Clinical question	Bottom-line answer
10. Does the influenza vaccine lower the risk of major adverse cardiovascular events in adults with coronary disease?18	This meta-analysis found that the influenza vaccine is associated with a significantly lower risk of major adverse cardiovascular events in adults with coronary disease. The benefit of influenza vaccination is strongest in adults with a history of recent acute coronary syndrome within the previous six months (number needed to treat = 8).
11. Are high-risk patients who are screened for diabetes better off than patients who are diagnosed through the usual means?19	Screening patients at high risk of developing diabetes provides no 10-year cardiovascular or mortality benefit. The findings of this study are consistent with those of another large study of screening for type 2 diabetes.20 Perhaps it is time to stop screening patients for diabetes and use our limited resources on endeavors that make a difference, like smoking cessation.
12. Is there any clinical benefit to a repeat bone mineral density screening test after an initial baseline screen in older men and women?21	This study found little, if any, additional benefit to repeat bone mineral density screening at four years beyond baseline bone mineral density testing in older men and women. A recent similar study 22 recommended a baseline examination at 65 years of age with repeat testing necessary only after 15 years in patients with mild osteopenia and after five years in patients with moderate osteopenia. It looks like we should be doing a lot fewer dual energy x-ray absorptiometry scans than we have been doing.
13. Are sigmoidoscopy and colonoscopy associated with a decreased likelihood of death from CRC?23	This study found a significant reduction in the number of CRCs and CRC-related mortality in persons who chose to undergo flexible sigmoidoscopy or colonoscopy. This may overestimate the benefit, because of unmeasured confounding (other things associated with the decision to have colonoscopy that are also associated with CRC mortality).
14. Does smoking cessation increase anxiety in smokers?24	The commonly held belief that smoking is a stress reliever—and, therefore, quitting increases anxiety—was not demonstrated in this study. Smokers who were able to quit had a significant reduction in average anxiety scores, whereas smokers who relapsed had increased scores. Perhaps those who are successful in quitting are able to develop skills for managing anxiety.