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How useful is ultrasound to evaluate patients with postmenopausal bleeding?
(Family Physicians Inquiries Network, 2004)
Using a threshold of ≤5 mm, transvaginal ultrasound (TVUS) can be used to identify those patients with postmenopausal bleeding who are at low risk for endometrial cancer, polyps, or atypical hyperplasia at a sensitivity ...
Should the varicella vaccine be given to all children to prevent chickenpox?
(Family Physicians Inquiries Network, 2004)
Healthy, unimmunized children who have not had varicella infection should be vaccinated (strength of recommendation: A, based on randomized controlled trials). Use of the vaccine in immunocompromised children is still being ...
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 effective is gastric bypass for weight loss?
(Family Physicians Inquiries Network, 2004)
Gastric bypass results in weight loss of approximately 33% at 2 years and 25% at 8 years (strength of recommendation [SOR]: B, based on a cohort study). Gastric bypass is one type of bariatric surgery, which also includes ...
What is the most effective diagnostic evaluation of streptococcal pharyngitis?
(Family Physicians Inquiries Network, 2004)
Standardized clinical decision rules, such as the Centor criteria, can identify patients with low likelihood of group A beta-hemolytic streptococ-cal (GABHS) pharyngitis who require no further evaluation or antibiotics (strength of recommendation...
Do antipyretics prolong febrile illness?
(Family Physicians Inquiries Network, 2004)
Antipyretics appear to have minor and variable effects on the course of febrile illness. Aspirin and acetaminophen do not prolong the course of rhinovirus illness, although they may prolong the period of viral shedding and ...
Should we discontinue Pap smear screening in women aged >65 years?
(Family Physicians Inquiries Network, 2004)
Women with a history of regular, normal Pap smear screening should discontinue screening by age 65 years (strength of recommendation [SOR]: B). Women without a history of serial normal Pap smears should continue screening ...
Do routine eye exams reduce occurrence of blindness from type 2 diabetes?
(Family Physicians Inquiries Network, 2004)
Screening eye exams for patients with type 2 diabetes can detect retinopathy early enough so treatment can prevent vision loss. Patients without diabetic retinopathy who are systematically screened by mydriatic retinal ...
Does a short symptom checklist accurately diagnose ADHD?
(Family Physicians Inquiries Network, 2004)
Several abbreviated checklists perform well in distinguishing children with attention deficit/ hyperactivity disorder (ADHD) from those without ADHD under ideal conditions and in research settings. While many guidelines ...
For knee pain, how predictive is physical examination for meniscal injury?
(Family Physicians Inquiries Network, 2004)
No single clinical examination element, or combination of such elements, reliably detects meniscal injury. The McMurray test is best for ruling in meniscal pathology. Assuming a 9% prevalence of meniscal tears among all knee injuries (a rate...
How reliable are self-measured blood pressures taken at home?
(Family Physicians Inquiries Network, 2004)
Self-measured blood pressures (SMBP) can be precise and accurate and, thus, reliably be used as an adjunct to office blood pressure measurements in selected clinical situations (strength of recommendation [SOR]: B, extrapolation and limited trials...
Is an outpatient workup safe for patients with a transient ischemic attack?
(Family Physicians Inquiries Network, 2004)
There is no compelling evidence that outpatient diagnostic workup of patients with transient ischemic attack (TIA) is less safe than inpatient workup, or that hospitalization prevents stroke or improves stroke outcomes ...
Are liver function tests required for patients taking isoniazid for latent TB?
(Family Physicians Inquiries Network, 2004)
Routine liver function test monitoring is not required for all patients on isoniazid therapy for latent tuberculosis (TB) infection (strength of recommendation: B, based on case series). No clinical trials have studied the potential risks...
Does combining aspirin and warfarin decrease the risk of stroke for patients with nonvalvular atrial fibrillation?
(Family Physicians Inquiries Network, 2004)
-dose warfarin (SOR: A, based on randomized controlled trials). To date, no clinical trials have investigated the efficacy and safety of combining adjusted-dose warfarin and aspirin for the prevention of stroke from NVAF....
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...
Are beta-2-agonists or anticholinergics more effective for treating COPD?
(Family Physicians Inquiries Network, 2004)
to greater improvements in forced expiratory volume in 1 second (FEV1) than either drug alone (SOR: A). However, until recently there were no convincing direct head-to-head comparisons of the 2 classes, and it is unclear whether this difference is clinically...
What effect do inhaled steroids have on delaying the progression of COPD?
(Family Physicians Inquiries Network, 2004)
improvements in FEV1 decline, the change does not appear to be clinically significant (7.7 to 9.0 mL/year). These findings do not take into account the potential impact of ICS on such patient oriented outcomes as exacerbation rates, quality of life, outpatient...
Is methylphenidate useful for treating adolescents with ADHD?
(Family Physicians Inquiries Network, 2004)
Methylphenidate (Ritalin) is effective in the shortterm treatment of attention deficit/hyperactivity disorder (ADHD) (strength of recommendation [SOR]: A, multiple randomized control trials). Though the immediate-release ...
Does tight control of blood glucose in pregnant women with diabetes improve neonatal outcomes?
(Family Physicians Inquiries Network, 2004)
and randomized controlled trial [RCT]). Intensive management reduces the risk of congenital anomalies more than conventional therapy, and lowers the risk of neonatal hypoglycemia (SOR: B, based on RCT). Very tight control does not reduce clinically significant...
Do inhaled beta-agonists control cough in URIs or acute bronchitis?
(Family Physicians Inquiries Network, 2004)
Patients who receive inhaled beta-agonists for cough due to acute upper respiratory infections (URI) are just as likely to report a productive cough at 7 days compared with patients treated with placebo (strength of ...