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2013 ACC/AHA Cholesterol Guideline Greatly Increases Number Eligible for Statin ...

Aug 15, 2014 - The new guideline from the ACC/AHA increases the number of adults between 40 and 75 years of age who are eligible to take statins by 12.8 million. The largest increases were among adults who would take statins for primary prevention and for adults between 60 and 75 years of age. The ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0815/od6.html

5% Fluorouracil Is the Preferred Treatment for Actinic Keratoses - POEMs - American ...

Aug 15, 2019 - The use of topical 5% fluorouracil is most likely to result in successful elimination of actinic keratoses in a field on the head or face.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0815/p249a.html

9-Valent HPV Vaccine Offers Only Small Advantage Over Quadrivalent Vaccine - POEMs - ...

Jul 1, 2015 - A new 9-valent HPV vaccine is generally similar in effectiveness to the older quadrivalent vaccine. There is a small benefit of the new vaccine compared with the older vaccine for women who are initially uninfected (2.4 vs. 4.2 cases per 1,000 person-years), but you would have to ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0701/p54.html

A Simple Cough Algorithm for Children with Chronic Cough - POEMs - American Family ...

Nov 15, 2013 - In children with chronic cough, a simple approach of ruling out specific indicators of cause, followed by treating a wet cough with antibiotics, results in a significant decrease in the duration of cough. Some of the causes of chronic cough were reactive airway disease, bronchiectasis, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1115/od1.html

Accuracy of Fecal DNA and Fecal Immunochemical Test for Colorectal Cancer Detection - ...

Sep 1, 2014 - Fecal DNA testing is more sensitive but less specific than fecal immunochemical testing (FIT), and as a result, has a higher false-positive rate. It is also more expensive than other noninvasive alternatives such as FIT. We do not know which test will be better at reducing mortality.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0901/p326a.html

ACE Inhibitors Decrease Cardiovascular Events in Patients with Diabetes, ARBs Do Not - ...

Sep 1, 2014 - In patients with diabetes, ACE inhibitors decrease cardiovascular events and all-cause mortality. ARBs do not. Both drug classes decrease heart failure incidence. Although both drug classes have been available for almost 15 years, there is only one study of 250 patients that directly ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0901/p326.html

Acetaminophen (Paracetamol) Minimally Effective for Back Pain and Osteoarthritis - ...

Oct 1, 2015 - Although acetaminophen was hoped to be a safer alternative to nonsteroidal anti-inflammatory drugs and opioids for the treatment of common musculoskeletal problems, on average it provides only minimal pain relief and improvement in function for patients with low back pain or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1001/p642.html

Active Surveillance for Localized Prostate Cancer: No Increased Mortality, but Higher ...

Feb 1, 2017 - This landmark study compared active surveillance with radical prostatectomy or radiation therapy for patients with T1c or T2 prostate cancer. The benefits of active surveillance include avoiding radical therapy in one-half of the patients, with no effect on disease-specific survival or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0201/p196.html

Acupuncture Effective for Chronic Pain Conditions - POEMs - American Family Physician

Nov 15, 2018 - Acupuncture, with its meridians, chi, and other concepts that do not seem to line up with anything physiologic, is vexing to most of us who trained in Western medicine. However, this meta-analysis, based on data from almost 21,000 patients, found it to be more effective than no ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od2.html

Adding Sitagliptin Does Not Reduce or Increase the Risk of Cardiovascular Outcomes - ...

Dec 1, 2015 - The glass half full is that sitagliptin does not increase the risk of cardiovascular events in patients with type 2 diabetes. The glass half empty is that it does not reduce the risk, either. And that is the important message: In patients with a mean glycated hemoglobin level of 7.2%, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1201/p1020a.html

Advance Care Planning Increases Execution of Advance Directives and Surrogate ...

Dec 1, 2018 - In this study, an intensive advance care planning intervention dramatically increased the completion of advance directives and the identification of surrogate decision makers.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p682a.html

Aliskiren Worsens Outcomes in High-Risk Patients with Diabetes - POEMs - American ...

Sep 1, 2013 - Aliskiren increases the likelihood of adverse cardiovascular outcomes in patients with diabetes and kidney or heart disease, and cannot be recommended.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/0901/p333.html

All Analgesics Are Better Than Placebo in Patients with Knee or Hip DJD - POEMs - ...

Oct 15, 2016 - In patients with hip or knee DJD, all analgesics are more effective than placebo in relieving pain and improving function. Although paracetamol (acetaminophen) is the least effective of all the drugs studied, it still may be the first treatment for these patients because of its safety ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1015/p664.html

Ambulatory Blood Pressure Important for Decision-Making About Treatment - POEMs - ...

Oct 15, 2018 - This study supports the guidelines recommending that treatment decisions be based on ambulatory blood pressure measurements rather than in-office blood pressure results. The difference between the two measurements in this cohort was 19/11 mm Hg, which is enough to change the decision to...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1015/od5.html

Amoxicillin/Clavulanate During COPD Exacerbations Decreases Symptoms and Delays ...

Apr 1, 2013 - Patients with exacerbations of mild to moderate COPD have a higher rate of cure when given amoxicillin/clavulanate compared with placebo.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/0401/p512.html

Amoxicillin/Clavulanate or Ibuprofen No Better Than Placebo for Acute Bronchitis - ...

Feb 1, 2014 - Treating acute bronchitis with amoxicillin/clavulanate or the nonsteroidal anti-inflammatory drug ibuprofen is no more effective than placebo in decreasing symptoms in general or duration of frequent cough. Treatment does, however, produce adverse effects in one in eight patients.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0201/p225.html

Amoxiclav Causes Diarrhea in 1 of 8 Persons Who Take It - POEMs - American Family ...

Jun 15, 2015 - The risk of diarrhea is significantly higher with amoxicillin/clavulanate (amoxiclav; Augmentin) than placebo, with a number needed to treat to harm (NNTH) of 8, which is not dissimilar from the number needed to treat for conditions such as otitis media. Contrary to popular belief, the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0615/p877.html

An Oral Appliance Does Not Improve Sleep in Patients with Less Severe Sleep Apnea - ...

Dec 1, 2015 - An oral appliance does not improve daytime sleepiness or other measures of a good night's sleep. It does, however, decrease apnea scores, snoring, and restless legs. Although not studied, these improvements may be valuable for bed partners who sleep each night enduring patients' lower ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1201/p1021.html

Anastrozole Decreases Rate of Breast Cancer in High-Risk Postmenopausal Women - POEMs -...

Aug 15, 2014 - Postmenopausal women at high risk of developing breast cancer who take anastrozole for five years have a lower rate of developing invasive breast cancer during that time frame.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0815/od7.html

Antibiotics May Equal Surgery for Children with Appendicitis - POEMs - American Family ...

Jun 1, 2017 - Antibiotic treatment appears to be effective for children with uncomplicated appendicitis without evidence of perforation or rupture, with 97% of children discharged without surgery. Approximately one in seven children will eventually have recurrence and require surgery. A couple of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0601/p737.html

Antidepressants and Psychological Therapies Are Effective for IBS - POEMs - American ...

Jan 15, 2015 - Antidepressants and psychological therapies are effective in treating the symptoms of IBS. This study, an update of a similar systematic review and meta-analysis completed five years ago, found the same level of effectiveness for both treatment approaches as the previous analysis, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0115/p134.html

Antipsychotics Worsen Symptoms in Patients with Delirium Who Receive Palliative Care - ...

Mar 15, 2017 - For hospitalized patients with acute delirium and symptoms of distress who are receiving palliative care, the use of risperidone (Risperdal) or haloperidol at conservative oral doses worsens symptoms and may shorten overall survival.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/od3.html

Are Some Antidepressants Safer than Others Regarding Suicide Risk? - POEMs - American ...

Jul 1, 2015 - Mirtazapine (Remeron) and venlafaxine are associated with higher rates of completed suicide in primary care patients. Rates of suicide attempts and completion are similar with the use of selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0701/p52a.html

Arthroscopic Meniscal Surgery Is Equivalent to Nonoperative Management - POEMs - ...

Jul 1, 2017 - The existing research base, with biases that typically make interventions look better, is unable to demonstrate that arthroscopy for meniscal injuries is any better than nonoperative approaches. Because this is a costly intervention and is being used more often, perhaps insurance ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0701/p55.html

As-Needed Budesonide/Formoterol Similar to Maintenance Budesonide Plus SABA in Patients...

Nov 15, 2019 - In these patients with mild asthma (more than one-half used a short-acting beta-agonist [SABA] such as albuterol two or fewer times per week), as-needed use of a combined budesonide/formoterol (Symbicort) inhaler was as effective at preventing exacerbations as daily maintenance ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p646a.html

As-Needed Use of Budesonide Plus Formoterol As Good As Daily Use of Steroid - POEMs - ...

Nov 15, 2018 - As-needed use of budesonide/formoterol is as effective as the daily use of maintenance budesonide plus as-needed terbutaline at preventing severe exacerbations, and results in a much lower cumulative steroid dose.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od4.html

Aspirin Following Anticoagulation Therapy Prevents Recurrent VTE - POEMs - American ...

Jun 1, 2013 - Although this ASPIRE study was underpowered to detect a difference in the primary outcome, when the results were combined with those of the WARFASA trial, the data show that daily low-dose aspirin prevents recurrent VTE as well as major vascular events without increasing bleeding in ...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/0601/p796.html

Aspirin in Low Doses Decreases Preeclampsia Risk - POEMs - American Family Physician

Sep 1, 2014 - Low-dose aspirin—ranging from 60 to 100 mg per day—beginning as early as the second trimester decreases the risk of preeclampsia, preterm birth, and intrauterine growth retardation in women who are at high risk of preeclampsia. No harms to the mother or newborn were identified in the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0901/p331.html

Aspirin Is as Safe and Effective as LMWH for Extended Thromboprophylaxis After Total ...

Dec 1, 2013 - Aspirin is as effective as dalteparin for extended thromboprophylaxis in patients who had total hip arthroplasty and had initially received 10 days of dalteparin prophylaxis postoperatively. Because of its relative safety, low cost, and easy administration, aspirin is an attractive ...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1201/p739.html

Aspirin No Different Than Rivaroxaban for Prevention of VTE After TKA or THA - POEMs - ...

Aug 15, 2018 - Extended prophylaxis with low-dose aspirin is similar in efficacy to rivaroxaban for the prevention of symptomatic VTE following TKA or THA. Aspirin is cheap, widely available, and effective, making it a good alternative to the more costly direct oral anticoagulants.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0815/p248.html

Aspirin Plus a High-Dose PPI Prevents Death and Progression in Patients with Barrett ...

Mar 15, 2019 - In this study, patients with Barrett esophagus were less likely to die or develop esophageal cancer or high-grade dysplasia if they took high-dose esomeprazole (Nexium) alone or in combination with aspirin.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0315/od5.html

Aspirin, Eicosapentaenoic Acid, and Placebo Equally Effective in Preventing Colorectal ...

Jun 1, 2019 - After 12 months, neither aspirin nor EPA, alone or in combination, are any better than placebo at preventing colorectal adenomas in patients with high-risk neoplasia.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p717.html

Aspirin’s Benefits and Harms Are Less Clear for Primary Prevention in Moderate-Risk ...

Apr 1, 2019 - In this study, after five years of treatment, patients at a moderate risk of heart disease who took low-dose aspirin did not show a decrease in coronary events and all-cause mortality and had slightly more gastrointestinal bleeding.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459a.html

Back-up Culture Not Needed for Negative Rapid Strep Test Results - POEMs - American ...

May 1, 2015 - Although rheumatic heart disease due to group A streptococcal infection has all but disappeared in wealthy countries, some countries still go to great lengths to test for streptococcal throat infections, including the United States. As a result, we spend more than $8 million per each ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0501/p643a.html

Bare Arm Best for Blood Pressure Measurement - POEMs - American Family Physician

Jun 1, 2017 - To get the most accurate measure, let patients sit for a few minutes, and then measure their blood pressure on a completely bare arm. Does a difference of 4 mm systolic and 6 to 7 mm diastolic matter?

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0601/p733.html

Bariatric Surgery Improves Quality of Life and Results in More Weight Loss Than ...

Jun 15, 2017 - Bariatric surgery using Roux-en-Y gastric bypass or sleeve gastrectomy was more effective than intensive medical therapy at improving quality of life and helping patients lose weight and reduce the need for medications. Anemia was more common with sleeve gastrectomy, and approximately ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0615/p805.html

Bariatric Surgery Plus Intensive Medical Therapy Is Better Than Medical Therapy Alone ...

Oct 15, 2014 - Bariatric surgery in conjunction with intensive medical therapy results in significantly enhanced glycemic control at three years compared with medical therapy alone, as well as better weight control, less use of glucose-lowering medications, and improved quality of life.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1015/p579.html

Behavioral Interventions Reduce Inappropriate Antibiotic Prescribing for Acute ...

Jun 15, 2016 - Requiring clinicians to justify antibiotic prescribing in the permanent electronic health record and to undergo periodic peer comparisons of prescribing rates are effective interventions for reducing inappropriate antibiotic prescribing for acute respiratory tract infections. Helpful ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1037.html

Benefits and Harms for Low-Dose Aspirin in Patients with Diabetes Mellitus - POEMs - ...

Jun 1, 2019 - The 7,740 patients who took low-dose aspirin experienced 51 fewer vascular deaths, nonfatal myocardial infarctions, or nonfatal ischemic strokes; 29 fewer transient ischemic attacks; and 44 fewer revascularizations than patients who took placebo over a mean of 7.4 years.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0601/p718.html

Best Approaches to Physical Diagnosis of Acute Red Eye - POEMs - American Family Physician

Apr 1, 2016 - Eliciting photophobia via pupillary constriction and the presence of anisocoria (greater than 1 mm) in patients with an acute red eye are the best predictors of serious eye disease (e.g., uveitis, keratitis, corneal abrasion, scleritis) requiring prompt referral. Lack of morning eye ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0401/p594.html

Beta Blockers Not Associated with Lower Morbidity/Mortality in Adults with CAD or CAD ...

Mar 1, 2013 - Beta-blocker therapy was not associated with a reduced risk of adverse cardiovascular events in adults with a prior MI, known CAD without prior MI, or three or more known risk factors for CAD.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/0301/p373.html

Beta-Lactam Not as Effective as Beta-Lactam Plus Macrolide for Treating CAP in the ...

May 15, 2015 - In this noninferiority trial, monotherapy with a beta-lactam was not as effective as combination therapy with a beta-lactam and a macrolide for achieving clinical stability in seven days for hospitalized patients with moderately severe CAP.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0515/p720.html

Blood Pressure Goal of 140 to 150 mm Hg Is Best for Patients with Diabetes - POEMs - ...

Jul 1, 2016 - Although most recent practice guidelines have relaxed the blood pressure goals for patients with diabetes, there are still a few holdouts that suggest aggressive treatment. This analysis shows that the ideal range for hypertension control in patients with diabetes is between 140 and 150...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0701/p59a.html

Breast Cancer Prevented in Some Women with Drug Treatment - POEMs - American Family ...

Nov 1, 2013 - In some postmenopausal women at higher-than-average risk of breast cancer, tamoxifen and, to a lesser extent, raloxifene (Evista) will prevent the development of breast cancer. For every 1,000 women who receive the prophylaxis, there will be seven to nine fewer cases of diagnosed breast...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1101/p608.html

Breast Cancer Screening with MRI: More False-Positives, More Biopsies - POEMs - ...

Nov 15, 2018 - Screening with MRI is not for everyone. Women who undergo breast cancer screening with MRI are much more likely to be referred for biopsy— that will ultimately be negative—than if they have screening mammography alone.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od5.html

Bridging Anticoagulation in Patients with Atrial Fibrillation Associated with More ...

Sep 1, 2015 - This study provides more evidence that bridging in patients with nonvalvular atrial fibrillation does not improve outcomes, and is actually associated with a higher risk of bleeding complications and cardiovascular events.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0901/p398.html

Brief Interventions for Weight Management in Kids Are Not Effective - POEMs - American ...

Feb 1, 2017 - Calculating the BMI of children and adolescents in primary care practices and counseling those who are overweight is ineffective to reduce BMI in children over several years of follow-up.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0201/p194a.html

Broad-Spectrum Antibiotics Increase Adverse Events in Children with Acute Respiratory ...

Apr 1, 2018 - Broad-spectrum antibiotics are no more effective than narrow-spectrum antibiotics for treating acute respiratory tract infections in infants and children, and adverse events are significantly more common in children treated with broad-spectrum antibiotics.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0401/p474a.html

CA 125 Relatively Specific for Diagnosing Endometriosis - POEMs - American Family ...

Jan 15, 2017 - For women with symptoms suggestive of endometriosis, serum CA 125 is a relatively specific (93%) and noninvasive test. It can be used to make a presumptive diagnosis in cases for which a medical management approach is being considered without having to perform a (diagnostic standard) ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0115/p122.html

Cannabinoids Somewhat Helpful for Nausea, Maybe Helpful for Spasticity, Probably Not ...

Oct 15, 2018 - This umbrella review found a modest benefit of cannabinoids for the treatment of neuropathic pain; a greater benefit for the treatment of spasticity and nausea and vomiting; and substantial harms. The studies were extremely heterogeneous in terms of the comparators, dose, duration, and ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1015/od3.html

CBT Effective for Chronic Insomnia - POEMs - American Family Physician

Jan 1, 2016 - A five-component approach to changing patients' beliefs and behaviors surrounding sleep is effective, at least in the short term, in getting persons to fall asleep and stay asleep, although total sleep time is not increased.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0101/p60.html

CBT Effective in Adolescents with Depression Who Do Not Want Medication - POEMs - ...

Sep 1, 2016 - In adolescents who eschew drug treatment of major depression, short-term CBT is more effective than treatment as usual in inducing recovery, with a number needed to treat of 4 to 10. CBT also produced faster results.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0901/p384.html

CCTA and Radionuclide Stress Testing Similar for Evaluation of Chest Pain - POEMs - ...

Dec 1, 2015 - For the evaluation of chest pain in intermediate-risk patients, CCTA is comparable with myocardial perfusion imaging in its ability to select patients for invasive management. Both modalities are also similar when it comes to downstream resource use and adverse cardiovascular events. ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1201/p1022.html

CEA vs. Stenting: Mixed Results, Mostly Bad - POEMs - American Family Physician

Jul 1, 2015 - These two randomized trials, one with short-term outcomes and the other with five-year outcomes, demonstrate that carotid artery stenting results in more frequent strokes (clinical and radiographically detected) than carotid endarterectomy (CEA). However, the rate of fatal and disabling...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0701/p52.html

Cervical Treatment Associated with Adverse Obstetric Outcomes - POEMs - American Family...

Dec 1, 2016 - Cervical treatments for dysplasia and early cervical carcinoma are associated with subsequent risk of preterm birth. Excisional treatments carry higher risk than ablative treatments, and multiple treatments carry higher risk than single treatments. The frequency and severity of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/1201/p933a.html

Chocolate Consumption May Make Acne Vulgaris Worse - POEMs - American Family Physician

Jan 15, 2017 - This study found a statistically significant increase in facial acne lesions among college students 48 hours after ingesting chocolate instead of jelly beans (average compared with baseline: 4.8 new lesions vs. 0.7 fewer lesions, respectively).

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0115/p122a.html

Chondroitin/Glucosamine Equal to Celecoxib for Knee Osteoarthritis - POEMs - American ...

Jun 15, 2016 - or patients with painful knee osteoarthritis, a high-dose combination of glucosamine hydrochloride (1,500 mg) and chondroitin (1,200 mg) was as effective in lessening pain and stiffness and improving function as celecoxib (200 mg). Other studies have not found benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1032.html

Chronic Sinusitis: Saline Irrigation Helps Somewhat; Steroid Does Not Add More Benefit ...

Feb 1, 2019 - This study showed that patients with chronic rhinosinusitis who continue to use a saline nasal wash (NeilMed) will often experience an improvement in symptoms that can be clinically meaningful, but the addition of the corticosteroid budesonide has yet to show an extra benefit.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p188.html

CIN Treatment May Increase Miscarriages but Does Not Affect Fertility - POEMs - ...

Apr 1, 2015 - In this analysis of 15 observational studies (it would be difficult and unethical to do randomized research on this topic), excision using any method for CIN did not affect fertility, although second trimester miscarriages were more likely. A study published at the same time found the ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0401/p490.html

Citalopram Plus Methylphenidate Better Than Either Alone for Geriatric Depression - ...

Nov 1, 2015 - Combined treatment with citalopram plus methylphenidate provided faster improvement of depression symptoms in older patients with unipolar depression. Combined treatment was also more likely than either medication alone to lead to remission of depression at four weeks and 16 weeks.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p820.html

Clinical Decision Support Linked to EMRs Does Not Decrease Mortality - POEMs - American...

Mar 15, 2015 - Despite several decades of the use of EMRs and computerized decision support systems, the overall quality of data supporting their use is poor and those data show these systems do not save lives or save money. Whether patient morbidity is improved is even less certain.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0315/p404.html

Clinical Diagnosis of Lyme Disease Frequently Misses the "Bull’s Eye" - POEMs - ...

Apr 1, 2018 - For children with suspected Lyme disease but without a classic bull's-eye lesion (erythema migrans of at least 5 cm), check serology rather than rely on your clinical impression. In this study, 12% of the children not suspected of having Lyme disease did have Lyme disease, and 31% of ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0401/p474.html

Clopidogrel Plus 21 Days of Aspirin Is Superior to Aspirin Alone Within First 24 Hours ...

Jan 1, 2014 - Patients with minor stroke (National Institutes of Health [NIH] Stroke Scale score ≤ 3) or TIA have a decreased risk of recurrent stroke if given aspirin plus clopidogrel vs. aspirin alone if started within 24 hours of the onset of symptoms. There was no significant increase in the risk...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0101/p55.html

Clopidogrel Plus Aspirin Provides More Net Benefit Than Aspirin Alone After Minor ...

Feb 1, 2019 - This study provides support for a strategy of adding clopidogrel to aspirin for the first week or so after a minor ischemic stroke or TIA because this is when the greatest benefit occurs. Harms were spread fairly evenly throughout the study period.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p188a.html

Colchicine Effective for First Episode of Acute Pericarditis - POEMs - American Family ...

Feb 1, 2014 - When used in addition to conventional anti-inflammatory therapy, colchicine decreases the rate of incessant or recurrent pericarditis. You would need to treat four patients with colchicine to prevent one such episode.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0201/p226.html

Cold Symptoms Unaffected by Regular Analgesic Dosing or Use of Steam - POEMs - American...

Sep 1, 2014 - Advice regarding the use of steam inhalation, ibuprofen alone or with acetaminophen, acetaminophen alone, and regular vs. as-needed use of analgesics did not show any improved effectiveness in treating symptoms of acute respiratory tract infections. Ibuprofen may be beneficial in ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0901/p335.html

Colorectal Cancer Screening Modalities: Variable Uptake, Variable Yield - POEMs - ...

Jun 15, 2016 - Based on the initial round of screening in this randomized trial, it appears that more patients complete fecal immunochemical testing than colonography or colonoscopy. Using the most conservative estimate, the yields of advanced adenomas and advanced neoplasms are similar.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0615/p1032a.html

Colorectal Neoplasia Yield Similar for FIT Every One, Two, or Three Years - POEMs - ...

Oct 15, 2013 - There appears to be no advantage to obtaining FIT more often than every three years.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1015/od3.html

Combination of Resistance and Aerobic Exercise Best for Older Persons with Obesity - ...

Sep 1, 2017 - In older patients with obesity embarking on a program to improve their health, weight loss accompanied by resistance training and aerobic training resulted in the biggest gains in functional status and physical performance.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0901/p331.html

Continued Warfarin Better Than Bridging Therapy for Pacemaker or Defibrillator Surgery ...

Sep 15, 2013 - This is the best and largest single trial comparing continued warfarin with a bridging strategy. Patients with an annual risk of thromboembolic events of 5% or more undergoing pacemaker or defibrillator surgery who continued to use warfarin had fewer device-pocket hematomas than ...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/0915/p403.html

Continuing Warfarin for 18 Months After Unprovoked PE Reduces Risk of Recurrent VTE - ...

Nov 1, 2015 - Continuing warfarin therapy for 18 months after an unprovoked PE reduces the risk of recurrent symptomatic venous thromboembolism (VTE). However, benefit beyond 18 months is not maintained after the warfarin is discontinued.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1101/p814.html

Corticosteroid Injections Ineffective for Knee Osteoarthritis - POEMs - American Family...

Sep 15, 2017 - This well-done study found that regular three-month intra-articular injections of triamcinolone for two years resulted in no significant difference in pain and function assessments compared with saline. However, a significant increase in cartilage loss and damage did occur in patients ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0915/p406.html

CT Coronary Angiography in Patients with Suspected CAD: No Short-Term Benefit, ...

Nov 15, 2015 - For patients with suspected stable CAD, adding CT coronary angiography had no short-term effect on patient symptoms or hospitalizations but increased the number of coronary angiograms. Additionally, more patients who had CT coronary angiography underwent preventive treatment and ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/1115/p928.html

D-dimer vs. Ultrasonography for DVT: Use Prediction Rule - POEMs - American Family ...

Sep 1, 2013 - Use the Wells criteria to determine the likelihood of deep venous thrombosis; patients at moderate to high risk should go straight to ultrasonography. Patients at low risk should have d-dimer testing, followed by ultrasonography only if the results are positive. This approach decreases ...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/0901/p337.html

Daily Multivitamins Do Not Reduce Major Cardiovascular Events in Men and Do Not Affect ...

Jun 1, 2013 - Daily multivitamin supplementation does not reduce the risk of major cardiovascular events in men. The risks of cardiovascular-related mortality and all-cause mortality were also not reduced by multivitamin supplementation.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/0601/p796a.html

Daily Multivitamins Have Minimal, if Any, Effect on Preventing Cancer in Men and Do Not...

Mar 15, 2013 - Daily multivitamin supplementation results in a minimal, if any, reduction in epithelial cell cancers in men. This study found no significant benefit to multivitamin supplementation in reducing the risk of prostate, colorectal, lung, or bladder cancers. The risks of cancer-related ...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/0315/p444.html

Dapagliflozin in High-Risk Type 2 Diabetes Reduces Hospitalization for Heart Failure ...

Aug 1, 2019 - The only cardiovascular benefit to treatment with dapagliflozin was a reduction in the likelihood of hospitalization; 125 patients would need to be treated for 10 years to prevent one hospitalization.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0801/p184.html

Decompression Surgery No More Effective Than Exercise for Shoulder Impingement Syndrome...

Feb 1, 2019 - Despite being one of the most common orthopedic surgeries performed, subacromial decompression is not significantly better than physical therapy to treat patients with pain and limited function caused by shoulder impingement.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p190.html

Delayed Antibiotic Prescription for New-Onset Cough Associated with Decreased ...

Jan 1, 2018 - Delayed antibiotic treatment (that is, giving a prescription with a suggestion to fill it only if symptoms are still present after three days) was associated with decreased revisits by adults with new-onset cough deemed to be infective.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0101/p53.html

Delayed Prescription for Respiratory Infections Produces Similar Results and ...

May 1, 2016 - In almost 400 Spanish primary care patients with mild to moderate symptoms of respiratory infection of less than one week's duration, both a take-and-hold prescription and a come back and pick up, if necessary prescription produced a similar clinical response—and similar patient ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0501/p789.html

Delayed Prescription Strategies Decrease Antibiotic Use - POEMs - American Family ...

Jul 15, 2014 - A delayed prescription approach in children and adults with acute respiratory tract infections, combined with explicit instructions for symptom control, is effective in decreasing antibiotic use, while not adversely affecting patient satisfaction or symptom duration or severity.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0715/p110.html

Desmopressin Effective for Treating Nocturia in Adults - POEMs - American Family Physician

Dec 1, 2014 - Desmopressin is a safe and effective treatment to offer adults with clinically significant nocturia. The initial starting dose should be 50 to 100 mcg, with lower dosing for the advanced older patient. All patients should be monitored for hyponatremia.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1201/p796a.html

Detrimental Effect of Tight Glucose Control on CV Mortality Persists Over Nine Years - ...

Mar 15, 2017 - The initial Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, which compared standard treatment with intensive control, found that despite good intentions, cardiovascular (CV) and overall mortality are significantly higher when blood glucose levels are lower.

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0315/od2.html

Dexamethasone May Reduce Sore Throat Symptoms in Adults at 48 Hours - POEMs - American ...

Aug 15, 2017 - A single dose of oral dexamethasone is no more effective than placebo in resolving acute sore throat symptoms at 24 hours in adults who do not receive immediate antibiotic therapy. However, among a multitude of exploratory secondary outcomes, the authors found that, compared with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2017/0815/p260a.html

Dextrose Prolotherapy Decreases Pain and Stiffness in Knee Degenerative Joint Disease -...

Nov 1, 2013 - Dextrose prolotherapy appears to be more effective in decreasing pain and stiffness, and improving function in patients with knee degenerative joint disease than saline injections and home exercise.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1101/od1.html

Diagnosing and Managing Acute Heart Failure Guidelines: NICE - POEMs - American Family ...

Feb 15, 2015 - There is not much new in these guidelines except some caveats on what not to do. Diagnose new acute heart failure with a natriuretic peptide measurement and, if the level is high, follow with transthoracic echocardiography. Do not routinely treat with opiates, nitrates, inotropes, ...

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0215/p260.html

Digital Media Use Associated with ADHD Symptom Development Among Adolescents - POEMs - ...

Feb 1, 2019 - High school students who reported a high frequency (many times per day) of digital media use (e.g., social networking, streaming movies or music, texting) were significantly more likely to self-report symptoms of ADHD over two years of follow-up (10% higher symptom reporting rate).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0201/p189.html

Direct Oral Anticoagulants Preferred Over Warfarin for Nonvalvular Atrial Fibrillation ...

Dec 1, 2018 - The balance of benefits and harms favors direct oral anticoagulants over warfarin (Coumadin) for patients with nonvalvular atrial fibrillation who require anticoagulation and are already taking low-dose aspirin.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1201/p683.html

Drugs for Chronic Idiopathic Constipation Are Similarly Effective - POEMs - American ...

Jun 15, 2018 - If nondrug measures are unsuccessful for chronic idiopathic constipation, the choice of a pharmacologic agent should be based on cost, tolerability, and long-term adherence rather than efficacy, because the efficacy is similar among drugs and drug classes.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0615/p819a.html

e-Cigarettes More Effective Than Nicotine Replacement for Cessation of Tobacco Use in ...

Oct 1, 2019 - Among adults who smoked a median of 15 cigarettes per day, those who were randomized to receive e-cigarettes were more likely to be abstinent at one year than those who received nicotine replacement (number needed to treat [NNT] = 12).

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p442.html

Early Adenotonsillectomy and Watchful Waiting Are Both Options for Children with Sleep ...

Oct 1, 2013 - Early surgery provides some symptomatic benefit and greater normalization of polysomnographic findings (a disease-oriented outcome) than watchful waiting for children with obstructive sleep apnea. However, many of the children in the watchful waiting group improved during the study ...

American Family Physician : POEMs

https://www.aafp.org/afp/2013/1001/p468.html

Early Cardioversion No Better Than Delayed Cardioversion for Recent-Onset Symptomatic ...

Nov 15, 2019 - For patients presenting to the emergency department with recent-onset symptomatic atrial fibrillation, early cardioversion is no better than delayed cardioversion in achieving sinus rhythm within four weeks.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p648.html

Early Imaging for Low Back Pain in Older Adults Raises Costs Without Improving Quality ...

Aug 15, 2015 - Among adults 65 years or older who present to primary care clinicians for a new episode of back pain, early imaging (before six weeks) resulted in no improved outcomes at one year, but increased overall health care costs by almost 30%.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0815/p310.html

Early PT for Acute Low Back Pain Is Cost-Effective, but Gain in Quality of Life Is ...

Apr 1, 2018 - At $30,000 per quality-adjusted life year (QALY) gained, early PT for acute low back pain in primary care is cost-effective by the usual criteria of $50,000 to $100,000 per QALY. However, the magnitude of improvement in quality of life is small and is probably not clinically meaningful.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0401/p475.html

Endovascular Therapies Do Not Improve Outcomes in Acute Stroke - POEMs - American ...

Jul 1, 2013 - Endovascular therapies (local delivery of t-PA, extracting the thrombus, or stenting) do not improve outcomes when added to intravenous t-PA alone.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/0701/p61.html

Epidural Steroid Injections Ineffective for Lumbar Spinal Stenosis - POEMs - American ...

Dec 1, 2014 - Epidural glucocorticoid injections are ineffective for lumbar spinal stenosis. Whether this will change practice for this lucrative procedure will be an interesting question.

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1201/p795a.html

Epidural Steroid Not Better Than Placebo Injection for Sciatica and Spinal Stenosis ...

Feb 15, 2016 - It is hard to figure out what to do with these results. On the one hand, steroid injection did not provide a significant benefit compared with placebo injection in patients with radicular pain or spinal stenosis. However, part of the reason for this may be the significant and sustained ...

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0215/p315a.html

Epidural Steroids for Sciatica Minimally Effective in the Short Term - POEMs - American...

Jul 15, 2013 - Epidural corticosteroid treatment produces a small and not clinically relevant decrease in leg pain and disability in the short term in patients with sciatica; any difference is gone after one year.

American Family Physician : POEMs

https://www.aafp.org/afp/2013/0715/p137.html

Epley Maneuver Effective in the Long Term for Positional Vertigo - POEMs - American ...

Nov 1, 2014 - How often do patients walk into our offices with a problem and walk out cured? The Epley maneuver, which is not particularly difficult to do, results in the long-term (at least one year) resolution of posterior canal benign paroxysmal positional vertigo. A video of the maneuver can be ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/1101/p660.html

Estrogen No Better Than Vaginal Lubricant for Postmenopausal Vaginal Symptoms - POEMs -...

Nov 15, 2018 - It is time to rethink the idea that vaginal atrophy caused by diminished estrogen is the cause of vaginal symptoms associated with menopause. Vaginal estradiol is no more effective than a non-prescription vaginal lubricant or placebo lubricant in the treatment of women with painful ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/1115/od3.html

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