AFP DEPARTMENT COLLECTION

POEMs

POEMs (Patient-Oriented Evidence that Matters) are summaries of research that is relevant to physicians and their patients and meet three criteria: address a question that primary care physicians face in day-to-day practice; measure outcomes important to physicians and patients, including symptoms, morbidity, quality of life, and mortality; and have the potential to change the way physicians practice.

May 15, 2017 Issue
More Accurate Prediction of the Pretest Probability of Cardiovascular Disease with European Risk Score
The European approach to determining the pretest likelihood of coronary artery disease (CAD) in patients with chest pain is superior to that of the Diamond-Forrester approach recommended by U.S. guidelines, and will result in less need for immediate invasive treatment.


May 15, 2017 Issue
Topiramate and Amitriptyline Not Effective for Migraine in Children
Topiramate, amitriptyline, and placebo all led to a similar, substantial improvement in migraine frequency and disability. How to harness this strong placebo effect for our patients is an important, but unanswered, question.


May 15, 2017 Issue
Pelvic Floor Exercises Modestly Improve Pelvic Floor Prolapse Symptoms
In women with mild to moderate pelvic floor prolapse, a formal program including physiotherapist-guided pelvic floor exercises only modestly improved symptoms.


May 1, 2017 Issue
One-Third of Adults with Diagnosed Asthma Can Be Weaned Off All Asthma Medications
This study found that current asthma was ruled out after repeated testing in one-third of adults with physician-diagnosed asthma. Patients ruled out for current asthma were less likely to be using asthma medications or daily controlling medications and less likely to have undergone testing for airflow limitation at the time of initial diagnosis.


Apr 1, 2017 Issue
Repeat Cytology Within Six Months Equals Colposcopy for Younger Women with ASCUS or LSIL
Among women 22 to 27 years of age with an index cervical cytology showing abnormal squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL), the incidence of invasive cervical cancer did not differ between repeat cytology within six months or colposcopy with biopsy within six months.


Apr 1, 2017 Issue
PCI Has More Benefits and Harms Than CABG for Selected Patients with Left Main Coronary Artery Disease
Patients undergoing PCI had fewer early myocardial infarctions, but more later deaths and later myocardial infarctions. There are other benefits to PCI, including shorter hospital stay, lower cost, and faster recovery. But patients should be informed of the tradeoffs, and it is important to look at longer-term outcomes beyond three years.


Apr 1, 2017 Issue
Placebo Plus Message of Benefit Decreases Chronic Low Back Pain
These investigators gave twice daily placebo to patients with chronic back pain and told them it was placebo. They also told them that placebos can have a pronounced effect (which is true). The addition of placebo to usual care improved patients' pain and disability scores over the three weeks of the study.


Apr 1, 2017 Issue
If You Give Amoxicillin/Clavulanate to Six- to 23-Month-Olds with AOM, 10 Days Is Preferable to Five days
These authors begin with the assumption that we should treat children who have AOM with amoxicillin/clavulanate. The greatest benefit was in children one to two years of age who had more severe pain and fever. In children with less severe symptoms, observation should still be the preferred option, as recommended by the American Academy of Family Physicians guidelines, accompanied by appropriate treatment of pain and fever.


Mar 15, 2017 Issue
Detrimental Effect of Tight Glucose Control on CV Mortality Persists Over Nine Years
The initial Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, which compared standard treatment with intensive control, found that despite good intentions, cardiovascular (CV) and overall mortality are significantly higher when blood glucose levels are lower.


Mar 15, 2017 Issue
Single-Dose Dexamethasone an Option for Acute Adult Asthma
A single dose of 12-mg dexamethasone, which has a longer duration of action than prednisone, is almost as effective as five days of 60-mg prednisone for the prevention of relapse in adults with acute asthma treated in an emergency department.


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