AFP DEPARTMENT COLLECTION

POEMs: Patient-Oriented Evidence that Matters

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.

Jun 1, 2020 Issue
No Short-Term Extra Benefit when Muscle Relaxants Are Added to Ibuprofen for Acute Low Back Pain
Adding a muscle relaxant to treatment with ibuprofen does not improve functional outcomes or pain, or lessen the number of people reporting moderate to severe back pain one week after starting treatment.


Jun 1, 2020 Issue
For Three-Vessel Disease, but Not Left Main Disease, CABG Is Preferred Over PCI
For patients with left main disease, PCI with a drug-eluting stent and CABG had similar all-cause mortality rates at 10 years. For those with three-vessel disease, CABG is associated with lower 10-year mortality.


Jun 1, 2020 Issue
Supplemental MRI Screening in Women with Very Dense Breasts Reduces Interval Cancer Rate but May Cause Overdiagnosis
Supplemental MRI screening for women with very dense breasts compared with mammography alone every two years significantly reduces the likelihood of an interval cancer, from 5 per 1,000 to 2.5 per 1,000 in the intention-to-treat population and to 0.8 per 1,000 in the per-protocol population.


Jun 1, 2020 Issue
Useful Signs and Symptoms for Diagnosing Hip Osteoarthritis
Although plain radiographs are often used to diagnose hip OA, the correlation between radiographic indicators of hip arthritis and hip pain is low.


May 15, 2020 Issue
Equivalent Pain Relief with Different Doses of Ibuprofen
Higher doses of ibuprofen for acute pain relief offer no more benefit at 60 minutes than a single 400-mg dose. The same has been shown for chronic treatment of osteoarthritis. A higher, anti-inflammatory dose is not needed.


May 15, 2020 Issue
Autism Screening with Follow-Up Overidentifies Autism Spectrum Disorder
Screening for ASD with the Modified Checklist for Autism in Toddlers with Follow-Up is effective in ruling out ASD in children who screen positive (negative predictive value of 98.6% at 2.2% prevalence).


May 15, 2020 Issue
Nonpharmacologic Approaches Are Better Than Medication to Control Aggression and Agitation in Dementia
Nonpharmacologic approaches to agitation or aggression in patients with dementia are more effective than medication (e.g., haloperidol). Outdoor activities, multidisciplinary care, and massage and touch therapy with or without music are all effective.


May 15, 2020 Issue
Surgery or Lasers Preferred to Foam Sclerotherapy for Varicose Veins
For symptomatic varicose veins at least 3 mm in diameter with evidence of saphenous vein reflux, laser ablation is the preferred initial therapy.


Apr 1, 2020 Issue
No Benefit to Routine Antipsychotic Use for Treatment or Prevention of Delirium in Hospitalized Patients
Evidence does not support the routine use of haloperidol or second-generation antipsychotics for the treatment or prevention of delirium in hospitalized patients. Although second-generation antipsychotics may reduce the incidence of delirium in the postoperative setting, more research is needed to confirm this.


Apr 1, 2020 Issue
Bedtime Instead of Morning Ingestion of Hypertension Medication Equals a Significantly Higher Reduction in Cardiovascular Disease Risk
This study found a significant reduction in mortality and morbidity among patients who took their once-daily anti-hypertensive medications at bedtime instead of in the morning. No significant difference occurred in compliance rates between bedtime and morning ingestion times. Individual experiences may differ in clinical practice.


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