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What are appropriate screening tests for adolescents?
(Family Physicians Inquiries Network, 2006)
Screen all women of childbearing age, including adolescents, for rubella susceptibility (strength of recommendation [SOR]: B). Screen all sexually active adolescent females for chlamydia (SOR: A), gonorrhea (SOR: B), and ...
Counseling or Antidepressants for Treating Depression?
(Family Physicians Inquiries Network, 2005)
Both antidepressant medications and psychologic treatment are beneficial for adult patients with mild to moderate depression, with no consistent evidence that one type of treatment is more effective than the other. [Strength ...
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...
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...
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)....
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...
Which oral antifungal is best for toenail onychomycosis?
(Family Physicians Inquiries Network, 2007)
Terbinafine, 250 mg taken daily for 12 weeks, is the best regimen for toenail onychomycosis due to better clinical and mycologic cure rates, tolerability, and cost effectiveness (strength of recommendation [SOR]: A, meta-analyses)....
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)...
Treatment of Otitis Media with Perforated Tympanic Membrane
(Family Physicians Inquiries Network, 2009)
Acute otitis media with tympanic membrane perforation in children should be treated with an oral antibiotic. (Strength of Recommendation [SOR]: A, based on meta- analysis of randomized controlled trials [RCTs]). Topical ...
Menstrual disturbances in perimenopausal women: What's best?
(Family Physicians Inquiries Network, 2009)
It's best to start with nonsteroidal anti- inflammatory drugs (NSAIDs), which effectively reduce heavy menstrual bleeding (strength of recommendation [SOR]: B, systematic review of randomized clinical trials [RCTs]). Perimenopausal women with heavy...
Can nonantidepressants help treat depression?
(Family Physicians Inquiries Network, 2009)
lithium, triiodothyronine (T3), and atypical antipsychotics are all effective adjuncts. Lithium (serum levels >0.5 mEq/L) can produce clinical improvement when added to ineffective antidepressant treatment (strength of recommendation [SOR]: A, meta...
What is the initial approach to the treatment of shoulder pain?
(Family Physicians Inquiries Network, 2002)
reviews and randomized clinical trials with inconsistent and inconclusive results)...
Is there a role for theophylline in treating patients with asthma?
(Family Physicians Inquiries Network, 2002)
With adults, oral theophylline may help lower the dosage of inhaled steroids needed to control chronic asthma. It offers no benefit for acute asthma exacerbations. For children, intravenous aminophylline may improve the clinical course of severe...
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 ...
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 ...
What's the best way to monitor low-risk patients with a history of differentiated thyroid cancer?
(Family Physicians Inquiries Network, 2009)
-analysis). Low-risk patients are defined as patients who have undergone total thyroidectomy and radioactive iodine (I131) remnant ablation therapy and show no clinical evidence of recurrent disease....
How can I improve patient adherence to prescribed medication?
(Family Physicians Inquiries Network, 2001)
Two randomized clinical trials have shown that simplified dosing schedules have improved patient adherence to medication as prescribed. Some, but not all, randomized controlled trials show multidimensional interventions can also improve adherence...
What is the best way to evaluate acute diarrhea?
(Family Physicians Inquiries Network, 2002)
-risk patients who have been hospitalized for 3 or more days) leads to a more rational use of stool cultures without missing cases of clinically significant disease. (Grade of recommendation: D, based on limited studies, reliance on expert opinion, and consensus.)...
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] ...
How often is coughing the presenting complaint in patients with gastroesophageal reflux disease?
(Family Physicians Inquiries Network, 2002)
Frequent coughing is a concern for approximately 35% of those with typical gastroesophageal reflux disease (GERD) symptoms of heartburn and acid regurgitation as compared with 11% in those who do not have these symptoms. Among pulmonary clinic...