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Introduction to Clinical Inquiries : new series by the Family Physicians Inquiries Network
(Family Physicians Inquiries Network, 2020)
Introduction to Clinical Inquiries and FPIN. The Clinical Inquiries were included in Canadian Family Physician beginning March 2020....
What Clinical Findings Can Be Used to Diagnose Deep Venous Thrombosis?
(Family Physicians Inquiries Network, 2004)
No single clinical finding can accurately diagnose DVT. [Strength of recommendation: A, based on a systematic review of homogeneous validating cohort studies with good reference standards.] However, when organized into clinical decision rules (CDRs...
Clinical Indicators of Obstructive Sleep Apnea
(Family Physicians Inquiries Network, 2011)
Clinical indicators (e.g., sex, snoring severity, history of apnea, age, menopausal status, waist-to-hip ratio, body habitus) can predict OSA as diagnosed using overnight polysomnography or sleep study. (Strength of Recommendation: B, based...
Potential harms of long-term acne treatment with oral antibiotics
(Family Physicians Inquiries Network, 2020)
Clinical Inquiries question: What are the potential harms of long-term acne treatment with oral antibiotics? Evidence-based answer: Specific evidence attributing adverse effects to long-term acne treatment with oral antibiotics is lacking. However...
How accurate is the clinical diagnosis of pneumonia?
(Family Physicians Inquiries Network, 2003)
No element or combination of elements from the clinical history and physical examination are sufficiently sensitive or specific to confirm or exclude acute community-acquired pneumonia (CAP). A chest x-ray is recommended to make the diagnosis (Grade...
Should you consider antibiotics for exacerbations of mild COPD?
(Family Physicians Inquiries Network, 2014)
Consider antibiotics for patients with exacerbations of mild to moderate chronic obstructive pulmonary disease (COPD).
Acupuncture for low back pain
(Family Physicians Inquiries Network, 2020)
Clinical Inquiries question: Is acupuncture effective in improving pain relief for low back pain? Evidence-based answer: Acupuncture is an effective treatment for relief from low back pain, even when compared with other interventions (sham...
Should a nylon brush be used for Pap smears from pregnant women?
(Family Physicians Inquiries Network, 2005)
Use of a nylon brush (Cytobrush and others) with spatula to obtain Papanicolaou (Pap) smears from pregnant women is more likely to obtain sufficient endocervical cells, without adverse consequence for the mother or for the ...
In patients with a previous CVA, do antioxidants protect against subsequent stroke?
(Family Physicians Inquiries Network, 2002)
Most recent randomized controlled clinical trials have not found a benefit in antioxidants (vitamin C, vitamin E, and/or beta-carotene) for preventing cardiovascular disease, including stroke. These recent clinical studies have not confirmed earlier...
Ruling out PE in pregnancy
(Family Physicians Inquiries Network, 2020)
Can clinical probability and a high-sensitivity D-dimer test reliably and safely rule out pulmonary embolism during pregnancy? PRACTICE CHANGER: Use a clinical probability score to identify patients at low or intermediate risk for pulmonary embolism...
When should acute nonvenereal conjunctivitis be treated with topical antibiotics?
(Family Physicians Inquiries Network, 2002)
Children with suspected or culture-proven acute nonvenereal bacterial conjunctivitis should be treated with topical antibiotics, which hastens clinical and microbiological remission and may prevent potentially serious morbidity. In light of recent...
Chlamydia test-of-cure in pregnancy
(Family Physicians Inquiries Network, 2020)
Clinical Inquiries question: What is the optimal interval between treatment and test-of-cure (TOC) in pregnant women with Chlamydia trachomatis (CT)? Evidence-based answer: The optimal interval between treatment and TOC in pregnant women with CT...
How do clinical prediction rules compare with joint fluid analysis in diagnosing gout?
(Family Physicians Inquiries Network, 2016)
Q: How do clinical prediction rules compare with joint fluid analysis in diagnosing gout? Evidence-based answer: Clinical prediction rules effectively diagnose gout without joint fluid analysis. The American College of Rheumatology clinical...
Hypoglycemia with insulin and sulfonylureas
(Family Physicians Inquiries Network, 2020)
Clinical Inquiries question: In patients with type 2 diabetes mellitus (T2DM), does the combination of insulin and sulfonylurea (SU) increase the risk of hypoglycemia? Evidence-based answer: The incidence of severe hypoglycemia in patients with T2DM...
Testosterone replacement and improved memory
(Family Physicians Inquiries Network, 2021)
Clinical Inquires question: Does testosterone replacement improve cognition in memory-impaired older men with low testosterone? Evidence-based answer: Testosterone therapy does not appear to improve cognition in older men with low testosterone...
Sleep apnea in adults: How accurate is clinical prediction?
(Family Physicians Inquiries Network, 2009)
Questionnaires, physical examination, and clinical prediction rules estimate the pretest probability of obstructive sleep apnea hypopnea syndrome (OSAHS), but are not specific enough to make the diagnosis (strength of recommendation [SOR]: B, meta...
Suspect carpal tunnel? : Try this
(Family Physicians Inquiries Network, 2013)
For best results, use the modified Phalen's test (MPT) rather than the traditional Phalen's when you suspect carpal tunnel syndrome (CTS).
Optimal timing for peripheral IV replacement?
(Family Physicians Inquiries Network, 2013)
Replace peripheral IV catheters as needed, rather than on a routine basis. Stength of recommendation: A: Based on a randomized equivalence trial.
When to "CAP" off treatment for pneumonia
(Family Physicians Inquiries Network, 2017)
clinical success rates as longer treatment regimens, but is associated with fewer negative patient outcomes....
Confidently rule out CAP in the outpatient setting
(Family Physicians Inquiries Network, 2021)
) -- without requiring a chest x-ray -- in an otherwise healthy adult outpatient who has an acute cough, a normal pulmonary exam, and normal vital signs using this simple clinical decision rule (CDR). STRENGTH OF RECOMMENDATION: A: Based on a systematic review...