American Family Physician

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AFP Journal Club

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AFP Journal Club: Transient Ischemic Attack: The Rules Have Changed - American ...

Jun 15, 2012 - This scientific guideline includes three game changers for physicians regarding TIA. The Journal Club authors discuss why physicians should be wary of clinical guidelines that are based on expert opinion.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2012/0615/p1179.html

AFP Journal Club: The "ARB-MI Paradox": Real or a Fluke? - American Family Physician

Jul 15, 2012 - The Journal Club authors discuss what factors make this meta-analysis, designed to determine whether the ARB-MI paradox is real or a statistical fluke, successful.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2012/0715/p136.html

AFP Journal Club: Can CPOE Systems Decrease Use of Laboratory Studies and Control ...

Sep 15, 2014 - Can computerized physician order entry systems decrease the use of laboratory studies? An intervention's durability (ability to provide sustained results) is important to consider before implementing the intervention based on a study's results.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2014/0915/p409.html

AFP Journal Club: Evidence to Guide Measles Immunization Recommendations - American ...

May 15, 2014 - Although measles vaccination is rarely associated with fever and seizures in children, the benefits of immunization outweigh the risks. Parents should be encouraged to follow recommended immunization schedule and avoid the MMR and varicella combination vaccine.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2014/0515/p786.html

AFP Journal Club: PPIs, Childhood Asthma, and the Problem of Therapeutic Creep - ...

Mar 15, 2014 - The use of a therapy in patients one would intuitively think might benefit, but in whom no benefit has been documented, is called therapeutic creep. The use of proton pump inhibitors for poorly controlled asthma is an example of this phenomenon.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2014/0315/p476.html

AFP Journal Club: Is Intensive Blood Pressure Control Beneficial in Patients with ...

Jan 15, 2014 - It seems to be safe to lower systolic blood pressure to a target of 140 mm Hg in those with an acute hemorrhagic stroke. However, there seems to be no clinical benefit to this approach when the data are adjusted for baseline NIH Stroke Scale scores.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2014/0115/p120.html

AFP Journal Club: Pulmonary Embolism Rule-Out Criteria: A Clinical Decision Rule ...

Jul 15, 2013 - A number of clinical decision rules have been released recently. The PERC rule is an example of one that works well because it was derived from a large number of patients, and it was internally and externally validated.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2013/0715/p98.html

AFP Journal Club: Does Delaying Complementary Foods Protect Children Against ...

Dec 15, 2013 - Breastfeeding duration, rather than exclusivity, may be the most important factor in prevention of atopic diseases. Earlier introduction of foods commonly associated with allergies may help prevent allergic and atopic diseases, but these data are inconclusive.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2013/1215/p818.html

AFP Journal Club: Do Abstracts of Articles in Major Journals Contain the Same ...

Oct 1, 2013 - Physicians should not rely on article abstracts when deciding whether a therapy is good. Abstracts often have misleading information and conclusions. It's important to read the body of the article.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2013/1001/p466.html

AFP Journal Club: Is Rivaroxaban Noninferior to Standard Warfarin Therapy in ...

Jun 15, 2013 - A trial showing that one drug is noninferior to another does not mean that these drugs are equivalent. The noninferiority margin allows researchers to choose their own benchmark for what is considered a clinically significant difference between two drugs.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2013/0615/p872.html

AFP Journal Club: Does Screening Mammography Lead to Overdiagnosis of Invasive ...

Mar 15, 2013 - Implementation of a universal mammographic screening program leads to an increase in the diagnosis of invasive breast cancer, because of improved detection of clinically significant cancer and overdiagnosis.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2013/0315/p408.html

AFP Journal Club: The Use of Coronary Computed Tomography Angiography to Rule Out ...

Nov 15, 2012 - Is coronary CTA good enough to allow for the safe discharge of low- to intermediate-risk patients with chest pain? Coronary CTA and standard care were equally effective at identifying a low-risk population. The test saved seven hospital hours, but at the expense of radiation exposure, ...

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2012/1115/p900.html

AFP Journal Club: How Do Clinical Practice Guidelines Go Awry? - American Family ...

Sep 15, 2012 - Many guidelines are dominated by recommendations from experts and are not based on sound clinical studies. The development of clinical practice guidelines needs to be transparent and devoid of commercial, financial, and political influences. Physicians should also be wary of outdated ...

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2012/0915/p514.html

AFP Journal Club: Rivaroxaban vs. Warfarin for Stroke Prevention in Patients with ...

Mar 15, 2012 - How does rivaroxaban compare with warfarin for stroke prevention in patients with nonvalvular atrial fibrillation? This study concluded that rivaroxaban is noninferior to warfarin. However, noninferiority trials do not meet the same rigorous design and statistical format of traditional ...

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2012/0315/p577.html

AFP Journal Club: Antibiotics for Acute Otitis Media in Young Children: The Case of ...

Jan 15, 2012 - A discussion of why the conclusion of a high-profile study, which suggests that antibiotics are beneficial in children six to 23 months of age with acute otitis media, is incorrect.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2012/0115/p104.html

AFP Journal Club: Antibiotics for Acute Otitis Media in Young Children - American ...

Nov 15, 2011 - Two studies aim to clarify the appropriate use of antibiotic treatment in young children with acute otitis media.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2011/1115/p1095.html

AFP Journal Club: Subarachnoid Hemorrhage and the CT Scan - American Family Physician

Sep 15, 2011 - Is CT sensitive enough to rule out subarachnoid hemorrhage? This study says yes, but rretrospective studies are inherently problematic. Normal head CT should be followed by a lumbar puncture.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2011/0915/p632.html

AFP Journal Club: Usefulness of Procalcitonin Measurement in Reducing Antibiotic Use...

Jul 15, 2011 - Measurement of procalcitonin is being pushed as a way to determine the presence or absence of bacterial infection and, therefore, as a way to reduce antibiotic use. But, how well does it work in the patients family physicians see? Why are the results of this study not as convincingly ...

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2011/0715/p177.html

AFP Journal Club: Clinical Significance of Meniscal Damage on Knee MRI - American ...

May 15, 2011 - Can you make the assumption that, in a patient with knee pain, meniscal damage found on MRI is responsible for his or her symptoms? Meniscal findings on knee MRI do not correlate well with pain.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2011/0515/p1160.html

AFP Journal Club: Donepezil to Manage Alzheimer Disease: New vs. Standard Dosing - ...

Mar 15, 2011 - Does donepezil benefit patients with Alzheimer disease, and is the new dosage superior to the standard dosage? This study showed benefit, but the data are misleading.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2011/0315/p742.html

AFP Journal Club: Can ECG Rule Out ACS if Performed While the Patient Is Having ...

Nov 15, 2010 - Is negative ECG performed while the patient is having chest pain good at ruling out acute coronary syndrome? Although this study says yes, other higher-quality studies say it does not rule out cardiac disease. Observational studies are not ideal for testing some hypotheses.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2010/1115/p1185.html

AFP Journal Club: Autism and Childhood Vaccinations: Debunking the Myth - American ...

Sep 15, 2010 - Are childhood vaccinations associated with subsequent development of autism? This month's article provides the science and statistics to dispel the theory that childhood vaccinations induce autism.

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2010/0915/p586.html

AFP Journal Club: Antidepressants for Initial Treatment of Depression - American ...

May 15, 2010 - Which antidepressants should be used for the initial treatment of depression? This quality multiple-treatment meta-analysis gives physicians a good starting point for choosing an antidepressant. Sertraline and escitalopram should be considered first-line agents whereas bupropion, ...

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2010/0515/p1205.html

AFP Journal Club: Beta Blockers and Noncardiac Surgery: Why the POISE Study Alone ...

Mar 15, 2010 - ...AFP Journal Club The Story Behind the Study Beta Blockers and Noncardiac Surgery: Why the POISE Study Alone Should Not Change Your Practice FREE PREVIEW Log in or buy this issue to read the full article. AAFP members and paid subscribers get free access to all articles. Subscribe now....

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2010/0315/p717.html

AFP Journal Club: Cancer Risks Associated with CT Scanning - American Family Physician

Jan 15, 2010 - Should we stop using beta blockers to prevent myocardial infarction in persons undergoing noncardiac surgery? The data remain inconclusive. Although the POISE study is an important contribution to the literature, it uses a protocol that is unrealistic and should not change current ...

American Family Physician : AFP Journal Club

http://www.aafp.org/afp/2010/0115/p111.html

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