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AFP Journal Club

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AFP Journal Club: Transient Ischemic Attack: The Rules Have Changed - American Family ...

Jun 15, 2012 - This scientific guideline includes three game changers for physicians regarding TIA. The Journal Club authors discuss why physicians should be wary of clinical guidelines that are based on expert opinion.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2012/0615/p1179.html

AFP Journal Club: The "ARB-MI Paradox": Real or a Fluke? - American Family Physician

Jul 15, 2012 - The Journal Club authors discuss what factors make this meta-analysis, designed to determine whether the ARB-MI paradox is real or a statistical fluke, successful.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2012/0715/p136.html

AFP Journal Club Department Collection - American Family Physician

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 ...

American Family Physician : Department Collection

https://www.aafp.org/afp/viewRelatedDepartmentsByDepartment.htm?departmentId=17&page=0

AFP Journal Club Department Collection - American Family Physician

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 ...

American Family Physician : Department Collection

https://www.aafp.org/afp/viewRelatedDepartmentsByDepartment.htm?departmentId=17

AFP Journal Club: If It Seems Too Good To Be True... - American Family Physician

May 15, 2015 - There are dangers in the early adoption of treatment modalities without repeated verification in the literature.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2015/0515/p729.html

AFP Journal Club: Thrombolysis for DVT: Has the Time Arrived? - American Family Physician

Apr 1, 2015 - Catheter-directed thrombolysis for proximal DVT is experimental but may be considered in a patient with phlegmasia and resulting compartment syndrome.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2015/0401/p430.html

AFP Journal Club: Benzodiazepines and Alzheimer Disease - American Family Physician

Feb 1, 2015 - 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.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2015/0201/p191.html

AFP Journal Club: Can CPOE Systems Decrease Use of Laboratory Studies and Control ...

Sep 15, 2014 - 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.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2014/0915/p409.html

AFP Journal Club: Evidence to Guide Measles Immunization Recommendations - American ...

May 15, 2014 - 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.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2014/0515/p786.html

AFP Journal Club: PPIs, Childhood Asthma, and the Problem of Therapeutic Creep - ...

Mar 15, 2014 - 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.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2014/0315/p476.html

AFP Journal Club: Is Intensive Blood Pressure Control Beneficial in Patients with Acute...

Jan 15, 2014 - 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.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2014/0115/p120.html

AFP Journal Club: Pulmonary Embolism Rule-Out Criteria: A Clinical Decision Rule That ...

Jul 15, 2013 - 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.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2013/0715/p98.html

AFP Journal Club: Does Delaying Complementary Foods Protect Children Against Allergic ...

Dec 15, 2013 - 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.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2013/1215/p818.html

AFP Journal Club: Do Abstracts of Articles in Major Journals Contain the Same ...

Oct 1, 2013 - 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.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2013/1001/p466.html

AFP Journal Club: Is Rivaroxaban Noninferior to Standard Warfarin Therapy in Preventing...

Jun 15, 2013 - A trial showing that one drug is noninferior to another does not mean that these drugs are equivalent. The noninferiority margin allows researchers to choose their own benchmark for what is considered a clinically significant difference between two drugs.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2013/0615/p872.html

AFP Journal Club: Does Screening Mammography Lead to Overdiagnosis of Invasive Breast ...

Mar 15, 2013 - Implementation of a universal mammographic screening program leads to an increase in the diagnosis of invasive breast cancer, because of improved detection of clinically significant cancer and overdiagnosis.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2013/0315/p408.html

AFP Journal Club: The Use of Coronary Computed Tomography Angiography to Rule Out CAD ...

Nov 15, 2012 - Is coronary CTA good enough to allow for the safe discharge of low- to intermediate-risk patients with chest pain? Coronary CTA and standard care were equally effective at identifying a low-risk population. The test saved seven hospital hours, but at the expense of radiation exposure, ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2012/1115/p900.html

AFP Journal Club: How Do Clinical Practice Guidelines Go Awry? - American Family Physician

Sep 15, 2012 - Many guidelines are dominated by recommendations from experts and are not based on sound clinical studies. The development of clinical practice guidelines needs to be transparent and devoid of commercial, financial, and political influences. Physicians should also be wary of outdated ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2012/0915/p514.html

AFP Journal Club: Rivaroxaban vs. Warfarin for Stroke Prevention in Patients with ...

Mar 15, 2012 - How does rivaroxaban compare with warfarin for stroke prevention in patients with nonvalvular atrial fibrillation? This study concluded that rivaroxaban is noninferior to warfarin. However, noninferiority trials do not meet the same rigorous design and statistical format of traditional ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2012/0315/p577.html

AFP Journal Club: Antibiotics for Acute Otitis Media in Young Children: The Case of the...

Jan 15, 2012 - A discussion of why the conclusion of a high-profile study, which suggests that antibiotics are beneficial in children six to 23 months of age with acute otitis media, is incorrect.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2012/0115/p104.html

AFP Journal Club: Antibiotics for Acute Otitis Media in Young Children - American ...

Nov 15, 2011 - Two studies aim to clarify the appropriate use of antibiotic treatment in young children with acute otitis media.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2011/1115/p1095.html

AFP Journal Club: Subarachnoid Hemorrhage and the CT Scan - American Family Physician

Sep 15, 2011 - Is CT sensitive enough to rule out subarachnoid hemorrhage? This study says yes, but rretrospective studies are inherently problematic. Normal head CT should be followed by a lumbar puncture.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2011/0915/p632.html

AFP Journal Club: Usefulness of Procalcitonin Measurement in Reducing Antibiotic Use ...

Jul 15, 2011 - Measurement of procalcitonin is being pushed as a way to determine the presence or absence of bacterial infection and, therefore, as a way to reduce antibiotic use. But, how well does it work in the patients family physicians see? Why are the results of this study not as convincingly ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2011/0715/p177.html

AFP Journal Club: Clinical Significance of Meniscal Damage on Knee MRI - American ...

May 15, 2011 - Can you make the assumption that, in a patient with knee pain, meniscal damage found on MRI is responsible for his or her symptoms? Meniscal findings on knee MRI do not correlate well with pain.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2011/0515/p1160.html

AFP Journal Club: Donepezil to Manage Alzheimer Disease: New vs. Standard Dosing - ...

Mar 15, 2011 - Does donepezil benefit patients with Alzheimer disease, and is the new dosage superior to the standard dosage? This study showed benefit, but the data are misleading.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2011/0315/p742.html

AFP Journal Club: Antidepressants for Initial Treatment of Depression - American Family...

May 15, 2010 - Which antidepressants should be used for the initial treatment of depression? This quality multiple-treatment meta-analysis gives physicians a good starting point for choosing an antidepressant. Sertraline and escitalopram should be considered first-line agents whereas bupropion, ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2010/0515/p1205.html

AFP Journal Club: Can ECG Rule Out ACS if Performed While the Patient Is Having Chest ...

Nov 15, 2010 - Is negative ECG performed while the patient is having chest pain good at ruling out acute coronary syndrome? Although this study says yes, other higher-quality studies say it does not rule out cardiac disease. Observational studies are not ideal for testing some hypotheses.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2010/1115/p1185.html

AFP Journal Club Toolkit -- American Family Physician

Nov 28, 2012 - The EBM glossary includes commonly used terms and abbreviations, and information about EMB study types.

American Family Physician : AFP Home

https://www.aafp.org/journals/afp/authors/ebm-toolkit/jc-toolkit.html

AFP Journal Club: Autism and Childhood Vaccinations: Debunking the Myth - American ...

Sep 15, 2010 - Are childhood vaccinations associated with subsequent development of autism? This month's article provides the science and statistics to dispel the theory that childhood vaccinations induce autism.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2010/0915/p586.html

AFP Journal Club: Beta Blockers and Noncardiac Surgery: Why the POISE Study Alone ...

Mar 15, 2010 - Should we stop using beta blockers to prevent myocardial infarction in persons undergoing noncardiac surgery? The data remain inconclusive. Although the POISE study is an important contribution to the literature, it uses a protocol that is unrealistic and should not change current ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2010/0315/p717.html

AFP Journal Club: Cancer Risks Associated with CT Scanning - American Family Physician

Jan 15, 2010 - ...AFP Journal Club The Story Behind the Study Cancer Risks Associated with CT Scanning ROBERT DACHS, MD, FAAFP, Ellis Hospital Family Medicine Residency Program, Schenectady, New York MARK A. GRABER, MD, FACEP, University of Iowa Carver College of Medicine, Iowa City, Iowa ANDREA...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2010/0115/p111.html

AFP Journal Club: Is Telmisartan Effective for Stroke Prevention? - American Family ...

Nov 15, 2009 - Does telmisartan therapy after stroke prevent recurrence and adverse cardiovascular events? Despite lowering blood pressure, telmisartan did not provide preventative benefit. This study reflects problems with publication bias and that surrogate markers, such as blood pressure control, ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2009/1115/p1042.html

AFP Journal Club: Is the San Francisco Syncope Rule Reliable? - American Family Physician

Sep 15, 2009 - Can the San Francisco Syncope Rule successfully determine which patients can be safely discharged after an acute syncopal episode? External validation suggests that the sensitivity of the rule is lower than first reported. Physicians need to apply their clinical acumen and override the ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2009/0915/p558.html

Upper Respiratory Tract Infections - American Family Physician

Oct 15, 2017 - This collection features AFP content on upper respiratory tract infections and related issues, including acute bronchitis, acute rhinosinusitis, bronchiolitis, common cold, croup, pharyngitis, rhinosinusitis, streptococcal pharyngitis, and strep throat.

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=29

AFP Journal Club: Honey as a Treatment for Cough in Children - American Family Physician

Jul 15, 2009 - Is honey an effective treatment for cough in children? Although this study failed to provide convincing evidence of effectiveness, honey may be a safe alternative to soothe cough in children older than one year.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2009/0715/p120.html

AFP Journal Club: Sample Medications and Overall Prescription Costs - American Family ...

May 15, 2009 - What are the effects of providing sample medications to patients? It increases prescription costs and causes physicians to use second-line choices.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2009/0515/p891.html

AFP Journal Club: Acyclovir or Steroids as Pharmacologic Treatment of Bell Palsy - ...

Mar 15, 2009 - Does acyclovir or steroids speed recovery in adults with Bell palsy? This study suggests that it is reasonable to start prednisolone in some cases, but physicians should not forget about practical considerations, such as lubricant eye drops, pain management, and chewing instruction. ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2009/0315/p435.html

AFP Journal Club: Choosing One PPI Treatment Over Another - American Family Physician

Nov 1, 2007 - Is one PPI better than another? All PPIs are equally effective in equipotent dosages, and choice should be based on price.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2007/1101/p1273.html

Asthma - American Family Physician

Nov 15, 2017 - This collection features AFP content on asthma and related issues, including allergens, beta agonists, chronic cough, exercise-induced bronchoconstriction, inhalers, and wheezing.

American Family Physician : AFP By Topic

https://www.aafp.org/afp/topicModules/viewTopicModule.htm?topicModuleId=3

AFP Journal Club: The Role of Chest CT in Diagnosing Pulmonary Embolism - American ...

Sep 1, 2008 - How good is chest CT at identifying pulmonary embolism? It might have higher false-positive and false-negative rates than previously thought.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0901/p554.html

AFP Journal Club: Is Prasugrel More Effective Than Clopidogrel in Patients with Acute ...

Dec 1, 2008 - Is prasugrel better than clopidogrel in patients with acute coronary syndrome who are scheduled for percutaneous coronary intervention? This study is misleading, and current practice should not change based on its results.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/1201/p1252.html

AFP Journal Club: Does Limiting Interruptions During Cardiac Resuscitation Improve ...

Oct 1, 2008 - Does the ACLS recommendation to limit interruptions during cardiac resuscitation improve outcomes for patients with cardiac arrest? It is a reasonable recommendation, but success rates in this study may be too good to believe.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/1001/p804.html

AFP Journal Club: Albuterol vs. Levalbuterol for Asthma Treatment in Children - ...

May 1, 2008 - For children with acute asthma exacerbations, is levalbuterol better than albuterol? There is no difference between the medications in effectiveness or side effects.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0501/p1214.html

AFP Journal Club: Choosing First-Line Therapy for Management of Type 2 Diabetes - ...

Jan 1, 2008 - Which controls type 2 diabetes best at five years: rosiglitazone, metformin, or glyburide? Metformin should be the first-line drug for managing type 2 diabetes. Insulin and sulfonylureas should be second line, and glitazones should be reserved for third line.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0101/p16.html

AFP Journal Club: Aripiprazole as Adjunctive Therapy in Patients with Major Depressive ...

Aug 1, 2008 - Does augmentation with aripiprazole help patients with major depressive disorder who have not responded to initial therapy? Adding aripiprazole to SSRIs or SNRIs did not significantly improve depression in this study. However, this study did not compare the study drug with a real-world ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0801/p308.html

When to Order Contrast-Enhanced CT - American Family Physician

Sep 1, 2013 - Family physicians often must determine the most appropriate diagnostic tests to order for their patients. It is essential to know the types of contrast agents, their risks, contraindications, and common clinical scenarios in which contrast-enhanced computed tomography is appropriate. ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0901/p312.html

AFP Journal Club: Inhaled Steroid Use and Asthma Control in Patients with Mild ...

Jul 1, 2008 - Can patients with mild persistent asthma safely decrease or eliminate inhaled steroids? The results of these studies may not be generalizable to the average primary care patient. Patients should be appropriately classified and treated using 2007 National Asthma Education and Prevention ...

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0701/p21.html

AFP Journal Club: NSAIDs vs. Acetaminophen for the Treatment of Ankle Sprains - ...

Dec 1, 2007 - Are NSAIDs better than acetaminophen for ankle sprains? Extended-release acetaminophen provides equivalent analgesia and return to activity as an NSAID in patients with mild to moderate ankle sprains. All NSAIDs have equivalent analgesic effect.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2007/1201/p1605.html

AFP Journal Club: Is Unfractionated Heparin Equivalent to Low-Molecular-Weight Heparin ...

Jun 1, 2008 - Is weight-based unfractionated heparin as good as weight-based low-molecular-weight heparin for outpatient treatment of venous thromboembolism? Even though this study was underpowered to prove equivalence, treatment with subcutaneous unfractionated heparin is a viable option.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0601/p1492.html

AFP Journal Club: Treatment of Acute Ischemic Stroke with t-PA - American Family Physician

Apr 1, 2008 - Does the widespread use of the thrombolytic tissue plasminogen activator (t-PA) more beneficial or harmful in patients with acute stroke? The benefits must be balanced against the harms. Informed consent is necessary when making the decision.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0401/p901.html

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