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How effective are complementary/alternative medicine (CAM) therapies for fibromyalgia?
(Family Physicians Inquiries Network, 2001)
Acupuncture, biofeedback, and S-adenosyl methionine (SAMe) have been shown to have some efficacy in the treatment of fibromyalgia in randomized controlled trials. Spa treatments, hypnotherapy, massage, and meditation may ...
Does evidence support the use of supplements to aid in BP control?
(Family Physicians Inquiries Network, 2020)
Q: Does evidence support the use of supplements to aid in BP control? Evidence-based answer: Yes. A number of well-tolerated natural therapies have been shown to reduce systolic and diastolic blood pressure (BP). (See TABLE1-8 for summary.) However...
Does turmeric relieve inflammatory conditions?
(Family Physicians Inquiries Network, 2011)
Limited evidence suggests that turmeric and its active compound, curcumin, are effective for rheumatoid arthritis and other inflammatory conditions (strength of recommendation [SOR]: C, primarily low-quality cohort studies with small patient numbers...
What is the best beta-blocker for systolic heart failure?
(Family Physicians Inquiries Network, 2015)
Q: What is the best beta-blocker for systolic heart failure? Evidence-based answer: Three beta-blockers--carvedilol, metoprolol succinate, and bisoprolol--reduce mortality equally (by about 30% over one year) in patients with Class III or IV...
How do antidepressants affect sexual function?
(Family Physicians Inquiries Network, 2013)
Evidence-based answer: patients treated with elective serotonin reuptake inhibitors (SSRIs) and the serotonin/norepinephrine reuptake inhibitor (SNRI) venlafaxine have significantly higher rates of overall sexual dysfunction--including desire...
Do oral contraceptives carry a significant risk of stroke for women with migranes?
(Family Physicians Inquiries Network, 2013)
Evidence-based answer: Estrogen-containing oral contraceptives may raise the risk of ischemic stroke in women with migraine, particularly migraine with aura (strength of recommendation [SOR]: C, small case-control studies with methodological flaws...
What is the best age to start vitamin D supplementation to prevent rickets in breastfed newborns?
(Family Physicians Inquiries Network, 2013)
Evidence-based answer: It's unclear what age is best to start vitamin D supplementation because no comparison studies exist. That said, breastfed infants who take vitamin D beginning at 3 to 5 days of life don't develop rickets (strength...
Is screening urinalysis in children worthwhile?
(Family Physicians Inquiries Network, 2003)
Screening urinalysis in asymptomatic children has not been shown to be beneficial (strength of recommendation: B; based on extrapolation from 1 meta-analysis). It is unlikely to be cost-effective and should be discontinued. While random urinalyses...
Is intra-articular platelet-rich plasma injection an effective treatment for knee OA?
(Family Physicians Inquiries Network, 2019)
Q: Is intra-articular platelet-rich plasma injection an effective treatment for knee OA? EVIDENCE-BASED ANSWER: PROBABLY NOT, based on the balance of evidence. While low-quality evidence may suggest potential benefit, the balance of evidence...
Is MRI useful for evaluation of acute low back pain?
(Family Physicians Inquiries Network, 2003)
Magnetic resonance imaging (MRI) is rarely helpful in the evaluation of acute low back pain. Limited evidence suggests that MRI may be useful in further assessing "red flag" in the history or physical exam. MRI has a high sensitivity and specificity...
Does frenotomy help infants with tongue-tie overcome breastfeeding difficulties?
(Family Physicians Inquiries Network, 2015)
Q: Does frenotomy help infants with tongue-tie overcome breastfeeding difficulties? Evidence-based answer: Probably not. No evidence exists for improved latching after frenotomy, and evidence concerning improvements in maternal comfort...
How effective are exercise and physical therapy for chronic low back pain?
(Family Physicians Inquiries Network, 2002)
Exercise is more effective for chronic low back pain than treatment with medication plus return to usual activity and as effective as conventional physiotherapy. The evidence is less consistent in showing that any particular exercise format provides...
Which interventions can increase breastfeeding duration?
(Family Physicians Inquiries Network, 2015)
Q: Which interventions can increase breastfeeding duration? Evidence-based answer: Breastfeeding support, beyond standard care, from lay people or professionals increases both short- and long-term breastfeeding duration (strength of recommendation...
Does caffeine intake during pregnancy affect birth weight?
(Family Physicians Inquiries Network, 2016)
Q: Does caffeine intake during pregnancy affect birth weight? Evidence-based answer: No. Reducing caffeinated coffee consumption by 180 mg of caffeine (the equivalent of 2 cups) per day after 16 weeks-gestation doesn't affect birth weight. Consuming...
What Clinical Findings Can Be Used to Diagnose Deep Venous Thrombosis?
(Family Physicians Inquiries Network, 2004)
No single clinical finding can accurately diagnose DVT. [Strength of recommendation: A, based on a systematic review of homogeneous validating cohort studies with good reference standards.] However, when organized into clinical decision rules (CDRs...
Should liver enzymes be checked in a patient taking niacin?
(Family Physicians Inquiries Network, 2005)
No randomized trials directly address the question of frequency of liver enzyme monitoring with niacin use. Niacin use is associated with early and late hepatotoxicity (strength of recommendation [SOR]: B, based on incidence data from randomized...
Whom should you test for secondary causes of hypertension?
(Family Physicians Inquiries Network, 2014)
Evidence-based answer: It's recommended that all children and adolescents with a new diagnosis of hypertension undergo renal ultrasound and laboratory evaluation for renal pathology (strength of recommendation [SOR]: C, consensus-based guidelines...
What are the risks of long-term PPI use for GERD symptoms in patients > 65 years?
(Family Physicians Inquiries Network, 2019)
Q: What are the risks of long-term PPI for GERD symptoms in patients > 65 years? EVIDENCE-BASED ANSWER: THE USE OF PROTON PUMP INHIBITORS (PPIs) to control gastrointestinal esophageal reflux disease (GRED) is significantly associated with increased...
What is appropriate fetal surveillance for women with diet-controlled gestational diabetes?
(Family Physicians Inquiries Network, 2006)
No evidence clearly supports the practice of increased fetal surveillance in the pregnancies of women with well-controlled (ie, fasting blood sugar <105 mg/dL) class A1 gestational diabetes (strength of recommendation [SOR]: B, consistent...
Should you screen for postpartum depression?
(Family Physicians Inquiries Network, 2013)
Should you screen for postpartum depression? Yes. Evidence suggests that screening new moms for depression leads to better outcomes, and should be routine. Practice changer: Make depression screening a routine part of the postpartum visit....