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.

What's it Worth? A Journal Club Podcast is a health podcast hosted by Diana Langworthy, with 45 episodes on record and a Required Pod Score of 80. PitchCentric scores this show on Booking Probability, Listen Score, and live audience signals refreshed every 24 hours.

Diana Langworthy hosts What's it Worth? A Journal Club Podcast, a health show with 45 episodes published.

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  Episode #10

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

  Aug 11, 202642 minS4

  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.

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  Episode #9

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

  Jul 28, 202643 minS4

  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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  What's it Worth? A Journal Club Podcast

  S4E9.5 - What's it Worth? For Everyone. Can Lavender Oil Help Anxiety? What to Know About Silexan

  Jul 28, 202611 min

  *]:pointer-events-auto R6Vx5W_threadScrollVars scroll-mb-[calc(var(--scroll-root-safe-area-inset-bottom,0px)+var(--thread-response-height))] scroll-mt-[calc(var(--header-height)+min(200px,max(70px,20svh)))]" dir="auto" data-turn-id= "request-6a4fb890-323c-83ea-bd01-eed2a278ec97-26" data-turn-id-container= "request-6a4fb890-323c-83ea-bd01-eed2a278ec97-26" data-testid= "conversation-turn-66" data-turn="assistant"> In this What's It Worth? For Everyone episode, we're asking: Can lavender oil help with anxiety? If you've ever felt anxious before a big test, job interview, medical appointment, or major life event, you're not alone. But when is anxiety a normal response to stress — and when is it something more, like generalized anxiety disorder? In this episode, we talk about the difference between short-term situational anxiety and ongoing anxiety symptoms that may need support from a healthcare professional. We also discuss Silexan , a specific oral lavender oil preparation that has been studied for anxiety symptoms and is available in some over-the-counter products. The key question is not simply, "Does lavender help anxiety?" It's: What kind of anxiety are we talking about, what product is being used, and how strong is the evidence? Key Takeaways Anxiety surrounding a stressful event can be normal, even when it feels uncomfortable. Generalized anxiety disorder is different from short-term situational anxiety and requires diagnosis by a medical professional. Silexan is a specific, concentrated oral lavender oil preparation, not the same thing as lavender tea, food, scent, or any random lavender supplement. Over-the-counter does not always mean proven, risk-free, or safe for everyone. Product, dose, ingredients, and labeling matter when considering supplements. Ongoing anxiety that affects sleep, concentration, work, relationships, or daily life is worth discussing with a healthcare professional. Questions Worth Asking Use these questions to guide conversations with your pharmacist, clinician, or healthcare team if you are considering an over-the-counter product for anxiety (or for any condition): What ingredients are in this product? Is this the same product and dose that has been studied? Could this interact with anything I take? Is this appropriate for my symptoms? When should I seek more help? Silexan may be an interesting option for some people, but it is not a replacement for diagnosis, therapy, prescription treatment, or ongoing care when those are needed. The goal is not just to take something. The goal is to understand what you are treating and choose a path that is safe, thoughtful, and actually helpful. This episode is for educational purposes only and is not medical advice. It does not replace care from your own healthcare team. ️ Host: Diana Langworthy, PharmD, BCPS | Associate Professor at the University of Minnesota College of Pharmacy | Clinical Pharmacist in Adult Internal Medicine, Fairview East Bank Hospital Enjoyed this episode? Find more evidence-based content, podcast episodes, social media, and ways to connect at https://beacons.ai/diana.the.pharm.d.etective

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  Episode #9

  S4E8 - Is it Possible to Decouple Bleeding from Clotting? Insights from the AZALEA-TIMI 71 Trial (Factor XI Series Part 2 of 2)

  Jul 21, 202619 minS4

  In Part 2 of our back-to-back series on the novel frontier of Factor XI inhibition, host Dr. Diana Langworthy and student co-hosts Caleb Nelson-Lange and Tim Haas dive into the AZALEA-TIMI 71 trial. Following our Part 1 discussion on the early termination of the OCEANIC-AF trial (asundexian), we turn our attention to abelacimab —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. The team also tackles a crucial Pharmacy Detective Moment: Why did the study use rivaroxaban as the comparator instead of apixaban? We discuss how this choice impacts the "Worth" of the findings... Key Takeaways 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? Abelacimab (both 90mg and 150mg) achieved a staggering reduction in the primary outcome compared to rivaroxaban — a composite of major and clinically relevant non-major bleeding —with hazard ratios of 0.33 and 0.26 , respectively. 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. Was the early termination a win for patients or a loss for long-term efficacy data? ---> Tune in to find out! Featured Study 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. https://doi.org/10.1056/NEJMoa2406674 Host Diana Langworthy, PharmD, BCPS | Associate Professor, University of Minnesota College of Pharmacy | Clinical Pharmacist, Inpatient Internal Medicine, M Health Fairview East Bank Hospital Student Co-Hosts Caleb Nelson-Lange | PharmD Candidate | Class of 2026 | University of Minnesota College of Pharmacy Tim Haas | PharmD Candidate | Class of 2028 | University of Minnesota College of Pharmacy 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 & Guidelines 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. https://doi.org/10.1056/NEJMoa2411777 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. https://doi.org/10.2217/cer-2023-0182 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. https://doi.org/10.1016/j.jacc.2023.08.017

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  What's it Worth? A Journal Club Podcast

  S4E8.5 - What's it Worth? For Everyone. Are We Waiting Too Long for New Treatments?

  Jul 14, 202610 minS4

  In this What's It Worth? For Everyone episode, we're asking: Are we waiting too long for new treatments? 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. It can feel frustrating to hear about exciting discoveries while waiting years before they become part of routine healthcare. 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. Key Takeaways A promising scientific idea is not the same as a proven treatment. Clinical trials help researchers answer two critical questions: Does it work? and Is it safe? Many exciting discoveries change as they are studied in larger groups of people. The goal of the scientific process is not to slow innovation—it is to help ensure new treatments provide meaningful benefits while minimizing harm. Progress in medicine depends on both curiosity and careful testing. Questions Worth Asking Use these questions to help guide conversations with your healthcare team when you hear about a new treatment: How strong is the evidence supporting this treatment? Has it been studied in people, or only in laboratory or animal studies? What are the known benefits? What are the known risks? How does it compare with treatments that are already available? Is this treatment appropriate for someone with my medical history? New discoveries are exciting—and they are how medicine moves forward. But every promising idea deserves careful testing before it becomes routine care. 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. This episode is for educational purposes only and is not medical advice. It does not replace care from your own healthcare team. 🎙️Host: Diana Langworthy, PharmD, BCPS | Associate Professor at the University of Minnesota College of Pharmacy | Clinical Pharmacist in Adult Internal Medicine, Fairview East Bank Hospital 📬 Enjoyed this episode? Find more evidence-based content, podcast episodes, social media, and ways to connect at https://beacons.ai/diana.the.pharm.d.etective .

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