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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...
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...
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).
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 ...
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 ...
Does chocolate have cardiovascular benefits?
(Family Physicians Inquiries Network, 2010)
Eating chocolate reduces blood pressure in the short term (strength of recommendation [SOR]: B, a meta-analysis and individual randomized controlled trials [RCTs]). No studies, however, have evaluated the long-term ...
Diagnosing Von Willebrand Disease
(Family Physicians Inquiries Network, 2010)
The diagnosis of vWD requires two clinical criteria: (1) a personal history, family history, or physical evidence of mucocutaneous bleeding and (2) a qualitative or quantitative decrease in functional activity of von Willebrand factor (v...
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] ...
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...
Is aspirin effective for primary prevention of colon cancer?
(Family Physicians Inquiries Network, 2010)
Aspirin probably shouldn't be used for routine prevention because of its potential risks (strength of recommendation [SOR]: B, systematic review of inconsistent evidence). However, aspirin is likely to be effective for ...
Does lowering a fever >101F in children improve clinical outcomes?
(Family Physicians Inquiries Network, 2010)
Treating fever significantly increases comfort, activity, feeding, and fluid intake and decreases the patient's temperature compared with placebo (strength of recommendation (SOR): A, multiple randomized controlled trials ...
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...
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 guidelines)....
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 ...
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...
Management of Alcohol Withdrawal Syndrome
(Family Physicians Inquiries Network, 2010)
AWS may be managed with outpatient therapy if the patient has mild to moderate symptoms. (Strength of Recommendation [SOR]: B, based on one randomized, prospective trial). The Clinical Institute Withdrawal Assessment Scale for Alcohol, Revised (CIWA...
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 should you treat the newly diagnosed hypertensive patient?
(Family Physicians Inquiries Network, 2010)
as well as overall cardiovascular risks, presence of target organ damage, and clinical cardiovascular disease, because lifestyle modification and medication can both affect quality of life (SOR: C, expert opinion)....
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 ...
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 ...