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What treatment is best for hypertrophic scars and keloids?
(Family Physicians Inquiries Network, 2011)
No one treatment is best (strength of recommendation [SOR]: C, meta-analysis of heterogenous studies); no good evidence exists comparing treatments with each other. Triamcinolone injections, triamcinolone injections combined with excision...
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...
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...
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...
How do we evaluate a marginally low B12 level?
(Family Physicians Inquiries Network, 2007)
The best way to evaluate a low-normal B12 level is to check serum methylmalonic acid and homocysteine levels1 (strength of recommendation [SOR]: B, based on consistent level 2 or 3 studies). Give 1 or 2 mg of oral vitamin B12 a day if levels...
Is high-dose oral B12 a safe and effective alternative to a B12 injection?
(Family Physicians Inquiries Network, 2012)
Both high-dose oral B12 and injected B12 raised low vitamin B12 levels and improved hematologic parameters and neurologic symptoms in short-term studies (3-4 months) predominantly involving patients with conditions associated with intestinal...
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...
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 antibiotics helpful for acute maxillary sinusitis?
(Family Physicians Inquiries Network, 2003)
with placebo, and, regardless of treatment, at least two thirds of patients are improved in 14 days (SOR: A, based on multiple systematic reviews). No evidence suggests that antibiotics decrease complication rates. Newer broad-spectrum antibiotics are no better...
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 using e-cigarettes cigarette smoking in adolescents?
(Family Physicians Inquiries Network, 2019)
Q: Does using e-cigarettes cigarette smoking in adolescents? Evidence-based answer: Probably. Electronic cigarette (e-cigarette) use by adolescents is associated with a 2- to 4-fold increase in cigarette smoking over the next year (strength...
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)...
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...
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...
Does screening by primary care providers effectively detect melanoma and other skin cancers?
(Family Physicians Inquiries Network, 2020)
Q: Does screening by primary care providers effectively detect melanoma and other skin cancers? Evidence-based answer: possibly. No trials have directly assessed detection of melanoma and other skin cancers by primary care providers. Training a...
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...
Effective Management of Flatulence
(Family Physicians Inquiries Network, 2009)
benefit in reducing flatus-associated odor. (SOR: C, based on disease-oriented evidence). Evidence for oral activated charcoal and simethicone has been inconsistent and does not support their use. (SOR: B, based on multiple small RCTs)....
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...
What is the best management for patients with evidence of asymptomatic ischemia on exercise stress testing?
(Family Physicians Inquiries Network, 2007)
-EST Heart Rate Recovery. For patients who have a low-risk DTS, the 4-year mortality is less than 1% to 2%; therefore, risk-factor reduction without further investigation is appropriate (strength of recommendation: B, based on cohort studies and consensus...
Does heat or cold work better for acute muscle strain?
(Family Physicians Inquiries Network, 2008)
Cryotherapy is better than heat for treating acute muscle strain (strength of recommendation [SOR]: C, consensus, usual practice, and expert opinion). Insufficient patient-oriented evidence exists regarding use of heat to treat acute soft...