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Glycemic Control in Patients with Type 2 Diabetes
(Family Physicians Inquiries Network, 2007)
There is no clearly superior oral agent for glycemic control in patients with type 2 diabetes. (Strength of Recommendation [SOR]: C) Metformin (Glucophage) has shown additional benefit when compared with other treatments (including insulin...
Metformin Therapy and Diabetes Prevention in Adolescents Who Are Obese
(Family Physicians Inquiries Network, 2007)
No studies have addressed the question of whether metformin reduces development of diabetes among adolescents who are obese. Metformin treatment in adolescents who are obese can modestly reduce risk factors for type 2 diabetes, including elevated...
Angiotensin blockade for diabetes: Monitor microalbuminuria?
(Family Physicians Inquiries Network, 2007)
No studies address whether continued screening for microalbuminuria once a patient is taking an angiotensin-converting enzyme (ACE) inhibitor or angiotensin-2 receptor blocker (ARB) improves outcomes. Indirect evidence and expert opinion suggest...
What's the best way to screen for anxiety and panic disorders?
(Family Physicians Inquiries Network, 2007)
The GAD-7 has the best evidence and utility in the primary care setting for generalized anxiety disorder (strength of recommendation [SOR]: A), while the proprietary Quick PsychoDiagnostics Panel (QPD) has the best operating ...
Can you differentiate bacterial from viral pediatric infections based on the CBC?
(Family Physicians Inquiries Network, 2007)
No--the complete blood count (CBC) alone does not have adequate sensitivity or specificity to tell bacterial from viral infections (strength of recommendation [SOR]: B, cohort studies). When used in conjunction with other clinical parameters...
What is the risk of bowel strangulation in an adult with an untreated inguinal hernia?
(Family Physicians Inquiries Network, 2007)
of Anesthesiologists class III and IV) (SOR: C, based on expert opinion and case series). It is reasonable to offer elective surgery or watchful waiting to low-risk patients who understand the risks of strangulation (SOR: C, based on expert opinion and case series)....
What's the best treatment for CIN 2 or 3?
(Family Physicians Inquiries Network, 2007)
Excision or ablation of the transformation zone are equally effective for treating an initial diagnosis of cervical intraepithelial neoplasia (CIN) grades 2 or 3 in women with a satisfactory colposcopy and no suggestion of microinvasive or invasive...
Which nondrug alternatives can help with insomnia?
(Family Physicians Inquiries Network, 2007)
Cognitive behavioral therapy (CBT) interventions -- particularly stimulus control and sleep hygiene -- are well-validated, effective treatments for chronic insomnia that are equivalent or superior to pharmacological ...
Are there big differences among beta-blockers in treating essential hypertension?
(Family Physicians Inquiries Network, 2007)
debate on the effectiveness of the agents in preventing adverse outcomes. The level of evidence has reached the point where the practice of using beta-blockers as monotherapy should be questioned (SOR : C, expert opinion)....
What are the best treatments for herpes labialis?
(Family Physicians Inquiries Network, 2007)
There are 3: valacyclovir, acyclovir, and topical penciclovir. Valacyclovir, 2g twice in 1 day taken during the prodromal stage of herpes labialis, reduces the episode duration and time to healing. Acyclovir, 400 mg, taken 5 times a day for 5 days...
What hormonal contraception is most effective for obese women?
(Family Physicians Inquiries Network, 2007)
Depot medroxyprogesterone acetate (DMPA; Depo-Provera) and the combination contraceptive vaginal ring (NuvaRing) are most effective for obese women because they don't appear to be affected by body weight (strength of ...
How do exercise and diet compare for weight loss?
(Family Physicians Inquiries Network, 2007)
Exercise alone produces short-term weight loss that is comparable with that induced by diet, after which a plateau in weight loss appears to occur (strength of recommendation [SOR]: B). Exercise in combination with diet ...
When should you suspect community-acquired MRSA? How should you treat it?
(Family Physicians Inquiries Network, 2009)
There are no clinical or epidemiologic features that will help you to clearly distinguish community-acquired methicillin-resistant Staphylococcus aureus infections (CA-MRSA) from methicillin-sensitive (CA-MSSA) infections (strength of recommendation...
Which technique for removing nevi is least scarring?
(Family Physicians Inquiries Network, 2007)
-- has a low risk of producing a hypertrophic or hypotrophic scar (strength of recommendation: C, expert opinion, committee guidelines)....
How effective are dietary interventions in lowering lipids in adults with dyslipidemia?
(Family Physicians Inquiries Network, 2007)
. Average decreases in LDL range from 6.96 to 25.14 mg/dL, depending on the particular intervention and participants' baseline characteristics (strength of recommendation [SOR]: C, based on meta-analyses of randomized controlled trials [RCTs] measuring...
How should we treat major depression combined with anxiety?
(Family Physicians Inquiries Network, 2007)
One approach is to use antidepressants alone, which reduce symptoms for patients with major depression plus symptoms of anxiety or major depression plus generalized anxiety disorder. Selective serotonin reuptake inhibitors ...
Which lifestyle interventions effectively lower LDL cholesterol?
(Family Physicians Inquiries Network, 2007)
Counseling, weight loss, exercise, and drinking alcohol all effectively lower low- density lipoprotein cholesterol (LDL-C). Specifically, one to 2 daily drinks of alcohol lowers L DL-C, if consumed regularly for more than 4 weeks (strength...
Sleep apnea in adults: How accurate is clinical prediction?
(Family Physicians Inquiries Network, 2009)
Questionnaires, physical examination, and clinical prediction rules estimate the pretest probability of obstructive sleep apnea hypopnea syndrome (OSAHS), but are not specific enough to make the diagnosis (strength of recommendation [SOR]: B, meta...
Secondary Causes of Obesity
(Family Physicians Inquiries Network, 2011)
velocity, delayed puberty, or clinical signs and symptoms of endocrine abnormalities (e.g., hirsutism, truncal obesity, violaceous striae). (Strength of recommendation [SOR]: C, based on expert opinion.) Underlying metabolic and genetic causes of obesity...
What's the best way to predict the success of a trial of labor after a previous C-section?
(Family Physicians Inquiries Network, 2015)
Q: What's the best way to predict the success of a trial of labor after a previous C-section? Evidence-based answer: while 8 scoring tools predict success rates for a trial of labor after previous cesarean section (TOLAC), it's unclear which...