Wednesday, December 21, 2016

The top 10 AFP Community Blog posts of 2016

- Jennifer Middleton, MD, MPH and Kenny Lin, MD, MPH

It's that time of year when we give thanks to our readers and highlight our most read posts of 2016. This list reflects the AFP Community Blog's growing audience; as compared to last year, when only one post was viewed more than 1000 times, this year five passed that mark.

1. Is Vitamin D supplementation good for anything? (January 12) - 2093 views

The next time a healthy adult of any age asks me if he or she should be taking a vitamin D supplement, I plan to answer: we don't know for sure, but probably not - and we don't need to know what your vitamin D level is, either.

2. 25 podcast episodes every family physician should listen to (July 18) - 1666 views

Podcasts, and their ability to make us engage with others’ stories, might be useful to physicians as they look for ways to take in new information, and above all, try to stay tuned in to the underlying messages their patients are sharing.

3. To rapid strep test or not to rapid strep test? (July 5) - 1416 views

Because the rapid strep test produces either a false positive or a false negative result a significant minority of the time, it is most useful in patients with an intermediate pre-test probability of having strep pharyngitis.

4. For acute low back pain, naproxen alone works best (February 22) - 1308 views

Prescribe naproxen alone for most patients with acute low back pain and no contraindications to nonsteroidal anti-inflammatory drugs (NSAIDs); reserve cyclobenzaprine for patients who can't use NSAIDs; and prescribe oxycodone/acetaminophen only in patients who can't tolerate NSAIDs or cyclobenzaprine.

5. Which medications lower mortality in type 2 diabetes? (March 14) - 1284 views

Metformin has a proven mortality benefit for all patients with type 2 diabetes, even those on insulin. Metformin is so beneficial that clinicians should only consider discontinuing it if a patient's GFR is less than 44 mL/min, not just because the serum creatinine level is > 1.5 in men or >1.4 in women as previously recommended.

6. Hyaluronic acid injections don't help knee DJD (April 25) - 953 views

Unfortunately, the placebo effect with hyaluronic acid comes with cost and risk; injections can cost hundreds of dollars for one dose, and typical therapeutic regimens involve a series of 3-5 injections over several weeks.

7. New USPSTF and ACP guidelines on depression screening and treatment (February 8) - 847 views

A new clinical practice guideline reviewed the comparative effectiveness of treatment for major depressive disorder and recommended that "clinicians select between either cognitive behavioral therapy or second-generation antidepressants after discussing treatment effects, adverse effect profiles, cost, accessibility, and preferences with the patient."

8. What we say when we don't give an antibiotic matters (April 11) - 837 views

This study will change the way I speak with parents and adult patients about my decision not to prescribe antibiotics. I will make sure not to trivialize their concerns or refer to an illness as "just" a virus, and I will aim to use objective language to describe my rationale either way.

9. Myth-busting and fact-sharing about Family Medicine (February 1) - 792 views

Medical students, other specialists, and even the lay public often have questions about Family Medicine. Kozakowski et al answer these questions and many more in "Responses to Medical Students' Frequently Asked Questions About Family Medicine."

10. Have your female patients asked you about ROCA? (June 6) - 739 views

Offering a screening test directly to consumers prior to establishing its clinical utility is presumptuous at best and exploitative at worst; hopefully our patients will discuss the shortcomings of this test, and ovarian cancer screening in general, with us prior to spending $295 on it.