Monday, December 17, 2018

The top ten AFP Community Blog posts of 2018

- Kenny Lin, MD, MPH

This year's list includes (#1 and #2) two of the top five most-viewed posts since this blog began in 2010. (In case you are wondering, the best-read post of all, on acetaminophen for nasal congestion from the common cold, has been viewed nearly 10,000 times.)

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1. PSA screening: USPSTF recommendations changed, but the evidence did not (October 22) - 3061 views

The first question family physicians ought to ask is: what new evidence compelled the Task Force to move from recommending against PSA screening in all men to determining that there was a small net benefit for screening in some men?

2. Acute Flaccid Myelitis: what family physicians should know (October 29) - 3018 views

Although still quite rare, occurrences of acute flaccid myelitis (AFM), a polio-like condition that results in sudden limb weakness, have been increasing in the United States. Family physicians can aid the CDC's investigation by recognizing AFM's presentation and reporting suspected cases to their local health departments.

3. Guest Post: Practicing what I preach about generic drugs (May 30) - 1152 views

I am a cancer survivor. I am alive today because of the love and support of my family, friends, and co-workers. I am alive because of the incredible doctors and medical staff at Walter Reed. I am also alive because of generic drugs. Generic drugs saved my life.

4. For hypertension and diabetes, lower treatment targets not necessarily better (March 21) - 891 views

Primary care clinicians often chose to intensify glycemic control in an older adult with a HbA1c level of 7.5% and multiple life-limiting comorbidities. As family physicians look for opportunities to improve care for patients with hypertension and diabetes, we should not miss opportunities to avoid harm.

5. Continue to Choose Wisely: updates to the AAFP Choosing Wisely recommendations (September 10) - 806 views

Developed by the AAFP's Commission on Health of the Public and Science, each of these evidence-based recommendations focuses on a practice that is either harmful or has very little supporting evidence of benefit.

6. For mild hypertension in low-risk adults, harms of drug therapy outweigh benefits (November 6) - 712 views

After a median follow-up duration of 5.8 years, there were no differences in all-cause mortality, stroke, myocardial infarction, acute coronary syndrome, or heart failure. However, the treated group had an increased risk of hypotension (number needed to harm = 41 at 10 years), syncope (NNH = 35), electrolyte abnormalities (NNH = 111), and acute kidney injury (NNH = 91).

7. Summer travel tips for you and your patients (June 18) - 667 views

Readers of American Family Physician should know about all of the resources available in our archives for prevention and management of medical conditions in travelers, the best of which are included in our Travel Medicine collection.

8. Supporting our patients' health outside of the office (May 7) - 661 views

Our patients' incomes, neighborhoods, and educational levels impact their health at least as much, if not more, than the interventions we discuss with them within our practice settings.

9. Increasing pneumococcal vaccination rates (April 9) - 649 views

In persons with COPD, the number needed to treat (NNT) for pneumococcal vaccination is 21 to avoid an episode of community-acquired pneumonia and 8 to avoid an acute COPD exacerbation.

10. Top research studies of 2017 for primary care practice (April 30) - 589 views

This year's top 20 studies included potentially practice-changing research on cardiovascular disease and hypertension; infections; diabetes and thyroid disease; musculoskeletal conditions; screening; and practice guidelines.

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On behalf of all of us at AFP, happy holidays and many blessings for the New Year.