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POEMs by Essential Evidence Plus

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POEMs are synopses of new evidence, carefully filtered for relevance to patient care and evaluated for validity by the Essential Evidence Plus editorial team.

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POEMs
Clinical Relevance of Information Index
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December  
31 Cabotegravir is an effective option for PrEP in patients at risk for HIV infection 20 % (n=960)
30 No benefit with balanced vs saline solution or slower vs faster rate for fluid resuscitation in ICU 21 % (n=1075)
29 Efpeglenatide reduces the risk of major adverse CV events in patients with T2DM + established CVD or chronic kidney disease (AMPLITUDE-O) 45 % (n=1019)
28 Salt substitute reduces mortality and stroke in elderly patients who have a history of, or are at risk of, stroke 55 % (n=1165)
24 Mobile stroke units that speed access to tPA improve 90-day outcomes slightly 24 % (n=1025)
23 Better adherence to dietary recommendations is associated with lower mortality 64 % (n=1101)
22 Bamlanivimab plus etesevimab reduces the likelihood of hospitalization or death in high-risk outpatients with COVID-19 (NNT = 20) 31 % (n=1004)
21 Only one cerumenolytic assists with in-office manual disimpaction of ear wax 60 % (n=1120)
20 Therapeutic anticoagulation reduces thromboembolism in hospitalized patients with COVID-19 and very high D-dimer levels (HEP-COVID) 32 % (n=1127)
17 Amoxicillin does not improve outcomes for nonpneumonia lower respiratory tract infection in children (ARTIC PC) 57 % (n=1128)
16 Some patients are willing to consider delayed antibiotic treatment of respiratory tract infection 62 % (n=1107)
15 Booster with Pfizer mRNA vaccine significantly reduces likelihood of infection and severe illness due to COVID-19 in adults 60+ 76 % (n=1206)
14 Symptom likelihood is similar in euthyroid people and those with subclinical hypothyroidism (TSH > 3.6 mU/L) 63 % (n=1022)
13 Fluvoxamine decreases hospitalizations in high-risk adults with COVID-19 (TOGETHER) 36 % (n=1143)
10 Predictive values for 6 common abdominal symptoms 66 % (n=1058)
09 Inosine is not effective in reducing the progression of early Parkinson disease 27 % (n=1033)
08 Living systematic review for WHO: casirivimab-imdevimab probably reduces hospitalization in persons with nonsevere COVID-19 29 % (n=995)
07 Minimal, if any, association between labor epidural analgesia and the risk of autism spectrum disorder in children 30 % (n=1067)
06 Better outcomes associated with treatment of acute sickle cell vaso-occlusive crises at infusion centers 13 % (n=1003)
03 Daily contact testing and self-isolation are similar for control of COVID-19 in secondary schools and colleges 43 % (n=1084)
02 Concurrent COVID-19 infection does not affect the sensitivity of D-dimer for pulmonary embolism diagnosis 39 % (n=1141)
01 Greater blood pressure lowering with a “quadpill” (quarter doses of 4 drugs) than with standard-dose monotherapy (QUARTET) 59 % (n=1180)
November  
30 Perioperative mortality for bariatric surgery is less than 0.1% 35 % (n=1108)
29 Every-other-year FIT is at least as effective as a single sigmoidoscopy to detect colorectal cancer 65 % (n=1178)
26 Recurrent herpes zoster more common in women, younger adults, and the immunosuppressed 57 % (n=1111)
25 Evidence of benefit is lacking for low back pain relief with muscle relaxants 68 % (n=1135)
24 Long-term outcomes are similar with below- and above-elbow casts in children with minimally displaced forearm fractures 31 % (n=1075)
23 Therapeutic anticoagulation may benefit noncritically ill patients hospitalized with COVID-19 29 % (n=1078)
22 Better estimate of prostate cancer risk based on the number of close relatives with prostate cancer and their age at diagnosis 54 % (n=1114)
19 There is limited data on ivermectin in patients with COVID-19 37 % (n=1118)
18 Practice guideline suggests a trial of CBD/THC for patients with chronic pain 53 % (n=1158)
17 Iron supplementation in infants living in countries with a high prevalence of anemia does not improve cognition or development 26 % (n=1069)
16 USPSTF 2021 recommends screening for chlamydia and gonorrhea in sexually active women 24 years or younger (B recommendation) 62 % (n=1129)
15 The outcomes associated with arrest of cervical dilation in active labor vary with degree of dilation 16 % (n=970)
12 Abelacimab prevents asymptomatic clots better than enoxaparin, but there is no difference in clinical clots or major bleeding 20 % (n=998)
11 Low-quality evidence: high-flow nasal oxygen > noninvasive ventilation for adults with acute respiratory failure 27 % (n=1053)
10 Pregnant women who become ill with COVID-19 are more likely to die and have adverse perinatal and neonatal outcomes 49 % (n=1170)
09 Refeeding syndrome is associated with a higher risk of 6-month mortality 22 % (n=1064)
08 USPSTF 2021 recommends low-dose aspirin at 12 weeks in pregnant persons at high risk of preeclampsia (B recommendation) 37 % (n=1103)
05 Bedside rounds: increased face time but no change in patients’ knowledge of their medical care 32 % (n=1091)
04 Universal depression screening in primary care: 77% false positives 59 % (n=1126)
03 IL-6 antagonists may be associated with lower mortality in adults hospitalized with COVID-19 24 % (n=1021)
02 Limited data indicate that music minimally improves cognition in persons with mild cognitive impairment or dementia 40 % (n=1063)
01 Third Pfizer vaccine dose significantly increases protection against both mild and severe COVID-19 in patients 60 years+ 73 % (n=1311)
October  
29 Overtreatment leads to harm in older patients with type 2 diabetes 68 % (n=1261)
28 Intravenous immune globulin plus corticosteroids is the best initial therapy for multisystem inflammatory syndrome in children 18 % (n=1112)
27 Platelet-rich plasma injection is no better than sham injection for midportion Achilles tendinopathy 34 % (n=1203)
26 No-test medical abortion is safe and effective 31 % (n=1110)
25 Clopidogrel monotherapy more effective than aspirin to prevent coronary events after PCI with drug-eluting stents (HOST-EXAM) 51 % (n=1214)
22 Pimavanserin of uncertain benefit to treat psychosis in patients with dementia 27 % (n=1035)
21 Limited data suggest that music improves sleep quality in older adults 47 % (n=1160)
20 Cytisine unable to demonstrate noninferiority to varenicline, but is still an option for smoking cessation 47 % (n=1121)
19 Rifaximin effective in decreasing post-TIPS hepatic encephalopathy in patients with cirrhosis 18 % (n=1041)
18 Vaccines are only slightly less effective against the delta variant 75 % (n=1327)
15 A single corticosteroid burst in children is associated with harms 46 % (n=1191)
14 Gender-affirming hormone treatment in adolescents is not associated with thrombosis 25 % (n=1161)
13 Tranexamic acid may reduce bleeding after cesarean delivery, but with a risk of adverse effects 20 % (n=1167)
12 Active management is more effective than expectant management for resolution of nonviable pregnancy of unknown location 26 % (n=1111)
11 Inhaled budesonide shortens duration of illness in high-risk outpatients with COVID-19 (PRINCIPLE) 46 % (n=1208)
08 Provided infant carriers increase the rate of sustained breastfeeding 33 % (n=1106)
07 Weekly tirzepatide + metformin better than daily insulin degludec + metformin in decreasing A1C, weight, and hypoglycemia (SURPASS-3) 40 % (n=1050)
06 Weak correlation between umbilical cord blood gas values and neonatal outcomes 20 % (n=1100)
05 Single-dose oral azithromycin not effective in the management of outpatient SARS-CoV-2 infection 49 % (n=1254)
04 Fewer strokes but more bleeding with aspirin + either clopidogrel or ticagrelor than with monotherapy in secondary stroke prevention 53 % (n=1171)
01 USPSTF 2021 recommends screening for gestational diabetes in asymptomatic pregnant persons at 24+ weeks (B recommendation) 49 % (n=1141)
September  
30 Conservative management = intervention in patients with hemodynamically stable spontaneous pneumothorax 32 % (n=1215)
29 Open-label placebo decreases opioid use after surgery 37 % (n=1145)
28 Centers for Disease Control and Prevention report on the Delta variant 76 % (n=1213)
27 The past use of an intrauterine device is not associated with infertility, but a past Mycoplasma genitalium infection is 43 % (n=1149)
24 Astodrimer gel (VivaGel) is effective to treat bacterial vaginosis 51 % (n=1133)
23 Substituting n-3 (omega-3) fatty acids for n-6 fatty acids decreases headache days in patients with frequent migraines 42 % (n=1124)
22 Targeted rehabilitation improves physical function in elderly patients hospitalized with heart failure (REHAB-HF) 40 % (n=1104)
21 Triple therapy is superior to dual therapy for children and adults with moderate to severe asthma 58 % (n=1199)
20 Guidelines for when to consider mortality-reducing treatments for patients with type 2 diabetes 62 % (n=1021)
17 AHA guideline for secondary stroke prevention 62 % (n=1049)
16 Antidepressant dose: Start low, stay low 65 % (n=1189)
15 Left atrial appendage occlusion during cardiac surgery for another reason reduces the risk of stroke (NNT = 43 over 4 years) 17 % (n=1003)
14 Recent studies of OTC products favor polyethylene glycol and senna for treating chronic constipation 72 % (n=1191)
13 Pre-encounter information decreases antibiotic expectations but not actual prescribing 53 % (n=1093)
10 ACG guideline on the prevention, diagnosis, and treatment of Clostridioides difficile infections 51 % (n=1138)
09 Preconception myo-inositol and probiotics decrease premature birth 24 % (n=1031)
08 Handheld narrowband UVB plus topical corticosteroids are more effective for active limited vitiligo than either alone 27 % (n=1082)
07 No difference in resolution of urinary tract infection symptoms with 7 vs 14 days of antibiotic therapy among afebrile men 61 % (n=1219)
06 Short-term antibiotic treatment is suitable for several outpatient infections 69 % (n=1273)
03 High-frequency spinal cord stimulation improves pain in patients with refractory painful diabetic neuropathy 33 % (n=1102)
02 Telephone-based cognitive behavioral therapy for insomnia is effective 50 % (n=1171)
01 No advantage to 325 mg over 81 mg aspirin for persons with established cardiovascular disease (ADAPTABLE) 70 % (n=1247)
August  
31 Bamlanivimab prophylaxis reduces incidence of COVID-19 in skilled nursing and assisted living facilities 24 % (n=1111)
30 Lowering blood pressure improves cardiovascular outcomes 60 % (n=1201)
27 Influenza vaccine during pregnancy not associated with adverse childhood health outcomes 62 % (n=1272)
26 Convalescent plasma does not decrease deaths or mechanical ventilation in patients with COVID-19, hypoxia, and elevated CRP levels (RECOVERY) 21 % (n=1180)
25 High-dose dexamethasone does not reduce mortality or complications in patients undergoing major noncardiac surgery 17 % (n=1171)
24 Doxycycline 100 mg twice daily for 7 days preferred for treatment of asymptomatic rectal chlamydia trachomatis 37 % (n=1228)
23 Fecal transplantation does not improve abdominal pain in persons with irritable bowel syndrome 34 % (n=1258)
20 European Respiratory Society guidelines for hospitalized patients with COVID-19 33 % (n=1112)
19 Very low incidence of acute myocarditis after mRNA COVID-19 vaccination in young adults 67 % (n=1301)
18 Fewer than 1 in 20 patients with onychomycosis achieve complete clearance with topical terbinafine 63 % (n=1269)
17 Patient-centered time-limited trials of therapies may reduce nonbeneficial care in the intensive care unit 19 % (n=1031)
16 Dual antiplatelet therapy is superior to aspirin in preventing short-term recurrent stroke at the cost of more major bleeding 54 % (n=1138)
13 Strict diet plus liraglutide plus moderate exercise results in weight loss, but liraglutide alone does not 53 % (n=1080)
12 Routine MRI reports for low back pain may decrease function and worsen pain because of catastrophyzing language 66 % (n=1273)
11 Screening for ovarian cancer with CA-125/ultrasound algorithm does not reduce mortality (UKCTOCS) 51 % (n=1228)
10 Some nonpharmacological treatments may decrease migraine frequency in children and adolescents 41 % (n=1172)
09 Group B streptococcal prophylaxis not associated with subsequent allergic disorders 34 % (n=1185)
06 USPSTF 2021 now recommends colorectal screening beginning at age 45 years (B recommendation) 61 % (n=1218)
05 CRP and procalcitonin cannot definitively diagnose bacterial lower respiratory tract infection in children 29 % (n=1125)
04 Ultrasound is accurate for diagnosing upper extremity fractures in children 32 % (n=1179)
03 6-hour balloon catheter placement is sufficient for cervical ripening at labor induction 17 % (n=1081)
02 Tofacitinib reduces composite outcome of death or respiratory failure in patients with COVID-19 pneumonia (NNT = 9) 22 % (n=1083)
July  
30 Final report from SPRINT: lowering SBP below 120 mm Hg decreases major adverse cardiac events and all-cause mortality 63 % (n=1247)
29 Anticonvulsants, SNRIs, and rubefacients are best initial choices for chronic pain caused by diabetic neuropathy or postherpetic neuralgia 66 % (n=1212)
28 More unfavorable outcomes with 6 weeks versus 12 weeks of oral antibiotic therapy for prosthetic joint infections 26 % (n=1165)
27 Tocilizumab decreases deaths and mechanical ventilation in patients hospitalized with COVID-19, hypoxia, and elevated CRP levels (RECOVERY) 24 % (n=1137)
26 No difference in cognitive decline in elderly patients with coronary artery disease undergoing CABG vs PCI 34 % (n=1160)
23 The 4 'A's Test (4AT) is reasonably accurate in ruling out delirium in adults 65 and older 45 % (n=1125)
22 USPSTF 2021 now recommends colorectal screening beginning at age 45 years (B recommendation) 61 % (n=1236)
21 Levetiracetam is comparable with current second-line agents to treat children with convulsive status epilepticus 21 % (n=1109)
20 Antibiotic therapy does not prevent death or acute exacerbations in adults with idiopathic pulmonary fibrosis 31 % (n=1196)
19 A lower oxygenation target for critically ill patients with respiratory failure does not reduce mortality 20 % (n=1161)
16 ACG guideline on managing patients with acute upper gastrointestinal and ulcer bleeding 43 % (n=1170)
15 Five days of antibiotic therapy is comparable with 10 days in children with community-acquired pneumonia (SAFER) 58 % (n=1253)
14 Delayed admission to the intensive care unit for heart failure is associated with higher mortality and readmissions 30 % (n=1142)
13 Resuming oral anticoagulants after a bleed is associated with fewer thrombi and deaths, but more bleeds 49 % (n=1181)
12 Limited data show adjunctive ketorolac modestly decreases pain in patients with renal colic 39 % (n=1174)
09 Non-antidepressant approaches are more effective for treating depression in patients with dementia 53 % (n=1219)
08 The majority of occiput posterior positions rotate to occiput anterior positions during second-stage labor 20 % (n=1130)
07 Multiple steroid injections into arthritic joints do not improve outcomes more than other injections 57 % (n=1218)
06 More frequent hemoglobin monitoring is associated with more transfusions in patients with gastrointestinal bleeding 35 % (n=1198)
05 Cannabinoids cause side effects but don't seem to cause serious adverse effects in patients older than 50 46 % (n=1230)
02 Pfizer/BioNTech mRNA vaccine is highly effective and safe in adolescents aged 12 to 15 years 69 % (n=1327)
01 Patients who undergo percutaneous coronary intervention have better outcomes using guided antiplatelet therapy 26 % (n=1142)
June  
30 Type of shoe doesn't seem to matter for moderate to severe knee osteoarthritis due to medial joint space narrowing 54 % (n=1177)
29 IL-6 inhibitors reduce mortality and the need for organ support in critically ill patients with COVID-19 19 % (n=1105)
28 Ruling out acute myocardial infarction based on patient characteristics 45 % (n=1224)
25 Outcomes not different with continued vs discontinued oxytocin in active phase of labor 16 % (n=1090)
24 No improvement in clinical status at 28 days with tocilizumab in patients with severe COVID-19 pneumonia 22 % (n=1162)
23 Even a small amount of maternal caffeine consumption is associated with decreased fetal growth 56 % (n=1315)
22 Decreased fetal movements associated with fetal risks 34 % (n=1200)
21 Adherence to lung cancer screening is relatively poor after baseline scan 44 % (n=1153)
18 The risk of progression from prediabetes to diabetes in older adults is low 65 % (n=1271)
17 Inadvertent HPV vaccine in pregnancy is not associated with adverse outcomes 36 % (n=1186)
16 For patients with type 2 diabetes mellitus who are taking a GLP-1, SGLT2 may be preferred to a sulfonylurea as add-on therapy 63 % (n=1109)
15 New-onset type 2 diabetes is associated with a higher risk of newly diagnosed cancers 56 % (n=1238)
14 Pre-hospital hypothermia does not improve outcomes in out-of-hospital cardiac arrest 21 % (n=1155)
11 Pfizer mRNA vaccine highly effective in a real-world population–based study in Israel 76 % (n=1381)
10 The probability of disease is frequently overestimated by primary care clinicians 57 % (n=1165)
09 Poor-quality data suggest that platelet-rich plasma is marginally more effective than steroids for plantar fasciitis 37 % (n=1171)
08 Relugolix plus estradiol plus norethindrone reduces heavy menstrual bleeding due to fibroids (LIBERTY 1 and 2) 32 % (n=1071)
07 High-dose zinc, vitamin C, or both are not effective in reducing symptoms of SARS-CoV-2 infection (COVID A to Z) 49 % (n=1259)
04 Epidural steroid injections provide minimal, if any, benefit in low back pain with sciatica 54 % (n=1232)
03 Ultrasound-guided steroid injections are more accurate than blind injections for frozen shoulder, but outcomes are similar 51 % (n=1240)
02 Inhaled budesonide reduces the risk of emergency department evaluation or hospitalization in early COVID-19 57 % (n=1288)
01 Cesarean rate due to nonreassuring fetal status is similar with double balloon catheter and dinoprostone pessary (MAGPOP) 15 % (n=1051)
May  
31 Proton pump inhibitors do not improve throat symptoms in patients without specific heartburn symptoms 56 % (n=1342)
28 Acupuncture plus intradermal needling is effective for cervical spondylosis–related neck pain 44 % (n=1180)
27 Take-and-hold prescriptions for children with respiratory infections decrease antibiotic use with similar outcomes 65 % (n=1258)
26 Prophylactic dextrose for at-risk newborns decreases the risk of hypoglycemia but not NICU admission 17 % (n=1166)
25 Cognitive behavioral therapy and hypnotherapy are the psychological therapies most likely to help irritable bowel syndrome 52 % (n=1244)
24 High-titer convalescent plasma associated with lower mortality in hospitalized nonventilated patients with COVID-19 20 % (n=1172)
21 Earlier initiation of anticoagulation associated with better outcomes in hospitalized patients with COVID-19 33 % (n=1262)
20 Vitamin D and/or fish oil supplementation do not reduce the risk of atrial fibrillation (VITAL) 45 % (n=1285)
19 Rural Black women who are given the option of home HPV sampling are more likely to get screened 21 % (n=1166)
18 More than half of adults hospitalized for COVID-19 still report significant symptoms at 4 months postdischarge (COMEBAC) 56 % (n=1338)
17 USPSTF 2021: Evidence insufficient to recommend for or against screening for hearing loss in adults (I statement) 54 % (n=1194)
14 Intermediate-dose prophylactic anticoagulation not recommended for patients with COVID-19 in the ICU 19 % (n=1176)
13 No benefit to daily albumin infusions for hospitalized patients with decompensated cirrhosis 23 % (n=1187)
12 Oral steroids don't improve symptom scores but decrease hospitalizations in preschoolers with acute wheezing (WASP) 44 % (n=1229)
11 USPSTF 2021 recommends annual lung cancer screening based on shared decision-making in high-risk adults (B recommendation) 56 % (n=1229)
10 Five days of ivermectin does not significantly decrease the duration of symptoms in patients with mild COVID-19 39 % (n=1270)
07 Low-quality evidence supports exercise, massage, yoga, acupuncture, and other interventions for chronic pain 66 % (n=1283)
06 RCT: In older persons, aspirin increases the risk of metastatic or stage 4 cancers and cancer mortality (ASPREE) 57 % (n=1269)
05 High-dose amoxicillin plus clavulanate no better than standard dose for acute sinusitis in adults 61 % (n=1322)
04 Outcomes not different with 1-step versus 2-step screening for gestational diabetes 39 % (n=1147)
03 Longer interval between doses of the Oxford/AstraZeneca vaccine may provide greater immunity against COVID-19 68 % (n=1334)
April  
30 Surprise Question has good positive predictive value for identifying primary care patients who will die in the next year 51 % (n=1200)
29 Ticagrelor plus aspirin is superior to aspirin alone in preventing stroke after TIA or minor stroke (THALES) 50 % (n=1264)
28 Rapid antigen tests for COVID-19 are much less sensitive in asymptomatic persons (40% vs 80% in symptomatic persons) 56 % (n=1278)
27 LNG-IUD is noninferior to copper IUD for emergency contraception 37 % (n=1217)
26 Adjust urine white blood cell cutoffs based on specific gravity in children with suspected urinary tract infection 43 % (n=1118)
23 USPSTF 2021 reaffirms recommendation against screening for asymptomatic carotid artery stenosis (D recommendation) 56 % (n=1209)
22 Restrictive transfusion strategy for patients with AMI and anemia is comparable with liberal strategy; more research needed 25 % (n=1092)
21 Opioid use is not associated with birth defects 41 % (n=1308)
20 Baclofen prevents agitation but delays awakening and lengthens ICU stay in critically ill patients with unhealthy alcohol use 13 % (n=1113)
19 COVID-19 risk score with and without laboratory data may reliably predict mortality in outpatient setting 41 % (n=1167)
16 Once-weekly semaglutide is an effective adjunct for weight loss in nondiabetic overweight/obese adults (STEP 3) 55 % (n=1238)
15 Tocilizumab and sarilumab are effective for critically ill patients with COVID-19 who require organ support 23 % (n=1128)
14 Sotagliflozin reduces hospitalizations and urgent visits in patients with T2DM and recent HF hospitalization (SOLOIST-WHF) 39 % (n=1045)
13 High-titer convalescent plasma prevents COVID-19 progression in elderly patients when given early 25 % (n=1183)
12 Brief counseling and feedback on grocery purchases does not significantly change saturated fat purchases or intake 45 % (n=1127)
09 Sublingual grass pollen produces some symptom relief, but it can take years 34 % (n=1158)
08 Cryoablation preferred as initial therapy for paroxysmal atrial fibrillation (EARLY-AF) 42 % (n=1216)
07 Multimodal physical therapy is more effective than topical lidocaine to treat provoked vestibulodynia 33 % (n=1108)
06 Sotagliflozin reduces hospitalizations and urgent visits for heart failure, but has no mortality benefit (SCORED) 38 % (n=1092)
05 Cannabis use is common among patients with rheumatologic illness 39 % (n=1175)
02 Single-dose opioid analgesics offer no benefit over non-narcotic analgesia for musculoskeletal pain 64 % (n=1295)
01 Convalescent plasma does not improve outcomes in patients hospitalized with severe COVID-19 pneumonia (PlasmAr) 25 % (n=1198)
March  
31 Digital mammography: more cancers detected, more recalls, more overdiagnosis than film-based mammography 49 % (n=1207)
30 TENS more effective than sham TENS in decreasing pain in patients with acute migraine 41 % (n=1160)
29 Thrombectomy alone is effective in treating acute large vessel occlusion ischemic stroke (DEVT) 27 % (n=1147)
26 American College of Gastroenterology guideline on managing irritable bowel syndrome 60 % (n=1205)
25 Limited role for antidepressants in back pain and osteoarthritis pain 61 % (n=1256)
24 Finerenone reduces composite cardiovascular outcome and risk of decreased eGFR, but increases risk of hyperkalemia 30 % (n=1009)
23 SR: Exercise is the only intervention to provide long-term improvement in patients with chronic low back pain 68 % (n=1311)
22 Low-carb diets may produce short-term diabetes remission 59 % (n=1244)
19 Large variation in cesarean delivery rates with induction for nulliparous women at term 19 % (n=1057)
18 Every other day use of rimegepant decreases migraine frequency by 1 per month 38 % (n=1071)
17 SGLT-2 inhibitors or GLP-1 receptor agonists reduce cardiovascular outcomes in patients with type 2 diabetes 67 % (n=1188)
16 Small risks of bleeding complications with aspirin use in pregnancy 32 % (n=1211)
15 Ten-year follow-up: bariatric surgery causes more remissions than medical treatment for patients with type 2 diabetes 41 % (n=1267)
12 Tighter blood pressure control does not increase the likelihood of orthostatic hypotension 62 % (n=1318)
11 High-dose influenza vaccine no more effective than the standard dose for adults with high-risk cardiovascular disease 53 % (n=1215)
10 Hard-soled shoe is comparable to short leg cast in patients with fifth metatarsal base avulsion fractures 45 % (n=1280)
09 Restrained Lyme disease management guidelines from 3 US specialty societies 47 % (n=1204)
08 USPSTF 2021 updates on effective interventions for tobacco smoking cessation in adults, including pregnant persons 66 % (n=1225)
05 Bamlanivimab decreases hospitalizations and ED visits in outpatients with mild to moderate COVID-19 (BLAZE-1) 27 % (n=1133)
04 Oral antibiotics are not equivalent to combination intravenous/oral antibiotics for acute uncomplicated appendicitis 32 % (n=1216)
03 REGN-COV2 monoclonal antibody cocktail may reduce the need for a medically attended visit for outpatients with COVID-19 26 % (n=1119)
02 Female hormone therapy is not associated with an increased risk of retinal artery or vein occlusion 41 % (n=1231)
01 Prevalence of pulmonary embolism is 5.9% in patients with COPD who are hospitalized with acute respiratory symptoms 43 % (n=1188)
February  
26 No benefit to remdesivir, HCQ, lopinavir, or interferon in large WHO trial of adults hospitalized with COVID-19 (Solidarity) 32 % (n=1139)
25 Combination of baricitinib and remdesivir reduces recovery time in patients hospitalized with COVID-19 pneumonia 23 % (n=1124)
24 Approximately 1 in 6 household and family contacts become infected with SARS-CoV-2 63 % (n=1293)
23 USPSTF 2020 recommends screening for hepatitis B virus infection in at-risk adolescents and adults (B recommendation) 50 % (n=1208)
22 Decreased risk of mechanical ventilation with tocilizumab for treatment of moderate to severe COVID-19 pneumonia 22 % (n=1220)
19 Subcutaneous hydration is safer than intravenous hydration for elderly patients 32 % (n=1216)
18 Typical outpatient systolic BP measurements are higher than those taken using research protocols and they vary widely 65 % (n=1254)
17 Lipid lowering is beneficial for secondary prevention but not primary prevention in patients 75 years and older 63 % (n=1274)
16 The use of tranexamic acid in upper gatrointestinal bleeding is ineffective and may be harmful 32 % (n=1318)
15 Eating eggs is not associated with cardiovascular disease 64 % (n=1454)
12 Scores based on bedside clinical findings are helpful in identifying pneumonia in febrile children 44 % (n=1214)
11 PREDICT Prostate online risk score accurately predicts the prognosis for men with nonmetastatic prostate cancer 41 % (n=1167)
10 Continuous glucose monitoring adds little benefit, especially in adults 48 % (n=1238)
09 Low-volume same-day colonoscopy preparation is as effective as split-dose high-volume or low-volume preparations 40 % (n=1225)
08 Low-dose digoxin and bisoprolol are equally beneficial for rate control/QOL in patients with CHF and permanent AF (RATE-AF) 52 % (n=1249)
05 New "-flozin" type 2 diabetes treatments improve outcomes in patients with heart failure, with or without diabetes 60 % (n=1294)
04 Framingham Risk Score and Pooled Cohort Equations both overestimate cardiovascular event risk 66 % (n=1310)
03 Positive CA125 test results for "symptomatic" women are wrong most of the time 44 % (n=1314)
02 Sore throat and rhinitis are predictive of a recurrent positive test result for COVID-19 51 % (n=1362)
01 For stroke patients with unknown time of symptom onset, intravenous alteplase decreases disability but increases mortality 31 % (n=1148)
January  
29 Rivaroxaban is noninferior to warfarin for valvular atrial fibrillation; also associated with fewer strokes 58 % (n=1304)
28 Take caution with intensive blood pressure reduction in patients with intracranial bleeds and very high systolic pressures 35 % (n=1261)
27 Vitamin C plus iron supplementation is no better than iron alone for iron-deficiency anemia 65 % (n=1323)
26 Fewer deaths and fewer ICU admissions with the use of a remotely monitored, automated alert system 21 % (n=1176)
25 Baloxavir similar to oseltamivir to reduce symptoms; no benefit after 36 hours or if older than 65 years (CAPSTONE-2) 38 % (n=1147)
22 Nebulized magnesium plus albuterol is no more effective than albuterol alone for refractory acute pediatric asthma 28 % (n=1168)
21 Colchicine reduces myocardial infarction and revascularization in patients with established coronary disease (LoDoCo2) 44 % (n=1328)
20 Early introduction of dietary gluten delays the diagnosis of celiac disease in breastfed infants (EAT) 44 % (n=1261)
19 SGLT2 inhibitors ("-flozin" meds) improve all-cause and CV mortality in patients regardless of diabetes or HF status 64 % (n=1301)
18 Vitamin D, omega-3 fatty acids, and strength training not beneficial for elderly without major comorbidities (DO-HEALTH) 56 % (n=1241)
15 Bariatric surgery in obese patients with hypertension can produce normotension in some of them (GATEWAY) 41 % (n=1258)
14 Screening smokers for lung cancer with low-dose CT decreases lung cancer mortality 55 % (n=1290)
13 USPSTF finds evidence insufficient to recommend hypertension screening in children (I statement) 49 % (n=1153)
12 iCanQuit smartphone app is effective in helping with smoking cessation 60 % (n=1183)
11 Poor-quality data suggest that anticholinergic medications are associated with dementia and cognitive decline in the elderly 55 % (n=1169)
08 A higher-dose magnesium sulfate regimen for obese women with preeclampsia is more likely to achieve target serum level 19 % (n=1108)
07 Guideline: Topical nonsteroidal anti-inflammatory drugs should be first-line treatment for muscle pain 73 % (n=1352)
06 American Thoracic Society home oxygen guideline for patients with COPD or interstitial lung disease 49 % (n=1189)
05 E-cigarettes plus counseling may be minimally better than counseling alone for smoking cessation 52 % (n=1224)
04 Fertility returns within 6 months for more than 50% of the women who stop using contraceptives 61 % (n=1248)
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