for routine cardiovascular risk screening. (Strength of Recommendation [SOR]: C, based on expert opinion and lack of clinical outcomes trials)...

Improvements of possible practical significance were seen for various clinical measures in studies of group treatment sessions for patients with back pain, arthritis, and rheumatic disease. However, studies on group treatment for patients...

The inability of clinical criteria to accurately differentiate bacterial from viral disease makes routine use of antibiotics inappropriate for clinically diagnosed maxillary sinusitis (strength of recommendation [SOR]: C, based on inconsistent...

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] ...

Calcium, in combination with vitamin D, prevents bone loss and is recommended in all patients. (Grade of recommendation: A, based on systematic reviews of randomized controlled trials [RCTs]). Alendronate and risedronate ...

Jaw claudication, diplopia, or a temporal artery abnormality on physical exam increase the likelihood of temporal arteritis. A finding of thrombocytosis in a patient with suspected temporal arteritis moderately increases ...

Several interventions may reduce the risk of contrast nephropathy for high-risk patients; however, most evidence uses surrogate markers for clinically relevant outcomes. Because dehydration is a risk factor for developing contrast nephropathy...

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 ...

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 ...

Efforts to increase physical activity or decrease sedentary activities have shown some short-term benefit, and adding dietary changes may be more effective. Aiming interventions at parents, intensive family therapy, ...

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 ...

of recommendation [SOR]: B, prospective cohort studies). Incision and drainage is the primary therapy for purulent skin and soft tissue infections (SOR: B, randomized, controlled clinical trials [RCTs]). There are inadequate data evaluating the role of oral...

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 ...

In patients with congestive heart failure due to systolic dysfunction who are in normal sinus rhythm, digoxin therapy reduces rates of hospitalization, as well as clinical deterioration, defined as worsening New York Heart Association (NYHA...

—inconsistent results of randomized trials). Clonidine, as an oral or transdermal preparation, reduces hot flushes (SOR: A—randomized clinical trials), as does gabapentin (SOR: A— single randomized clinical trial). In cancer patients who have had surgical menopause...

A BNP level less than 100 pg per mL (100 ng per L) can rule out heart failure. (Strength of Recommendation [SOR]: A, based on meta-analyses.) BNP levels should be used when the pretest probability of heart failure based on overall clinical...

Fluoxetine (Prozac) use may result in an average, short-term weight loss of up to 3.3 kg (7 lb, 4 oz) in obese patients, but the longterm effects and maintenance of weight loss after discontinuation of the drug have not ...

No combination of clinical findings can reliably distinguish acute viral rhinosinusitis from acute bacterial rhinosinusitis in primary care. Although unreliable, the best clinical predictor of acute bacterial sinusitis is the combination...

on consensus guidelines) due to poor diagnostic accuracy. When you suspect GABHS pharyngitis either clinically or epidemio-logically, confirm the diagnosis of pharyngitis by a laboratory test. Patients with a positive throat culture or a rapid antigen detection...

No individual or combination of blood tests can reliably diagnose pelvic inflammatory disease (PID)(strength of recommendation [SOR]: A, metaanalysis). The combination of white blood cell count, C-reactive protein (CRP), ...