J Am Board Fam Med
-
It is unclear how well a C-reactive protein (CRP) value predicts a serious infection (SI) in young febrile children in general practice. ⋯ In general practice CRP has little clinically relevant value in discriminating febrile children in need of medical care from those who are not.
-
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.
-
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.
-
Multicenter Study
Building a Foundation to Reduce Health Inequities: Routine Collection of Sociodemographic Data in Primary Care.
Detailed data on social determinants of health can facilitate the identification of inequities in access to health care. We report on a sociodemographic data collection tool used in a family medicine clinic. ⋯ Collecting data on social determinants of health through a self-administered survey, and linking them to a patient's chart, is feasible and acceptable. A modified survey is now administered to all patients. Such data are already being used to identify health inequities, develop novel interventions, and evaluate their impact on health outcomes.
-
Primary care offices are integrating behavioral health (BH) clinicians into their practices. Implementing such a change is complex, difficult, and time consuming. Lean workflow analysis may be an efficient, effective, and acceptable method for use during integration. The objectives of this study were to observe BH integration into primary care and to measure its impact. ⋯ This pilot integration of BH showed significant improvements in treatment initiation and other measures. Strengths of Lean analysis included workflow improvement, system perspective, and project success. Further evaluation is indicated.