Clinical Inquiries, 2021

Permanent URI for this collection

https://hdl.handle.net/10355/80581

Browse

Recent Submissions

Now showing 1 - 5 of 12
  • Thumbnail Image
    Item
    Q Which injections are effective for lateral epicondylitis?
    (Family Physicians Inquiries Network, 2021-11) Vukelic, Brian; Abbey, Rebecca; Knox, Jordan; Migdalski, Alyssa
    Evidence-based answer: placebo injections actually improve lateral epicondylitis at high rates. No other injections convincingly improve it better than placebo. Corticosteroid injection is not superior to saline or anesthetic injection (strength of recommendation [SOR] A, systematic review of randomized controlled trials [RCTs]). Platelet-rich plasma (PRP) injection is not superior to saline injection (SOR A, meta-analysis of RCTs). Botulinum toxin injection, compared to saline injection, modestly improved pain in lateral epicondylitis, but with short-term grip-strength weakness (SORA, meta-analysis of RCTs). Prolotherapy injection, compared to saline injection, improved pain at 16-week, but not at 8-week, follow-up (SOR B, one small pilot RCT). Hyaluronic acid injection, compared to saline injection, resulted in a statistically significant pain reduction (6%) but did not achieve the minimum clinically important difference (SOR B, single RCT). Autologous blood injection, compared to saline injection, did not improve disability ratings (SOR B, one small RCT).
  • No Thumbnail Available
    Item
    Q Does inadequate sleep increase obesity risk in children?
    (Family Physicians Inquiries Network, 2021-12) Herzog, Daniela; Thai, Kristin; Neher, Jon O.; Auten, Beth
    Evidence-based answer: Yes, a link has been established but not a cause-effect relationship. Shorter reported sleep duration in childhood is associated with an increased risk of overweight or obesity years later (strength of recommendation [SOR]: B, meta-analyses of prospective cohort trials with high heterogeneity). In toddlers, accelerometer documentation of short sleep duration is associated with elevation of body mass index (BMI) at 1-year follow-up (SOR: B, prospective cohort). Adequate sleep is recommended to help prevent excessive weightgain in children (SOR: C, expert opinion).
  • No Thumbnail Available
    Item
    Q Is exercise therapy effective treatment for low back pain?
    (Family Physicians Inquiries Network, 2021-11) Broszko, Christine; Golden, Krystyna; Holmes, Cody R.; Fulleborn, Stephanie; Biglow, Carolyn
    Evidence-based answer: Yes, it is somewhat effective. Exercise therapy—including general exercise, yoga, Pilates, and motor control exercise—has been shown to modestly decrease pain in chronic low back pain (LBP); levels of benefit in short-([less than or equal to] 3 months) and long- ([grater than or equal to] 1 year) term follow-up range from 4% to 15% improvement (strength of recommendation [SOR] A, based on a systematic review of randomized controlled trials [RCTs]). Exercise therapy may improve function and decrease work disability in subacute and chronic LBP, respectively (SOR A, based on a meta-analysis of RCTs). Exercise therapy has not been associated with improvement in acute LBP (SOR A, based on a meta-analysis of RCTs).
  • No Thumbnail Available
    Item
    Q Do carotid artery calcifications seen on radiographs predict stenosis in asymptomatic adults?
    (Family Physicians Inquiries Network, 2021-09) Cowdrey, Diana; Hanh, Thomas; Vellardita, Lia
    Evidence-based answer: not very well. In asymptomatic patients, carotid artery calcification seen on radiograph has a positive predictive value of 70% and a negative predictive value of 75% for carotid artery stenosis (strength of recommendation [SOR]: B, systematic review of observational studies with heterogeneous results and a retrospective cohort study). Carotid calcifications on radiographs may be more predictive of carotid stenosis in people with atherosclerotic risk factors (SOR: C, cross-sectional study). Harms outweigh benefits in screening for carotid artery stenosis in asymptomatic adults (SOR: B, multiple cohort studies); therefore, incidental radiographic carotid artery calcifications in asymptomatic patients should not prompt further testing
  • Thumbnail Image
    Item
    Q: Can family physicians accurately screen for AAA with point-of-care ultrasound?
    (Family Physicians Inquiries Network, 2021-07) Cade, Nathan; Granath, Brad; Nehr, Jon O.; Sarfranek, Sarah
    Evidence-based answer: LIKELY YES. Point-of-care ultrasound (POCUS) screening for abdominal aortic aneurysm (AAA) by nonradiologist physicians is 98% sensitive and 99% specific, compared with imaging performed by radiologists (strength of recommendation [SOR]: B, meta-analysis of diagnostic accuracy studies mostly involving emergency medicine physicians). European family physicians demonstrated 100% concordance with radiologist readings (SOR: C, very small subsequent diagnostic accuracy studies).
Items in MOspace are protected by copyright, with all rights reserved, unless otherwise indicated.