[Top 4 Research Studies of the month for Italian Primary Care Physicians: June 2024.]

Abstract

This monthly article provides a collection of summaries of the most relevant studies identified as POEMs (patient-oriented evidence that matters) for Italian primary care physicians. 1) Although bleeding risk scores such as HAS-BLED and HEMORR2HAGE are widely recommended by guidelines for decision-making regarding long-term anticoagulation, their accuracy in primary care patients seems to be pretty terrible. Studies in the primary care setting that derive and then externally validate simple, pragmatic risk scores are needed. 2) Point-of-care ultrasound is increasingly finding a role at the bedside, and this study adds to that evidence base. In the patient with acute abdominal pain, point-of-care ultrasound has been shown to be highly accurate for diagnosis of appendicitis, small bowel obstruction, aneurysm - and now, acute diverticulitis. 3) According to a recent meta-analysis, rhythm control is associated with a lower risk of dementia and cognitive dysfunction than rate control. Most of the data come from middling quality studies, which likely overestimate the purported protective effects. 4) Limited quality research finds no difference in outcomes among common treatments for acute otitis externa, including antibiotic, steroid, antiseptic, or nonpharmacologic treatment. Given the low quality of trials conducted so far, it remains to be seen if larger, better studies will find out a difference, but for now the existing literature gives us little guidance.