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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...
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)....
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...
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...
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)
of antiepileptic agents is conflicting (SOR: C, inconsistent patient-oriented evidence). Valproate is ineffective for treating aggression (SOR: C, very small RCT). No data exist to guide long-term medication use. All available studies lasted no longer than 12 weeks...
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....
Which patients benefit from lowering LDL to <100 mg/dL?
(Family Physicians Inquiries Network, 2010)
, expert opinion). The evidence also indicates that high-risk patients benefit from a statin--preferably in high doses--regardless of their baseline LDL or degree of LDL reduction with treatment (SOR: A, a large randomized controlled trial [RCT] and meta-analyses)....
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...
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'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 ...
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....
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 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 ...
Do intra-articular steroid injections affect glycemic control in patients with diabetes?
(Family Physicians Inquiries Network, 2010)
A single intra-articular steroid injection into the knee produces acute hyperglycemia for 2 or 3 days in patients with diabetes who otherwise have good glucose control (strength of recommendation [SOR]: B, small cohort ...
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 ...
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...
Should patients with acute DVT limit activity?
(Family Physicians Inquiries Network, 2010)
Ambulation, combined with compression of the affected extremity, appears to be safe for medically stable patients with deep venous thromboses (DVT) (strength of recommendation [SOR]: A, consistent randomized controlled ...
What's the best treatment for pyogenic granuloma?
(Family Physicians Inquiries Network, 2010)
Simple surgical excision is associated with a low risk of recurrence, but often leaves a visible scar. Curettage or shave excision, with cautery, is more likely to succeed in 1 session than cryotherapy; both may leave a ...