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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  
30 NICE guidelines for the treatment of depression 67 % (n=1147)
29 Spinal cord stimulation no better than placebo stimulation for chronic pain after lumbar spine surgery 24 % (n=1085)
28 Rebound symptoms common with COVID-19 even after placebo treatment 55 % (n=1136)
27 USPSTF 2022: Screening for anxiety is recommended in children and adolescents aged 8 to 18 years (B recommendation) 47 % (n=1069)
26 USPSTF 2022: Screening for major depressive disorder recommended in adolescents aged 12 to 18 years (B recommendation) 50 % (n=1031)
23 Endovascular therapy is effective for basilar artery occlusion in patients with moderate/severe symptoms (ATTENTION) 22 % (n=1006)
22 Symptom severity and duration of Long COVID 57 % (n=1139)
21 American Academy of Pediatrics guideline: increase thresholds for light therapy 27 % (n=989)
20 Tocilizumab beneficial for adults with persistent polymyalgia rheumatica symptoms who receive steroid therapy 32 % (n=1040)
19 Limiting eating to an 8-hour period with caloric restriction produced greater short-term weight loss 49 % (n=1145)
16 Dapagliflozin provides modest reduction in hospitalization for heart failure with LVEF greater than 40% (DELIVER) 49 % (n=1058)
15 Allopurinol does not improve cardiovascular outcomes in patients with ischemic heart disease but no gout (ALL-HEART) 40 % (n=1095)
14 Treatment of gestational diabetes mellitus to a tighter glycemic target is not beneficial 34 % (n=1081)
13 Nasal steroid treatment speeds return of smell but not the overall rate of olfactory recovery 48 % (n=1135)
12 Improved decongestion with the addition of acetazolamide to intravenous loop diuretics for acute heart failure 32 % (n=865)
09 Percutaneous coronary intervention does not improve outcomes for patients with ischemic heart disease and LVEF of less than 35% 0 % (n=)
09 Percutaneous coronary intervention does not improve outcomes for patients with ischemic heart disease and LVEF of less than 35% 37 % (n=1031)
08 Limited evidence for meds, music, and massage to treat anxiety in residents of long-term care facilities 0 % (n=)
08 Limited evidence for meds, music, and massage to treat anxiety in residents of long-term care facilities 35 % (n=1050)
07 PEN-FAST score to predict penicillin allergy not useful in pediatric population 39 % (n=1030)
06 Bacterial meningitis is infrequently predicted by positive urinalysis in infants younger than 2 months 0 % (n=)
06 Bacterial meningitis is infrequently predicted by positive urinalysis in infants younger than 2 months 25 % (n=1013)
05 Pregnancy outcomes not improved with 1-step testing versus 2-step testing for gestational diabetes 0 % (n=)
05 Pregnancy outcomes not improved with 1-step testing versus 2-step testing for gestational diabetes 35 % (n=1040)
02 Intensive cardiovascular screening has little benefit in older men (DANCAVAS) 0 % (n=)
02 Intensive cardiovascular screening has little benefit in older men (DANCAVAS) 52 % (n=1048)
01 The Ages and Stages Questionnaire is moderately accurate at ruling in/out developmental delays in children 12 to 60 months of age 0 % (n=)
01 The Ages and Stages Questionnaire is moderately accurate at ruling in/out developmental delays in children 12 to 60 months of age 36 % (n=989)
November  
30 Antibiotics for asymptomatic bacteriuria in residents of aged care facilities: bacteriological, but not clinical, cure; more adverse events 54 % (n=1049)
29 White cells do not equate to bacterial cells in the urine of hospitalized patients 59 % (n=1126)
28 Neither vitamin D nor omega-3 fatty acid supplementation reduce the risk of frailty (VITAL) 57 % (n=1094)
25 USPSTF 2022 recommends screening for syphilis in persons at increased risk (A recommendation) 51 % (n=1064)
24 Antipsychotic use during pregnancy is not associated with lower school test scores in offspring 32 % (n=1095)
23 Postoperative and nonoperative atrial fibrillation associated with similar risks of stroke and death 45 % (n=1103)
22 Liraglutide probably the best second drug to prevent cardiovascular events in patients with T2DM who take metformin 58 % (n=1054)
21 Nonpharmacologic approaches can improve fibromyalgia symptoms 55 % (n=1113)
18 SGLT2 inhibitors optimal drug class for heart failure with preserved and mildly reduced ejection fraction 59 % (n=1075)
17 Glargine and liraglutide are the best second drugs after metformin for achieving tight glycemic control (in a study without SGLT2 inhibitors) 58 % (n=1042)
16 Abrocitinib and upadacitinib likely to be most effective immunomodulators for atopic dermatitis, but very expensive 28 % (n=948)
15 Decreased intubation risk with high-flow nasal cannula oxygen for COVID-19 respiratory failure (SOHO-COVID) 30 % (n=1040)
14 USPSTF 2022: Insufficient evidence of benefit vs harm of screening for type 2 diabetes in children and adolescents (I statement) 48 % (n=1035)
11 Warfarin provides greater net benefit than rivaroxaban for patients with atrial fibrillation and rheumatic heart disease 45 % (n=1101)
10 Limited SR demonstrates SGLT2 inhibitors improve outcomes in adults with heart failure 53 % (n=1025)
09 Algorithm to predict malignancy in a pelvic mass in female patients 26 % (n=983)
08 Polypill better for secondary cardiovascular prevention than physician-directed care 51 % (n=1098)
07 Amitriptyline, duloxetine, and pregabalin each effective in decreasing pain from diabetic peripheral neuropathy; combinations even better 62 % (n=1142)
04 Higher incidence of volume overload with aggressive fluid resuscitation for acute pancreatitis (WATERFALL) 31 % (n=1048)
03 Pessaries are moderately effective for the treatment of female pelvic organ prolapse 46 % (n=1040)
02 Nirmatrelvir/ritonavir (Paxlovid) reduces hospitalization, mortality in patients 65+ with COVID-19; effect on younger patients unclear 60 % (n=1099)
01 Single-dose antihistamines more effective at decreasing acute vertigo severity within 2 hours than single-dose benzodiazepines 53 % (n=1091)
October  
31 A high-sensitivity troponin T less than 6 ng/L is very good at ruling out myocardial infarction or death in next 30 days 45 % (n=1090)
27 Stricter criteria for diagnosis and treatment of gestational diabetes is not beneficial 36 % (n=1037)
26 USPSTF 2022: updated review of statins for the primary prevention of cardiovascular disease 64 % (n=1084)
25 Peppermint oil capsules might relieve symptoms of irritable bowel syndrome 44 % (n=1094)
24 Low FODMAP diet most likely to improve symptoms for patients with irritable bowel syndrome 57 % (n=592)
21 Hypnosis for irritable bowel syndrome 38 % (n=1056)
20 Stent plus medical therapy is equal to medical therapy alone for symptomatic severe intracranial stenosis (CASSISS) 25 % (n=995)
19 Reduced all-cause mortality associated with post-fracture bisphosphonate treatment 49 % (n=1076)
18 Surgical reconstruction for nonacute ACL injuries has slightly better outcomes than rehabilitation (ACL SNNAP) 33 % (n=1026)
17 Cannabis provides some relief (with side effects) for chronic pain 48 % (n=1118)
14 COVID-19 vaccine is not associated with adverse birth outcomes 60 % (n=1143)
13 Treatment of prediabetes with metformin or intensive lifestyle therapy for at least 3 years has no long-term benefits (Diabetes Prevention Program) 61 % (n=1131)
12 Similar functional outcomes after treating minimally displaced or nondisplaced scaphoid waist fractures with surgery or immobilization 33 % (n=1026)
11 Lack of evidence that vaginal progesterone prevents recurrent preterm birth 22 % (n=985)
07 Enoxaparin better than aspirin for prevention of venous thromboembolism after total hip or knee arthroplasty 39 % (n=1059)
06 Weekly dulaglutide lowers glycated hemoglobin in young people with T2DM; no data on clinical outcomes 34 % (n=985)
05 Ketorolac plus dexamethasone is more effective for pain relief than ketorolac alone in adults with renal colic 39 % (n=1094)
04 Ticagrelor plus aspirin after CABG reduces vein graft failure but increases risk of serious bleeding 38 % (n=1015)
03 Yoga appears to be effective in reducing migraine intensity and frequency 46 % (n=1081)
September  
30 Hypnotic agents are effective for insomnia but at the expense of adverse effects 64 % (n=1049)
27 Fish oil supplementation does not reduce the risk or severity of dry eye disease 36 % (n=1064)
26 Azithromycin improves asthma control and reduces exacerbations in kids with poor control, but replication needed 38 % (n=1071)
23 American Gastroenterological Association position statements for colorectal cancer screening 54 % (n=1057)
22 Tirzepatide helps obese adults without diabetes lose 15% to 21% of their body weight over 72 weeks 49 % (n=1055)
21 Overuse alert: Pharmacogenomic testing for selection of antidepressant provides minimal, if any, benefit (PRIME) 37 % (n=1055)
20 Similar likelihood of adverse effects with mRNA and inactivated virus vaccines for COVID-19 58 % (n=1070)
19 Annual stroke rate for asymptomatic severe carotid stenosis without surgical intervention is 0.9% 45 % (n=1081)
16 Treating fever does not affect outcomes 58 % (n=1121)
15 COVID-19 vaccine moderately effective (48%) at preventing symptomatic infection in children 5 to 11 years old 56 % (n=1029)
14 Short-term benefit from ultrasonography-guided steroid injection for Achilles tendinopathy 37 % (n=1052)
13 Soft bandages and rigid casts are comparable in children with torus fractures of the wrist (FORCE) 32 % (n=1008)
12 Greater social determinants of health burden associated with an increased risk of hospitalization 54 % (n=1019)
09 Electroacupuncture is effective for insomnia treatment in adults with depression 37 % (n=991)
08 No added benefit with high-dose steroids or different oxygenation strategies for acute hypoxemic respiratory failure due to COVID-19 28 % (n=1045)
07 Supplemental vitamin D does not reduce the risk of fracture in older adults (VITAL) 62 % (n=1102)
06 Likelihood of long COVID varies by variant, sex, and vaccination status 61 % (n=1107)
05 Maternal benefit with planned delivery for preeclampsia 21 % (n=977)
02 Three-dose vaccine or 2 doses + previous infection protect against severe disease from BA.1 or BA.2 COVID-19 variants 69 % (n=1075)
01 Allergenic food exposure at 3 months of age decreases food allergy at 36 months (PreventADALL) 51 % (n=1044)
August  
31 Only some musculoskeletal conditions benefit from surgery 56 % (n=1039)
30 Postoperative opioids are no better for pain relief and cause more adverse effects than nonopioids 55 % (n=1075)
29 2022 NICE guidance: type 2 diabetes 68 % (n=1050)
26 Point-of-care testing for respiratory pathogens did not reduce antibiotic use in children or improve outcomes 34 % (n=976)
25 Maternal triptan use during pregnancy is not associated with risk of attention-deficit/hyperactivity disorder in offspring 37 % (n=1025)
24 USPSTF 2022: No recommendation for or against screening for glaucoma in adults (I statement) 44 % (n=1009)
23 Azithromycin associated with lower rate of chorioamnionitis in preterm prelabor rupture of membranes 17 % (n=993)
22 SGLT2 inhibitors reduce heart-failure-–related hospitalization in patients without diabetes 55 % (n=1063)
19 Hybrid and natural immunity are robust but, like vaccine immunity, wane over time 67 % (n=1067)
18 Low-quality evidence: CBT and hypnosis may be effective for pain relief in children with functional abdominal pain 30 % (n=934)
17 Treatment of mild chronic hypertension during pregnancy is beneficial 41 % (n=1013)
16 Brief intervention ineffective to decrease unhealthy drug use 49 % (n=1021)
15 Early treatment of screen-detected anal high-grade squamous intraepithelial lesions reduces progression to cancer 25 % (n=991)
12 Motivational interviewing ineffective in helping patients lose weight 54 % (n=1067)
11 No change in mortality with restricted intravenous fluid therapy in patients with septic shock 22 % (n=1007)
10 Treatment with a single immune checkpoint inhibitor successfully treated advanced rectal cancer 24 % (n=991)
09 USPSTF 2022 recommends against beta-carotene or vitamin E to prevent cardiovascular disease or cancer 53 % (n=1021)
08 Another study fails to find PRP injections effective for adults with degenerative joint disease of the knee 49 % (n=1067)
05 Manual rotation of occiput posterior during labor increases the rate of spontaneous vaginal delivery 19 % (n=969)
04 USPSTF 2022: No recommendation for impaired visual acuity screening in older adults 54 % (n=983)
03 Use of procalcitonin guidance reduces antibiotic duration in hospitalized patients 26 % (n=966)
02 Combination albuterol-budesonide rescue inhaler somewhat better than albuterol alone for preventing severe asthma exacerbations (MANDALA) 59 % (n=1035)
01 Intensive urate lowering for erosive gout is difficult to achieve and does not improve outcomes 44 % (n=1037)
July  
28 Medication abortion for pregnancy of unknown location a reasonable option 29 % (n=973)
27 Neither aducanumab nor donanemab is cost-effective in treating adults with early Alzheimer disease 40 % (n=967)
26 Baricitinib is effective for severe alopecia areata, but long-term safety is not known 23 % (n=936)
25 Fewer than 4% of children with newly diagnosed hypertension in primary care or school settings have secondary causes 31 % (n=977)
22 Amniotomy immediately following Foley cervical ripening shortens time to delivery 17 % (n=932)
21 BNT162b2 COVID-19 vaccination during pregnancy is not associated with adverse neonatal outcomes 56 % (n=1041)
20 Extended study with a lower dose of steroids reports overall benefit for adults with IgA nephropathy 18 % (n=948)
19 Patient-oriented gains with LDL lowering are small 63 % (n=1050)
18 Fourth dose of Pfizer-BioNTech COVID-19 vaccine is effective in persons 60 and older 71 % (n=1065)
15 Smartwatches might become an alternative to Holter monitoring in high-risk patients 49 % (n=1036)
14 Screening for atrial fibrillation in primary care is not effective (VITAL-AF) 56 % (n=994)
12 Minimal difference, if any, in the efficacy of intramuscular vs intra-articular steroid injection for knee osteoarthritis 53 % (n=1016)
11 Breathing program for long COVID symptoms may improve breathlessness 36 % (n=978)
08 Several COVID-19 treatments are ineffective in both controlled and observational studies 50 % (n=959)
07 Long-term risks are similar for CT and invasive coronary angiography as initial diagnostic strategy for stable chest pain 37 % (n=979)
05 Small study finds real TENS is more effective than sham TENS for pain relief in adults with renal colic 29 % (n=963)
04 USPSTF 2022: Recommendation against screening for chronic obstructive pulmonary disease (D recommendation) 56 % (n=998)
01 POCUS-measured jugular venous pressure can accurately predict elevated central pressure 27 % (n=949)
June  
30 Guideline for the management of heart failure: early prevention for patients at risk, quadruple therapy for those with symptoms 58 % (n=989)
29 Ketamine reduces suicidal ideation quickly, but may not reduce the short-term likelihood of suicide attempts 25 % (n=1022)
28 Better functional outcomes, but more bleeds with endovascular therapy for large ischemic strokes 26 % (n=972)
27 Time restriction of food consumption does not provide added benefit over calorie restriction alone 52 % (n=1050)
24 USPSTF 2022: Insufficient evidence for or against screening for eating disorders in adolescents and adults (I statement) 41 % (n=955)
23 Coronary artery calcium score adds little to cardiovascular risk scoring accuracy 43 % (n=979)
22 Nirsevimab reduces the risk of a medically attended visit for respiratory syncytial virus 20 % (n=920)
21 No clear difference among antipsychotic agents in preventing relapse in adults with schizophrenia 38 % (n=1036)
20 Ivermectin is ineffective for patients with mild to moderate COVID-19 48 % (n=1107)
17 USPSTF 2022 recommends against initiating aspirin for primary prevention of cardiovascular disease in adults 60+ years (D recommendation) 66 % (n=1131)
16 Aducanumab is not effective for mild cognitive impairment or mild Alzheimer's dementia and has major safety issues 37 % (n=1039)
15 Digital therapeutic device more effective than standard at-home exercise program to reduce female stress urinary incontinence 39 % (n=1011)
14 Surgery is no better than nonoperative treatment for Achilles tendon rupture in adults 38 % (n=1128)
13 Switching among generic thyroxine products is not responsible for serum thyrotropin changes 58 % (n=1082)
10 Dietary sodium restriction does not prevent adverse events in ambulatory adults with heart failure (SODIUM-HF) 50 % (n=1075)
09 Combination antidepressant therapy is more effective than monotherapy for acute severe depression and nonresponding depression 63 % (n=1105)
08 Placebo decreases pain and medication use in children with functional abdominal pain or irritable bowel syndrome 35 % (n=1056)
07 Sonographic assessment of occiput position does not affect failed operative vaginal delivery rate 15 % (n=986)
06 Omega-3 fatty acid supplementation of more than 1 g per day increases the risk of atrial fibrillation 47 % (n=1121)
03 Risk of recurrent venous thromboembolism is 3% in patients with subsegmental pulmonary embolism who are not anticoagulated 39 % (n=1038)
02 Adding extra puffs of steroid inhaler when a short-acting beta-agonist is needed reduces exacerbations in moderate to severe asthma 60 % (n=1109)
01 More intensive low-density lipoprotein lowering is associated with fewer subsequent ischemic strokes 57 % (n=1080)
May  
31 No benefit to ivermectin for the treatment of COVID-19 in regions where strongyloidiasis is not endemic 35 % (n=1060)
30 Postcardiac surgery high-sensitivity troponin levels greater than 200 times the upper limit of normal are associated with greater mortality 19 % (n=1024)
27 Influenza vaccine shortly after myocardial infarction reduces 1-year mortality (NNT = 50) 49 % (n=1100)
26 Presence or absence of leukocytes makes no difference in effectiveness of PRP injection in persons with knee osteoarthritis 32 % (n=1025)
25 Lifestyle interventions during pregnancy are associated with reduced maternal risk 43 % (n=1085)
24 Neonatal hypoglycemia not associated with lower educational achievement in moderate to late preterm and term infants 25 % (n=1049)
23 Oral therapy as effective as intravenous therapy for endocarditis, bacteremia, and osteomyelitis 44 % (n=1227)
20 Less delirium with focus on mobility, nutrition, and cognitive engagement for older hospitalized patients (CHERISH) 39 % (n=1100)
19 Mask mandates in school reduce COVID-19 cases among students, staff, and members of the community 63 % (n=1213)
18 Dual antiplatelet therapy with either clopidogrel or ticagrelor is more effective than aspirin alone in preventing recurrent stroke 56 % (n=1166)
17 In patients who take non–vitamin K antagonist oral anticoagulants, alteplase is not associated with an increased risk of intracranial bleeds 26 % (n=1101)
16 Updated American College of Chest Physicians guideline on antithrombotic therapy for venous thromboembolism 57 % (n=1099)
13 High-efficiency air cleaners decrease exacerbations and the use of rescue medication in former smokers with COPD 48 % (n=1130)
12 Vaginal progesterone is most beneficial for the prevention of preterm birth in women at high risk 25 % (n=1116)
11 Tocopherol acetate (vitamin E) ointment is effective for chronic anal fissure 48 % (n=1104)
10 Prone position is difficult to maintain and may be ineffective in non-ICU patients with COVID-19 22 % (n=1070)
09 Urine collection devices do not reduce contamination in women with suspected urinary tract infections 48 % (n=1134)
06 Clinical decision support tool reduces routine nighttime vital sign checks but does not affect clinical outcomes 27 % (n=1059)
05 Comparable outcomes with 5 days and 10 days of antibiotics in children with community-acquired pneumonia (SCOUT-CAP) 56 % (n=1151)
04 British guidelines for the management of rosacea 54 % (n=1121)
03 Screening colonoscopies are overused 57 % (n=1202)
02 Persons older than 60 years with prediabetes are more likely to become normoglycemic than to develop diabetes or die 63 % (n=763)
April  
29 MA: Limited data shows thrombectomy 6 to 24 hours after stroke onset is effective in highly selected persons 27 % (n=703)
28 Selective serotonin reuptake inhibitors are probably the best first option for patients with panic disorder 66 % (n=774)
27 Reading to young children may reduce social and emotional problems later in their lives 53 % (n=1120)
26 Shared decision-making does not decrease antibiotic prescribing 54 % (n=1080)
25 Low risk of second allergic reaction to SARS-CoV-2 vaccines 54 % (n=1106)
22 Casirivimab plus imdevimab decreases mortality only in seronegative persons hospitalized with COVID-19 22 % (n=951)
21 Large increases in the risk of cardiovascular events following COVID-19 infection that required hospitalization 55 % (n=1115)
20 Traumatic brain injury is associated with all-cause dementia but not Alzheimer's dementia in military veterans 31 % (n=796)
19 Anticoagulant therapy for 6 weeks is noninferior to 3 months for provoked VTE in patients younger than 21 years (Kids-DOTT) 28 % (n=755)
18 Incarceration during nonoperative management of incisional hernia is uncommon but increases the risk of death 31 % (n=772)
15 AAN guideline on withdrawing anticonvulsants in seizure-free adults and children 35 % (n=742)
14 Caution advised with use of statins during pregnancy 31 % (n=778)
13 Probiotic bacterial spores reduce the likelihood of C. diff relapse in the short term (NNT = 4) in frequent relapsers 38 % (n=1142)
12 AAN guideline on managing painful diabetic polyneuropathy 61 % (n=1151)
11 Closed-loop system improves glycemic control but not hypoglycemia for young children with type 1 diabetes mellitus 22 % (n=1049)
08 MA: Several drugs are effective for weight loss in obese or overweight adults; it's unclear whether they improve health outcomes 52 % (n=1118)
07 Water-based exercise therapy is better than standard physical therapy for adults with chronic low back pain 57 % (n=1218)
06 A stepwise framework for discussing information your patients found online 65 % (n=1141)
05 USPSTF 2022 concludes evidence is insufficient to recommend screening for asymptomatic atrial fibrillation (I statement) 57 % (n=1154)
04 All-cause mortality is comparable in patients with left main coronary artery disease treated with PCI or CABG 40 % (n=1165)
01 Intramuscular ketorolac 15 mg and 60 mg are comparable for acute musculoskeletal pain relief 46 % (n=1214)
March  
31 Thromboprophylaxis after discharge improves clinical outcomes for certain high-risk patients hospitalized with COVID-19 (MICHELLE) 33 % (n=1147)
30 Molnupiravir reduces hospitalization in at-risk outpatients with symptomatic COVID-19 35 % (n=1093)
29 American College of Gastroenterology guideline for diagnosing and managing GERD 67 % (n=1138)
28 Proton pump inhibitor use associated with an increased risk of gastric cancer 68 % (n=1340)
25 Nirmatrelvir/ritonavir (Paxlovid) reduces risk of hospitalization in at-risk outpatients (EPIC-HR) 47 % (n=1165)
24 Risperidone and paliperidone are less effective and more harmful than shown in published studies 41 % (n=1164)
23 More in-hospital adverse events associated with surgical ostomy feeding tubes than with nasal or oral feeding tubes 19 % (n=1118)
22 mRNA COVID-19 vaccines are associated with a small increase in myocarditis 64 % (n=1277)
21 USPSTF 2021 recommends oral fluoride supplementation and fluoride varnish application to prevent caries in children (B recommendation) 46 % (n=1155)
18 Twice as many complications associated with PICCs than with midline catheters for short-term use 26 % (n=1139)
17 Ibuprofen, ketorolac, and diclofenac are equivalent for the treatment of acute nonradicular low back pain 66 % (n=1287)
16 High-intensity exercise twice weekly improves academic scores in fourth graders 44 % (n=1209)
15 Oral ginger is an effective antiemetic in children with gastroenteritis 50 % (n=1262)
14 Oxygen via high-flow nasal cannula reduces the need for intubation in patients with severe COVID-19 34 % (n=1199)
11 British Society of Gastroenterology guidelines for the management of irritable bowel syndrome 63 % (n=1132)
10 Beta-blockers and tricyclic antidepressants are more commonly associated with orthostatic hypotension 64 % (n=1258)
09 Intravenous remdesivir for 3 days reduces hospitalization in outpatients with symptomatic COVID-19 37 % (n=1178)
08 Omega-3 fatty acid supplementation may increase the risk of incident depression (VITAL-DEP) 39 % (n=1202)
07 Specific antibodies are present in breast milk after maternal mRNA vaccination 50 % (n=1236)
04 Pfizer-BioNTech vaccine booster reduces mortality due to COVID-19 by 90% 75 % (n=1282)
03 Communicating risk with words: One person's 'rare' is another person's 'common' 67 % (n=1207)
02 COVID-19 mRNA vaccine given in third-trimester pregnancy is not associated with adverse maternal outcomes 55 % (n=1265)
01 Finerenone decreases hospitalization for heart failure in patients with type 2 diabetes and chronic kidney disease (NNT = 189/year) 30 % (n=1071)
February  
28 Routine replacement of peripheral intravenous catheters is associated with fewer bloodstream infections 32 % (n=1192)
25 Comparable post-op pain relief for opioid- and nonopioid-based regimens following ACL reconstruction 33 % (n=1116)
24 Amoxicillin for children with CAP: low-dose for 3 days is noninferior to high-dose for 7 days (CAP-IT) 56 % (n=1210)
23 High-sensitivity troponin safely reduces admissions and duration of stay in the emergency department 41 % (n=1206)
22 DAPT with aspirin plus clopidogrel for 30 days is the best option after minor stroke or TIA 56 % (n=1170)
21 Poor-quality studies: several public health measures are effective in controlling the spread of COVID-19 71 % (n=1209)
18 Cannabidiol may increase the blood levels of SSRIs, tricyclic antidepressants, beta-blockers, and more 60 % (n=1188)
17 No improved patient-oriented outcomes with sacubitril/valsartan in adults with heart failure and preserved EF (PARALLAX) 39 % (n=1105)
16 Subcutaneous scopolamine butylbromide reduces the death rattle in dying patients (SILENCE) 37 % (n=1190)
15 Silicone adhesive multilayer foam dressings prevent sacral pressure ulcers in at-risk hospitalized adults (NNT = 50) 33 % (n=1127)
14 Lowering blood pressure does not decrease the risk of T2DM in persons with hypertension; ACEIs/ARBs do 59 % (n=1223)
11 For mild/moderate acne, adapalene + BPO, clindamycin + BPO, and adapalene alone are most effective, in that order 60 % (n=1187)
10 Alteplase before endovascular treatment is recommended over endovascular treatment alone for acute ischemic strokes 25 % (n=1100)
09 Useful signs, symptoms, and hematologic parameters for diagnosing infectious mononucleosis 56 % (n=1243)
08 Waning immunity against symptomatic infection with Delta variant after 20 weeks, but not hospitalization or death for most groups 67 % (n=1512)
07 Sotrovimab reduces the likelihood of hospitalization in at-risk outpatients with mild to moderate COVID-19 (NNT = 16) 44 % (n=1195)
04 Avoiding video screens for 48 hours after a head injury decreases concussion recovery time 56 % (n=1295)
03 Fractional CO2 laser no more effective than sham for improving postmenopausal vaginal symptoms 27 % (n=1126)
02 Metformin may be better than insulin for the treatment of gestational diabetes 39 % (n=1273)
01 Peppermint oil and placebo are similarly effective in alleviating symptoms of moderate to severe irritable bowel syndrome 45 % (n=1239)
January  
31 Screening high-risk patients for atrial fibrillation with implantable loop recorder does not prevent stroke or systemic emboli (LOOP) 39 % (n=1196)
28 Similar number of cardiovascular events and reduced bleeding with abbreviated dual antiplatelet therapy after PCI 40 % (n=1162)
27 Midodrine is worth a trial in people with frequent episodes of vasovagal syncope 40 % (n=1208)
26 Early CT angiography for suspected acute coronary syndrome reduces further ischemic testing; no effect on long-term clinical outcomes 30 % (n=1141)
25 Platelet-rich plasma injections are not superior to placebo injections for ankle osteoarthritis 39 % (n=1195)
24 Stopping smoking after a diagnosis of early lung cancer is related to longer survival 55 % (n=1192)
21 Compared with medical therapy, PFO closure decreases the number of clinically apparent strokes 23 % (n=1154)
20 Tight control associated with more frequent and persistent hypoglycemia in elderly persons with diabetes mellitus 62 % (n=1241)
19 Mirtazapine does not reduce agitated behaviors in persons with dementia (SYMBAD) 48 % (n=1246)
18 In-office procalcitonin testing can lead to less antibiotic prescribing 35 % (n=1170)
17 Intensive BP control modestly decreased the likelihood of a broad composite of CV events, but with methodologic limitations 56 % (n=1149)
14 Several strategies appear to be effective in preventing falls in community-living elders 52 % (n=1127)
13 No benefit to varenicline beyond 12 weeks or combined with nicotine replacement therapy for smoking cessation 62 % (n=1209)
12 Reduced antibiotic prescribing guided by CRP testing does not worsen outcomes in nursing home patients 31 % (n=1171)
11 Empagliflozin reduces hospitalization for heart failure with preserved ejection fraction (NNT = 59 per year), but not mortality outcomes (EMPEROR-Preserved) 51 % (n=1164)
10 Acupuncture is effective for chronic prostatitis symptoms 32 % (n=1144)
07 Antiplatelet therapy vs no antiplatelet therapy after intracranial hemorrhage: similar rates of subsequent bleeds and major vascular events (RESTART) 34 % (n=1157)
06 Anticoagulation does not improve outcomes in symptomatic outpatients with COVID-19 (ACTIV-4B) 44 % (n=1226)
05 HPV-based screening can replace cytology-based screening for cervical cancer 51 % (n=1198)
04 Relapse of depression more likely after discontinuation of medication (number needed to treat to harm = 6). 67 % (n=1272)
03 Oral ondansetron decreases vomiting in children with acute gastroenteritis 48 % (n=1255)
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