AFP Journal Club

Three presenters review an interesting journal article on topics that affect family physicians and give their opinions about the clinical value of the studies.

For key concepts in evidence-based medicine, tips on assessing the quality of research studies, and teaching pointers for journal clubs, see our toolkit, culled from AFP's Journal Club series.

May 15, 2015 Issue
If It Seems Too Good To Be True...
There are dangers in the early adoption of treatment modalities without repeated verification in the literature.

Apr 1, 2015 Issue
Thrombolysis for DVT: Has the Time Arrived?
Catheter-directed thrombolysis for proximal DVT is experimental but may be considered in a patient with phlegmasia and resulting compartment syndrome.

Feb 1, 2015 Issue
Benzodiazepines and Alzheimer Disease
Benzodiazepine exposure over the preceding five years seems to be associated with an increased likelihood of an Alzheimer disease diagnosis. A dose-response gradient also seems to exist.

Sep 15, 2014 Issue
Can CPOE Systems Decrease Use of Laboratory Studies and Control Costs?
Can computerized physician order entry systems decrease the use of laboratory studies? An intervention's durability (ability to provide sustained results) is important to consider before implementing the intervention based on a study's results.

May 15, 2014 Issue
Evidence to Guide Measles Immunization Recommendations
Although measles vaccination is rarely associated with fever and seizures in children, the benefits of immunization outweigh the risks. Parents should be encouraged to follow recommended immunization schedule and avoid the MMR and varicella combination vaccine.

Mar 15, 2014 Issue
PPIs, Childhood Asthma, and the Problem of Therapeutic Creep
The use of a therapy in patients one would intuitively think might benefit, but in whom no benefit has been documented, is called therapeutic creep. The use of proton pump inhibitors for poorly controlled asthma is an example of this phenomenon.

Jan 15, 2014 Issue
Is Intensive Blood Pressure Control Beneficial in Patients with Acute Intracerebral Hemorrhage?
It seems to be safe to lower systolic blood pressure to a target of 140 mm Hg in those with an acute hemorrhagic stroke. However, there seems to be no clinical benefit to this approach when the data are adjusted for baseline NIH Stroke Scale scores.

Dec 15, 2013 Issue
Does Delaying Complementary Foods Protect Children Against Allergic and Atopic Diseases?
Breastfeeding duration, rather than exclusivity, may be the most important factor in prevention of atopic diseases. Earlier introduction of foods commonly associated with allergies may help prevent allergic and atopic diseases, but these data are inconclusive.

Oct 1, 2013 Issue
Do Abstracts of Articles in Major Journals Contain the Same Information as the Body of the Paper?
Physicians should not rely on article abstracts when deciding whether a therapy is good. Abstracts often have misleading information and conclusions. It's important to read the body of the article.

Jul 15, 2013 Issue
Pulmonary Embolism Rule-Out Criteria: A Clinical Decision Rule That Works
A number of clinical decision rules have been released recently. The PERC rule is an example of one that works well because it was derived from a large number of patients, and it was internally and externally validated.

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