MARK H. EBELL, MD, MS, University of Georgia, Athens, Georgia
ROLAND GRAD, MD, MSc, McGill University, Montreal, Quebec, Canada
Am Fam Physician. 2013 Sep 15;88(6):
disclosure: Dr. Ebell is cofounder and editor-in-chief of Essential
Evidence Plus, published by Wiley-Blackwell. Dr. Grad has no relevant
This is the second annual summary of top research studies in primary care. In 2012, through regular surveillance of more than 100 English-language clinical research journals, seven clinicians identified 270 studies with the potential to change primary care practice, called POEMs, or patient-oriented evidence that matters. These studies were then summarized in brief, structured critical appraisals and e-mailed to subscribers, including members of the Canadian Medical Association. A validated tool was used to obtain feedback from these physicians about the clinical relevance of each POEM and the benefits the physicians expected for their practice. The 20 identified research studies rated as most relevant cover common topics such as diabetes mellitus, cardiovascular disease prevention, infectious disease, musculoskeletal disease and exercise, cancer screening, and women's health.
Final CommentsA few themes emerge from these 20 research studies. One is that there is value and efficiency in taking a patient-centered approach to care. Treating low-risk patients as aggressively as high-risk patients is inappropriate, and may be harmful. Whether we are talking about control of blood glucose levels, cardiovascular prevention, or the interval for osteoporosis screening, sometimes less testing or less treatment can be better for our patients. It is worth examining the Choosing Wisely campaign, which provides a long list of evidence-based recommendations for more efficient care, with contributions from the American Academy of Family Physicians and other specialty societies. An editorial about the Choosing Wisely campaign, including a table of primary care–relevant recommendations, is available in American Family Physician.
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