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.

Jan 01, 2022 Issue
Guidelines for When to Consider Mortality-Reducing Treatments for Patients With Type 2 Diabetes Mellitus
The guidelines give clear guidance on selecting an SGLT2 inhibitor, a GLP-1 receptor agonist, or neither in patients with type 2 diabetes. The guidelines are a bit conservative to some, but guideline development is a two-step process: determining the evidence and then weighing the value based on benefits and risks.


Jan 01, 2022 Issue
A Single Corticosteroid Burst in Children Is Associated With Harms
Although corticosteroid bursts have potential for improving outcomes for many acute illnesses, this study shows that the potential harms are not trivial.


Jan 01, 2022 Issue
Provided Infant Carriers Increase the Rate of Sustained Breastfeeding
Giving an infant carrier to mothers before or at delivery increases sustained breastfeeding from three to six months following birth. The authors speculate that this outcome is caused by increased physical contact.


Jan 01, 2022 Issue
Evidence of Benefit Is Lacking for Low Back Pain Relief With Muscle Relaxants
Nonsteroidal anti-inflammatory drugs are a better choice for the treatment of low back pain. Despite benzodiazepine and nonbenzodiazepine muscle relaxants being used for almost 50 years to treat low back pain, the supporting evidence is of low certainty. None of the treatments will produce a clinically important difference over placebo.


Dec 01, 2021 Issue
Ultrasonography Is Accurate for Diagnosing Upper Extremity Fractures in Children
Diagnostic ultrasonography is highly accurate for diagnosing most upper extremity fractures but slightly less accurate for fractures involving the elbow. Clinicians should not use ultrasonography alone to rule in elbow fractures in children.


Dec 01, 2021 Issue
Some Nonpharmacologic Treatments May Decrease Migraine Frequency in Children and Adolescents
Active nonpharmacologic treatments such as biofeedback, relaxation techniques, and general or specific psychological support (e.g., cognitive behavior therapy) may be a good place to start when trying to decrease migraine frequency in children and adolescents. The research is positive, although there is not much out there.


Dec 01, 2021 Issue
Left Atrial Appendage Occlusion During Cardiac Surgery for Another Reason Reduces the Risk of Stroke
Surgical closure of the left atrial appendage during cardiac surgery for another reason safely reduces the risk of ischemic stroke. Because the risk of stroke in the first 30 days after any cardiac surgery is approximately 2% and the absolute reduction in the risk of stroke with the procedure was approximately 2%, performing this procedure in patients who are not already undergoing cardiac surgery is not ideal.


Dec 01, 2021 Issue
Third Pfizer Vaccine Dose Significantly Increases Protection Against Mild and Severe COVID-19 in Patients 60 Years and Older
A third booster dose of the Pfizer-BioNTech mRNA vaccine against COVID-19 provides a large increase in protection for people 60 years and older against mild and severe infection. The protection against mild infection could help reduce community spread and reduce the incidence of long COVID in some infected patients.


Nov 01, 2021 Issue
Dual Antiplatelet Therapy Is Superior to Aspirin in Preventing Short-Term Recurrent Stroke at the Cost of More Major Bleeding
If the authors have found all the relevant studies, administering dual antiplatelet therapy within 24 hours of a mild to moderate stroke or TIA is more effective than aspirin at decreasing recurrent stroke over the subsequent 90 days. There is a low overall risk of major bleeding, but it is significantly higher with dual antiplatelet therapy than with aspirin.


Nov 01, 2021 Issue
Anticonvulsants, SNRIs, and Rubefacients Are Best Initial Choices for Chronic Pain Caused by Diabetic Neuropathy or Postherpetic Neuralgia
Given the balance of benefits and harms, there is moderately good evidence for anticonvulsants (pregabalin [Lyrica] and gabapentin [Neurontin] were similarly effective and well tolerated) and serotonin-norepinephrine reuptake inhibitors (SNRIs; with duloxetine [Cymbalta] and venlafaxine being similarly effective and well tolerated) for treating diabetic neuropathy and postherpetic neuralgia. Rubefacients (usually salicylates) appear to be effective but are less well studied with low-quality evidence. Acupuncture, opioids, and tricyclic antidepressants cannot be recommended based on current evidence.


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