AFP DEPARTMENT COLLECTION

Cochrane for Clinicians

These are summaries of reviews from the Cochrane Library.

Jul 1, 2017 Issue
Acupuncture for Migraine Prevention
There is moderate-quality evidence that whole-body acupuncture is effective for migraine prevention. Compared with usual care, acupuncture is more effective at reducing headache frequency by at least 50% (number needed to treat [NNT] = 4).


Jul 1, 2017 Issue
Surgery vs. Medical Therapy for Heavy Menstrual Bleeding
In women of reproductive age with chronic heavy menstrual bleeding, hysterectomy is the most effective treatment for controlling symptoms. Conservative surgery is more effective for controlling bleeding symptoms at one and two years than oral medications or the levonorgestrel-releasing intrauterine system, but by five years there is no difference.


Jun 1, 2017 Issue
Self-Monitoring and Self-Management of Oral Anticoagulation
In patients taking warfarin (Coumadin) for anticoagulation, there is moderate-quality evidence that both self-monitoring (number needed to treat [NNT] = 100) and self-management (NNT = 53) reduce thromboembolic events, and that self-management reduces all-cause mortality (NNT = 67).


Jun 1, 2017 Issue
Physical Fitness Training for Patients with Stroke
There is moderate-quality evidence that physical fitness training improves disability after stroke. Cardiovascular training that includes only aerobic exercise has a moderate effect on disability (standard mean difference [SMD] = 0.52 on a pooled disability scale), although it is not clear whether this effect is sustained after patients stop training.


May 1, 2017 Issue
Beta2 Agonists for Acute Cough or a Clinical Diagnosis of Acute Bronchitis
There is insufficient evidence to determine whether beta2 agonists can improve symptoms for children with acute cough or bronchitis with wheeze. Beta2 agonists are not likely to benefit and may cause adverse effects in adults who do not have evidence of airflow restriction (number needed to harm [NNH] = 2).


May 1, 2017 Issue
Citrate Salts for Preventing and Treating Calcium-Containing Kidney Stones in Adults
Citrate supplementation reduces stone size to less than 5 mm and prevents new stone formation when compared with placebo or no intervention. Citrate therapy also stabilizes existing stones and decreases the need for retreatment. These benefits come at the expense of upper gastrointestinal disturbances that lead to a higher dropout rate.


Apr 1, 2017 Issue
Effects of Altered Dietary Salt Intake in Patients with Chronic Kidney Disease
Reducing salt intake lowers blood pressure and reduces proteinuria in patients with CKD, but there is no evidence to determine whether lowering salt consumption leads to clinically significant reductions in end-stage renal disease, cardiovascular events, or all-cause mortality.


Apr 1, 2017 Issue
Preventing Unintended Adolescent Pregnancy
Among adolescents, educational interventions increase reported condom use at most recent intercourse, whereas contraceptive-promoting interventions increase use of hormonal contraception.


Mar 1, 2017 Issue
Radioactive Iodine Therapy vs. Antithyroid Medications for Graves Disease
Radioactive iodine therapy and antithyroid medications produce similar health-related quality-of-life outcomes in patients with Graves disease. Radioactive iodine therapy is an appropriate choice for patients who prefer definitive treatment.


Feb 1, 2017 Issue
The Effect of Statins on Dementia and Cognitive Decline
Statins given in later life to patients at risk of vascular disease do not prevent dementia or cognitive decline compared with placebo. Adverse effects are similar between groups.


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