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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...
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).
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...
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...
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...
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).
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...
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....
Patients insist on antibiotics for sinusitis? Here is a good reason to say no
(Family Physicians Inquiries Network, 2008)
Stop prescribing antibiotics for adults with a clinical diagnosis of acute sinusitis, unless the patient has severe symptoms Antibiotics have little if any positive effects on the severity and duration of symptoms, and they cause adverse effects...
Is nedocromil effective in preventing asthmatic attacks in patients with asthma?
(Family Physicians Inquiries Network, 2004)
In general, about 50% to 70% of patients respond to nedocromil (SOR: A, multiple RCTs and meta-analyses). Unfortunately, which patients respond is not predictable from clinical parameters. Nedocromil is worth trying in mild persistent asthma...
What's best for IBS?
(Family Physicians Inquiries Network, 2012)
Recommend antispasmodics or antidepressants for patients with irritable bowel syndrome (IBS) and explain that, while fiber may have other benefits, it is unlikely to relieve IBS symptoms. Stength of recommendation: A: Based ...
Are breast self-exams or clinical exams effective for screening breast cancer?
(Family Physicians Inquiries Network, 2005)
]). Clinical breast examination is an important means of averting some deaths from breast cancer, but demands careful attention to technique and thoroughness (SOR: B, extrapolating from a high-quality RCT)....
This adjunct medication can speed CAP recovery
(Family Physicians Inquiries Network, 2015)
prednisone 50 mg/d to hospitalized patients with mild to moderate community-acquired pneumonia. It decreases time to clinical stability and length of hospital stay....
Antiepileptic Drug Level Monitoring
(Family Physicians Inquiries Network, 2008)
monitoring may be clinically useful in special populations, including patients with suspected drug toxicity or noncompliance, pregnant patients, and patients with renal failure. Monitoring dosage increases of drugs with nonlinear kinetics, such as phenytoin...
Which Lipoprotein Measurements Are Clinically Useful?
(Family Physicians Inquiries Network, 2007)
for routine cardiovascular risk screening. (Strength of Recommendation [SOR]: C, based on expert opinion and lack of clinical outcomes trials)...
How should a DEXA scan be used to evaluate bisphosphonate therapy for osteoporosis?
(Family Physicians Inquiries Network, 2005)
If bone density is evaluated after initiating bisphosphonate drug therapy, it should be tested no earlier than 2 years (strength of recommendation [SOR]: B, based on case series of dual energy x-ray absorptiometry [DEXA] ...