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Focus on Leadership, Climate, Culture, and Instructional Practices: Practical Strategies for School Improvement.
(2007-02)
This presentation discusses leadership, climate, culture and instructional practices. It raises questions and links topics together for a big-picture view....
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 ...
What is the best way to evaluate acute diarrhea?
(Family Physicians Inquiries Network, 2002)
Limited evidence delineates the relative probabilities of causes of acute diarrhea, typically defined as a diarrheal disease lasting 14 days or fewer, in the developed world. Viruses (rotavirus, Norwalk, and other enteric viruses) are responsible...
Do antipyretics prolong febrile illness?
(Family Physicians Inquiries Network, 2004)
(strength of recommendation [SOR]: A-, based on small randomized controlled trials). Acetaminophen did not affect symptoms, overall condition, or time to complete healing in children with varicella, although it increased the time to total scabbing of lesions...
Do antibiotics prevent recurrent UTI in children with anatomic abnormalities?
(Family Physicians Inquiries Network, 2004)
Evidence is insufficient to recommend for or against antibiotic prophylaxis to prevent recurrent urinary tract infections (UTI) in children with anatomic abnormalities. Guidelines acknowledge this lack of evidence, but still recommend using...
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...
How long is expectant management safe in first-trimester miscarriage?
(Family Physicians Inquiries Network, 2005)
More than 80% of women with a first-trimester spontaneous abortion have complete natural passage of tissue within 2 to 6 weeks with no higher complication rate than that from surgical intervention (strength of recommendation [SOR]: A, based...
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 the ThinPrep better than conventional Pap smear at detecting cervical cancer?
(Family Physicians Inquiries Network, 2004)
the conventional Papanicolaou (Pap) smear at detecting cervical cancer (strength of recommendation [SOR]: A-, based on 1 large validating cohort study with a good reference standard and 1 systematic review). There is insufficient evidence to recommend 1 preparation...
How effective is prophylactic therapy for gout in people with prior attacks?
(Family Physicians Inquiries Network, 2004)
of gout, although the data to support their use is limited. Some evidence suggests that despite their serum uric acid-lowering effects, uricosurics (such as probenecid) fail to reduce gout attacks (SOR: B, based on 2 cohort studies). We were unable to find...
Does combining aspirin and warfarin decrease the risk of stroke for patients with nonvalvular atrial fibrillation?
(Family Physicians Inquiries Network, 2004)
(NVAF) (strength of recommendation [SOR]: A, based on randomized controlled trials). Aspirin therapy at a dose of 75 to 325 mg reduces the risk of stroke to a lesser degree and may be useful for low-risk patients with NVAF or patients at high risk...
First- or second-generation antihistamines: which are more effective at controlling pruritus?
(Family Physicians Inquiries Network, 2004)
, antihistamines are no better than placebo (SOR: B, small RCTs and other studies). Other categories of pruritus are best treated with non-antihistamine agents (SOR: C, based on expert opinion and disease-oriented research)....
Other than anticoagulation, what is the best therapy for those with atrial fibrillation?
(Family Physicians Inquiries Network, 2004)
Rate control with long-term anticoagulation is recommended for most patients with atrial fibrillation (strength of recommendation [SOR]: A, based on randomized controlled trials [RCTs]). A rhythm-control strategy provides no survival or quality...
How should a DEXA scan be used to evaluate bisphosphonate therapy for osteoporosis?
(Family Physicians Inquiries Network, 2005)
If bone density is evaluated after initiating bisphosphonate drug therapy, it should be tested no earlier than 2 years (strength of recommendation [SOR]: B, based on case series of dual energy x-ray absorptiometry [DEXA] scanning precision...
Does warfarin prevent deep venous thrombosis in high-risk patients?
(Family Physicians Inquiries Network, 2004)
[SOR]: A, based on large randomized controlled trials and meta-analysis). Warfarin is useful in preventing DVT in patients with cancer, specifically those treated with chemotherapy (SOR: B, based on small randomized controlled trials). Warfarin may...
Morning Report and All That [poster]
(2007)
interns and residents on finding answers to clinical questions and teaches sessions on evidence-based practice....
What medication best prevents migraine in children?
(Family Physicians Inquiries Network, 2003)
controlled trial, prospective or retrospective cohort studies, or trials with conflicting evidence). Flunarizine and nimodipine have the best evidence of benefit in children; however, availability, cost, and side effects limit their usefulness (SOR: B, based...
Should we screen adults for asymptomatic microhematuria?
(Family Physicians Inquiries Network, 2004)
Screening patients for asymptomatic microhematuria does not appear to improve outcomes, since screening does not identify a population with increased prevalence of urologic malignancy (strength of recommendation [SOR]: A, based on prospective cohort...
Is an outpatient workup safe for patients with a transient ischemic attack?
(Family Physicians Inquiries Network, 2004)
There is no compelling evidence that outpatient diagnostic workup of patients with transient ischemic attack (TIA) is less safe than inpatient workup, or that hospitalization prevents stroke or improves stroke outcomes after TIA (strength...
What is a reasonable initial approach to the patient with fatigue?
(Family Physicians Inquiries Network, 2001)
Half of all patients presenting with fatigue have a psychological cause. Patients with a history of anxiety or depression or those with a duration of symptoms for more than 3 months are more likely to remain symptomatic 6 months later. Physicians...