I read the American Family Physician fairly regularly and sometimes I come across an article good enough to summarize here. In the May 1, 2016 issue is an article titled, “Top 20 Research Studies of 2015 for Primary Care Physicians.” In each AFP is a section called POEMs, for “Patient Oriented Evidence that Matters,” and these are the most relevant of the 2015 POEMs summarized in one article. I’ll comment on a few of these here:
- Rapid Strep tests in the office are improving, with a sensitivity of 86%, making the yield of doing a strep throat culture in adults (who have a lower prevalence than children) minimally productive.
- In patients hospitalized for community acquired pneumonia when an extensive evaluation to look for the causative organism is done, 23% had a cause alone, 11% a bacterial cause alone, 3% had evidence of both bacterial and viral cause, 1% had a fungal cause, but in the majority 62% no cause was found.
- In community-dwelling women age 70-80 who had fallen in the last year randomized to get Vit D 800 units, twice weekly walking exercies, neither or both the women who walked twice weekly had a 50% reduction in falls requiring medical attention (but none of the interventions prevented less serious falls.)
- In a randomized trial of nicotine patch use to facilitate quitting smoking 8,24 and 52 week duration of patch use had similar success rates of a bit over 20% at 1 year.
- A large study showed treatment of mild hypertension (140-159/90-99) showed slight improvement in cardiovascluar outcomes. Treatment for 5 years prevented 1 stroke per 173 patients, 1 caardiovascular death per 95 patients, and one death overall per 99 patients.
- Aspirin use to prevent cardiovascular events like stroke and heart attack remains controversial. One large metaanalysis showed treatment showed treatment over 7 years could prevent 253 cardiovascular events (think stroke or heart attack) but at the cost of causing 261 major bleeding events (thinks gastrointestinal hemorrhage or bleeding into the brain).
In the same journal is a nice one page summary of adult preventative services recommendation. Below is the summary. Here is a link to the page.