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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] ...
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...
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...
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 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....
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 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 ...
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 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 ...
Management of Alcohol Withdrawal Syndrome
(Family Physicians Inquiries Network, 2010)
-analyses suggest that long-acting benzodiazepines are generally preferred for managing AWS in the inpatient setting. (SOR: A). However, there is also evidence that benzodiazepines are safe in the outpatient setting. (SOR: B, based on one randomized prospective...
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 ...
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...
How can we keep impaired glucose tolerance and impaired fasting glucose from progressing to diabetes?
(Family Physicians Inquiries Network, 2010)
Lifestyle interventions aimed at weight loss of 5% to 10% of body weight along with moderate aerobic exercise such as brisk walking for 150 minutes a week are the most effective means to prevent impaired fasting glucose (IFG) or impaired glucose...
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 ...
Angiotensin blockade for diabetes: Monitor microalbuminuria?
(Family Physicians Inquiries Network, 2007)
No studies address whether continued screening for microalbuminuria once a patient is taking an angiotensin-converting enzyme (ACE) inhibitor or angiotensin-2 receptor blocker (ARB) improves outcomes. Indirect evidence and expert opinion suggest...