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 1, 2018 Issue
Lumbar Fusion of Variable Value Based on Treating Diagnosis, with Significant Complication Rates
Lumbar fusion for degenerative spinal disease appears to be most beneficial for patients undergoing the procedure for spondylolisthesis, but it is of little clear benefit for patients with other indications, such as spinal stenosis or chronic back pain.


May 1, 2018 Issue
Single Question Is Useful for Identifying Acute Mountain Sickness in Travelers at High Altitude
Three different diagnostic scoring tools have similar accuracy for identifying adults at risk of AMS. One tool, the clinical functional score, is the simplest to use and consists of asking a single question.


May 1, 2018 Issue
Exercise Alone and Various Combinations of Interventions Reduce the Risk of Injurious Falls in Older Adults
Exercise alone; exercise combined with vision assessment and treatment; exercise combined with vision assessment and treatment, and environmental assessment and modification; and clinic-level quality improvement strategies combined with multifactorial assessment and treatment, calcium supplementation, and vitamin D supplementation are all effective interventions for reducing the risk of injurious falls in older adults.


May 1, 2018 Issue
One-Third of Patients with Anxiety Disorder Will Relapse When Antidepressant Treatment Stops
Discontinuing the antidepressant treatment in patients with anxiety disorders will cause a relapse in almost one-third of them. One in six patients previously treated successfully will also relapse despite continued treatment.


Apr 15, 2018 Issue
Routine Oxygen Supplementation After Acute Stroke Does Not Improve Functional Outcomes
For nonhypoxic patients with acute stroke, routine oxygen therapy for 72 hours, either continuously or at night only, does not improve functional outcomes at 90 days. Long-term outcomes were not assessed in this study, and the question remains whether 90 days is an adequate length of time to see most of the meaningful recovery from stroke.


Apr 1, 2018 Issue
Clinical Diagnosis of Lyme Disease Frequently Misses the "Bull’s Eye"
For children with suspected Lyme disease but without a classic bull's-eye lesion (erythema migrans of at least 5 cm), check serology rather than rely on your clinical impression. In this study, 12% of the children not suspected of having Lyme disease did have Lyme disease, and 31% of children thought to have Lyme disease did not have serologic findings at that time or within 30 days.


Apr 1, 2018 Issue
Broad-Spectrum Antibiotics Increase Adverse Events in Children with Acute Respiratory Infections with Minimal Benefit
Broad-spectrum antibiotics are no more effective than narrow-spectrum antibiotics for treating acute respiratory tract infections in infants and children, and adverse events are significantly more common in children treated with broad-spectrum antibiotics.


Apr 1, 2018 Issue
Early PT for Acute Low Back Pain Is Cost-Effective, but Gain in Quality of Life Is Likely Too Small to Notice
At $30,000 per quality-adjusted life year (QALY) gained, early PT for acute low back pain in primary care is cost-effective by the usual criteria of $50,000 to $100,000 per QALY. However, the magnitude of improvement in quality of life is small and is probably not clinically meaningful.


Mar 15, 2018 Issue
High-Sensitivity Troponin I of Less Than 5 ng per L Has Negative Predictive Value of 99.9% for Cardiac Death at One Year
A cardiac troponin I concentration of less than 5 ng per L in adults who present with potential acute coronary syndrome has a negative predictive value (NPV) of at least 99.9% for cardiac death at 30 days and at one year.


Mar 15, 2018 Issue
Minimal Effect of ERT on Sexual Function in Menopausal Women
Transdermal, but not oral, estrogen produced a small improvement in sexual function scores in menopausal women. The increases were very small and may not be noticeable by most women.


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