EE+ POEM Archive
- LABA + glycopyrronium reduces exacerbations slightly more than LABA + steroid
- LABA + ICS reduces exacerbations (NNT = 53 over 6 months), but not hospitalizations
- LABA+LAMA+ICS associated with greater decline in all-cause mortality than LABA+LAMA in patients with severe COPD (IMPACT)
- LABAs don't increase hospitalization in patients with asthma also using inhaled steroids
- Lab-based = non-lab-based models for CVD prediction
- Lab-based prediction model can rule out serious bacterial infections in febrile infants
- Laboratory results are not an exact science
- Lace-up braces decrease rate, not severity, of ankle sprains in HS athletes
- Lack of evidence for lactose intolerance remedies
- Lack of evidence that vaginal progesterone prevents recurrent preterm birth
- Lactation associated with reduced risk of MI
- Lactobacilli after antibiotic treatment for BV
- Lactobacillus plantarum does not prevent antibiotics-associated gastrointestinal symptoms in kids
- Lactobacillus prevents abx-related diarrhea in adults, not children
- Lactobacillus prevents ulcerative colitis relapse
- Lactogenesis not impaired by early postpartum contraceptive implant
- Lanadelumab is an effective prophylactic treatment for hereditary angioedema
- Laparoscopic uterosacral nerve ablation (LUNA) doesn't alleviate chronic pelvic pain
- Large increases in the risk of cardiovascular events following COVID-19 infection that required hospitalization
- Larger bottles associated with greater weight in infants
- Large variation in cesarean delivery rates with induction for nulliparous women at term
- Laser and surgery slightly better than foam therapy for varicose veins
- Lasofoxifene has disease-specific benefits, but no change in all-cause mortality
- Late-life dementia index predicts development of dementia (CHS)
- Latent TB high in patients from sub-Saharan Africa and Southeast Asia
- Lateral episiotomy is associated with reduced risk of maternal anal sphincter injury in vacuum-assisted deliveries
- Lebrikizumab does not improve any patient-oriented outcomes in asthma
- Lecanemab does not significantly improve cognition in early Alzheimer's disease, is expensive, and causes brain edema and hemorrhage in some patients
- Leeches may decrease pain in advanced knee DJD
- LEEP within prior year associated with miscarriage
- Left atrial appendage occlusion during cardiac surgery for another reason reduces the risk of stroke (NNT = 43 over 4 years)
- Legal abortion safer for women than childbirth
- Lenalidomide effective for relapsed multiple myeloma
- Lenient = strict rate control in prevention of adverse outcomes in AF
- Less anal trauma in operative delivery with mediolateral episiotomy
- Less bleeding with fondaparinux vs enoxaparin for ACS with PCI
- Less delirium with focus on mobility, nutrition, and cognitive engagement for older hospitalized patients (CHERISH)
- Less hypoxemia with preoxygenation using noninvasive ventilation during emergency intubation
- Less is more when it comes to blood transfusions
- Less pain with lidocaine gel for Q-tip test
- Less renal replacement therapy with sodium bicarbonate infusion for patients with severe metabolic acidosis
- Less than 1% uterine rupture with VBAC
- Less than 20% of patients with urinary incontinence benefit from Rx therapy
- Less-than-double cesarean delivery rate with elective induction of labor at 39 weeks'
- Less upper gastrointestinal bleeding and no effect on mortality with prophylactic pantoprazole in mechanically ventilated patients
- Less uterine rupture on VBAC with labor before first cesarean
- Lethargy, grunting, and hypercapnia predict ventilator risk in kids with RSV
- Letrozole=clomiphene for achieving pregnancy in PCOS
- Letrozole is noninferior to mifepristone for the management of missed miscarriage
- Letrozole more efficacious than clomiphene for infertility treatment among individuals with polycystic ovarian syndrome
- Levels of Evidence
- Levetiracetam is comparable with current second-line agents to treat children with convulsive status epilepticus
- Levofloxacin-based 3-drug therapy for resistant H. pylori
- Levonorgestrel is ineffective emergency contraception for obese women
- Levonorgestrel IUD effective for menorrhagia
- Levonorgestrel-releasing IUS effective for menorrhagia
- Levothyroxine reduces preterm birth in euthyroid women w/ autoantibodies
- Liberal oxygen therapy in hospitalized patients: too much of a good thing? (IOTA)
- Lifestyle better than metformin for delaying DM in patients with IGT (DPPOS)
- Lifestyle change greatly reduces disability, increases mobility in obese pts
- Lifestyle changes do not affect outcomes in patients with pre-diabetes or diabetes
- Lifestyle changes of little benefit in GERD
- Lifestyle intervention reduces risk of excess gestational weight gain
- Lifestyle interventions during pregnancy are associated with reduced maternal risk
- Lifestyle interventions in pregnancy may reduce maternal weight gain
- Light drinking during pregnancy doesn't cause cognitive/behavioral problems at 3 years
- Light therapy as effective as fluoxetine for SAD
- Light therapy improves behavioral disturbances, sleep, depression in elderly with cognitive impairment
- Likelihood of amoxicillin rash in children with mono only about 30%
- Likelihood of long COVID varies by variant, sex, and vaccination status
- Likelihood of most adverse treatment outcomes lowest with active surveillance of clinically localized prostate CA (ProtecT)
- Limited, inconsistent, and conflicting data on health effects of electronic cigarettes
- Limited, low-quality data suggest fecal transplant is ineffective for patients with irritable bowel syndrome
- Limited, low-quality studies find probiotics provide short-term relief in proxy measures of halitosis
- Limited amount and quality of data on medications for treating neuropsychiatric symptoms of dementia
- Limited benefit for routine cervical cancer screening with co-testing versus HPV testing alone
- Limited data: deprescribing is safe, but at the risk of symptom recurrence
- Limited data: hypnosis improved symptoms in kids with IBS
- Limited data: levetiracetam, ketogenic diet, and modified Atkins diet decrease seizure frequency in children younger than 3 years with epilepsy
- Limited data indicate that music minimally improves cognition in persons with mild cognitive impairment or dementia
- Limited data on estimating renal function in the elderly
- Limited data on inhaled steroids for preventing acute mountain sickness
- Limited data on oral desensitization vs avoidance in food allergy
- Limited data on probiotics for treating patients with celiac disease
- Limited data on probiotics to prevent antibiotic-induced diarrhea in kids
- Limited data show adjunctive ketorolac modestly decreases pain in patients with renal colic
- Limited data show anticonvulsants are associated with a small reduction in early seizures in adults with mild or moderate traumatic brain injury
- Limited data show CAM + standard medical therapy = standard medical therapy for acute nonradicular low back pain
- Limited data show umbilical cord milking at birth does not decrease mortality
- Limited data suggest operative = nonoperative treatment of proximal humeral fractures in elderly
- Limited data suggest platelet-rich plasma injections offer short-term pain relief in adults with hip degenerative joint disease
- Limited data suggest that music improves sleep quality in older adults
- Limited data to guide lipid lowering in octogenarians
- Limited evidence: manipulation ineffective for acute low back pain (Cochrane)
- Limited evidence base for treating orthostatic hypotension
- Limited evidence for CAM in fibromyalgia
- Limited evidence for dental prophylaxis in patients with arthroplasty
- Limited evidence for meds, music, and massage to treat anxiety in residents of long-term care facilities
- Limited evidence for memantine in mild-moderate Alzheimer disease
- Limited evidence for prophylactic ABX for children with recurrent UTIs
- Limited evidence of benefits of vitamin D supplementation
- Limited evidence of benefit to treating low-grade DCIS
- Limited evidence on prophylactic antibiotics in acute necrotizing pancreatitis
- Limited evidence on the long-term prescribing of opioids in elders
- Limited evidence suggests aerobic exercise decreases symptoms of postpartum depression
- Limited evidence suggests intranasal steroids modestly help acute sinusitis
- Limited evidence to support the benefit of sodium restriction for heart failure
- Limited management options for bed bugs
- Limited meta-analysis suggests SGLT2 inhibitors improve cardiovascular outcomes in patients with T2DM + atherosclerosis
- Limited role for antidepressants in back pain and osteoarthritis pain
- Limited SR demonstrates SGLT2 inhibitors improve outcomes in adults with heart failure
- Limiting eating to an 8-hour period with caloric restriction produced greater short-term weight loss
- Linaclotide effective in short-term for chronic constipation
- Linagliptin and glimepiride equally effective for adults with type 2 diabetes
- Linagliptin and glimepiride equally effective for adults with type 2 diabetes: POEM amended to include Canadian pricing
- Linagliptin does not increase (or decrease) risk of adverse CVD outcomes
- Linezolid no better than vancomycin for treatment of nosocomial pneumonia
- Lipid lowering is beneficial for secondary prevention but not primary prevention in patients 75 years and older
- Lipid-related markers slightly improve CVD prediction
- Lipid targets for kids: limited data
- Lipid treatment for primary prevention not effective in older adults
- Liquid-based = conventional cervical cytology
- Liraglutide probably the best second drug to prevent cardiovascular events in patients with T2DM who take metformin
- Liraglutide produces modest weight loss and lots of side effects at a high cost
- Liraglutide reduces mortality (NNT = 71) in patients with T2DM and very high CV risk
- Lisdexamfetamine (Vyvanse) effective for binge-eating disorder
- Listen for clues that indicate which patients who are taking opioids may be open to other options
- Lithium prevents suicide in patients with mood disorder
- Little association between antibiotic use in pregnancy or early infancy and neurodevelopmental disorders in childhood
- Little benefit to revascularization over intensive medical treatment in DM with CAD
- Little correlation between hip pain and radiographic evidence of osteoarthritis
- Little guidance from the research literature on best treatment for otitis externa
- Little if any benefit to early invasive strategy for stable angina and at least moderate reversible ischemia (ISCHEMIA trial)
- Little information on racial differences between antihypertensives
- Live attenuated influenza vaccine not effective in recent US flu seasons
- Live attenuated nasal flu vaccine safe, effective for ages 1 to 5
- Living systematic review for WHO: casirivimab-imdevimab probably reduces hospitalization in persons with nonsevere COVID-19
- LMWH = UFH for thrombocytopenia
- LMWH better than UFH for acute DVT
- LMWH better than unfractionated heparin for preventing DVT in medical patients
- LNG-IUD is noninferior to copper IUD for emergency contraception
- LNG-IUD more beneficial than systemic progestin to treat complex atypical endometrial hyperplasia in obese women
- LNG-IUS effective for heavy menstrual bleeding
- LNG-IUS effective treatment for mild to moderate endometrial hyperplasia
- Long-acting beta-agonists increase severe asthma events
- Long-acting bronchodilators similarly safe in COPD patients
- Long-acting contraception associated with low failure
- Long-acting contraception associated with reduction in repeat abortion
- Long-acting contraceptive methods effective longer than approved duration
- Long-acting muscarinic antagonists + inhaled steroids = long-acting B-agonists + inhaled steroids
- Long-acting nitrates no good for heart failure with preserved ejection fraction (NEAT-HFpEF)
- Long-acting opioids for noncancer pain associated with increased risk of death from causes other than overdose
- Long deferral of umbilical cord clamping reduces the odds of death after preterm birth
- Longer interval between doses of the Oxford/AstraZeneca vaccine may provide greater immunity against COVID-19
- Longer needles = less reaction to immunizations
- Long-term aspirin use minimally increases risk of age-related macular degeneration
- Long-term average HbA1c greater than 9% in adults with T2DM associated with increased risk of dementia
- Long-term buprenorphine treatment program initiated in hospital effective for opioid users, but retention is low
- Long-term erythromycin decreases COPD exacerbations
- Long-term fluoxetine effective for bipolar II depression
- Long-term follow-up confirms lack of mortality benefit of strict blood sugar control in T2DM
- Long-term follow-up of CAPP2: aspirin prevents colorectal cancer in Lynch syndrome carriers
- Long-term increased mortality risk among adults aged 18 to 50 years after acute stroke
- Long-term mortality benefits with CABG for ischemic cardiomyopathy
- Long-term nicotine replacement no more effective
- Long-term outcomes are similar with below- and above-elbow casts in children with minimally displaced forearm fractures
- Long-term outcomes better with CABG than PCI in pts with complex CAD (SYNTAX)
- Long-term outcomes good for LASIK surgery
- Long-term outcomes improved with shorter door-to-needle times for stroke patients who receive thrombolysis
- Long-term PPI use increases hip fracture risk
- Long-term results favor open surgery over endovascular repair for AAA
- Long-term results of drug treatment for obesity
- Long-term risks are similar for CT and invasive coronary angiography as initial diagnostic strategy for stable chest pain
- Long-term statin use decreases risk of gallstone disease
- Long-term use of bisphosphonates increases the risk of fractures in older women
- Long-term use of PPIs appears to be safe in children
- Long-term use of ticagrelor in addition to aspirin post-MI reduces recurrent MI, increases major bleeding
- Long-term vitamins do not prevent lung cancer
- Lorazepam added to haloperidol effective for agitated delirium in end-of-life cancer patients
- Lorazepam and diazepam equally effective in treatment of pediatric status epilepticus
- Lorcaserin helps patients lose 8 pounds the first year, 68% maintain it 1 year later
- Lorcaserin is safe, but only modestly effective (6 pounds greater weight loss than placebo)
- Lorcaserin prevents or causes remission of T2DM in overweight/obese patients with or at high risk of CVD (CAMELLIA-TIMI 61)
- Low-carb diet better than low-fat diet to reduce CV risk factors and cause weight loss
- Low-carb diets may produce short-term diabetes remission
- Low-cost manual liquid cytology feasible
- Low dose (40 mg/d) doxycycline effective for acne rosacea
- Low-dose aspirin beneficial for the prevention of preterm birth in nulliparas with singleton pregnancy
- Low-dose aspirin does not prevent onset of cardiovascular disease in older adults (ASPREE)
- Low-dose aspirin not effective for primary prevention of CV events (again) and increases risk of serious bleeding
- Low-dose aspirin not useful for venous ulcers
- Low-dose calcium promising for prevention of pre-eclampsia
- Low-dose CT screening decreases mortality in heavy smokers
- Low-dose CT screening of smokers decreases lung cancer deaths, but not overall mortality
- Low-dose digoxin and bisoprolol are equally beneficial for rate control/QOL in patients with CHF and permanent AF (RATE-AF)
- Low-dose edoxaban effective for stroke prevention for elderly patients with atrial fibrillation
- Low-dose epidural analgesia during second stage of labor did not prolong the stage
- Low-dose ferrous sulfate best for infants and children with iron-deficiency anemia
- Low-dose haloperidol does not prevent delirium after noncardiac thoracic surgery
- Low-dose ibuprofen throat lozenge effective for sore throat pain
- Low-dose insulin at least as good as standard doses in biochemical control of kids with DKA
- Low-dose morphine less effective than diclofenac or acetaminophen for renal colic
- Low-dose oral = high-dose IV steroids for initial treatment of acute COPD exacerbation
- Low-dose penicillin prevents recurrent cellulitis
- Low-dose rivaroxaban improves outcomes in patients with ACS (ATLAS)
- Low-dose theophylline is minimally helpful, if at all, in preventing COPD exacerbations
- Low-dose zinc (5 mg or 10 mg) is as good as 20 mg for childhood diarrhea
- Lower costs and healthcare utilization with hospital care at home
- Lowering blood pressure does not decrease the risk of T2DM in persons with hypertension; ACEIs/ARBs do
- Lowering blood pressure improves cardiovascular outcomes
- Lowering BP after lacunar stroke -- no improved outcomes (SPS3)
- Lowering homocysteine with B vitamins doesn't improve cognition
- Lower mortality with CT screening for lung cancer, but at very high cost
- Lower risk of atrial fibrillation with addition of vasopressin to catecholamines for treatment of shock
- Lower risk of cesarean delivery with induction of labor at term
- Lower risk of early ventilator-associated pneumonia with antibiotics in patients with out-of-hospital cardiac arrest
- Lower systolic BP during antihypertensive treatment associated with more deaths in the elderly
- Lower transfusion threshold for sepsis = fewer transfusions, no effect on mortality
- Lowest effective estrogen dose for hot flushes
- Low FODMAP diet most likely to improve symptoms for patients with irritable bowel syndrome
- Low FODMAPS diet is better than an oral spasmolytic for irritable bowel syndrome (NNT = 7 – 9)
- Low-glycemic index diet for gestational DM of little benefit
- Low HbA1C, BP, and cholesterol in elderly patients with DMT2 associated with high mortality
- Low hCG in peri- and postmenopausal women normal
- Low HS-troponin I accurate in identifying patients at low risk of cardiac events
- Low incidence of pregnancy with same-day-start contraception
- Low-intensity PSA-based screening does not reduce mortality, but leads to overdiagnosis and potential harm
- Low-intensity pulsed US = sham US in chronic patellar tendinopathy
- Low-intensity warfarin may be inferior to standard-intensity warfarin for preventing VTE after joint arthroplasty
- Low-level laser therapy improves neck pain
- Low magnesium level not related to hypertension or CVD
- Low maternal and neonatal complications after Keilland’s rotational forceps delivery
- Low prevalence of pulmonary embolism in patients who present to ED with syncope
- Low-quality evidence: CBT and hypnosis may be effective for pain relief in children with functional abdominal pain
- Low-quality evidence: high-flow nasal oxygen > noninvasive ventilation for adults with acute respiratory failure
- Low-quality evidence: probiotics = placebo in preventing infections in the elderly
- Low-quality evidence on weight loss interventions in elderly patients
- Low-quality evidence supports exercise, massage, yoga, acupuncture, and other interventions for chronic pain
- Low rate of bacteremia in children hospitalized with pneumonia
- Low rate of symptomatic VTE after elective knee arthroscopy
- Low rates of bleeding with both aspirin plus clopidogrel and aspirin alone after TIA or minor stroke
- Low-risk criteria inaccurate in febrile neonates
- Low risk of DVT after knee arthroscopy
- Low risk of need for contralateral inguinal hernia repair after unilateral repair
- Low risk of residual CIN after treatment if HPV negative
- Low risk of second allergic reaction to SARS-CoV-2 vaccines
- Low-risk patients with PE can be treated as outpatients
- Low risk with estrogen therapy in postmenopausal women with prior hysterectomy after 10.7 years
- Low to moderate marijuana use not associated with adverse pulmonary function
- Low vitamin D level associated with poor cognition; intervention data still lacking
- Low-volume same-day colonoscopy preparation is as effective as split-dose high-volume or low-volume preparations
- Low-volume sulfate prep is effective and well tolerated
- LP of little value in children with complex partial seizures
- Lubiprostone (Amitiza) effective for chronic constipation in adults
- Lubricant does not interfere with Pap smears
- Lumbar fusion no better than exercise and therapy in the long term
- Lumbar fusion of variable value based on treating diagnosis, with significant complication rates
- Lumbar supports decrease symptoms but not work absence
- Lung cancer is infrequently found via screening, but follow-up imaging is common
- Lung cancer screening is cost effective, but only if done correctly
- Lung cancer screening may increase the likelihood of smoking cessation
- Lung cancer screening requires additional imaging in 40% of patients in real world
- Lung cancer screening with low-dose CT does not affect smoking cessation rates
- Lung maturity tests not sufficient before 39 weeks
- Lung ultrasound accurate for diagnosis of pneumonia in adults
- Lung ultrasound reduces need for CXR in children with suspected pneumonia
- Lying down = more spontaneous vaginal births in nulliparous women with an epidural