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Is aspirin effective for primary prevention of colon cancer?
(Family Physicians Inquiries Network, 2010)
Aspirin probably shouldn't be used for routine prevention because of its potential risks (strength of recommendation [SOR]: B, systematic review of inconsistent evidence). However, aspirin is likely to be effective for secondary prevention...
Does hypercoagulopathy testing benefit patients with DVT?
(Family Physicians Inquiries Network, 2010)
There is no evidence to suggest that testing for hypercoagulopathy benefits most patients with deep venous thrombosis (DVT). Nor has research established that thrombophilia test results improve the ability to predict recurrence better than clinical...
Does spinal manipulation relieve back pain?
(Family Physicians Inquiries Network, 2010)
Spinal manipulation therapy (SMT) reduces lower back pain and improves the ability to perform everyday activities more than sham therapies (strength of recommendation [SOR]: A, multiple randomized controlled trials [RCTs] ...
Acupuncture for migraine headaches
(Family Physicians Inquiries Network, 2010)
Acupuncture reduces the frequency of migraine headaches when used as an adjunct to, or in place of, medical management. (Strength of Recommendation: A, based on meta-analyses)....
How best to help kids lose weight
(Family Physicians Inquiries Network, 2010)
Screen children and adolescents for obesity and offer them multifaceted weight loss interventions, based on new evidence (and a recent US Preventive Services Task Force [USPSTF] recommendation) of their effectiveness. Consider adding a weight loss...
Sunscreen Use for Skin Cancer Prevention
(Family Physicians Inquiries Network, 2010)
Daily sunscreen use reduces the incidence of squamous cell carcinoma but not the incidence of basal cell carcinoma. (Strength of Recommendation [SOR]: B, based on a single randomized controlled trial with less than 13 years of follow...
Thiazolidinedione Therapy for Managing Metabolic Syndrome
(Family Physicians Inquiries Network, 2010)
There is no patient-oriented evidence supporting the use of TZD therapy in patients in the general population who have metabolic syndrome. Rosiglitazone (Avandia) use decreases cardiovascular morbidity and mortality in patients with metabolic...
Which drugs should post-MI patients routinely receive?
(Family Physicians Inquiries Network, 2010)
the best evidence (SOR: B, a single RCT) a beta-blocker (SOR: A, meta-analysis) renin-angiotensin-aldosterone system blockers, whether or not the ejection fraction is diminished after myocardial infarction (MI) (SOR: A, meta-analysis for angiotensin...
Does red wine reduce cardiovascular risks?
(Family Physicians Inquiries Network, 2010)
evidence exists to determine whether wine reduces cardiovascular risk more than other alcoholic beverages....
How useful are genital exams during boys' sports physicals?
(Family Physicians Inquiries Network, 2010)
Examination may be useful to identify hernia but not testicular cancer. Insufficient evidence exists to recommend for or against screening genital exams for boys playing sports. Given the low risk of harm, screening for hernias as a part of a...
How should we monitor men receiving testosterone replacement therapy?
(Family Physicians Inquiries Network, 2010)
symptom response to testosterone are also recommended, although direct evidence is lacking (SOR: C, consensus opinion). Monitoring lipid levels is unnecessary (SOR: A, based on several meta-analyses), as is monitoring testosterone levels (SOR C, consensus...
What's the best approach to diagnosing food allergies in infants?
(Family Physicians Inquiries Network, 2010)
A well-designed oral food challenge (OFC) is the most reliable diagnostic test for infants whose clinical history and physical examination suggest a specific food allergy (strength of recommendation [SOR]: C, consensus ...
Which drugs are best when aggressive Alzheimer's patients need medication?
(Family Physicians Inquiries Network, 2010)
controlled trials [RCTs]). However, evidence of drug-related deaths in patients taking these drugs mandates weighing the benefits against the risks. SSRIs may be a safer, effective alternative (SOR: B, limited studies). Evidence for the efficacy...
Add a fibrate to a statin?
(Family Physicians Inquiries Network, 2010)
Do not routinely add a fibrate to a statin for patients with type 2 diabetes who are at high risk for cardiovascular events. Stength of recommendation: B: Based on a good-quality randomized controlled trial....
Help patients prevent repeat ankle injury
(Family Physicians Inquiries Network, 2010)
Advise patients being treated for ankle sprain that reinjury -- which is especially common during the first year -- can result in chronic pain or disability, and that a home-based proprioceptive training program has been shown to significantly...
Does exercise alleviate symptoms of depression?
(Family Physicians Inquiries Network, 2010)
Exercise reduces patient-perceived symptoms of depression when used as monotherapy (strength of recommendation [SOR]: B, meta-analysis of randomized controlled trials [RCTs] with significant heterogeneity). It relieves ...
Does office spirometry improve quit rates in smokers?
(Family Physicians Inquiries Network, 2010)
Simply performing spirometry and offering cessation advice doesn't improve quit rates in patients who smoke (strength of recommendation [SOR]: A, systematic review of randomized controlled trials [RCTs]). However, when the ...
Which history and physical findings are most useful in identifying rotator cuff tears?
(Family Physicians Inquiries Network, 2010)
It's unknown which -- if any -- historical factors are most useful, because no studies evaluating their accuracy with rotator cuff tears have been done. As for physical findings, no single physical examination finding is ...
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...
How should you treat a child with flat feet?
(Family Physicians Inquiries Network, 2010)
Flexible flatfoot (FFF)doesn�۪t increase the risk of injury or pain during exercise (strength of recommendation [SOR]: B, 2 small prospective cohort studies). Treating FFF with orthotics doesn�۪t change the course of arch ...