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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...
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...
Are Selective COX-2 Inhibitors as Effective as NSAIDs in Patients with Rheumatoid Arthritis?
(Family Physicians Inquiries Network, 2004)
The efficacy of COX-2 inhibitors is similar to that of nonselective NSAIDs in reducing the symptoms of rheumatoid arthritis. [Strength of Recommendation: A]
First- or second-generation antihistamines: which are more effective at controlling pruritus?
(Family Physicians Inquiries Network, 2004)
For urticarial itch, first- and second-generation antihistamines have similar clinical benefit and are superior to placebo (strength of recommendation [SOR]: A, systematic review of randomized trials [RCT]). For itch related to atopic dermatitis...
Does Screening for Tuberculosis in Children Decrease Morbidity or Mortality?
(Family Physicians Inquiries Network, 2004)
Routine screening of low-risk children for tuberculosis infection before entering kindergarten is not necessary. [Strength of recommendation: C] Targeted screening of high-risk children for tuberculosis infection using the ...
Is the long-term use of proton pump inhibitors safe?
(Family Physicians Inquiries Network, 2004)
Long-term use of proton pump inhibitors (PPIs) appears safe, resulting in no clinically relevant adverse effects (strength of recommendation: B, based on nonsystematic reviews, cohort studies, or low-quality randomized controlled trials...
Can transvaginal ultrasound detect endometrial disease among asymptomatic postmenopausal patients?
(Family Physicians Inquiries Network, 2004)
Transvaginal ultrasound should not replace endometrial biopsy for detection of endometrial disease among asymptomatic postmenopausal patients. Endometrial biopsy has been considered a standard for the clinical diagnosis of endometrial disease among...
Do vitamin C supplements reduce mortality in patients with cardiovascular disease?
(Family Physicians Inquiries Network, 2004)
Vitamin C, when taken as a dietary supplement, does not appear to reduce mortality in patients with cardiovascular disease. [Strength of recommendation: B, based on reviews of cohort studies and a single randomized controlled ...
Does Lidocaine-Prilocaine Cream (EMLA) Decrease the Pain of Neonatal Circumcision?
(Family Physicians Inquiries Network, 2004)
EMLA cream reduces the pain experienced by newborns during circumcision compared with placebo. [Strength of recommendation: A, based on a systematic review of randomized controlled trials (RCTs)]. However, dorsal penile ...
What is the best macrolide for atypical pneumonia?
(Family Physicians Inquiries Network, 2004)
Erythromycin, clarithromycin, and azithromycin are equally effective in treating pneumonia caused by Mycoplasma pneumoniae or Chlamydophila (formerly Chlamydia) pneumoniae (strength of recommendation [SOR]: B, small ...
Does a Low-Sodium Diet Reduce Blood Pressure?
(Family Physicians Inquiries Network, 2004)
Reducing sodium intake does lead to a slightly lower average blood pressure. However, no evidence from controlled trials proves that reducing sodium intake decreases morbidity or mortality, or proves that modest sodium ...
What is the best approach for managing recurrent bacterial vaginosis?
(Family Physicians Inquiries Network, 2004)
The best way to prevent recurrent bacterial vaginosis is to treat the initial episode with the most effective regimen. Metronidazole (500 mg orally twice daily for 7 days) has the lowest recurrence rate among antimicrobial ...
Are antibiotics effective in preventing pneumonia for nursing home patients?
(Family Physicians Inquiries Network, 2004)
(SOR: B, based on individual randomized controlled trial); pneumococcal vaccination of residents (SOR: B, based on randomized, nonblinded clinical trials and consistent case-control studies). Two other suggested interventions have not been extensively...
Do ACE inhibitors decrease mortality in patients with hypertension?
(Family Physicians Inquiries Network, 2004)
When used to treat patients with hypertension, ACE inhibitors reduce cardiovascular and all-cause mortality as effectively as diuretics, beta blockers, and calcium channel blockers. [Strength of recommendation: A, based ...
Should we screen adults for asymptomatic microhematuria?
(Family Physicians Inquiries Network, 2004)
Screening patients for asymptomatic microhematuria does not appear to improve outcomes, since screening does not identify a population with increased prevalence of urologic malignancy (strength of recommendation [SOR]: A, ...
When should patients with mitral valve prolapse get endocarditis prophylaxis?
(Family Physicians Inquiries Network, 2004)
Patients with suspected mitral valve prolapse (MVP)should undergo echocardiography before any procedure that may place them at risk for bacteremia. Patients with MVP and documented absence of mitral regurgitation or valvular ...
Does screening for diabetes in at-risk patients improve long-term outcomes?
(Family Physicians Inquiries Network, 2004)
No randomized clinical trials or prospective studies have demonstrated adequate evidence to screen individuals for diabetes mellitus. A recently published meta-analysis for the United States Preventative Services Task Force (USPSTF) stated...
Does injection of steroids and lidocaine in the shoulder relieve bursitis?
(Family Physicians Inquiries Network, 2004)
Subacromial steroid injection may provide a small, short-term benefit compared with placebo. The short-term effectiveness of steroid injection compared with nonsteroidal anti-inflammatory agents (NSAIDs) remains unclear. ...
Do antibiotics improve outcomes in chronic rhinosinusitis?
(Family Physicians Inquiries Network, 2004)
For children, antibiotics do not appear to improve short-term (3-6 weeks) or long-term (3 months) outcomes of chronic rhinosinusitis (strength of recommendation [SOR]: A, randomized controlled trials). No adequate ...