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What's best for IBS?
(Family Physicians Inquiries Network, 2012)
Recommend antispasmodics or antidepressants for patients with irritable bowel syndrome (IBS) and explain that, while fiber may have other benefits, it is unlikely to relieve IBS symptoms. Stength of recommendation: A: Based on a meta-analysis....
Complementary and alternative therapies for atopic dermatitis
(Family Physicians Inquiries Network, 2012)
Evening primrose oil may be effective for the treatment of atopic dermatitis. (Strength of Recommendation [SOR]: B, based on one randomized controlled trial [RCT].) Homeopathy may be as good as conventional therapy for eczema. Probiotics (SOR: A...
Evaluation of asymptomatic atrial fibrillation
(Family Physicians Inquiries Network, 2012)
In hemodynamically stable patients without acute chest pain, the evaluation and treatment of atrial fibrillation should not change based on symptoms alone. (Strength of Recommendation: A, based on multiple cohort studies.) As many as 75 percent...
Does cervical membrane stripping in women with group B Streptococcus put the fetus at risk?
(Family Physicians Inquiries Network, 2012)
No direct evidence points to fetal harm from cervical membrane stripping (CMS) to induce labor in term pregnancies complicated by group B Streptococcus (GBS) colonization (strength of recommendation [SOR]: B, a Cochrane systematic review)....
How does smoking in the home affect children with asthma?
(Family Physicians Inquiries Network, 2012)
Children with asthma who are exposed to smoking in the home are likely to have more severe asthma symptoms, more asthma-related doctor visits (strength of recommendation [SOR]: B, a preponderance of evidence from heterogeneous cohort studies), and a...
Evaluation of hip pain in older adults
(Family Physicians Inquiries Network, 2012)
The evaluation of hip pain in patients 65 years and older should include a history and physical examination, followed by pertinent imaging studies. (Strength of Recommendation [SOR]: C, based on expert opinion.) Patients who have hip pain for more...
Rethinking antibiotics for sinusitis-again
(Family Physicians Inquiries Network, 2012)
Stop prescribing amoxicillin for acute rhinosinusitis. It's unlikely to provide a speedier recovery than over-the-counter (OTC) remedies alone. Stength of recommendation: B: Based on a single high-quality randomized controlled trial....
The shrinking case for saw palmetto
(Family Physicians Inquiries Network, 2012)
Advise men with benign prostatic hyperplasia (BPH) not to take saw palmetto for urinary symptoms. Explain that it has not been found to alleviate symptoms, even at triple the standard dose. Stength of recommendation: A: Based on evidence from a high...
BP meds: this simple change improves outcomes
(Family Physicians Inquiries Network, 2012)
of recommendation: B: Based on a well-done randomized clinical trial (RCT) and a subgroup analysis....
Screening Mammography for Reducing Breast Cancer Mortality
(Family Physicians Inquiries Network, 2012)
include false-positive results, diagnosis and treatment for cancer that would not have become clinically evident during the woman's lifetime, false-negative results (i.e., false reassurance), radiation exposure, biopsies, and anxiety....
Intranasal steroids vs antihistamines: which is better for seasonal allergies and conjunctivitis?
(Family Physicians Inquiries Network, 2012)
--by about 25% more than placebo, whereas oral antihistamines decrease TNSS by 5% to 10% (strength of recommendation [SOR]: B, systematic review of randomized controlled trials [RCTs], most without clinically validated or standardized outcome measures...
Does blood pressure screening benefit children?
(Family Physicians Inquiries Network, 2012)
Screening may not show benefits in childhood but could pay off for adults. Although major professional organizations recommend measuring blood pressure (BP) at every clinic visit for all children older than 3 years (strength of recommendation [SOR...
A safer way to prevent VTE recurrence
(Family Physicians Inquiries Network, 2012)
After patients with unprovoked venous thromboembolism (VTE) complete a 6- to 18-month course of oral anticoagulation therapy, consider a switch to aspirin. Stength of recommendation: A: Based on one well-designed, randomized controlled trial (RCT)....
Treating pulmonary embolism at home?
(Family Physicians Inquiries Network, 2012)
Treat low-risk patients with pulmonary embolism (PE) with low-molecular-weight heparin (LMWH) in an outpatient setting. Stength of recommendation: B: Based on one good quality randomized controlled trial (RCT)....
Should breastfeeding babies be given pacifiers?
(Family Physicians Inquiries Network, 2012)
Do not discourage the use of pacifiers by healthy infants who are breastfeeding. Stength of recommendation: A: Based on a good-quality meta-analysis...
Would this long-acting bronchodilator be better for your patient?
(Family Physicians Inquiries Network, 2012)
of recommendation: A: Based on one well-designed randomized controlled trial....
What are the benfits and risks of IUDs in adolescents?
(Family Physicians Inquiries Network, 2012)
Little available evidence specifically addresses the benefits and risks of intrauterine devices (IUDs) in adolescents. Most studies have evaluated IUD use in nulliparous adults. Levonorgestrel IUDs cause less menstrual bleeding than oral...
Human parathyroid hormone for treating osteoporosis
(Family Physicians Inquiries Network, 2012)
Human parathyroid hormone should be used in patients with severe osteoporosis to decrease the rate of vertebral and nonvertebral fractures. (Strength of Recommendation [SOR]: A, based on a systematic review and randomized controlled trial [RCT...
Medications for weight loss in patients with Type 2 diabetes mellitus
(Family Physicians Inquiries Network, 2012)
Fluoxetine (Prozac) and orlistat (Xenical) produce modest short-term weight loss, but their long-term benefits are unclear and their safety is uncertain. (Strength of Recommendation [SOR]: B, based on a meta-analysis of randomized controlled trials...
Should you consider antibiotics for exacerbations of mild COPD?
(Family Physicians Inquiries Network, 2014)
Consider antibiotics for patients with exacerbations of mild to moderate chronic obstructive pulmonary disease (COPD).