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Accuracy of Dermoscopy vs. Visual Inspection for Diagnosing Melanoma in Adults - ...

Feb 1, 2020 - The addition of dermoscopy to in-person visual inspection of skin lesions increases specificity and sensitivity in the detection of melanoma. In-person evaluation with dermoscopy is more accurate than image-based assessment.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2020/0201/p145.html

Adding Ultrasonography to Mammography Increases False-Positive Findings Without an ...

Jan 1, 2020 - Adding ultrasonography to screening mammography in women younger than 50 years at low, intermediate, or high breast cancer risk is not associated with an increase in breast cancer detection. It is associated with increased unnecessary biopsy recommendations and results in more frequent ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p53a.html

Allergy Testing: Common Questions and Answers - American Family Physician

Jul 1, 2018 - An estimated 10% to 30% of the global population has an allergic disease. Clinical presentations of allergic diseases, respiratory infections, and autoimmune conditions have similar features. Allergy and immunologic testing can help clarify the diagnosis and guide treatment. Immediate ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0701/p34.html

Allopurinol Hypersensitivity Assay HLA-B*58:01 Genotyping - Diagnostic Tests: What ...

Nov 1, 2019 - The allopurinol hypersensitivity assay, or HLA-B*58:01 test, is a blood test to detect the presence of a human leukocyte antigen B (HLA-B) genetic variant that increases the risk of life-threatening, severe cutaneous adverse reactions in patients taking allopurinol.

American Family Physician : Diagnostic Tests: What Physicians Need to Know

https://www.aafp.org/afp/2019/1101/p530.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

Amenorrhea: A Systematic Approach to Diagnosis and Management - American Family Physician

Jul 1, 2019 - Menstrual patterns can be an indicator of overall health and self-perception of well-being. Primary amenorrhea, defined as the lifelong absence of menses, requires evaluation if menarche has not occurred by 15 years of age or three years post-thelarche. Secondary amenorrhea is ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0701/p39.html

Anemia in Older Adults - American Family Physician

Oct 1, 2018 - Anemia is associated with increased morbidity and mortality in older adults. Diagnostic cutoff values for defining anemia vary with age, sex, and possibly race. Anemia is often asymptomatic and discovered incidentally on laboratory testing. Patients may present with symptoms related to ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1001/p437.html

Applying a Clinical Decision Rule for CAD in Primary Care to Select a Diagnostic Test ...

May 1, 2019 - Using the INTERCHEST chest pain decision rule to decide next steps when a patient presents to a primary care physician with chest pain.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/0501/p584.html

Attention Deficit/Hyperactivity Disorder: Screening and Evaluation - FPIN's Help Desk ...

Jun 1, 2019 - The Conners Abbreviated Symptom Questionnaire has the best combination of positive and negative likelihood ratios.

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2019/0601/p712.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

Breast Cancer Screening: ACP Releases Guidance Statements - Practice Guidelines - ...

Feb 1, 2020 - The American College of Physicians reviewed guidelines from other organizations and developed four statements to provide advice to clinicians about breast cancer screening for women who are at average risk.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2020/0201/p184.html

Cancer Screening: ACS Releases Annual Summary of Recommendations - Practice Guidelines ...

Jun 1, 2019 - The American Cancer Society (ACS) provides a summary of recommendations for cancer screening each year, including any updates and recent data, and advice for when recommendations cannot be made.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0601/p719.html

Cerebrospinal Fluid Biomarkers for Detection of Alzheimer Disease in Patients with Mild...

Jun 1, 2018 - There is insufficient evidence to support the routine use of cerebrospinal fluid (CSF) biomarkers for the detection of progressive dementias in patients with mild cognitive impairment (MCI). These tests carry the risk of overdiagnosis of dementia and, therefore, overtreatment.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/0601/p714.html

Cervical Cancer Screening - American Family Physician

Apr 1, 2018 - Screening in women has decreased the incidence and mortality of cervical cancer. Precancerous cervical lesions (cervical intraepithelial neoplasias) and cervical carcinomas are strongly associated with sexually-transmitted high-risk human papillomavirus (HPV) infection, which causes ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0401/p441.html

Chronic Cough After Acute Viral Bronchiolitis: Suggestions from the ACCP - Practice ...

May 15, 2019 - To address the high prevalence of bronchiolitis, the effects of chronic cough on patients' quality of life, and adverse effects from inappropriate use of medications, an expert panel from the American College of Chest Physicians performed systematic reviews to develop several ...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0515/p654.html

Clinical and Personal Utility of Genetic Risk Testing - Curbside Consultation - ...

May 1, 2018 - On April 6, 2017, the U.S. Food and Drug Administration (FDA) approved marketing of the 23andMe Personal Genome Service, the first direct-to-consumer genetic test. This test uses genomic DNA collected from mail-in saliva collection kits to provide information on a patient's genetic risk...

American Family Physician : Curbside Consultation

https://www.aafp.org/afp/2018/0501/p600.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

Colorectal Cancer Screening and Prevention - American Family Physician

May 15, 2018 - Colorectal cancer is a common cause of morbidity and mortality in the United States. Most colorectal cancers arise from preexisting adenomatous or serrated polyps. The incidence and mortality of colorectal cancer can be reduced with screening of average-risk adults 50 to 75 years of ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0515/p658.html

Colorectal Cancer Screening: ACS Updates Guideline for Adults with Average Risk - ...

Jan 15, 2019 - To support early identification and treatment, the American Cancer Society (ACS) has updated its 2008 guidance on counseling and referring patients at average risk of colorectal cancer (CRC) based on new evidence regarding screening options and the ever-changing risk of CRC.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0115/p129.html

Counseling Patients About Prostate Cancer Screening - Editorials - American Family ...

Oct 15, 2018 - The AAFP finds that the net benefit of population screening for prostate cancer is small at best, and it does not recommend routinely discussing PSA-based screening if the patient does not request it.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/1015/p478.html

Depression After ACS Events: AAFP Releases Updated Guidelines - Practice Guidelines - ...

Jun 15, 2019 - The American Academy of Family Physicians has released a guideline focusing on depression in adults within three months of an ACS event (unstable angina or myocardial infarction). The guideline is based on a systematic review of randomized controlled trials and observational studies and...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/0615/p785.html

Depression: Screening and Diagnosis - American Family Physician

Oct 15, 2018 - Depression affects an estimated 8% of persons in the United States and accounts for more than $210 billion in health care costs annually. The U.S. Preventive Services Task Force (USPSTF) and American Academy of Family Physicians recommend screening for depression in the general adult ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1015/p508.html

Diagnosing Dementia and Clarifying Goals of Care - Lown Right Care: Reducing Overuse ...

Sep 15, 2019 - A collaboration between AFP and the Lown Institute promotes a vision of delivering heath care that is based on the evidence, balanced in its approach, and focused on the patient.

American Family Physician : Lown Right Care: Reducing Overuse and Underuse

https://www.aafp.org/afp/2019/0915/p369.html

Diagnosing DVT in Nonpregnant Adults in the Primary Care Setting - Point-of-Care Guides...

Dec 15, 2019 - What is the best approach to the evaluation of nonpregnant adults with suspected first lower extremity deep venous thrombosis (DVT) in the outpatient primary care setting?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/1215/p778.html

Diagnosing VTE: Guidelines from the American Society of Hematology - Practice ...

Dec 1, 2019 - The American Society of Hematology has published recommendations for determining the optimal diagnostic strategy based on pretest risk.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2019/1201/p716.html

Diagnosis of Heart Failure with Reduced Ejection Fraction - Point-of-Care Guides - ...

Feb 15, 2020 - Can signs, symptoms, and simple tests be used to determine the likelihood of heart failure with reduced ejection fraction?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2020/0215/p230.html

Downsides of Detecting Atrial Fibrillation in Asymptomatic Patients - Editorials - ...

Mar 15, 2019 - Despite the lack of outcomes evidence, the rise of wearable ECG sensors will cause many individuals to seek care for misdiagnosed AF. The best intervention for patients with correct diagnoses remains unclear. Primary care physicians must use their skills in discussing uncertainty and ...

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0315/p354.html

Evaluating Diagnostic Tests: Introducing a New Feature in AFP - Editorials - American ...

Jul 1, 2019 - This new feature cuts through the hype and provides independent, objective assessments of new diagnostic tests that readers are considering incorporating into their practices.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0701/p8.html

Evaluating Medical Decision-Making Capacity in Practice - American Family Physician

Jul 1, 2018 - Medical decision-making capacity is the ability of a patient to understand the benefits and risks of, and the alternatives to, a proposed treatment or intervention (including no treatment). Capacity is the basis of informed consent. Patients have medical decision-making capacity if they...

American Family Physician : Article

https://www.aafp.org/afp/2018/0701/p40.html

Evaluation of Suspected Dementia - American Family Physician

Mar 15, 2018 - Dementia is a significant and costly health condition that affects 5 million adults and is the fifth leading cause of death among Americans older than 65 years. The prevalence of dementia will likely increase in the future because the number of Americans older than 65 years is expected ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0315/p398.html

Fasting and Nonfasting Lipid Levels Similarly Predict Cardiovascular Disease Risk - ...

Jan 1, 2020 - Guidelines recommend checking lipid levels in nonfasting patients. They are easier to obtain and are equally predictive of subsequent cardiac events. Although triglyceride levels may be higher in nonfasting patients, cholesterol levels will be similar whether the patient was fasting or ...

American Family Physician : POEMs

https://www.aafp.org/afp/2020/0101/p53.html

First Trimester Bleeding: Evaluation and Management - American Family Physician

Feb 1, 2019 - Approximately one-fourth of pregnant women will experience bleeding in the first trimester. The differential diagnosis includes threatened abortion, early pregnancy loss, and ectopic pregnancy. Pain and heavy bleeding are associated with an increased risk of early pregnancy loss. ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0201/p166.html

FIT Has Similar Yield as Colonoscopy for Colorectal Cancer and Advanced Adenoma Over 10...

May 15, 2019 - Over a 10-year period, the rates of detection of colorectal cancer (CRC) and advanced adenomas using FIT are similar to those seen in studies of screening colonoscopy. This does not prove that FIT reduces morbidity and mortality due to CRC as effectively as colonoscopy.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od5.html

FIT More Acceptable with Better Detection Rate Than gFOBT for Colorectal Cancer ...

Jun 15, 2018 - FIT is more sensitive and specific than the older guaiac-based fecal occult blood tests (gFOBTs) when screening for colorectal cancer. We now know that it is also more acceptable to patients and increases uptake in a centrally administered screening program.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0615/p818.html

Flexible Sigmoidoscopy or Fecal Occult Blood Testing for Colorectal Cancer Screening in...

Aug 1, 2019 - This meta-analysis provides high-quality evidence that flexible sigmoidoscopy and fecal occult blood testing both reduce the risk of death from colorectal cancer. The study did not provide a clear answer regarding a superior screening modality, so the decision to choose one test over ...

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2019/0801/od1.html

Food Insecurity: How You Can Help Your Patients - Editorials - American Family Physician

Aug 1, 2018 - Physicians can improve the health of patients who experience food insecurity by following the SEARCH (screen, educate, adjust, recognize, connect, help) mnemonic and by using the resources outlined in this article.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0801/p143.html

Fully Automated Blood Pressure Measurement Is the Way to Go in the Office - POEMs - ...

Nov 15, 2019 - automated measurement aligns better with ambulatory blood pressure monitoring, the best predictor of cardiovascular events, than manual measurement; manual readings are an average 13.4 to 14.5 mm Hg (systolic) higher than daytime ambulatory or automated readings in patients with ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1115/p646.html

General Health Checks in Adults for Reducing Disease-Related Morbidity and Mortality - ...

Dec 1, 2019 - General health check visits have no benefit on cardiovascular morbidity or on total, cardiovascular, or cancer-related mortality. There is also no evidence that they cause patient harm.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1201/p676.html

Geriatric Assessment: An Office-Based Approach - American Family Physician

Jun 15, 2018 - Family physicians should be proficient in geriatric assessment because, as society ages, older adults will constitute an increasing proportion of patients. Geriatric assessment evaluates medical, social, and environmental factors that influence overall well-being, and addresses ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0615/p776.html

Guideline, with No Evidence, Suggests Annual Screening for Urinary Incontinence in ...

Apr 1, 2019 - The goal of screening is to identify a disorder before it becomes symptomatic if early treatment has the potential for greater benefit than waiting until symptoms are reported. Despite the failure to meet this definition, this guideline suggests annual screening of women for urinary ...

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0401/p459.html

Health Maintenance in School-Aged Children: Part I. History, Physical Examination, ...

Aug 15, 2019 - The goals of the health maintenance visit in school-aged children (five to 12 years) are promoting health, detecting disease, and counseling to prevent injury and future health problems. During the visit, the physician should address patient and parent/caregiver concerns and ask about ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0815/p213.html

Hearing Loss in Adults: Differential Diagnosis and Treatment - American Family Physician

Jul 15, 2019 - More than 30 million U.S. adults have hearing loss. This condition is underrecognized, and hearing aids and other hearing enhancement technologies are underused. Hearing loss is categorized as conductive, sensorineural, or mixed. Age-related sensorineural hearing loss (i.e., ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0715/p98.html

Hemolytic Anemia: Evaluation and Differential Diagnosis - American Family Physician

Sep 15, 2018 - Hemolytic anemia is defined by the premature destruction of red blood cells, and can be chronic or life-threatening. It should be part of the differential diagnosis for any normocytic or macrocytic anemia. Hemolysis may occur intravascularly, extravascularly in the reticuloendothelial ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0915/p354.html

High-Sensitivity Troponin I of Less Than 5 ng per L Has Negative Predictive Value of ...

Mar 15, 2018 - A cardiac troponin I concentration of less than 5 ng per L in adults who present with potential acute coronary syndrome has a negative predictive value (NPV) of at least 99.9% for cardiac death at 30 days and at one year.

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0315/p410.html

HPV Testing Better Than Cytology for Women Vaccinated Against HPV - POEMs - American ...

Sep 15, 2018 - In women who had received the HPV vaccine, screening for HPV every five years, with cytology and colposcopy follow-up as needed, resulted in higher rates of identification of high-grade pre-cancerous disease than standard liquid-based cytology every 2.5 years with HPV follow-up ...

American Family Physician : POEMs

https://www.aafp.org/afp/2018/0915/p384.html

Human Trafficking: How Family Physicians Can Recognize and Assist Victims - Editorials ...

Aug 15, 2019 - Identifying a trafficking victim requires an understanding of the law as well as knowledge of risk factors and signs and symptoms of exploitation.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0815/p202.html

Identification of and Treatment for Unhealthy Alcohol Use in Primary Care Settings - ...

Jun 15, 2019 - We have identified the ways in which family physicians can implement the USPSTF screening recommendation for unhealthy alcohol use and then intervene when a patient has a positive screen.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/0615/p733.html

Identifying Outpatients with Acute Cough at Very Low Risk of Pneumonia - Point-of-Care ...

Aug 15, 2019 - In patients with acute cough, is it possible to identify a subset with a very low likelihood of community-acquired pneumonia?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2019/0815/p246.html

Identifying Patients with Headache Who Are at Risk of Subarachnoid Hemorrhage - ...

Aug 15, 2018 - When is urgent imaging warranted in patients presenting with sudden, severe, nontraumatic headache and normal findings on a neurologic examination?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/0815/p256.html

Identifying Patients with Newly Diagnosed Acute Pulmonary Embolism Who Are at Low Risk ...

Jun 15, 2018 - Standard management of acute PE includes five days of inpatient treatment with parenteral anticoagulation, followed by long-term oral anticoagulation as an outpatient. However, guidelines from the American College of Chest Physicians state that early discharge before five days can be ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/0615/p811.html

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