J Am Board Fam Med
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The goal of this study was to evaluate the quality of evidence supporting primary care-relevant Choosing Wisely(TM) recommendations using the Strength of Recommendation Taxonomy (SORT). ⋯ We found that a majority of primary care-relevant Choosing Wisely recommendations are based on expert consensus or disease-oriented evidence. Further research is warranted to strengthen the evidence base supporting these recommendations in order to improve their acceptance and implementation into primary care.
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Primary care panel sizes are an important component of primary care practices. Determining the appropriate panel size has implications for patient access, physician workload, and care comprehensiveness and will have an impact on quality of care. ⋯ Subsequently, multiple studies observed that a panel size of 2500 is not feasible because of time constraints and results in incomplete preventive care and health care screening services. In this article we review the origins of a panel size of 2500, review the subsequent work examining this number and effectively debunking it as a feasible panel size, and discuss the importance of primary care physicians setting an appropriate panel size.
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Childhood obesity has increased dramatically over several decades, and the American Academy of Pediatrics has recommended primary care practices as ideal sites for the identification, education, and implementation of therapeutic interventions. The objective of this study was to describe the implementation and results for the Fit Family Challenge (FFC), a primary care-based childhood obesity intervention. ⋯ A primary care-based childhood obesity intervention may result in significant clinical and lifestyle changes.
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Comparative Study
The Performance of Fertility Awareness-based Method Apps Marketed to Avoid Pregnancy.
In recent years there has been an explosion in the development of medical apps, with more than 40,000 apps now available. Nearly 100 apps allow women to track their fertility and menstrual cycles and can be used to avoid or achieve pregnancy. Apps offer a convenient way to track fertility biomarkers. However, only some use evidence-based fertility awareness-based methods (FABMs), which with ideal use have rates of effectiveness similar to those of commonly used forms of hormonal birth control. Since having a baby or preventing a pregnancy are important responsibilities, it is critical that women and couples have access to reliable, evidence-based apps that allow them to accurately track their fertility. ⋯ Relying solely on an app to use an FABM, without appropriate training in the method, may not be sufficient to prevent pregnancy.