" data-turn-source-index="9"><!----></sup><sup class="superscript" data-turn-source-index="9"><!----></sup><sup class="superscript" data-turn-source-index="9"><!----></sup></span> <span data-path-to-node="11,4"><!----><!----><!----><!----><!----> <!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><a class="ng-star-inserted" href="https://doi.org/10.1056/NEJMoa2407105" target="_blank" rel= "noopener">https://doi.org/10.1056/NEJMoa2407105</a><!----><!----> <!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----></span></p> <p><!----><!----><!----><!----><!----><!----><!----><!----> <!----></p> <h3 data-path-to-node="12"><strong data-path-to-node="12" data-index-in-node="0">Host</strong></h3> <p data-path-to-node="13"><strong data-path-to-node="13" data-index-in-node="0">Diana Langworthy, PharmD, BCPS</strong> | Associate Professor, University of Minnesota College of Pharmacy | Clinical Pharmacist, Inpatient Internal Medicine, M Health Fairview East Bank Hospital</p> <h3 data-path-to-node="14"><span style= "font-size: 12pt;"><strong data-path-to-node="14" data-index-in-node="0">Student Co-Hosts</strong></span></h3> <p data-path-to-node="15"><strong data-path-to-node="15" data-index-in-node="0">Caleb Nelson-Lange</strong> | PharmD Candidate | Class of 2026 | University of Minnesota College of Pharmacy</p> <p data-path-to-node="15"><strong data-path-to-node="15" data-index-in-node="52">Tim Haas</strong> | PharmD Candidate | Class of 2028 | University of Minnesota College of Pharmacy</p> <h2 data-start="3538" data-end="3566"><span style= "font-size: 12pt;"><strong data-start="3541" data-end="3566">Join the Conversation</strong></span></h2> <p data-start="3568" data-end="3789"><span style= "font-size: 10pt;">Have a study you'd like us to decode on a future episode?</span><br data-start="3625" data-end="3628" /> <span style="font-size: 10pt;">Email <strong data-start="3634" data-end="3667"><a class="decorated-link cursor-pointer" rel= "noopener" data-start="3636" data-end= "3665">whatsitworthpodcast@gmail.com</a></strong> or share how you're navigating evidence in practice—I love hearing how clinicians and learners think through uncertainty.</span></p> <p data-start="3568" data-end="3789"><span style= "font-size: 10pt;">Or you can find me on my socials - Check out my Beacons for links to my TikTok and LinkedIn</span></p> <p data-start="3568" data-end="3789"><span style= "font-size: 12pt;"><strong data-start="3541" data-end= "3566">https://beacons.ai/diana.the.pharm.d.etective</strong></span></p> <p data-start="3568" data-end="3789"> </p> <h3 data-path-to-node="16"><span style= "font-size: 10pt;"><strong data-path-to-node="16" data-index-in-node="0">Additional References & Guidelines</strong></span></h3> <ol> <li style="font-size: 10pt;" data-path-to-node="17"><span style= "font-size: 10pt;">Joglar, J. A., Chung, M. K., Armbruster, A. L., et al. (2024). 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of patients with atrial fibrillation. Journal of the American College of Cardiology, 83(1), 109–279. <!----><!----><!----><!----><!----><!----><!----><!----> <!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><a class="ng-star-inserted" href="https://doi.org/10.1016/j.jacc.2023.08.017" target="_blank" rel= "noopener">https://doi.org/10.1016/j.jacc.2023.08.017</a></span></li> <li style="font-size: 10pt;" data-path-to-node="17"><span style= "font-size: 10pt;"><!----><!----><!----><!----><!----><!----> <!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><span data-path-to-node="18,0">Ruff, C. T., Patel, S. M., Giugliano, R. P., et al. (2024). Abelacimab versus rivaroxaban in patients with atrial fibrillation. </span><span data-path-to-node= "18,2"><span class="citation-358">New England Journal of Medicine</span><span class="citation-358">,</span> <span class= "citation-358">391</span><span class="citation-358">(1), 21–33.</span></span> <span class= "citation-358 citation-end-358"><sup class="superscript" data-turn-source-index="10"><!----></sup></span> <span data-path-to-node="18,4"><!----><!----><!----><!----><!----> <!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><!----><a class="ng-star-inserted" href="https://doi.org/10.1056/NEJMoa2406674" target="_blank" rel= "noopener">https://doi.org/10.1056/NEJMoa2406674</a></span></span></li> <li style="font-size: 10pt;" data-path-to-node="17"><span style= "font-size: 10pt;"><span data-path-to-node="19,0">Piccini, J. P., Caso, V., Connolly, S. J., et al. (2022). Safety of the oral factor XIa inhibitor asundexian compared with apixaban in patients with atrial fibrillation (PACIFIC-AF): A multicentre, randomised, double-blind, double-dummy, dose-finding phase 2 study.</span> <span data-path-to-node="19,2"><span class="citation-357">The Lancet</span><span class="citation-357">,</span> <span class= "citation-357">399</span><span class="citation-357">(10333), 1383–1390.</span></span></span></li> </ol> <p><!----><!----><!----><!----><!----><!----><!----><!----> <!----></p>
42 total episodes available
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Deep-dive analytics for What's it Worth? A Journal Club Podcast
Frequently asked questions
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- What is What's it Worth? A Journal Club Podcast?
- How often does this podcast release new episodes?
This podcast updates bi-weekly.
- Where can I listen to this podcast?
This podcast is available on 9 platforms including Apple Podcasts, Spotify, and more. You can also use the RSS feed directly.
- Does this podcast accept guests?
No, this podcast does not typically feature guests.
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