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Practice facilitation to improve colorectal cancer screening in federally qualified health care clinics in rural Missouri
(University of Missouri--Columbia, 2021)
(MPICCS) utilizes staff members called practice facilitators to increase CRC screening rates at rural health care clinics. Practice facilitators assist partner clinics in implementing evidence-based interventions (EBIs)....
Safe-T expanding services and improving patient outcomes
(2023)
"Sexual assault is a serious public health issue affecting men, women and children statewide. In 2021 there were 3,262 reports of sexual assault in Missouri (Missouri State Highway Patrol, 2023). 12% of reported sexual ...
Perceptions, barriers, and methods for the early detection and intervention of clinical deterioration in hospitalized adults
(2023)
) event (Buist et al., 2004). Components of detection tools are founded on evidence that is overwhelmingly retrospective. A common limitation of CD detection is that these tools are often accurate at predicting decline but are not as successful...
What is the best treatment for plant-induced contact dermatitis?
(Family Physicians Inquiries Network, 2013)
It's unclear which treatment is best, because there have been no head-to-head comparisons of treatments for Rhus (plant-induced) contact dermatitis. That said, topical high-potency steroids slightly improve pruritus and ...
What behavioral interventions are safe and effective for treating obesity?
(Family Physicians Inquiries Network, 2006)
with appropriate use (strength of recommendation [SOR]: A, based on multiple randomized controlled trials). Hypnosis can be used as an adjunct to behavioral therapy for weight loss (SOR: A, based on systematic reviews)....
Does birth weight predict childhood obesity?
(Family Physicians Inquiries Network, 2008)
A birth weight greater than 4,000 g is associated with an increased risk of obesity in both childhood and adolescence (strength of recommendation [SOR]: B, systematic review and multiple cohort studies).
What's the best diagnostic evaluation of night sweats?
(Family Physicians Inquiries Network, 2007)
There is no single best evidence-based approach to the diagnostic evaluation of night sweats, given the limited number of studies on the subject. A detailed history, however, does appear to be the most important initial diagnostic tool (strength...
How effective is spironolactone for treating resistant hypertension?
(Family Physicians Inquiries Network, 2019)
Q: How effective is spironolactone for treating resistant hypertension? EVIDENCE-BASED ANSWER: VERY EFFECTIVE. Spironolactone reduces systolic blood pressure (SPB) by 11 to 17 mm Hg and diastolic blood pressure (DPB) by up to 6 mm Hg in patients...
Pharmacologic therapy for eustachian tube dysfunction
(Family Physicians Inquiries Network, 2013)
There are no medications that improve patient-oriented outcomes in children or adults with eustachian tube dysfunction. (Strength of Recommendation [SOR]: A, based on a systematic review of randomized controlled trials [RCTs].) Oral corticosteroids...
Time to stop glucosamine and chondroitin for knee OA?
(Family Physicians Inquiries Network, 2018)
Time to stop glucosamine and chondroitin for knee OA? Prior studies provided conflicting results regarding the efficacy of these medications. This study offers evidence for discontinuing them. Practice changer: Tell patients with moderately severe...
How effectively do ACE inhibitors and ARBs prevent migraines?
(Family Physicians Inquiries Network, 2018)
Q: How effectively do ACE inhibitors and ARBs prevent migraines? Evidence-based answer: The angiotensin-converting enzyme (ACE) inhibitor lisinopril reduces the number of migraines by about 1.5 per month in patients experiencing 2 to 6 migraines...
Management of ADHD in preschool-aged children
(Family Physicians Inquiries Network, 2013)
RCTs.) Alternative therapies, such as elimination diets, have limited evidence of success and should generally be avoided or used in conjunction with standard therapies. (SOR: B, based on a systematic review of a small number of heterogeneous RCTs.)...
What causes a low TSH level with a normal free T4 level?
(Family Physicians Inquiries Network, 2006)
cardiovascular outcomes and evidence is insufficient that it improves neuropsychiatric outcomes (strength of recommendation [SOR]: C). Bone mineral density may be increased with treatment of SCH (SOR: B, based on one randomized clinical trial)....
What is appropriate management of iron deficiency for young children?
(Family Physicians Inquiries Network, 2006)
should continue for 2 additional months to replenish iron stores. Recheck hemoglobin at the end of treatment and again 6 months later (strength of recommendation [SOR]: C, based on expert opinion). For primary prevention, counsel parents on the use...
Can unintended pregnancies be reduced by dispensing a year's worth of hormonal contraception?
(Family Physicians Inquiries Network, 2019)
Q. Can unintended pregnancies be reduced by dispensing a year's worth of hormonal contraception? Evidence-based answer: probably, although studies that looked directly at this outcome are limited. A systematic review showed that women who received a...
ASH choosing wisely
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2014-01)
The Choosing Wisely(R) campaign challenges medical societies to identify 5 tests, procedures, or treatments within each specialty's clinical domain that are offered to patients despite an absence of evidence demonstrating benefit or, in some cases...
Is therapy based on endoscopy results better than empiric therapy for dyspepsia?
(Family Physicians Inquiries Network, 2005)
In the initial management of dyspepsia for patients without "alarm" symptoms (weight loss, recurrent vomiting, dysphagia, anemia, evidence of bleeding, onset of dyspepsia after age 45 years), therapy based on the results of early endoscopy...
How effective are pharmacologic agents for alcoholism?
(Family Physicians Inquiries Network, 2002)
are combined with either counseling or Alcoholics Anonymous programs. (Grade of recommendation: B, based on multiple randomized controlled studies with short and incomplete follow-up of patients.)...
How often does long-term PPI therapy cause clinically significant hypomagnesemia?
(Family Physicians Inquiries Network, 2018)
Q: How often does long-term PPI therapy cause clinically significant hypomagnesemia? EVIDENCE-BASED ANSWER: Rarely. Proton pump inhibitors (PPIs) may be associated with decreases in serum magnesium laboratory values to below 1.6 to 1.8 mg...
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...