Does hypercoagulopathy testing benefit patients with DVT?

There is no evidence to suggest that testing for hypercoagulopathy benefits most patients with deep venous thrombosis (DVT). Nor has research established that thrombophilia test results improve the ability to predict recurrence better than clinical risk assessment alone (strength of recommendation [SOR]: B, multiple cohort studies)

What GI stress ulcer prophylaxis should we provide hospitalized patients?

Patients in intensive care unit (ICE) settings who are receiving prolonged mechanical ventilation (for >48 hours) or who have a coagulopathy or multiple organ dysfunction (especially renal failure) should receive stress ulcer prophylaxis. Current evidence does not support prophylaxis for non-ICU patients(strength of recommendation [SOR]: B, based on multiple systematic reviews)

Which lifestyle interventions effectively lower LDL cholesterol?

Counseling, weight loss, exercise, and drinking alcohol all effectively lower low- density lipoprotein cholesterol (LDL-C). Specifically, one to 2 daily drinks of alcohol lowers L DL-C, if consumed regularly for more than 4 weeks (strength of recommendation [SOR]: A, based on consistent results of multiple randomized controlled trials [RCTs])

Systemic Racism and Health Disparities: A Statement from Editors of Family Medicine Journals

The year 2020 has been marked by historic protests across the United States and the globe sparked by the deaths of George Floyd, Ahmaud Arbery, Breonna Taylor, and so many other Black people. The protests heightened awareness of racism as a public health crisis and triggered an antiracism movement. The editors of several North American family medicine publications have come together to address this call to action and share resources on racism across our readerships.http://deepblue.lib.umich.edu/bitstream/2027.42/163331/1/Final Statement on Systemic Racism- with acknowledgements.pdf-1Description of Final Statement on Systemic Racism- with acknowledgements.pdf : Main ArticleSEL

Defining and Measuring Interpersonal Continuity of Care

BACKGROUND In an effort to learn more about the importance of continuity of care to physicians and patients, I reviewed the medical literature on continuity of care to define interpersonal continuity and describe how it has been measured and studied. METHODS A search of the MEDLINE database from 1966 through April 2002 was conducted to find articles focusing on the keyword “continuity of patient care,” including all subheadings. Titles and abstracts of the resulting articles were screened to select articles focusing on interpersonal continuity in the physician-patient relationship or on the definition of continuity of care. These articles were systematically reviewed and analyzed for study method, measurement technique, and research theme. RESULTS A total of 379 original articles were found that addressed any aspect of continuity as an attribute of general medical care. One hundred forty-two articles directly related to the definition of continuity or to the concept of interpersonal continuity in the physician-patient relationship. Although the available literature reflects little agreement on how to define continuity of care, it is best defined as a hierarchy of 3 dimensions; informational, longitudinal, and interpersonal continuity. Interpersonal continuity is of particular interest for primary care. Twenty-one measurement techniques have been defined to study continuity, many of which relate to visit patterns and concentration rather than the interpersonal nature of the continuity relationship. CONCLUSIONS Future inquiry in family medicine should focus on better understanding the interpersonal dimension of continuity of care

Interpersonal Continuity of Care and Care Outcomes: A Critical Review

PURPOSE We wanted to undertake a critical review of the medical literature regarding the relationships between interpersonal continuity of care and the outcomes and cost of health care. METHODS A search of the MEDLINE database from 1966 through April 2002 was conducted by the primary author to find original English language articles focusing on interpersonal continuity of patient care. The articles were then screened to select those articles focusing on the relationship between interpersonal continuity and the outcome or cost of care. These articles were systematically reviewed and analyzed by both authors for study method, measurement technique, and quality of evidence. RESULTS Forty-one research articles reporting the results of 40 studies were identified that addressed the relationship between interpersonal continuity and care outcome. A total of 81 separate care outcomes were reported in these articles. Fifty-one outcomes were significantly improved and only 2 were significantly worse in association with interpersonal continuity. Twenty-two articles reported the results of 20 studies of the relationship between interpersonal continuity and cost. These studies reported significantly lower cost or utilization for 35 of 41 cost variables in association with interpersonal continuity. CONCLUSIONS Although the available literature reflects persistent methodologic problems, it is likely that a significant association exists between interpersonal continuity and improved preventive care and reduced hospitalization. Future research in this area should address more specific and measurable outcomes and more direct costs and should seek to define and measure interpersonal continuity more explicitly