AFP DEPARTMENT COLLECTION

Editorials: Controversies in Family Medicine

This is a series of editorials presenting different views on current clinical issues in family medicine. Each editorial includes a link to another editorial with the opposing view.

Jan 1, 2016 Issue
Should Family Physicians Routinely Screen Patients for Hepatitis C? No: One-time Screening Still Has Too Many Unanswered Questions
Given current scientific uncertainties, limited resources, and evolving guidelines, a reasonable middle ground would be to focus HCV testing and therapy on patients who are most likely to have long-term complications from the infection.


Jan 1, 2016 Issue
Should Family Physicians Routinely Screen Patients for Hepatitis C? Yes: Screening Makes Sense for High-Risk Adults
For patients to receive appropriate care for their chronic infection and receive curative treatment, they must first know they are infected, and it all begins with screening.


Sep 1, 2015 Issue
Should Preparticipation Cardiovascular Screening of Athletes Include ECG? Yes: Screening ECG Is Cost-Effective
Cardiovascular screening with ECG is a valid, cost-effective, and worthwhile endeavor in the preparticipation sports evaluation.


Sep 1, 2015 Issue
Should Preparticipation Cardiovascular Screening of Athletes Include ECG? No: There Is Not Enough Evidence to Support Including ECG in the Preparticipation Sports Evaluation
Although there are many reasons to conduct preparticipation sports examinations, there is insufficient evidence to support cardiac screening with ECG.


Feb 15, 2015 Issue
Should Family Physicians Screen for Testosterone Deficiency in Men? Yes: Screening for Testosterone Deficiency Is Worthwhile for Most Older Men
With the possible exception of patients with cardiovascular disease, testosterone replacement therapy remains a potentially beneficial option in improving health-related quality of life in men.


Feb 15, 2015 Issue
Should Family Physicians Screen for Testosterone Deficiency in Men? No: Screening May Be Harmful, and Benefits Are Unproven
Testosterone testing leads to testosterone treatment, which is inappropriate for the vast majority of patients. Testosterone treatment should be reserved for patients who are truly hypogonadal.


Aug 15, 2014 Issue
Should Family Physicians Follow the New ACC/AHA Cholesterol Treatment Guideline? Yes: Implementing the New ACC/AHA Cholesterol Guideline Will Improve Cardiovascular Outcomes
The recommendations appropriately focus treatment on those most likely to benefit.


Aug 15, 2014 Issue
Should Family Physicians Follow the New ACC/AHA Cholesterol Treatment Guideline? Not Completely: Why It Is Right to Drop LDL-C Targets but Wrong to Recommend Statins at a 7.5% 10-Year Risk
The recommendations should have paid more attention to the inherent uncertainties in risk estimates and the importance of individual patient circumstances and preferences.


Jul 15, 2014 Issue
Should Family Physicians Routinely Screen for Lung Cancer in High-Risk Populations? Yes: CT-Based Screening Is Complex but Worthwhile
When offered to the appropriate population in the appropriate context, CT-based lung cancer screening will reduce the number of deaths caused by this difficult disease.


Jul 15, 2014 Issue
Should Family Physicians Routinely Screen for Lung Cancer in High-Risk Populations? No: The USPSTF’s Recommendation for Lung Cancer Screening Is Overreaching
There is still considerable uncertainty about the true magnitude of benefit from annual lung cancer screening, as well as the financial and psychological costs; therefore, the scope of the recommendation should be limited to one of individualized, shared decision making.


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