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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 ...
Counseling or Antidepressants for Treating Depression?
(Family Physicians Inquiries Network, 2005)
, based on randomized controlled trials (RCTs) and systematic reviews] There is limited evidence that antidepressant medications and cognitive behavioral therapy are similarly effective for patients with severe depression [Strength of recommendation: B...
Is MRI useful for evaluation of acute low back pain?
(Family Physicians Inquiries Network, 2003)
is limited and weak2,3 (strength of recommendation: C, based on limited randomized controlled trials)....
Are antibiotics helpful for acute maxillary sinusitis?
(Family Physicians Inquiries Network, 2003)
). However, this benefit does not persist in trials that better reflect general practice by using clinical diagnostic criteria (SOR: C, inconsistent studies). In trials showing improvement with antibiotics, symptoms decrease, at best, 2 to 3 days sooner than...
What does the evidence tell us about treating very-high-risk patients to an LDL <70 mg/dL?
(Family Physicians Inquiries Network, 2009)
No studies directly compare low-density lipoprotein (LDL) levels <70 mg/dL to levels of 71 to 100 mg/dL in very-high-risk patients. However, no evidence suggests a "floor" for LDL cholesterol levels beyond which further reductions of heart disease...
What is the best treatment for chronic constipation in the elderly?
(Family Physicians Inquiries Network, 2007)
There is no one best evidence-based treatment for chronic constipation in the elderly. While the most common first-line treatments are dietary fiber and exercise, the evidence is insufficient to support this approach in the geriatric population...
Are nasal steroid sprays effective for otitis media with effusion?
(Family Physicians Inquiries Network, 2003)
in the short term, alone or in combination with antibiotics (SOR: A, based on randomized controlled trials). However, within 3 to 12 weeks, resolution of OME with nasal steroids is no better than placebo. No evidence exists that treatment with nasal steroids...
What are the relative risks and benefits of progestin-only contraceptives?
(Family Physicians Inquiries Network, 2005)
Little evidence describes the risks and benefits of progestin-only contraceptives therapy. No good-quality evidence exists to determine the risk of cancer associated with progestin-only contraceptives. Data are insufficient to discern their effect...
Treatment of Impetigo
(Family Physicians Inquiries Network, 2007)
of recommendation [SOR]: A) Based on the available evidence on effectiveness, no clear preference can be given for any one oral antibiotic over another. (SOR: A)...
Should we recommend universal neonatal hearing screening?
(Family Physicians Inquiries Network, 2005)
Universal neonatal hearing screening leads to both earlier detection and earlier treatment of infants with hearing loss (strength of recommendation [SOR]: A, based on a systematic review). Available evidence suggests early identification...
Hip Pain in Preschool-Age Children
(Family Physicians Inquiries Network, 2009)
Evidence is lacking on the most common causes of hip pain in children because most data come from cohort studies and include referred patients. Based on these studies, transient synovitis is the most common cause of hip pain in preschool...
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...
Is the long-term use of proton pump inhibitors safe?
(Family Physicians Inquiries Network, 2004)
Long-term use of proton pump inhibitors (PPIs) appears safe, resulting in no clinically relevant adverse effects (strength of recommendation: B, based on nonsystematic reviews, cohort studies, or low-quality randomized controlled trials...
When is neuroimaging warranted for headache?
(Family Physicians Inquiries Network, 2005)
of recommendation [SOR]: B, based on a validating cohort study), decreased level of
consciousness (SOR: B, based on a retrospective, nonconsecutive case study), occipitonuchal location, multiple associated symptoms, and age older than 55 years (SOR: B, based on a...
Do nasal decongestants relieve symptoms?
(Family Physicians Inquiries Network, 2003)
Oral and topical nasal decongestants result in a statistically significant improvement in subjective symptoms of nasal congestion and objective nasal airway resistance in adults' common colds (strength of recommendation [SOR]: A, based on randomized...
How accurate is the clinical diagnosis of pneumonia?
(Family Physicians Inquiries Network, 2003)
of Recommendation: A, based on well-designed cohort studies). No studies specifically demonstrate improved patient outcomes through use of chest x-ray in adults; however, accurate diagnosis is expected to reduce the number of unnecessary antibiotic prescriptions...
Are antibiotics effective in preventing pneumonia for nursing home patients?
(Family Physicians Inquiries Network, 2004)
. Three measures effectively prevent pneumonia in nursing home patients: influenza vaccination of residents (strength of recommendation [SOR]: B, based on systematic review of homogenous cohort observational studies); influenza vaccination of caregivers...
Does cranberry juice prevent or treat urinary tract infection?
(Family Physicians Inquiries Network, 2003)
Cranberry juice (200 mL daily to 250 mL 3 times daily) or cranberry concentrate tablets (at least 1:30 parts concentrated juice twice daily) reduce recurrent, symptomatic urinary tract infection (UTI) in women by 12% to 20% (absolute risk reduction...
For fibromyalgia, which treatments are the most effective?
(Family Physicians Inquiries Network, 2005)
well-being and have a moderate beneficial effect on tenderness and stiffness (strength of recommendation [SOR]: A, based on a systematic review of randomized controlled trials [RCTs]). Selective serotonin reuptake inhibitors (SSRIs) may moderately...
Is osteoporosis screening in postmenopausal women effective?
(Family Physicians Inquiries Network, 2003)
No single study evaluates the effectiveness of osteoporosis screening. However, screening women over the age of 65 years -- or those between 60-64 years with certain risk factors -- is recommended based on available evidence. First, osteoporosis...