CFPCLearn Tools for Practice Activity – CFPC – 193581
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#393 Avoiding the void? Mirabegron for overactive bladder
What are the benefits and harms of mirabegron for patients with overactive bladder (OAB)?
#392 Mission Slimpossible, Part 3: Tirzepatide for weight loss
Is tirzepatide effective for weight loss?
#391 Trying Tongue-Tie Treatment: Does Frenotomy Fix Feeding Frustrations?
Does surgical frenotomy in infants with ankyloglossia (tongue-tie) improve mother or infant breastfeeding outcomes?
welcome
test
I am surprised by the lower efficacy of the Oxford vaccine.
I wonder about colchicine vs allopurinol for gout prevention efficacy.
Just a few additional comments since I understand you are looking for feedback. These modules are organized under a heading that states “most recent”. In actual fact they are arranged from least frequent at the top. It might be worthwhile organizing these modules into time frames so that one does not have to scroll down multiple pages every time they start amodule. Just a suggestion.In actual fact they are arranged from least frequent at the top. It might be worthwhile organizing these modules into time frames so that one does not have to scroll down multiple pages every time they start a module. Just a suggestion.
so i will stop recommending patients to do daily dosing of fe. they can do 2x/week or every other day
Great article
Great article
Very educative
Very relevant to my practice
Very educative and relevant to my practice
no
helpful for a common problem in family practice
I like the combination products but will use individual as cost is often a factor
Very important discussion in context of Covid 19 vaccination
It would be nice to get an update on this topic this summer given that we probably know much more now than we did a year ago on this topic.
great summary of relevant information
good update-evedence for what have `known`
the statement on sham control being more effective was confusing
acupuncture is practiced by physio now so a lot of people are trying it and if they have no benefits it is expensive
Limitations on publicly-funded studies was declared.
Doesn’t address different baseline risk and different populations of vaccines trials making direct comparison fraught with issues on effectiveness
Not Applicable
I wishe there was study to compare the physio with acupuncture
I do not care for diabetic patients but I am interested
I have always wondered about taking both Plavix and ASA but now I can stop one after 21 days
None
I would have like a qualifier to explain why indigenous populations are at increased risk from GABHS complications; does this mean the Centor score needs another point for peoples from First Nations communities?
The answer focussed on mothers of preterm infants, whereas the question posed was broader.
More data on CBD would address the clinical question more completely.
Info on risk of amputation may need to be updated.
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Good topic
I have been a fan of vaccines from the beginning and have no hesitation telling people I got both and so did all my family
to the point!
I work in the ED so do not prescribe meds frequently for acne. If an occasional patient does need treatment I will know what to prescribe.
Didn’t get into what was considered asymptomatic..I mean every patient seems to be tired, losing more hair and a bit colder than normal but these symptoms are very vague and hard to define severity for cut off for testing
Didn’t get into what was considered asymptomatic..I mean every patient seems to be tired, losing more hair and a bit colder than normal but these symptoms are very vague and hard to define severity for cut off for testing
I find this a clear statement in an area that is usually confusing
would help to describe “sham acupuncture”
cost is a barrier
what dose and preparation?
mechanism might be weight control causing less joint strain
as above, they were not really telling us whether moisturizer after frequent baths was helpful
good
This was a good format and info. Now out of date and therefore less relevant.
as above, the evidence is there but we have a number of people who decline for religious reasons and they are a tough population
ddd
I have not used this product for weight loss but some of my colleagues have, and it is nice to see that it actually works but I am sorry that you gain the weight back when you stop
US data is biased against AZ vaccine
none
semaglutide is expensive
The criteria to only look at patient reported outcomes was nice to see, but ended up limiting the usefulness of the summary
shame no medical opinion offered re its real life use.
shame no medical opinion offered re its real life use.
was suprised at finding since i had assumed the opposite
It’s good that patients don’t need to pay dollars to buy bathing additives
A neurologist offered me biological for my migraines . this info did not change my mind to accept this therapy. 1-2 days for $7000 and the potential side effects not worth it to me (but have been worth it to a few patients. nice to have a clear way to present the info to pts to make informed choice
Thanks so much
Educative
Very Relevant to my practice
Good to know
Educative
Very Educative
Very good and relevant article
Good to know
Very releant to my practice
I have seen these medications used but they are expensive and often only work for a short time
I have known people personally who have used this treatment instead of a vaccine and it is frightening
I had a patient advocate for this therapy recently, so this is very topical and helpful.
I am a locum replacement physician so do not see many patients with COVID but I am aware of it and this article showed that the incidence is high
I wanted advice for treatment of long covid fatigue in the pediatric population as I have a 10 yo patient at 6 months post infection and I have no advice
Did not comment on vaccinated vs non vaccinated – that would be helpful
I found it interesting about colchicine as I have many patients with multiple co morbidities and they are on heart medication and colchicine for gout, I can’t say I saw any preventative effect
I wounder about patients who also have gout- I have had a patient wanting to know how to manage any med change with gout flares.
Excellent info THANKS!
as above there are a lot of overweight people being denied a knee replacement based on their weight, and I do not think that is fair
What exercises are most helpful?
Good point
Not worth using for Covid
Good clinical info
Podcast was not necessary to explain results of a study. Activity would have been quicker if it was simply a summary of the study
as above, I love compression socks but they are hard to get on and hot in the summer
That is sad as Trazodone was a good option
Education material is so short
we have high vaccine resistance in my community so I am not optimistic we will do a lot of children, but we should, we have the highest COVID rate per 100,000 in the province
It was about 5-11yos but context info was about 12-17yos. How to compare these two?
Very useful pearl for practice; thanks!
The citations for this TFP were mainly from NACI and other such bodies rather than original peer-reviewed studies.
The citations for this TFP were mainly from NACI and other such bodies rather than original peer-reviewed studies.
The citation for #12 had inaccurate reporting
Very useful information as a Hospitalist. I would have liked any other pharmacological recommendations for short term sleep disturbance for inpatients in hospital.
More recent evidence please
None
doesn’t look like it hurts to try this
Good update
Good review.
Good update.
Good update.
Good update
Good review.
Good review.
Good update.
Good update
Good update
Good update
Good update
Good topic
Irrelvant cme.
Oral or IV steroids are the mainstay of treatment of covid-19 if steroids are required.
It would be nice to summarize antibiotic guidelines for non-MRSA coverage in this same article
Should have done this module before holidays!
good advise
non conclusive study
very practical and clinically useful information
Currently I only work in Emerg so it is less relevant for me
Good update
My partner is a musician. what photo do I give him?
see correction
I currently work only with seniors, but I remain interested in other areas of practice.
even googling, i can’t find the names of commercial products that i can recommend
very good
excellent
influence on chf is what i would want to know about
huge variability in dose. why would you use lowest dose on knee – doesn’t make sense
i have trouble remembering which drugs fall in which class – i think including brand names would help
perhaps worth talking about leaving an IUS and using it as part of HRT
I would have been interested to learn how vaccination affects long COVID symptoms and what the vaccination rate amongst the study group referenced was.
Again thank you for a relevant and current education
Thank you for being active in educating FPs
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I appreciated the disclaimer about the effect of industry sponsorship on the quality of the information
This is basically saying: we don’t know to what extent this is useful. So… what?
Bias against staplers, was study sponsored by paper clip industry?
not a lot of evidence provided considering strong bias for this type of insulin
I would like to know severity of fracture displacement that were included in these studies.
would be nice to see studies re different doses of steroids
Very helpful
I don’t do any ER work or hospital work
See above re: industry sponsored trials
Helpful
Helpful
Some bias as study funded by industry/duloxetine
this activity states that there is moderate to high risk of bias but it does not specify
None
A tools for practice summarising the degree of effect from various interventions but using similar “end point” for direct comparison would be beneficial
A tools for practice summarising the degree of effect from various interventions but using similar “end point” for direct comparison would be beneficial
this doesn’t actually answer the title question. If you say only use short term then you should propose a long term solution for this long term problem.
this doesn’t include other antipsychotics like methotrimeprazine used in palliative care
Je trouve qu’on y retrouvait tout de même peu d’informations.
Is there more current info on this?
I’d be interested in understanding how nexplanon compares with DMPA
Well, I get that all the studies were industry-funded but I wonder if that isn’t a more major limitation than the discussion suggested.
I wonder about the use of TXA in resource poor settings or when there will be a delay to endoscopy
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Nil
Unfortunately CBT and mindfulness are not accessible in the rural area in which I practice.
Interesting that while ineffective, the TXA also does no harm.
None
Would be nice to see data with empagliflozin 25mg since this dose is often used in diabetes patients.
Thank you for an excellent and relevant common topic
none
Bias-the RCTs were performed by drug companies
I have seen alot of side effects in my practice that seem to be related to the COVID vaccines. Wasn’t really addressed in this CME.
Too short
This was a pretty light one. I don’t know of anybody who uses TXA in non traumatic GI bleeds
It might be difficult to get our mental health team on board with this?
awesome
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excellent teachign method prefer CME Credit 0.5 or 1.0 type of the topics sch as CKD disease in DM x2 prevetion ect
None, thank you.
None, thank you.
was a good read
no adverse effects were reported
does CCS endorse these findings?
this doesn’t consider goals of care for these elderly patients
Not really sure about using normal OC when nursing but if people wished it I would consider it now
I don’t do ER care, but this would be helpful to those that do.
none
Thanks
Very educative
Very relevant to my practice
Very Relevant to my practice
Good to know
Very relevant to my practice
Very Educative
Very relevant to my practice
Very relevant to my practice
Very educative
Good to know
Very Educative
Intresting
Very educative
Good to know
Good to know
Good to know
Very relevant to my practice
Good to know
Good to know
Good to know
Very relevant to my practice
Good to know
Very educative
Very relevant to my practice
Very educative
Good to know
Good to know
Good to know
Very educative
Very Relevant to my practice
Good to know
Good to know
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
very old evidence
Thx
Thanks
Thx
Thx
Thx
Thx
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thx
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i do not do er work so less useful
nil
Thanks
Are there concerns about infant expose to synthetic hormones ?
Are there concerns about infant expose to synthetic hormones ?
Great summary
The information was delivered in a bit vague style
Keep upnthe good work
Nil
Nil
I do not insert IUD’s and have found them to not be accepted too well with patients
interesting, history still counts in medicine
I work in a family medicine clinic, and I will print this out and take to clinic to discuss w my nurses, as they will appreciate the knowledge and recommendations as well!
NA
Good platform
Helpful article
Love the format
Useful summary of the meaningfulness of different magnitudes of Likelihood ratios at the end.
This topic doesn’t address antibiotic resistance which is main reason for culture.
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Helpful
This is counter to my training as a medical trainee. It may have been helpful to include a list of indication for testing (beyond “treatment failure”), etc.
Thank you
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thank-you
None
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None
Thx
Thanks
ty.
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I would like more clear statement about how to accurately diagnose UTI – was helpful to learn that UCx not always accurate and confirmed understanding that Udip unreliable, so do we treat all who present (but that is still just 60% who have UTI)… what are the other important issues to consider that would address the remaining 40%
Nicely done. Also, it’s nice to get credit for the wee PEER evidence blurbs.
I love the automatic MainPro integration and the excellent mobile web UI. Nicely done.
great work
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I didn’t realize my comments would include my name! I also think the vit E study was too poor to include in this review.
just confirmed what I knew from experience
None
All ok.
That Dapagliflozin did have a significant mortality reduction and emapagliflozin did not was not highlighted. NLPDP only funds dapagliflozin for heart failure
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(I lied!!… I am mostly retired but need CME credits!)
Helpful
Helpful
None additional
Would love to know the NNH to balance the NNT to have a more fulsome discussion w/ families
I still wonder if it’s worth starting atropine as early as possible once death rattle begin. Harm seems low…
none
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X
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No
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Keep them coming!
nothing to add
thank you
none
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Nil
Was next-day somnolence considered under safety effects? There is a growing list of impairing medications that are prescribed by doctors who are unaware of their patients’ jobs which have been implicated in vehicle crashes and in jobs considered safety-sensitive. Most physicians don’t consider the impairing side effects on the individual’s function in their vocation. Add this class of meds to the list. Hoping there is an awareness on the impacts of using these meds on a person’s function.
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no additional comment
none
Thank you
na
I wish they analysed further reports on the addiction aspect of the medication.
Thanks
Great practical information.
(bias – study was industry sponsered)
(bias – study industry sponsered)
give me clear instructions on how to claim credits for the Self-Learning modules I read.
The quality of evidence is indeed poor. The question of undiagnosed underlying reactive airways is an obvious lack in the analysis. The low risk to benefit ratio also would have been worth exploring.
We pay enough dues. We shouldn’t have to pay for this content
Thanks
.
..
thanks
The title implies that there is a comparison between ICS and SABA. But this question was never address. Instead the studies focus on ICS vs placebo and SABA vs placebo
inhalers work for post viral cough
I was disappointed there weren’t more trials give me a better evidence based solution
this is really relevant this time of year
None
It is a bit of a concern that the largest RCT showing the benefit of ICS is industry funded.
NA
nil
Thank you.
nil
I deal mostly with a geriatric population
another registration process and password to forget
Would be nice to have a link that would take you directly to the paper that was summarized for the learning point.
I like these practice tool tips- They are very informative and practical and save me a lot of time.
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confirmed & solidified my knowledge about 3. HF management; 5. IUD efficacy; 4. BPH management
thanks for doing this!
This was a very useful, high yield one! thanks
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non
non
Thank you for concise info
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Consider rash quizzes and answers
Do ECG challenges
Do ECG challenges
NA
NA
I am shocked that ethics approved provision of a placebo influenza vaccination
N/a
nope
do beta blockers not reduce mortality in heart failure?
a lot of families may not be able to afford a switch in formula for such short term benefits
NA
NA
fun facts – thank you
thank you
NA
NA
🙏🏽👍🏼🙌🏼
🙏🏽👍🏼🙌🏼
no additional comments
NA
Nothing to add.
excellent educational material
Thank you.
Thank you.
Thank you.
Nil
Nil
none at this time
–
outcomes were somewhat a surprise
I will tell them about this activity
will tell colleagues about this activity
thank you
Thanks
I worry this approach is simplistic. There appears to be no consideration given to other conditions that can cause uti symptoms eg STIs
How practical is this approach in FM practice, to immunize within 3 days after development of IHD as patients may still be in non-FM care during this time?
Thanks!
helpful tool for a new class of meds
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NA
Good
Did not address the main reason for using these devices – it’s painful and inconvenient to prick one’s finger 4 x per day. Even if the outcomes were a bit worse compared to 4x daily GM they are still worthwhile. This summary misses the point.
Nothing
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THanks for helpful sessions.
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I am surprised but as expensive as they are glad they are not much better
s
Thank you.
The data would be interesting if broken down by specific statins. Anecdotally, I have patients who have muscle symptoms and switch and then are fine. The data could be higher for muscle issues if it included failed statins prior.
I saved this to show patients
Test
Test
I find the turn of phrase “In elderly…” a bit unusual.
Thanks 🙂
excellent job thanks
Great
Can you cover parathyroid issues?
Thank you.
N/A
Glad to NOT HAVE TO SEARCH FOR PW’s every time
NA
NA
I find it difficult to remember where I learned something, and a link to completed ‘Tools’ would be good for reference.
Great, applicable CME
NA
automatic cme point collection very convenient
not relevant to family medicine in my opinion
Nil
Dk
Na
Nil
Thanks
Useful
N/A
NA
Orthopedic surgeons should be aware.
Thanks
x
Some orthopedic colleagues are still recommending long courses of LMWH
–
Very good
Helpful
Lily is the best
more cancer screening modules
more cancer screening modules
this is outdated
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excellent and concise presentation.
Seems great to use so far, thank you!
none
excellent tool for practice!
none
short and sweet
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would have liked to know which “beta-lactams” the studies made reference to
I like the ease of this platform
Thank you.
Thank you.
NA
Now just need colleagues to buy in on this one!
ASB should be followed up.
none
If Nitrite positive on urinalysis, how does that change antibiotic choice?
Less vs. fewer; you’re killing me!
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Excellent
Very good
Timely, brief review with pertinent details.
what about vaccinated
Thank you.
Study funded by the manufacturer
THANKS
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NA
Perhaps update- specific proven benefits
read this on CMA Joule
I wish there were links to the programs mentioned – even though this article now helps confirm that psychological interventions as useful, accessing the programs remains difficult.
thank you ,humour is allways wellcome
I would love to have more information on post paxlovid rebound. Infectivity return? Revert to isolation precautions as if newly positive?
Good short info
Great review
Thank you.
Love ease and practicality of use
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Not clinically meaningful interpretation
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NA
Nil
I would have been interested in the data of paxlovid for vaccinated patients.
NA
Article should have provided clear explanation if any difference I. Tolerability/side effects are know.
Thank you.
nothing now
Doing Excellent job.
Great learning
Excellent job!
None
N/A
I am very happy PPI’s are not helpful in this instance. It’s hard enough to get MRPs to stop using them in regular folks (adults and elders).
would appreciate even more simplicity in entering CME credits
great topics
NA
NA
Thank you for making this content accessible.
Really enjoying the content
More free content
I would like some guidance included on when reflux SHOULD be concerning in an infant, and what to do (refer or other)
No
Thank you. Good item.
we can receive more of such information it is easy to absorb and straight forward
I appreciate this through but succinct summary. I am curious about the last study that showed a statistical difference. I’m still not clear which diet was superior in that last small RCT. The: “(Continuous)” note could have referred to the last number, meaning the one least effective at six months, or the one that show to be superior?
Thank you
Thank you
none
Excellent job!
Thank you.
Thank you.
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NA
None
None, thanks
None
Statins and poly pharmacy in the elderly. Needs to be in this context
very informative.
very informative
very informative
Thank you
short quiz
send on Email once a wk that motivates to read and do it
Thank you.
none
NA
NA
N/A
My first experience with platform – great!
This statement “Real-world evidence suggests effectiveness in Omicron-infected.” needs a qualifies in that in low risk people no benefit is seen.
Na
2013 study….. more data available??
Others say domperidone should not be used and unclear if this has changed.
Tramadol is an opioid
https://pubmed.ncbi.nlm.nih.gov/26490760/
WHO now recommends short course amoxicillin (5 days)
If they did not find side effects, it means they didnt look.
Cold prevention likely also with the use of face masks
https://www.nejm.org/doi/10.1056/NEJMoa2212270
Please see https://www.escardio.org/The-ESC/Press-Office/Press-releases/Evening-dosing-of-blood-pressure-medication-not-better-than-morning-dosing
The marginal increase in BP is not clinically significant in my opinion.
none
Very informative
Excellent job!
N/A
Why were we all advised to measure Lp(a) once in all Canadians then if it is not useful… would have saved a lot of money for OHIP too as they are covering the cost.
I usually add aripiprazole as a second line agent to antidepressants. I wanted to see more info on this drug.
I would need to do additional reading about this class of medications before considering prescribing them.
NA
old and limited evidence used (>30y, no RCT)
very good
This TFP contradicts new CCS guidelines… very confusing
Thank you.
useful and relevant
Not clear if we should continue ordering lipoprotein given this vs CCS guidelines
Thank you
excellent job thanks
Excited to start using this platform. Thanks.
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See above.
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NA
thanks
Excellent job!
As noted, it would be appreciated if there is an update/clarification if there is evidence that statins should be started on patients >65 with no other comorbidities
Thank you:)
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Excellent.
X
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NA
Great resource – more free content please
good bite size info.
Thank you.
Thank you.
More free content please
Thanks
Good overview of common issues in primary care
N/A
very sensible info
X
practical updates and info
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Nil
none
NA
Thank you.
.
n/a
nil
n/a
please continue this type of info.
Thank you for your ongoing cme options
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no
no
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None.
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this platform of learning is very good
thank you
–
Great 👍
Mone
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Thanks
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Na
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Mone
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Mone
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Interesting
I wonder why RCTs comparing TXA to cOCPs for HMB weren’t included.
none
will help me encourage pregnant patients to discuss with their OB care provider
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Na
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Great
Great to implement
Thanks
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NA
I use ACOG guidelines for ASA patient selection and d/c at 38 weeks to mitigate bleeding risk
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Good
Great
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No
Thank you
I was hoping to get an answer on whether drops are good for tearing due to dry eyes, but the symptoms measured were pain and FB sensation.
NA
Love the transparency
NA
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Loe this littles cherries- great learnings
none
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I still want to know – what are the sequelae of untreated dry eye? Could this be important, regardless of perceived symptom relief?
More free content please
CBT and mindfulness facilitators limited in our area
Thank you.
Thank you.
n/a
keep them coming
good program and thanks for doing the work to produce this
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no comments
Nothing
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Keep same work.
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yes
More free content please
This must be a very difficult thing to run, thank you
some topics on nutrition, lifestyle would be useful. Thanks.
Thank you
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Thank you.
more Dermatology
I enjoy this program
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Tks
was good
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Which performed well vs poorly might have been helpful.
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na
na
interesting that no difference in efficacy of potent vs nonpotent steroid
None
Most relevant to hospitalist physicians- usually the discharging physician would be prescribing the anticoagulants after surgery
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Test
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Very useful topic
No exploration of side-effects or harms from statins as implied from title of topic!
Please provide free CME.
Please provide free CME.
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NA
Will try gabapentin
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Very instructive article
NA
Thank you.
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Excellent
Thank you
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Nil
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I’ve been using venlafaxine and suprised no studies on this were cited
Dose and complications can be helpful
thanks
For this topic it would have been good to add how to support patients through this or which AHP could do it
Thank you!
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App?
NA
Not applicable
new platform to me. need some time to tell
..
would prefer a study that looked at higher risk individuals
TOO MANY QUESITONS
CCFP should send statements to all FP when new vaccines are approved – pharmacist seem to have better info then we do
Thank you.
Thank you.
this kind of summary is very important, and honest. How about doing one on COVID vaccines!! 😉 (I’m not holding my breath…)
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Useful summary for busy GP
Helpful tool for practice
Thanks for the learning topic
Maybe remoce separate sign in requirement
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No
No
new experience
NA
N/A
Thank you
Thank you for making learning fun
Thank you
Nil
Surprisingly high placebo effect
Useful information
great info
thank you for the opportunity
n/a
Nil
Content about which vaccines were approved in Canada and for which uses would have been helpful
Why is Oxybutynin not used more if it’s so much more effective?
Thanks.
New to me
Very easy learning process
this is very practical and efficient use of my time
good cases so far
I am enjoying this program
Good to avoid corticosteroid
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practice changing!
this is a great resource on cfpclearn
I actually thought the percentage of patients that gain weight on this medication would’ve been higher than quoted
first time to platform. excellent
What does habituation, tolerance, withdrawel look like with benzos vs z drugs
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Consider cognitive behavioural therapy
None.
Thank you
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practical and patient oriented
Interested to see more data in high risk patients, along with more long term data–? need to re-vaccinate
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would be interesting to know if any similar studies focused on any G.I.T. benefits from chewing gum
the managemrnt of chronic pain is often problematic. It is quite reasonable to start with regular use of hihg dose tylenol as a first pharmacological step.
thanks
thanks
thanks
thanks
thanks
thanks
none
Enable more free content
Enable more free content
nice to know official dose of cranberry
not unexpected but I wish for other options
interesting but doesn’t change my thinking
virtual is never a good option
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na
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Confirms pretty much what I am doing in practice
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Very good article
Very good article
Very good article
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None
at t
Discrepancy between dosing recommandations of the podcast vs INESSS in Quebec for amoxicillin 40 vs 90 mg/kg/day
Good area of study.
n/a
n/a
great
none, thank youy
good topic
no harm if pt is not diabetic
excellent topic
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n/a
good topic
good topic
excellent topic
excellent topic
excellent topic
good topic
good topic
good topic
good topic
excellent topic
good topic
It would’ve been nice to know the difference between tablets versus juice versus low calorie juice.
good topic
excellent topic
good topic
excellent topic
excellent topic
excellent topic
excellent topic
Excellent topic
Excellent
Excellent
Excellent
Excellent
Good
Excellent
Excellent
Excellent
Excellent
? Not pravastatin
noe
none
Why we are prescribing this medication
Good
Good
Good
Excellent
Excellent
Excellent
Excellent
Good
Good
Good
Good
Excellent
Excellent
Good
Excellent
Excellent
Great article
Excellent
Excellent
Excellent
Excellent
This was very useful.
NA
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Excellent
Good topic
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Did I miss the cost of this medication?
Good topic
Excellent
Excellent
Good topic
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Good topic
Excellent
Great
Great
Excellent
Excellent
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10 day penicillin most effective for preventing rheumatic fever
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My understanding is there are studies that show colon cancer risk reduction with daily ASA use but this has to be done for 6 to 7 years and is at the risk of increased bleeding
Excellent topic
Great topic
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One
This article clearly pointed out adverse effects and cost of the atypicals
Good article
This information will put us at odds with our specialist colleagues
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Excellent
Great topic
Great job
Great
Excellent topic
Excellent
Excellent
Good
Excellent
Excellent topic
Excellent topic
Excellent topic
Excellent topic
Excellent
Good topic
Excellent topic
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Excellent topic
Excellent topic
Great topic
5 to10% stop .adverse.common.hypotension,hallucinations,paranoia
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Great topic
Good relaxing topic
Excellent
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very common topic that is often difficult
the era of diabetes meds coverage for all
what about benzyamine throat gargles, warm-salted-ASA water gargles
never knew about Ivermectin 1% daily
very relevant and common clinical question
Guideline recommended
Crisaborole is a better choice for atopic dermatitis
Tell our cardiology colleagues tho read this
I think this data is outdated
Most accurate ogtt, fbg,hba1c
good review of evideence for very common topic
good to see trial with dose
no concerns
Excellent access to information
I find writing down the reflections super helpful to solidify the learning. I always have more than one learning point though!! Thanks so much for this accessible learning.
Most preferred oral contraceptive not mentioned.
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One
None
na
It might’ve been useful to know the mean age of the groups treated with oral contraceptives. Was it younger than the spironolactone group?
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None
This article did not discuss failures due to improper use of medication
No laba alone asthma.
What do they mean by supervised activity?
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good to think about apathy vs depression and have some options to discuss with family regarding potential treatment trials
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Great that the point about not having to monitor potassium unless indicated was great.
I’m always impressed at how small the benefit of many of our CV meds offer. This despite what our cardiology colleagues insist we prescribe. Many of these meds are not a panacea. Given their cost and potential adverse effects I think it reasonable to point out and explain the ARR if these meds.
Tell this to our cardiology colleagues
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Noncompliance a big issue in my practice
So why are my local orthopedist so gung-ho on insisting on weight loss trial before they’ll agree to performing a total knee arthroplasty
informative
informative
informative/ but. no other option for OA
informative –
good to know- informative
Thank you – informative !!
to expensive
Very informative, thank you
Nine
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New treatment ideas for me.
S, not good for the audiologists.urprising results
Good confirmation of my Knowledge.
None
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good review and proof.
Useful knowledge.
Good decisive information.
Wayne Gretzky believes in it.
Large difference in number of doses required.
good review
Proof of a likely useful practice.
Good definite assessment.
Good definitive review.
Compelling direct review direction for practice.
Covid is not gone.
Direct evidence fact presented.
Is this info being used in any guidelines?
Good concise practice advise.
New idea the real time monitors aren’t very much better.
Is this part of any post-cardiac event guidelines?
Proof of a logical treatment option.
Fast review of new medication option.
Good every day topic.
Proof to wait
Useful info.
Confirmation of the known.
Surprising efficacy
Proof for known information.
Useful in my own family.
Good to know there is no significant harm.
I would like stats for how many use it.
Surprising fact for TXA use.
I did not know about this drug.
useful topic.
good to get scientific proof.
Definite answer
Proof presented.
Reversed my thinking.
Is it in any guidelines?
Worth looking at.
Good current topic.
Definite proof !
Useful topic.
Good large population sresults.
Vert useful topic
Disappointing findings.
Clear proof
Proof of a known therapy.
Good social topic.
None
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?
There should have been some mention about whether continuing benzoyl peroxide actually lowers resistance; it was barely mentioned
n/a
New ideas for me.
Frustrating condition to treat.
Study not useful
Frustratingly little help in fracture prevention.
Encouraging OA treatment .
Great to have stats for use when speaking with non-voters
Mortality stat is concerning.
Cost is prohibitive
None
One
None
None
None
N/A
Change in my thinking
I was unaware of any useful treatment.
Good topic.
very convincing evidence.
Definite evidence.
No big difference in outcomes .
Useful proof.
Another useful medication.
No change needed.
Good topic.
Not the answer.
Good practical topic.
N95 not much better.
Good topic.
None
None
One
None
None
None
None
More proven Covid information.
Good statistical proof.
Known “fact “proven.
Useful topic.
Confirms my understanding.
Effective treatment.
Good proof of vaping danger.
finally something better than curettage.
Sobering stats.
Expensive ,invasive with minimal benefit
New meds have little use.
Useful topic.
Very useful topic.
Limited affect ,good office time saver.
Surprising benefits.
Clear direction.
Studies are limited use to me.
None
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None
Giving prices helps make the decisions
Not a useful topic.
useful topic with surprising results.
Good social topic.
Disappointing results.
Good proof not to use.
Comparing to non-medical treatments is useful.
Disheartening study.
Good to know Cefalexin doesn’t help.
I have never heard of this!
Proof of a good idea.
Useful proof.
proof of my understanding of this non-drug.
Both are good
Encouraging study.
Useful fast screen.
Good non-medication subject.
Weak evidence
None
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None
Confirmation of my opinion.
More hype than usefulness.
Very limited proven uses in medicine.
No harm or benefit.
Good to have proof for this highly charged topic.
Good to have the proof.
Limited usefulness.
I was unaware that riboflavin could work in migraine prevention.
Good proof to allow use.
PEG. use first.
Who could afford that treatment?
Try stopping or decreasing PPIs.
Unknown drug to me.
Excellent non-drug topic.
Shows limited use not the widespread use currently.
No change in pattern of usage.
New treatment idea.
Good change in approach.
Good definitive management direction.
Easy to do, cost negligent.
I wish there was something new to offer.
Useful knowledge.
Good proof , patient acceptance may be difficult.
Good attempt to produce evidence for or against a suspect treatment.
Definitive study.
Good information to have proof for.
Very useful topic.
No help for my consumption excuses.
Good to know efficacy.
Allergic and chronic sinusitis only.
None
None
None
None
Definitive proof
Vert useful topic.
Useful proof.
Confirmed known treatment ideas.
New idea for me.
no help in allergy prevention.
No comment on how painful the injection is.
Little use for my practice.
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Frustrating to treat.
Generic whenever possible.
Common perception not proven.
Not True.
No surprising finding.
New knowledge for me.
Gov’t stockpiles aren’t useful resource management.
Good proof of an established practice
Shocked by the cost.
Fall risk.
Guidelines discourage use.
Use in males recommended.
New idea to me.
Both are recommended.
Surprising.
Little thought of risk.
No proven answer
Surprising findings.
Expensive poor results.
Still a recreation use only.
Unfortunately no much good evidence
I need to rethink my annual flu shot.
Surprising the potential harm.
Cost effective treatment.
Industry results suspect.
Don’t use in children < 6.
Better to prevent with limited treatment options.
Not in pregnancy.
Best of the smoking cessation methods.
Good topic
Most of the results were industry generated.
Until more access to this therapy won’t change my clinical practice
None
Guidelines most useful.
Firstline in ER.
Good information
Good effort and research to help apathy in Dementia population
Did not mention if there are centres or psychiatrists who have already started treating patients? As a family doctor one can refer patients
Very informative
Thanks
Vit D a non-issue
A change in my understanding.
Colchicine remains a good treatment.
Sequential therapy is a new idea for me.
Good relevant topic.
Proof of a known recommendation.
Good to know
There does not seem to be as much concern as in the past with vaccines and autism
Good to know efficacies are about the same
Good to avoid risk of amniocentesis
useful general topic.
Patient factors (BMI) are a large factor.
Poor lack of benefit for hard work!
Not for back pain or widespread pain.
Surprising evidence.
As good as steroid.
This changed my understanding.
Better success rate than I previously thought.
Useful knowledge for a small patient population.
No DM under age 6.
Surprising results.
New idea to me.
Stop IM B12 shots.
Ibuprofen then acetaminophen then codeine
Follow the Guidelines.
Very informative
Relevant to my practice
Good information
Evidence is different than my understanding.
A change in my understanding
Surprising.
Different than my current understanding.
Good to see the Guidelines presented with this topic too.
Good current topic.
New idea for me.
Good to have guidelines.
Guidelines agree with evidence.
Good to know for grandchildren.
Guidelines agree with evidence.
Useful evidence.
Less Bone Density Tests needed.
No change in my practice.
Test ,treat no retest.
No autism cause.
Guidelines agree with evidence.
I need to be checked.
Cost effective prevention.
Frustrating that good results not available.
As good as the std treatment.
Good to see the guidelines presented.
As good as Amytriptyline
Good debunking an old idea.
n/a
n/a
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n/a
Good useful study
Surprisingly beneficial.
Good definitive info.
n/a
n/a
Surprisingly effective
n/a
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n/a
n/a
N/A
Significant weight loss makes a huge difference, based on my 44 years of clinical experience.
Hope I never need this RX
If it was not for the weight gain, if would have been my first line Rx choice 15 years ago.
all meds are poison with potential benefits
??
n/a
n/a
Great topics!
One systematic review3 found more ear, nose and throat-related adverse events but no absolute numbers reported. – which one, med or placebo?
Good summary and clinically relevant.
Good summary
Good relevant summary.
Great review.
Good summary of clinical endpoints
Good summary of efficacy.
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Great summary.
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Is it possible to also do a review of what the effects are of vaping vs. no vaping (not smoking)?
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These are so good!
I believe the information in this article may be a little out of date. Remdesivir is available in Canada outside clinical trials.
No,happy to learn
For reference, I would like to see how the lesion reduction is for topical treatments alone, and for oral isotretinoin. This would be helpful when counseling patients.
Would be nice to know if this also applied to those with renal impairment/CKD.
It would be helpful to add a filter setting to filter out articles that have already been read
thank you
thank you for the article
This is an excellent review and very timely.
NA
Why not just say we don’t know?
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No comment
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na
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na
na
Nil
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No
Thank you!
Thank you!
No
What about glue over tape? I like tape for approximation and glue to cover the wound and keep the tape on.
Thank you!
Thank you!
Thank you!
Thank you!
Thank you!
Thank you!
–
do a topic about HRT in elderly woman with genitourinary symptoms
Good info
Good information
I do not do OB But pertinent data in ER medicine for my practice
updated May 25, 2015?
would have appreciated the evidence for the living in northern Nations – to advocate for funding
N/A
Relevant topic – see a case every few weeks in general practice
Confirms current clinical practice
Good topic- unfortunately not a lot of readily accessible options for TRD
I previously printed off this article and read it this morning. I spent the remainder of fifteen minutes reviewing insulin therapy for patients with type 2 diabetes.
Useful topic
Helpful information
Useful information
Nothing
i am cranky today
Going to try oxytocin a little more perhaps
Good information
Not enough to convince the target population
.
Very useful article
if it works well and it does, .Dont fix it
idem
idem
good topic
None
would love to read about prevnar 20
providing video link would be helpful
What was the dietary calcium intake in the studies?
good practical information.
Thank you
Thank you
more hiv content
more hiv content
Thank you for the presentation
short and to the point.
None
would like more details free T vs bound
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None
Thank you.
Thank you.
It is difficult to dispel public perception of benefit in light of so much anecdotal evidence. Are their harms to chronic use and suppression of endogenous production?
I have so many men asking me about TRT even though they have normal levels, so this was very timely, thank you
testosterone has a significant anti-inlammatory effect
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Visual Learning Maps: Use visual maps or diagrams to simplify complex medical concepts and improve understanding.
Back Button: If there is a back button so you can go to previous steps and check or correct one of your answers for Reflective. Learning Activity.
thank you
none
none
Plug Jean and that you’re mere insulin slightly better than n.B a
Helpful info.
Love these short snappers, refreshing is fun
the bottom line should be reworded a little to based on limited evidence testosterone does not increase ………etc
Has good pericare as in bidet use been tested against antibiotics.
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I am enjoying this program
keep them coming
would like to see CGRP antagonists compared to triptans!
Kind of frustrating when prior suggestions on Vit D were supposedly evidence based
Are there any end organ benifits to adding insulin in the 2 diabetes?
–
–
What impact does lower the ldl below target ie 2ndary prevention do long term.
Thamkyou forvthis program
Good information
suggest topic on oral, topical,(vaginal vs patch) for estrogen, also what about reading lab for testosterone in men who think they have a low testosterone and need it.
Why is PCV 13 even recommended in Canada?
A good christmas topic.
Industry funded….can we trust?
Thank you
Thank you
NA
Non
Interesting and valuable information but not very relevant to my practice as I see very few prenatal patients
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
Nil
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Nil
nothing
None
patients choices can also influence my decision
Nil
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Nil
This is still not available in Canada
none
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None
We are still in the infancy stage of genetic testing for treatment
N/a
Helpful summary
there is no concrete answer , those who are suffering resistant depression and also can afford to pay for pharmacogenomic testing can be offered this testing
useful and relevant
Further support abroad, standard recommendations?
Coverage for shots?
Thanks
Thankyou
Thanks
Acute care topics
none
None
None
None
N/A
N/A
N/A
Nice to have an idea regarding the amount of potential weight loss
Important to state importance of benefit from biphosphonates which require reasonable vit D levels
Thanks
Thanks
Updates always helpful
Thanks, await further studies
Thanks
Thanks
Helpful, once controlled,, next steps?
Thanks- combo therapies with different classes, risks and benefits appreciated in DM and cardiac care
Loving these succinct articles
Finding theses articles really interesting!
Great articles
Excellent
Excellent
Excellent
Excellent
Excellent
n/a
Thanks
Cost?
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
THANKS
THANKS
THANKS
OA 40 % IMPROVEMENT IN ACUTE SETTING, LONGTERM UNKNOWN
Good evidence-based review on initiating insulin
Thanks
Thanks
Thanks
–
–
None
None
Nice that oyr credits earned shows for year
Thank-you!
good review
Thank you
no concerns
no concerns
no concerns
none
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None
None
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
I support the conclusion that there does not appear to be a link between MMR vaccine and autism. However I have learned that there is seldom smoke without a fire. Even if you ignore the Wakefield study there are still unanswered questions that will never be addressed if we demonize those who are critical of the current immunization program with more vaccines added all the time and virtually no information provided to the public about the absolute benefits and risks of each new vaccine. It feels like vaccines are a sacred topic. One we are not allowed to question.
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Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
ncorporate video tutorials, podcasts, and webinars to reach a wider audience and offer content in different formats.
Ensure the platform is fully optimized for mobile devices.
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Thanks
Good information
Excellent content
Thanks
Thanks
Thanks
Thanks
helpful, thank you
Thanks
Good information
Good information
Thanks
Thanks
Thanks
Thanks
THANKS
THANKS
Good information
Good information on constipation treatment
good information
No interaction between clopiogrel and PPI”S.
–
–
–
–
Maybe Li or bupropion first given NNHs
Hmm, we have ortho using just asa locally…
Good information
Good information
Good information
Good information
n/a
n/a
Good information
Adding insulin when the underlying problem is insulin resistance will simply amplify the resistance
No further comments.
N/A
N/A
very little mention of tamsulosin in this review, which is the most commonly Rx’d drug for BPH.
Thanks
Thanks
None
Conflicting positions in CV literature
Non
Non
Non
good information
this is a developing topic
N/a
Thank you
Na
Na
Na
na
na
Good info, very relevant to practice
Thanks
N/A
very informative and concise
good to know
good to know
informative and concise
very informative and concise
good to know
very informative and concise
very informative and concise
informative and concise
good to know
very informative and concise
good to know
short and to the point.
I wish this said how easily one obtains potassium hydroxide? Compounding pharmacy? Price?
I was surprised no s/e were noted from dexa. Likely not long enough f/u but 15 mg is high@!
Good to have confirmed a practice which empirically seems to help
Thanks
Thanks
Thanks
Thanks
Thx
Non
na
no concerns
no concerns
n/a
n/a
good summary
good to know
good to know
good to know
good to know
very informative and concise
same as my practice
very informative and concise
informative and concise
very informative and concise
good to know
good to know
Shame the evidence isn’t higher quality, unbiased
good to know
good to know
What options of GLP agonist available in canada?
I skipped parts 2 & 3 by mistake!
None
Thank you for process improvement
thank you
thank you
good to know
very informative and concise
–
–
Nol
None.
More Gyn/OB/Paeds topics please
I still wonder if either medication provides any real-life benefit?
Good session!
very informative and concise
good to know
good to know
Non
good to know
good to know
good to know
good to know
none
would like information about costs of different drugs
I would love more info about practicing in the resource-limited setting most family physicians are now facing.
Nil
also interesting rate of 110 allowed–fell this is often suggested to be lower
Finasteride has significant side effects, but clearly better outcome.
none
no
no
no
what dose is recommended?
None
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na
na
none
none
I often prescribe 3 days of oral fluconazole.
n/a
none
learnt new information
Should have commented on lack of data a primary intervention as opposed to loosing wt and exercise as well as not smoking etc
na
na
very well done, right to the point
excellent learning/teaching tool for us busy family doctors and probably doctors in general.. well done
Thank you
Thx
Non
nil
nil
nil
n/a
n/a
more info about. new Migraine Tx
thank you for this infp.
might consider
It would be helpful if activities I’d already done dropped off the list that is shown
needed more information for this one
Good topic
Good topic
Good topic
Good topic
Good point
Good to know Mirtazapine can be used for fibromyalgia.
Good review
Good topic
Good topic
Good topic
It wasn’t clear what infection was being referred to—influenza or Covid/other?
Good topic
Good points
Need to know the amount of peppermint oil drops or dose of peppermint oil tablets.
Good topic
Good point
Good point
Good review
Good topic
Good topic
Good topic
Good topic
Good topic
Good points
Good topic
Good topic
Amazing
Also awaiting new osteoporosis guidelines
N/A
n/a
I often use the 5 mm punch biopsy and always close, but might consider steri strip or glue in certain circumstances going forward.
I do not believe this is available in my community of practice yet.
good topic
very informative and concise
good to know
good to know
good to know
good to know
I would recommend that once a module has been completed, it no longer shows up as an option to be completed.
Hb increase by 6g/L sounds really awesome
Nil
None
will await further studies before concluding this is safe or effective
n/a
this seems to be a complete reversal
moreRCT needed to establish long term effects
cacb in treatment of elderly
VERY HELPFUL
i like it
Pharmacogenomic testing not widely available at this time
Thanks.
none
none
no
no
good to know
same as my practice
informative and concise
good to know
very informative
very informative and concise
good to know
very informative
Poor grammar – see comment
excellent information
would been more helpful to have more information on tranexamic acid
I would really apprieciate some learning modules about autism itself.
None
none
none
really enjoy these, been doing since 2015
hated giving needles to babies
none
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none
Were the impacts on magnesium and B12 surrogate markers? Any clinical significance?
Doses of meds used in trials would be helpful
It’s too bad iv tranxemaic acid hs to be used mainly in ER rather than the office.
I would probably not use it in the elderly due to somnolence and falls risk.
I’m still looking for a way to know which of the learning materials in CPFC learn, I have completed in which I have not when scrolling through the topics
love this program
love this program
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none
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I wonder if this is still appropriate?
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
Sign in is slow and cumbersome ? Facial recognition
Please make sign in easier!
Good reminder, dose, length of use
Have a great day!
good topic
Some discussion of dose of Apixaban would be helpful – ie 5 mg bid vs 2.5 mg bid for frailer folks.
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
I only do surgical assisting
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fibromyalgia study group
Really useful review
Non
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The summary of the evidence was helpful and re-inforcing
no concerns
good to know
very informative
very informative and concise
very informative and concise
good to know
informative and concise
good to know
good to know
good to know
same as my practice
good to know
good to know
Website slow loading and annoying that I can’t flip to a page (ie every time I use this I have to scroll through ones. I’ve seen many many times to get to the new ones, or start at the oldest and work my way backwards, but still the same.) would be better if they were pages that I could skip to so I could look more efficiently.
Seriously, consider rejigging this website. Easy to access the first 50 or so tools, and the last 50, but how would I access to number 200 without scrolling forever?
I only do surgical assisting
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good topic
good topic
good topic
good topic
good topic
A review of other serum markers being tested for cardiovascular risk may be helpful
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Outside the clinic the solution isn’t readily available
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There isn’t anything that works really well
I will use less gabapentanoids
waste of money
In practice it does not seem to work that well
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Good
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None
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Evidence presented clearly with transparency about a lack of RCTs.
I would be interested to see if there were any changes in weight, cholesterol levels, healthy eating habits, etc.
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I would be interested in how we characterize severity of Bell’s palsy. Is it based on limitations of ability to eat/drink/speak?
A quick summary of the association between pedometers, weight reduction and decreased glucose/blood pressure would be helpful.
It is interesting that PPI increased the CV risk with ticagrelor in the non-randomized subgroup analysis despite a lack of associated mechanism.
It is interesting that there is a difference between reductions in blood pressure after treatment when comparing HBPM with OBP.
For the increased mortality with beta carotene and vitamin E, it would be interesting to see postulated mechanisms.
It is interesting that the BRIDGE trial showed no significant difference in death and thromboembolic events at day 30-37.
I only do surgical assisting
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The old adage of waiting 4-6 weeks was based on underpowered trials.
I think it is still notable to take into consideration that the four smaller RCTs found no difference in comparisons between ibuprofen, acetaminophen, oxycodone and acetaminophen-codeine.
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Any cases on elevated triglycerides would be helpful
This is what I have been doing
Cost and coverage?
I just allow pts to decide if to continue it
I will likely use more ocp for acne in females
More CME like this will be appreciated.
Excellent information
Very useful topic.
nil
The second line under the title “Evidence” seems to be incomplete “The OST based on weight and age was developed.”
would be nice to include how many hours of fasting this information is based on.
good point
weird this TFP never mentions the infection
I only do surgical assisting
good practical article
i was not sure from article whether any definitive diagnosis of pneumococcal disease as opposed to generic pneumonia
I no longer work in ER so not likely to be able to apply this tool useful info though
I wasn’t sure if the conclusion from the review of observational studies meant that running did not increase the risk of OA. Rather, patients with symptomatic OA may choose not to be runners.
dosage of spironolactone not given
rarely see exacerbation of childhood asthma in the office as most go to ER
dosage not specified
cost involved in physio prohibitive for a number of people, joining classes at municipal gym/leisure centre more economic and group involvement i believe encourages continued participation
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no longer work in ER but good to know that treatment may help and does no harm
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confirms practice
Non
Nil
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No
No
No
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Very rarely do I use a beta blocker for hypertension unless a patient has other comorbid reasons to use it. It is not a medication of choice for me for treating hypertension and confirms my practice.
It is another option I had not really considered and although may have a bit of placebo effect if nothing else, it may be worth trying on patients that cannot tolerate other options or as an add-on.
In practice I find most patients cannot tolerate doses required for treatment due to sedation and dizziness.
Confirms what I have been doing!
Duloxetine and Mirtazapine are more effective, and I will lean more towards them but willing to try pregabalin second line.
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Why ask about sexual orientation each question. It seems intrusive.
Useful topic, so many patients ask about this!
Helpful topic as this is a common problem
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The caveat that beta blockers are highly effective for post-myocardial infarction and heart failure is important.
It would be interesting to know the physiology of why LABAs without ICS do not result in increased adverse events in COPD.
I wonder why x-rays led to lower self rated health status. Do they cause patients to fixate more on abnormalities that may or may not be found?
With this evidence, should the Canadian guidelines for medical expulsive therapy be updated? Per the context section of this program, MET is still recommended for stones < 10 mm for patients without need for urgent urological intervention.
It is somewhat concerning that none of the trials included blinding or intention to treat analysis.
Thank you for including the retrospective cohort studies showing a significantly higher number of unsatisfactory smears when lubricant was used.
Thanks this was useful
These agents seem to be very well prescribed, but the benefit seems fairly small to me.
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Great learning point!
Great learning point!
My first-hand experience is that patients report clinical cure after one dose of treatment at a success rate much lower than 80%. Will look at option to reswab/swab
The podcast episode that goes with this tool was great at laying out this info, thanks
Some more info on the details of the testing may have helped with the understanding of this information
The practical context of reduction of sanitary item use, this is the type of practical info that is helpful. Please look to include with other topics. thanks and good job
This topic is tricky because it seems to garner interest naturally from patients and the evidence/indication to treat vs. their desire to be on treatment, there is a disconnect there.
Ideally this result should be bolstered by more than the single HYVET trial.
Many patients are unable to tolerate statins due to side effects, it would be interesting to see a trial comparing CVD outcomes in ezetimibe vs. placebo.
I believe TXA is closer to $30-40 per dose.
excellent; thanks for the tip!
Patients spend a lot of money on supplements and it’s nice to have evidence to support their questions
The lack of availability for covid 19 testing in the community decreases the utility of guidelines for our patient management of covid as many patients will never be tested
I suspect that infant botulism should be a significant concern compared to any benefit derived from using honey as a cough suppressant.
Chronic pain is a complicated condition to begin with; therefore, if gabapentin and pregabalin offer some benefit in certain populations, then they should not be discounted.
I wonder where the supposed link between nicotine replacement and myocardial infarction comes from.
It would be nice to know the reason why Health Canada recommends NRT before varenicline or bupriopion.
It is difficult to objectively judge comfort as an outcome measure for antipyretic use.
It would be interesting to know the qualitative reasons that parents feel vaccine hesitancy apart from the Wakefield study, as this study may only serve as a confirmation bias of previously held beliefs.
IDA is said to carry an increased risk of mortality in the very elderly, but a mechanism is not provided.
The new osteoporosis guidelines recommend repeating BMD 3 years after initiating pharmacotherapy.
Lower BMD scores are not particularly relevant if clinically significant fractures are unaffected.
It is interesting to note that although rosiglitazone use was associated with increased rate of MI, it was not associated with increased rate of cardiovascular death.
We should also consider that NPH often requires multiple doses per day which is less convenient compared to the once daily dosing of LAIA.
I found “big honey” amusing 🙂
It would be useful to expand the strict rate control trial to patients with higher CHADVASC scores.
It is important to also consider the risk of syncope and hypotension as outlined in the article.
It would be interesting to further explore the link between cerebrovascular events and antipsychotic use.
The cost effectiveness and time savings for foregoing INR testing with dabigatran should also be considered.
I wonder if there are current head to head trials of different formulations of topical NSAIDS.
Post-menopausal women are more likely to require calcium supplementation for osteoporosis and may also have a higher risk of cardiovascular disease, as a confounding factor.
I wonder why amoxicillin-clavulanic acid was the primary antibiotic used in this study as opposed to purely amoxicillin.
A controlled, randomized, blinded trial may be helpful for the CCSVI procedure prior to discounting the results.
The original study was based on only Asian women, but the results have been extended to a variety of races and sexes. It would be interesting to see how this progression was made.
The cost of the Medication will likely limit its use.
Confirmed my practice. I am glad the treatment dosing and duration parameters were discussed.
The side effects of PEG also appear to be minimal (vomiting, diarrhea)
It would be helpful to study the factors related to regaining weight after dieting.
This review potentially calls into question the efficacy of steroid injections for other joints like hips and knees.
This article highlights the need for further study on antiemetic agents in paediatric patients.
I appreciate having a TFP and a podcast that go together. Helps to cement the learning, thanks
I concur that it is important to consider death due to underlying morbidity prior to considering the impact of radiation.
If a patient has depression and migraines, perhaps TCAs would be a good first line option.
We should also carefully consider side effects of beta blockers like hypotension and dizziness.
With a low percentage of patients filling delayed antibiotic prescriptions, this suggests they may not have been needed and a delayed approach is prudent.
The dry mouth and constipation side effects are likely to be significant for elderly populations, who commonly are prescribed incontinence medications.
There appears to be significant side effects of Daxas such as weight loss and diarrhea.
The European study does seem flawed given two different antibiotics were used for each treatment arm.
Interestingly, colchicine and NSAIDS should not be used in patients with kidney impairment.
I wonder if Tamiflu studies have similar issues to those of COLD-FX.
The use of antipsychotics has been traditionally limited by side effects like extrapyramidal symptoms.
It would be nice to tease apart the anti-inflammatory and antimicrobial properties of macrolide antibiotics.
This was a good reminder that synthetic hormones were linked to greater cardiovascular events.
It is interesting that opioid use was associated with fractures.
This was a good reminder that lipid levels are not analogous with cardiovascular outcomes.
I wonder if the short term use of oral steroids for COPD exacerbations has a negative effect on future episodes of pneumonia or fractures.
This CPD activity is out of date as we now use Shingrix not Zostavax
Anecdotally many patients suffer from myalgias and muscle weakness on statins, which leads to reluctance to continue the medication.
I don’t find this study credible
nil
Practical advice
Nil
Good advice for common condition
Good info
Much too simple, should have included explanations on risk of bleeding vs stroke prevention
read lots on this lately so it must be controversial again
Good info point.
They could have discussed some BP medications and given examples of admissions for hypertensive crisis.
Excellent.
no
Load in slow, does not “remeber me” ever, making it cumbersome!
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No
I only do surgical assisting
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info about starting doses
Lowering the A1c cut off will likely also increase the chance of false positives.
Omega-3 may still have a role in other conditions such as macular degeneration or cancer.
This review also reinforces the need to consider other factors when deciding on form of contraception such as patient compliance and convenience of administration.
The absolute reduction in mortality with bupropion or nicotine replacement is reassuring.
well done
well done
It makes sense that duration of DAPT is dictated by risk of future MI and bleed.
I would be interested in learning more about the link between dabigatran and myocardial infarctions.
I wonder if there is another confounding factor influencing the relationship between caffeine and mortality.
It is unfortunate that screening men for AAA does not effect all-cause mortality.
I wonder why H. influenza rates have increased despite Hib being a part of the routine vaccine schedule.
An update with the new adjuvant zoster vaccine may be helpful.
Apart from the risks of hemorrhage and pneumothorax with transthoracic needle biopsy, there are also the emotional consequences to the patient of having an undetermined diagnosis.
I would assume the primary adverse event was constipation.
40% of time lost from work being attributed to the common cold is significant.
I would be wary of hypoglycemia risk for the strict targets used in the ACCORD and ADVANCE trials.
It is interesting that although febuxostat lowers uric acid level more effectively than allopurinol, it also has a higher number of gout episodes.
It may be more effective to focus on smoking cessation and lifestyle interventions in acute macular degeneration patients.
The effect of vitamin supplementation in undernourished populations suggests that supplements may be useful in new immigrant patients.
As noted in the review, patients with a hysterectomy would likely skew the results of the referenced study.
We should also consider the risk of intra-articular infection and septic joints when performing injections.
The NNH is quite high for developing diabetes on a statin; therefore, this risk should be relatively minimal.
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With conflicting recommendations from the Canadian Paediatrics Society and American guidelines, it appears that the evidence behind probiotics for C. difficile associated diarrhea is not strong.
I wonder why Health Canada has not approved other antivirals, besides valacyclovir, for the treatment of cold sores.
Triptans are likely accessible to patients in Ontario through the Exceptional Access Program.
Difficult to get funding for duloxetine and pregabalin in BC
I wonder if there is any particular form of cancer that calcitonin is most associated with.
With only the single ACCORD trial testing fibrates added to statin therapy, I am not sure we can definitively say that there is no synergistic effect between the two classes of agents.
As expected diabetes and prior CHD seem to have an additive effect on CVD events.
Even if mortality rates are not affected by the influenza vaccine, decreased morbidity and improved quality of life are still important outcomes.
I wonder if the risk of cardiovascular events is minimal or reduced in a short, one time use NSAID such as for acute pain in the Emergency Room.
I hesitate to accept that low dose (0.15 mg/kg) dexamethasone has an equal effect to high dose dexamethasone given that the review mentioned had a small sample size.
Duloxetine may be especially helpful in patients with both chronic pain and depression, two conditions that often coincide.
Another consideration is patients on beta blockers, ACE inhibitors and MRAs are more likely to become hypotensive.
If the dyspnea attributed to ticagrelor use does not affect PFTs, then is it possible that it is a subjective feeling of dyspnea as opposed to a physiological change.
informtive
informative
It seems paradoxical that mega doses of vitamin D are associated with falls and fractures, which are two outcomes vitamin D and calcium are designed to prevent.
helps in MX
I would be interested to see if there were any changes in MOCA scores with ChEI administration.
I do not practice travel medicine, but with a NNT of 3 for antibiotics at onset, this may be a viable treatment for Traveler’s Diarrhea.
I think it is also important to consider the patient’s age and overall quality of life before trying to follow stringent targets.
I believe there is some evidence now that treating fever can prolong illness
30 min of regular exercise relevant to 27%risk reduction
none
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it is helpful to review ASA for a.fib in younger people
Description of preparation of TXA soaked pledgets could be helpful
Does not change my practice as nosebleeds requiring more than external pressure uncommon in my setting.
I think I’ll be less likely to recommend abrysvo, given the cost to my patients many of who do not have a lot of extra income.
will continue using Nortriptyline
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I will make a more significant risk assessment for social activity before rx’ing PREP given the cost
none
I won’t rx oral abx for acne as often (use topical instead)
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informative
Alberta numbers don’t add up?
my clinical experience is Tirzapetide carries more nausea and GI symptoms compared to Semaglutide
Particularly useful in perimenopausal women
Non
This summary showed very clear results, which is rare in medical studies in general, so it was nice to have such a confident conclusion here.
None
None
I only do surgical assisting
So why is Tirzepatide unlicensed and are we not meant to prescribe it?
NA
I have seen instances of riskier behaviour in MSM on PrEP.
Good to know about tirzepatide though net yet available in Canada
This sounds like a promising new drug
healpful info for a common problem
reassuring information
what is the cost and how many patient drug plans would actually cover this for 72 weeks
No
very expensive drug
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more significant wt loss more likely to be beneficial for OA progression, pain control …Always encourage patients to loose wt and exercise ( modified activty )
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Glad I trained at U of T in the 90s.
I have started in the last year to prescribe a PPI more often, but this will help explain to parents that it may actually do more harm than good.
very interesting new information for me!
very good summary of the benefits of the flozins!
this reflects my current approach to nightmare therapy
This is difficult to evaluate due to the inability to randomize but seems like an exciting option in the future in the right patient
Funny how people keep mentioning the cost but look at the overall cost of obesity on lifestyle and medications ultimately required to treat the many co-morbidities of the same.
The comment about risk of abuse is ignorant. We use ketamine all the time in the ER without worrying about this. This could become a viable treatment in the future of it becomes cost effective and available in smaller rural areas.
This one surprised me since we have recommended it for so long, especially with supplemental calcium
Sadly, although I still love suturing, glue and steri-strips and stapling are just much more time effective. Good to know the results are much the same.
Very interesting idea I never thought of before. Benefit is not great but risk is minimal
Terrible outdated session that should be removed
Confirms my current practice
Helpful hint
Helpful info
Useful info
Useful info
How is this new or unexpected information for anyone? We have long known that the vast majority of people who claim penicillin allergy in fact do not have the same.
Helpful info
Helpful info
Helpful reminder
Helpful info
Helpful info
I was aware of this information but a good reminder
Very helpful info
Helpful info
Very useful info
Surprising results. I find it helps with my patients
Weight gain common with mirtazapine
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Useful info
Nice to see the evidence supporting discontinuing statins after age 75
Very helpful info
I didn’t know this was an issue
Helpful info
Helpful info about the antivirals
Confirms my experience
In over 20 years I have never seen triglyceride-associated pancreatitis
I have never suggested ginger for this issue
Confirms my practice
Helpful info
I hope the pharmacists prescribing follow these same recommendations since they would get paid more for longer courses of antibiotics
I love kissing so this is great news
Confirms my experience
I did not know about this drug but won’t use it
Helpful info
Helpful info to pass on to patients
This confirms what I have been doing
Confirms my experience
Confirms my experience
Confirms my experience
This is new info for me
Confirms my practice
Useful info to pass on to patients
I work in a prison with hundreds of opioids abusers so this is useful info
Useful info
Useful info for pcos patients
Useful information
Useful info
Confirms my current practice
Helpful info
Useful info
Useful info
I already Rx OAT so this is encouraging info
This confirms my current understanding
These Tools For Practice attached to a podcast are very helpful to reinforce the learning from the podcast.
Results seemed too vague to change my practice procedures.
Nice summary.
Fear of myalgia is lessening with time
NA
Presented evidence only for Amoxicillin/clavulanate
Good bit of fun while preparing for CFPC exam.
good overall
good overall
Exercise was not previously part of the typical treatment plan for these cases but it will be highly recommended now.
Some of the phrasing is difficult to follow. Ie outcomes described initially as ibuprophen, acetaminophen or both..results then written in a strange order.. Perhaps write the bullets in the same order as the leading bullet to help with flow. ex: time without fever in first few hours ibuprophen superior to acetaminophen by 55.3 minutes (or whatever time), and non-inferior to combination
Cost doesn’t seem worth it
Placebo/marketing of tylenol will ensure its continued usage
Great topic
Very relevant
Would like to have seen thicker cloth or 2 layer vs surgical or n95 comparison
Very useful
interesting, the decrease in voids, I would not take it personally
Cost a concern
No recommendations for antibiotic type or duration
In my practice not first line painful for patient
I would be looking for secondary causes
Excellent article new information regarding treatment
Helpful review
Good reminder of this birth control option
Improved side effect profile compared to anti-cholinergics is the most encouraging element presented here.
Agree with other comments
Good to know these meds largely useless
helpful topic
x
Confirms what I knew.
This confirms my experience and gives useful info to pass on to patients
Quoting 50’000 deaths makes this very old information
Helpful information
I did not know it was an issue so did not stop these drugs during the pandemic
Helpful information
Helpful info to reassure runners
Helpful info to inform patients who ask for serology
Useful info to educate patients under 50 who are anxious to have a screening colonoscopy
Confirms my practice
Helpful info to reassure patients that oral is as effective as injection
Thank you.
Log in mad easier.
Practice will change to consider IUDs more frequently as first line treatment.
Will switch to considering IUD use as first treatment option now.