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Medicine by the numbers

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Mildly Elevated Liver Transaminase Levels: Causes and Evaluation - American Family ...

Dec 1, 2017 - Mild, asymptomatic elevations (less than five times the upper limit of normal) of alanine transaminase and aspartate transaminase levels are common in primary care. It is estimated that approximately 10% of the U.S. population has elevated transaminase levels. An approach based on the ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1201/p709.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

Syncope: Evaluation and Differential Diagnosis - American Family Physician

Mar 1, 2017 - Syncope is an abrupt and transient loss of consciousness caused by cerebral hypoperfusion. It accounts for 1% to 1.5% of emergency department visits, resulting in high hospital admission rates and significant medical costs. Syncope is classified as neurally mediated, cardiac, and ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0301/p303.html

Palpitations: Evaluation in the Primary Care Setting - American Family Physician

Dec 15, 2017 - Palpitations are a common problem in the ambulatory primary care setting, and cardiac causes are the most concerning etiology. Psychiatric illness, adverse effects of prescription and over-the-counter medications, and substance use should also be considered. Distinguishing cardiac from ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1215/p784.html

The Adult Well-Male Examination - American Family Physician

Dec 15, 2018 - The adult well-male examination should provide evidence-based guidance toward the promotion of optimal health and well-being. The medical history should focus on tobacco and alcohol use, risk of human immunodeficiency virus and other sexually transmitted infections, and diet and ...

American Family Physician : Article

https://www.aafp.org/afp/2018/1215/p729.html

Chronic Kidney Disease: Detection and Evaluation - American Family Physician

Dec 15, 2017 - Chronic kidney disease affects 47 million people in the United States and is associated with significant health care costs, morbidity, and mortality. Because this disease can silently progress to advanced stages, early detection is critical for initiating timely interventions. Multiple ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1215/p776.html

Evaluation of the Solitary Pulmonary Nodule - American Family Physician

Dec 15, 2015 - A solitary pulmonary nodule is a common radiologic finding that is often discovered incidentally and may require significant workup to establish a definitive diagnosis. A solitary pulmonary nodule is a well-circumscribed round lesion measuring up to 3 cm in diameter and surrounded by ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1215/p1084.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

Acute Coronary Syndrome: Diagnostic Evaluation - American Family Physician

Feb 1, 2017 - Myocardial infarction (MI), a subset of acute coronary syndrome, is damage to the cardiac muscle as evidenced by elevated cardiac troponin levels in the setting of acute ischemia. Coronary artery disease is the leading cause of mortality in the United States. Chest pain is a common ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0201/p170.html

Colorectal Cancer Screening and Surveillance in Individuals at Increased Risk - ...

Jan 15, 2018 - Individuals at increased risk of developing colorectal cancer include those with a personal or family history of advanced adenomas or colorectal cancer, a personal history of inflammatory bowel disease, or genetic polyposis syndromes. In general, these persons should undergo more ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0115/p111.html

Assessment of Asymptomatic Microscopic Hematuria in Adults - American Family Physician

Dec 1, 2013 - Although routine screening for bladder cancer is not recommended, microscopic hematuria is often incidentally discovered by primary care physicians. The American Urological Association has published an updated guideline for the management of asymptomatic microscopic hematuria, which is ...

American Family Physician : Article

https://www.aafp.org/afp/2013/1201/p747.html

Vitamin D Screening and Supplementation in Community-Dwelling Adults: Common Questions ...

Feb 15, 2018 - Measurement of vitamin D levels and supplementation with oral vitamin D have become commonplace, although clinical trials have not demonstrated health benefits. The usefulness of serum 25-hydroxyvitamin D levels to assess adequate exposure to vitamin D is hampered by variations in ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0215/p254.html

Hoarseness in Adults - American Family Physician

Dec 1, 2017 - Hoarseness is a common presentation in primary care practices. Combined with other voice-related changes, it falls under the umbrella diagnosis of dysphonia. Hoarseness has a number of causes, ranging from simple inflammatory processes to less common psychiatric disorders to more ...

American Family Physician : Article

https://www.aafp.org/afp/2017/1201/p720.html

The Adult Well Male Examination - American Family Physician

May 15, 2012 - The adult well male examination should incorporate evidence-based guidance toward the promotion of optimal health and well-being, including screening tests shown to improve health outcomes. Nearly one-third of men report not having a primary care physician. The medical history should ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0515/p964.html

Preoperative Assessment in Older Adults: A Comprehensive Approach - American Family ...

Aug 15, 2018 - Surgical outcomes are significantly influenced by patients’ overall health, function, and life expectancy. A comprehensive geriatric preoperative assessment of older adults requires expanding beyond an organ-based or disease-based assessment. At a preoperative visit, it is important to ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0815/p214.html

Primary Care for Persons Who Inject Drugs - American Family Physician

Jan 15, 2019 - More than 750,000 persons in the United States inject opioids, methamphetamine, cocaine, or ketamine, and that number is increasing because of the current opioid epidemic. Persons who inject drugs (PWID) are at higher risk of infectious and noninfectious skin, pulmonary, cardiac, ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0115/p109.html

Chronic Pelvic Pain in Women - American Family Physician

Mar 1, 2016 - Chronic pelvic pain in women is defined as persistent, noncyclic pain perceived to be in structures related to the pelvis and lasting more than six months. Often no specific etiology can be identified, and it can be conceptualized as a chronic regional pain syndrome or functional ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0301/p380.html

Approach to Acute Headache in Adults - American Family Physician

May 15, 2013 - Approximately one-half of the adult population worldwide is affected by a headache disorder. The International Headache Society classification and diagnostic criteria can help physicians differentiate primary headaches (e.g., tension, migraine, cluster) from secondary headaches (e.g., ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0515/p682.html

Urine Drug Tests: Ordering and Interpreting Results - American Family Physician

Jan 1, 2019 - Urine drug testing is an essential component of monitoring patients who are receiving long-term opioid therapy, and it has been suggested for patients receiving long-term benzodiazepine or stimulant therapy. Family physicians should be familiar with the characteristics and capabilities ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0101/p33.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

Unintentional Weight Loss in Older Adults - American Family Physician

May 1, 2014 - Unintentional weight loss in persons older than 65 years is associated with increased morbidity and mortality. The most common etiologies are malignancy, nonmalignant gastrointestinal disease, and psychiatric conditions. Overall, nonmalignant diseases are more common causes of ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0501/p718.html

Detecting Elder Abuse and Neglect: Assessment and Intervention - American Family Physician

Mar 15, 2014 - Elder mistreatment includes intentional or neglectful acts by a caregiver or trusted person that harm a vulnerable older person. It can occur in a variety of settings. One out of 10 older adults experiences some form of abuse or neglect by a caregiver each year, and the incidence is ...

American Family Physician : Article

https://www.aafp.org/afp/2014/0315/p453.html

Neuropsychological Evaluations in Adults - American Family Physician

Jan 15, 2019 - Neuropsychologists provide detailed assessments of cognitive and emotional functioning that often cannot be obtained through other diagnostic means. They use standardized assessment tools and integrate the findings with other data to determine whether cognitive decline has occurred, to ...

American Family Physician : Article

https://www.aafp.org/afp/2019/0115/p101.html

Prostate Cancer Screening - American Family Physician

Oct 15, 2015 - Among American men, prostate cancer is the most commonly diagnosed cancer and the second leading cause of cancer-related death. Although prostate-specific antigen (PSA) testing has been used to screen for prostate cancer for more than 25 years, the test has low sensitivity and ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1015/p683.html

Screening for Cancer: Concepts and Controversies - American Family Physician

Nov 1, 2014 - Early detection of cancer is a core task in family medicine, and patients have come to expect screening tests, sometimes out of proportion to what evidence can justify. To understand the controversies surrounding screening and to provide sound advice to patients, family physicians ...

American Family Physician : Article

https://www.aafp.org/afp/2014/1101/p625.html

Health Maintenance in Postmenopausal Women - American Family Physician

May 1, 2017 - Cardiovascular disease is the leading cause of death and disability in postmenopausal women older than 50 years. Clinicians should use the pooled cohort risk assessment equations or another risk calculator every three to five years to estimate a woman’s 10-year risk of atherosclerotic ...

American Family Physician : Article

https://www.aafp.org/afp/2017/0501/p561.html

Diagnostic Approach to Chronic Constipation in Adults - American Family Physician

Aug 1, 2011 - Constipation is traditionally defined as three or fewer bowel movements per week. Risk factors for constipation include female sex, older age, inactivity, low caloric intake, low-fiber diet, low income, low educational level, and taking a large number of medications. Chronic ...

American Family Physician : Article

https://www.aafp.org/afp/2011/0801/p299.html

Disability Evaluations: More Than Completing a Form - American Family Physician

Jan 15, 2015 - According to the World Health Organization, more than 1 billion persons worldwide have a disability. In the United States, more than 56 million American workers have some form of disability; of these, more than 38 million persons have a severe disability. Blacks and Hispanics are among ...

American Family Physician : Article

https://www.aafp.org/afp/2015/0115/p102.html

Evaluation of Nausea and Vomiting: A Case-Based Approach - American Family Physician

Sep 15, 2013 - In the absence of acute abdominal pain, significant headache, or recent initiation of certain medications, acute nausea and vomiting is usually the result of self-limited gastrointestinal infections. Nausea and vomiting is also a common adverse effect of radiation therapy, chemotherapy,...

American Family Physician : Article

https://www.aafp.org/afp/2013/0915/p371.html

Health Maintenance in Women - American Family Physician

Jan 1, 2013 - The health maintenance examination is an opportunity to focus on disease prevention and health promotion. The patient history should include screening for tobacco use, alcohol misuse, intimate partner violence, and depression. Premenopausal women should receive preconception counseling ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0101/p30.html

Diagnostic Imaging of Acute Abdominal Pain in Adults - American Family Physician

Apr 1, 2015 - Acute abdominal pain is a common presentation in the outpatient setting and can represent conditions ranging from benign to life-threatening. If the patient history, physical examination, and laboratory testing do not identify an underlying cause of pain and if serious pathology remains...

American Family Physician : Article

https://www.aafp.org/afp/2015/0401/p452.html

Cancer Screening in Older Patients - American Family Physician

Apr 15, 2016 - Although cancer is the second leading cause of death among persons 65 years and older, there is a paucity of clinical trial data about the effectiveness and harms of cancer screening in this population. Given the heterogeneous nature of the older population, cancer screening in these ...

American Family Physician : Article

https://www.aafp.org/afp/2016/0415/p659.html

Diagnostic Approach to Pleural Effusion in Adults - American Family Physician

Apr 1, 2006 - The first step in the evaluation of patients with pleural effusion is to determine whether the effusion is a transudate or an exudate. An exudative effusion is diagnosed if the patient meets Light's criteria. The serum to pleural fluid protein or albumin gradients may help better ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0401/p1211.html

Preventive Health Care for Men Who Have Sex with Men - American Family Physician

Jun 15, 2015 - Men who have sex with men (MSM) comprise at least 4% of males in the United States. MSM may describe themselves as gay, bisexual, or heterosexual. Because current medical practice does not always facilitate discussion of sexual behaviors, this group of men may face barriers to receiving...

American Family Physician : Article

https://www.aafp.org/afp/2015/0615/p844.html

PSA Screening for Prostate Cancer - Medicine by the Numbers - American Family Physician

May 1, 2015 - Studies show no deaths were prevented and 1 in 5 underwent a prostate biopsy for a false-positive test. Read more.

American Family Physician : Medicine by the Numbers

https://www.aafp.org/afp/2015/0501/od3.html

Common Breast Problems - American Family Physician

Aug 15, 2012 - A palpable mass, mastalgia, and nipple discharge are common breast symptoms for which patients seek medical attention. Patients should be evaluated initially with a detailed clinical history and physical examination. Most women presenting with a breast mass will require imaging and ...

American Family Physician : Article

https://www.aafp.org/afp/2012/0815/p343.html

Breast Cancer Screening Update - American Family Physician

Feb 15, 2013 - Breast cancer is the most common non–skin cancer and the second leading cause of cancer death in North American women. Mammography is the only screening test shown to reduce breast cancer–related mortality. There is general agreement that screening should be offered at least biennially ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0215/p274.html

The Case Against Coronary Artery Calcium Scoring for Cardiovascular Disease Risk ...

Dec 15, 2019 - Although coronary artery calcium testing may slightly improve future risk prediction, this theoretical benefit is outweighed by its potential harms.

American Family Physician : Editorials

https://www.aafp.org/afp/2019/1215/p734.html

Approach to the Adult Patient with Fever of Unknown Origin - American Family Physician

Dec 1, 2003 - Fever of unknown origin (FUO) in adults is defined as a temperature higher than 38.3 degrees C (100.9 degrees F) that lasts for more than three weeks with no obvious source despite appropriate investigation. The four categories of potential etiology of FUO are classic, nosocomial, ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1201/p2223.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

Initial Evaluation of the Patient with Suspected Dementia - American Family Physician

May 1, 2005 - Dementia is a common disorder among older persons, and projections indicate that the number of patients with dementia in the United States will continue to grow. Alzheimer's disease and vascular dementia account for the majority of cases of dementia. After a thorough history and ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0501/p1745.html

Diagnosis of Acute Abdominal Pain in Older Patients - American Family Physician

Nov 1, 2006 - Acute abdominal pain is a common presenting complaint in older patients. Presentation may differ from that of the younger patient and is often complicated by coexistent disease, delays in presentation, and physical and social barriers. The physical examination can be misleadingly ...

American Family Physician : Article

https://www.aafp.org/afp/2006/1101/p1537.html

Diagnosis of Chronic Obstructive Pulmonary Disease - American Family Physician

Jul 1, 2008 - Chronic obstructive pulmonary disease affects more than 26 million adults in the United States. Family physicians provide care for most of these patients. Cigarette smoking is the leading risk factor for chronic obstructive pulmonary disease, although other risk factors, including ...

American Family Physician : Article

https://www.aafp.org/afp/2008/0701/p87.html

Screening for Osteoporosis to Prevent Fractures: Recommendation Statement - U.S. ...

Nov 15, 2018 - The USPSTF recommends screening for osteoporosis with bone measurement testing to prevent osteoporotic fractures in women 65 years and older.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2018/1115/od1.html

Prostate Cancer Screening: The Continuing Controversy - American Family Physician

Dec 15, 2008 - Prostate cancer is the second most common cancer in men, with a lifetime prevalence of 17 percent. Prostate cancer symptoms generally occur in advanced stages, making early detection desirable. Digital rectal examination and prostate-specific antigen testing are the most commonly used ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1215/p1377.html

Should Family Physicians Routinely Screen for Lung Cancer in High-Risk Populations? ...

Jul 15, 2014 - When offered to the appropriate population in the appropriate context, CT-based lung cancer screening will reduce the number of deaths caused by this difficult disease.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2014/0715/od2.html

Mini-Mental State Examination for the Detection of Dementia in Older Patients - ...

Dec 1, 2016 - When scores are adjusted based on a patient's education level, the MMSE may be useful to rule out a diagnosis of dementia in clinically unevaluated patients 65 years and older (sensitivity = 97%; specificity = 70%). Scores of less than 24 may also be useful to rule in dementia in ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2016/1201/p880.html

Ruling Out Pulmonary Embolism in the Primary Care Setting - Point-of-Care Guides - ...

Jun 1, 2018 - What is the best approach to evaluate patients with suspected pulmonary embolism in the outpatient, primary care setting?

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/0601/p750.html

Screening for Cervical Cancer: Recommendation Statement - U.S. Preventive Services Task...

Feb 15, 2019 - The USPSTF recommends screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk human papillomavirus ...

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2019/0215/od1.html

Proteinuria in Adults: A Diagnostic Approach - American Family Physician

Sep 15, 2000 - Proteinuria is a common finding in adults in primary care practice. An algorithmic approach can be used to differentiate benign causes of proteinuria from rarer, more serious disorders. Benign causes include fever, intense activity or exercise, dehydration, emotional stress and acute ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0915/p1333.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

Should Screening Techniques for Colorectal Cancer All Have an 'A' Recommendation? No: ...

May 15, 2017 - The AAFP will continue to evaluate different screening tests as more research becomes available, but currently can endorse only those options that have the strongest evidence that benefits exceed harms.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2017/0515/p618.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

Screening for Atrial Fibrillation with Electrocardiography: Recommendation Statement - ...

Mar 15, 2019 - The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for atrial fibrillation with electrocardiography.

American Family Physician : U.S. Preventive Services Task Force

https://www.aafp.org/afp/2019/0315/od1.html

Assessing Breast Cancer Risk in Women - American Family Physician

Dec 15, 2008 - Understanding modifiable and nonmodifiable factors that increase or decrease breast cancer risk allows family physicians to counsel women appropriately. Nonmodifiable factors associated with increased breast cancer risk include advanced age, female sex, family history of breast cancer, ...

American Family Physician : Article

https://www.aafp.org/afp/2008/1215/p1361.html

Common Hyperpigmentation Disorders in Adults: Part I. Diagnostic Approach, Cafe au Lait...

Nov 15, 2003 - The cause of hyperpigmentation usually is traced to the activity and presence of melanocytes. Cafe au lait macules may be solitary benign findings or may indicate the presence of neurofibromatosis with its associated complications. Diffuse hyperpigmentation should prompt a search for ...

American Family Physician : Article

https://www.aafp.org/afp/2003/1115/p1955.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

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

Vitamin D Screening and Supplementation in Primary Care: Time to Curb Our Enthusiasm - ...

Feb 15, 2018 - Evidence for vitamin D screening and supplementation in adults shows that these commonplace practices have virtually no established health benefits.

American Family Physician : Editorials

https://www.aafp.org/afp/2018/0215/p226.html

Evaluation of Acute Headaches in Adults - American Family Physician

Feb 15, 2001 - Classifying headaches as primary (migraine, tension-type or cluster) or secondary can facilitate evaluation and management A detailed headache history helps to distinguish among the primary headache disorders.

American Family Physician : Article

https://www.aafp.org/afp/2001/0215/p685.html

Screening for Breast Cancer: Current Recommendations and Future Directions - American ...

Jun 1, 2007 - Breast cancer is one of the most significant health concerns in the United States. Recent reviews have questioned the value of traditional breast cancer screening methods. Breast self-examination has been shown not to improve cancer-specific or all-cause mortality in large studies, but ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0601/p1660.html

Estimating Cardiovascular Risk - Point-of-Care Guides - American Family Physician

May 1, 2017 - The primary prevention of cardiovascular disease (CVD) depends on accurate estimation of cardiovascular risk. However, a recent systematic review identified 363 prediction models.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2017/0501/p580.html

Common Hyperpigmentation Disorders in Adults: Part II. Melanoma, Seborrheic Keratoses, ...

Nov 15, 2003 - Nevi, or moles, are localized nevocytic tumors. The American Cancer Society's ABCD rules are useful for differentiating a benign nevus from malignant melanoma. While acanthosis nigricans may signal an underlying malignancy (e.g., gastrointestinal tumor), it more often is associated with...

American Family Physician : Article

https://www.aafp.org/afp/2003/1115/p1963.html

Improving Quality by Doing Less: Overscreening - Editorials - American Family Physician

Jan 1, 2015 - This editorial is the first in a series of three that addresses the related issues of over-screening, overdiagnosis, and overtreatment. Overscreening often leads to overdiagnosis and overtreatment.

American Family Physician : Editorials

https://www.aafp.org/afp/2015/0101/p22.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

Should Family Physicians Screen for Testosterone Deficiency in Men? No: Screening May ...

Feb 15, 2015 - Testosterone testing leads to testosterone treatment, which is inappropriate for the vast majority of patients. Testosterone treatment should be reserved for patients who are truly hypogonadal.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2015/0215/p226.html

Evaluation of Dysuria in Adults - American Family Physician

Apr 15, 2002 - Dysuria, defined as pain, burning, or discomfort on urination, is more common in women than in men. Although urinary tract infection is the most frequent cause of dysuria, empiric treatment with antibiotics is not always appropriate. Dysuria occurs more often in younger women, probably ...

American Family Physician : Article

https://www.aafp.org/afp/2002/0415/p1589.html

Should Family Physicians Screen for Testosterone Deficiency in Men? Yes: Screening for ...

Feb 15, 2015 - With the possible exception of patients with cardiovascular disease, testosterone replacement therapy remains a potentially beneficial option in improving health-related quality of life in men.

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2015/0215/p220.html

Screening Mammography: The Goal Is Changing - Editorials - American Family Physician

Feb 15, 2013 - Screening mammography is one of an increasing number of clinical issues that will require rethinking the clinical mission and restructuring clinical practice to help patients make informed choices.

American Family Physician : Editorials

https://www.aafp.org/afp/2013/0215/p246.html

A Primary Care Approach to the Patient with Claudication - American Family Physician

Feb 15, 2000 - Peripheral arterial occlusive disease occurs in about 18 percent of persons over 70 years of age. Usually, patients who have this disease present with intermittent claudication with pain in the calf, thigh or buttock that is elicited by exertion and relieved with a few minutes of rest. ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0215/p1027.html

Clinical Diagnosis of Gout Without Joint Aspirate - Point-of-Care Guides - American ...

Sep 15, 2016 - Gout is ideally diagnosed through identification of characteristic negatively birefringent crystals under polarized light microscopy in fluid aspirated from end-organ deposits, typically from a joint. However, fewer than 10% of patients with gout see a rheumatologist, and most cases of ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2016/0915/p505.html

Evaluation of the Subfertile Man - American Family Physician

May 15, 2003 - Infertility affects 15 percent of couples, and 50 percent of male infertility is potentially correctable. Evaluation of the subfertile man requires a complete medical history, physical examination, and laboratory studies. The main purpose of the male evaluation is to identify and treat ...

American Family Physician : Article

https://www.aafp.org/afp/2003/0515/p2165.html

Screening for Intimate Partner Violence, Elder Abuse, and Abuse of Vulnerable Adults - ...

May 15, 2019 - A.F., a 32-year-old woman, presents for a health maintenance visit. It has been more than a year since she was last seen. She has no significant medical history and has never used tobacco, alcohol, or any other substances.

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2019/0515/p649.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

Diagnosis of Gastrointestinal Bleeding in Adults - American Family Physician

Apr 1, 2005 - The clinical evaluation of gastrointestinal bleeding depends on the hemodynamic status of the patient and the suspected source of the bleeding. Patients presenting with upper gastrointestinal or massive lower gastrointestinal bleeding, postural hypotension, or hemodynamic instability ...

American Family Physician : Article

https://www.aafp.org/afp/2005/0401/p1339.html

Diagnosis of Stable Ischemic Heart Disease: Recommendations from the ACP - Practice ...

Oct 1, 2013 - The American College of Physicians (ACP), in collaboration with the American College of Cardiology Foundation, American Heart Association, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, and Society of Thoracic Surgeons, has developed a guideline...

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2013/1001/p469.html

Asymptomatic Microscopic Hematuria in Adults: Summary of the AUA Best Practice Policy ...

Mar 15, 2001 - The American Urological Association (AUA) convened the Best Practice Policy Panel on Asymptomatic Microscopic Hematuria to formulate policy statements and recommendations for the evaluation of asymptomatic microhematuria in adults. The recommended definition of microscopic hematuria is ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0315/p1145.html

Giant Cell Arteritis: Biopsy After Corticosteroid Initiation - FPIN's Clinical ...

Jan 15, 2017 - Corticosteroid therapy in patients with suspected giant cell arteritis should not degrade the accuracy of temporal artery biopsy if the biopsy is performed within four weeks of corticosteroid initiation. Temporal artery biopsy can be performed up to four weeks after starting high-dose ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2017/0115/p116.html

Screening for High Blood Pressure in Adults - Putting Prevention into Practice - ...

Mar 15, 2016 - A 55-year-old black man presents for a blood pressure evaluation. He is trying to be more physically active and health conscious but has not seen a physician for five years. He takes no medications, has no concerns, and his physical examination findings are unremarkable. According to ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2016/0315/p511.html

Peripheral Artery Disease Screening and Cardiovascular Disease Risk Assessment with the...

Dec 15, 2014 - J.P. is a 40-year-old man with a 15 pack-year smoking history. His father has type 2 diabetes mellitus. J.P.'s vital signs, weight, and lipid levels are within normal limits. At his office visit, he brings an advertisement for a health fair with information on screening for peripheral ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2014/1215/p859.html

Efficient Identification of Adults with Depression and Dementia - American Family ...

Sep 15, 2004 - Family physicians must decide how to screen for depression or dementia and which patients to screen. Mental health questionnaires can be helpful. In practice-based screening, questionnaires are administered to all patients, regardless of risk status. In case-finding screening, ...

American Family Physician : Article

https://www.aafp.org/afp/2004/0915/p1101.html

Screening for Ovarian Cancer - Putting Prevention into Practice - American Family ...

Jun 15, 2018 - A 61-year-old woman presents to your office for a well-woman examination. She had a normal Papanicolaou (Pap) test last year and has no medical problems. She quit smoking 10 years ago, reports a family history significant only for cardiovascular disease, and is sexually active with her ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2018/0615/p813.html

How to Counsel Men About PSA Screening - Editorials - American Family Physician

Nov 15, 2016 - For family physicians to put PSA screening guidance into practice, they must elicit patients' preferences and provide accurate, understandable information about the benefits and harms.

American Family Physician : Editorials

https://www.aafp.org/afp/2016/1115/p782.html

Should Family Physicians Use Coronary Artery Calcium Scores to Screen for Coronary ...

Sep 1, 2012 - No: Screening is Unproven, Expensive, and Potentially Harmful. Coronary artery calcium (CAC) scores have been recommended as a way to screen for coronary artery disease (CAD). Before we get too enthusiastic about this expensive new test, remember that a good screening test must perform ...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2012/0901/p405.html

Should Family Physicians Use Coronary Artery Calcium Scores to Screen for Coronary ...

Sep 1, 2012 - Yes: Screening Improves CAD Risk Management in Selected Patients. Sudden death is often the first manifestation of atherosclerotic coronary artery disease (CAD). One-third of deaths from CAD in the Atherosclerosis Risk in Communities study occurred without warning signs, and there was ...

American Family Physician : Editorials: Controversies in Family Medicine

https://www.aafp.org/afp/2012/0901/p398.html

General Health Checks for Reducing Morbidity and Mortality - Cochrane for Clinicians - ...

Oct 1, 2013 - Although general health checks increase the number of new diagnoses, they do not decrease total, cardiovascular-related, or cancer-related morbidity or mortality. The studies in this Cochrane review have limited applicability to the current recommended practice of providing selective, ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2013/1001/p432.html

Screening for Obstructive Sleep Apnea in Adults - Putting Prevention into Practice - ...

Jul 15, 2017 - R.K. is a 52-year-old white man who presents to your office for a preventive health visit. He is overweight and has a history of hypertension and hyperlipidemia, which are stable and well controlled with medication. One of his coworkers was recently diagnosed with obstructive sleep ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2017/0715/p123.html

The Annual Pelvic Examination: Preventive Time Not Well Spent - Editorials - American ...

Jan 1, 2013 - Given the lack of evidence to support annual pelvic examinations, it would be better for patients if we spend that time addressing screening, counseling, and other preventive services for which strong evidence exists.

American Family Physician : Editorials

https://www.aafp.org/afp/2013/0101/p8.html

ACS/ASCCP/ASCP Guidelines for the Early Detection of Cervical Cancer - Editorials - ...

Sep 15, 2012 - The American Cancer Society (ACS), the American Society for Colposcopy and Cervical Pathology (ASCCP), and the American Society for Clinical Pathology (ASCP) recently published updated recommendations for the early detection of cervical cancer. The guidelines are based on a systematic ...

American Family Physician : Editorials

https://www.aafp.org/afp/2012/0915/p501.html

Simple Clinical Prediction Rule Determines Risk of Heart Failure with Preserved ...

May 15, 2019 - A simple clinical prediction rule using noninvasive data can identify patients at low, moderate, and high risk for HFPEF.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/0515/od3.html

Evaluation of Asymptomatic Microscopic Hematuria in Adults - American Family Physician

Sep 15, 1999 - In patients without significant urologic symptoms, microscopic hematuria is occasionally detected on routine urinalysis. At present, routine screening of all adults for microscopic hematuria with dipstick testing is not recommended because of the intermittent occurrence of this finding ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0915/p1143.html

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

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

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

Screening for Breast Cancer - Putting Prevention into Practice - American Family Physician

Jul 15, 2016 - S.O. is a 47-year-old woman who presents to your office for a well-woman visit. She is healthy, takes no medications, and has no health concerns. She has never been diagnosed with breast cancer, nor have any of her first-degree relatives. Her digital mammography two years ago was ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2016/0715/p143.html

New Tests for Cervical Cancer Screening - American Family Physician

Sep 1, 2001 - The Papanicolaou (Pap) smear has been used to screen women for cervical cancer since 1940. Recently, a number of new technologies have been developed to improve the detection of cervical cancer and its precursors. However, there is substantial controversy about whether the new tests ...

American Family Physician : Article

https://www.aafp.org/afp/2001/0901/p780.html

Does Screening Mammography Lead to Overdiagnosis of Invasive Breast Cancer? - AFP ...

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

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

Mammography Screening for Breast Cancer: Recommendation of the U.S. Preventive Services...

Sep 15, 2010 - The November 2009 U.S. Preventive Services Task Force (USPSTF) recommendation for breast cancer screening, while sparking much controversy, was not a radical departure from the previous 2002 recommendation. The USPSTF approached the recommendation update with the basic questions of what...

American Family Physician : Editorials

https://www.aafp.org/afp/2010/0915/p602.html

AAFP Recommends Universal Screening for HIV Infection Beginning at 18 Years of Age - ...

Apr 15, 2014 - The AAFP recommends delaying the start of routine HIV screening until 18 years of age, and screening all patients 18 to 65 years of age. The AAFP notes that screening younger patients may still be beneficial based on high-risk behaviors.

American Family Physician : Editorials

https://www.aafp.org/afp/2014/0415/p614.html

Diagnostic Evaluation of Erectile Dysfunction - American Family Physician

Jan 1, 2000 - Erectile dysfunction, the persistent inability to attain or maintain penile erection sufficient for sexual intercourse, affects millions of men to various degrees. The majority of cases have an organic etiology, most commonly vascular disease that decreases blood flow into the penis. ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0101/p95.html

Screening for Glaucoma - Putting Prevention into Practice - American Family Physician

Oct 15, 2014 - A 55-year-old black woman presents to your office for a routine well-woman examination. Her medical history is significant for hypertension, which is well controlled with medication. She mentions that her mother was diagnosed with glaucoma a few years ago and is currently undergoing ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2014/1015/p569.html

Screening for Chronic Kidney Disease - Putting Prevention into Practice - American ...

Feb 15, 2014 - A 55-year-old woman with no history of diabetes mellitus or hypertension asks to be screened for chronic kidney disease (CKD). Her 88-year-old mother has end-stage renal disease and is currently undergoing renal dialysis. The patient says she wants to take all necessary precautions to ...

American Family Physician : Putting Prevention into Practice

https://www.aafp.org/afp/2014/0215/p293.html

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