- Sacroiliac joint fusion using titanium implants appears to be effective for SI joint dysfunction and pain
- Saffron promising for treatment of PMS
- Saline irrigation more effective than spray for nasal symptoms
- Salmeterol + fluticasone better than tiotropium in COPD (INSPIRE)
- Salmeterol appears safe in children, but no benefit regarding exacerbations
- Same benefit with equivalent chlorthalidone and HCTZ
- Same-day discharge after elective PCI not associated with worse outcomes
- Same-day discharge after PCI is safe
- SBP of 120 instead of 140 in adults 75 years or older = significant benefits and some harms (SPRINT)
- SBP of 120 instead of 140 in nondiabetic, high-risk elderly leads to significant benefits and some harms (SPRINT)
- School-based interventions improve outcomes in kids with asthma
- Screening + brief intervention ineffective for alcohol overuse
- Screening and brief intervention for illicit drug use does not reduce drug use
- Screening and treatment for obesity recommended
- Screening CA-125 and transvaginal ultrasound does not reduce ovarian cancer mortality
- Screening echocardiogram not beneficial
- Screening for AAA in women not very effective
- Screening for and treating iron deficiency in children: no evidence of benefit or harm
- Screening for breast cancer: False-positive rates 60% over 10 years
- Screening for carotid artery stenosis not helpful, may be harmful (USPSTF)
- Screening for diabetes does not delay mortality
- Screening for dysphagia in patients with stroke is not very reliable
- Screening for hepatitis C has minimal benefit (NNS = 4000)
- Screening for partner violence does not improve quality of life
- Screening for pre-diabetes: neither HbA1c nor fasting glucose results are very accurate
- Screening for T2DM: more vascular disease found at baseline, no difference downstream (Diabscreen)
- Screening for T2DM does not improve 7-year outcomes (ADDITION-Cambridge)
- Screening for thyroid disease doesn't improve infant outcomes
- Screening for type 2 DM: 10-year mortality not improved (ADDITION-Cambridge)
- Screening mammography overdiagnoses women with breast cancer
- Screening MRI finds something in 1 in 6 asymptomatic people
- Screening tests for cognitive impairment not very accurate
- Screening tool for adult ADHD of uncertain effectiveness
- Second blood pressure reading drops 8 mm Hg from initial high reading
- Secondhand smoke exposure associated with more surgery and anesthesia complications in children
- Second-line antibiotics more effective than first-line in AECB
- Seizure recurrence generally < 20% after first seizure
- Select adult patients can be safely discharged directly home from an ICU
- Selective ECGs in PPEs: relatively expensive, modest yield
- Selective oropharyngeal contamination preferred for ICU patients
- Selective use of FNAB is a good option for small thyroid nodule
- Self-help book reduces visits for irritable bowel
- Self-irrigation of ears modestly decreases healthcare use
- Self-management interventions reduce hospitalization and improve quality of life in patients with heart failure
- Self-management teaching not helpful for COPD
- Self-management training, routine monitoring not effective for COPD
- Self-monitoring BP leads to lower blood pressure compared with office monitoring
- Self-monitoring ineffective in patients with diabetes (ESMON)
- Self-monitoring modestly improves BP control in patients with HTN
- Self-monitoring no better than coagulation clinics
- Self-taken swabs improve gonorrhea and chlamydia test accuracy
- Semaglutide reduces CV events in high-risk patients with T2DM
- Semuloparin reduces VTE in cancer patients but at high cost (SAVE-ONCO)
- Sentinel node biopsy = less lymphedema, better QOL (ALMANAC)
- Sequential H. pylori tx increases cures
- Sequential therapy better for H. pylori eradication
- Sequential therapy may be more effective for eradication of HP
- Serial proximal vein ultrasonography + D-dimer = whole-leg Doppler for suspected leg DVT
- Sertraline ineffective for depression associated with heart failure
- Sertraline ineffective for hot flushes
- Sertraline reduces risk of depression in adults after traumatic brain injury
- Sertraline slightly reduces symptoms of depression and provides other benefits in primary care
- Serum inflammatory markers inaccurate in diagnosing late fracture-related infections
- Serum phosphorus but not calcium nor PTH levels assoc with CVD and mortality in CKD
- Several methods to help children learn to swallow medicines
- Severe hypoglycemic episodes raise risk of dementia in adults with T2DM
- Severe neurological risk to infants born after maternal Zika virus infection in pregnancy
- Sexual, urinary, and bowel dysfunction common after treatment for localized prostate cancer
- Shenfu injections for sepsis: shorter ICU stays, but no mortality benefit
- Shock-wave therapy effective for some shoulder tendinitis
- Shockwave therapy modestly helps chronic Achilles tendinopathy
- Short-course antibiotics effective for acute exacerbation of COPD
- Shorter courses of antibiotics for community-acquired pneumonia at least as good as longer courses
- Shorter duration of antibiotics, similar success rates with algorithm-based therapy for staphylococcal bacteremia
- Shorter induction time with Foley plus vaginal misoprostol
- Shorter stay, fewer interventions with initial cholecystectomy for choledocholithiasis
- Shorter time to delivery with concurrent balloon cervical ripening and oxytocin in multiparas
- Short-term clopidogrel + aspirin prevents second ischemic stroke better than aspirin alone
- Short-term high-flow oxygen therapy for low-risk patients decreases reintubation rates
- Short-term outcomes for new-onset mild carpal tunnel syndrome better with steroid injection than splints
- Short-term outcomes of stenting worse than CEA in symptomatic pts
- Short-term use of vitamin D = placebo in children with autism
- Short- vs long-duration antibiotics in children with bacterial meningitis
- Sibutramine increases risk of CV events and is not effective for weight loss
- Signs and symptoms can indicate an increase in the likelihood of ovarian cancer
- Signs and symptoms not helpful in diagnosis of AMI/ACS
- Sildenafil does not improve outcomes in adults with heart failure and preserved EF
- Sildenafil may improve antidepressant-induced sexual dysfunction in women
- Silver-impregnated dressing of limited benefit in healing leg wounds and ulcers
- Silymarin (milk thistle) does not improve disease markers for chronic HCV infection
- Similar accuracy of liquid-based and conventional Pap testing
- Similar outcomes after PCI in hospitals with or without on-site cardiac surgery (CPORT-E)
- Similar outcomes with atosiban and nifedipine in the treatment of threatened preterm birth
- Similar outcomes with induction vs expectant management at 39 weeks' in older women
- Similar risk of major malformations in infants of asthmatic women with alternate treatment regimens
- Simple clinical factors can identify patients at increased risk of CVD
- Simple clinical prediction rule determines risk of heart failure with preserved ejection fraction
- Simple delirium scoring system identifies delirium severity
- Simple fibula fractures can be treated with splinting
- Simple maneuvers can decrease vasovagal syncope episodes
- Simple risk model predicts risk of VTE after surgery
- Simple risk score predicts severity of COPD exacerbations
- Simple safety measures reduce catheter-related bloodstream infections
- Simple score predicts risk of advanced proximal colon neoplasia
- Simple tests of frailty of uncertain value
- Simply decreasing time in bed paradoxically increases sleep in patients with insomnia
- Simvastatin = placebo for cognitive decline in mild-moderate Alzheimer disease
- Simvastatin improves outcome of venous ulcers
- Single blood pressure measurements inaccurate
- Single-dose aspirin does not increase sensitivity of fecal immunochemical testing
- Single dose azithromycin effective for cholera
- Single-dose dexamethasone = 3 days of steroids in children with acute asthma
- Single-dose dexamethasone an option for acute adult asthma
- Single-dose drug treatment effective for some soil-transmitted helminth infections
- Single dose of honey effective for cough in kids
- Single-dose oral dexamethasone decreases sore throat pain
- Single intra-articular hyaluronic acid = placebo in hip DJD
- Single maintenance and reliever therapy more effective than inhaled steroids and short-acting B-agonists for asthma (SMART)
- Single nondetectable high-sensitivity troponin result rules out AMI
- Single progesterone test identifies nonviable pregnancy
- Single question alcohol screen accurate
- Single question can rule out drug abuse in high prevalence population
- Single question is useful for identifying acute mountain sickness in travelers at high altitude
- Sinusitis Guidelines 2013 -- American Academy of Pediatrics
- Sirolimus stents decrease long-term restenosis (RAVEL)
- Six clinical variables in patients with dysphagia identify decreased esophageal cancer risk
- Skin protection wheelchair cushions better than standard foam cushions in preventing pressure ulcers
- Skipping breakfast may aid in weight loss
- Skip the strict salt and fluid restriction for hospitalized heart failure patients
- SLE: Overall prevalence = 73 per 100,000; incidence = 5.5 per 100,000 per year
- Sleep counseling improves sleep and symptoms in children with ADHD
- Sleep-disordered breathing with hypoxia increases risk of dementia in elderly women
- Sliding-scale insulin does not improve blood glucose control in hospitalized patients
- Slightly less hypoglycemia with degludec than glargine, no other benefits, much higher cost
- Slightly lower risk of major bleeds with apixaban (NNT = 83); no difference in efficacy
- Slow delivery associated with less anal injury
- Small benefit to breast cancer screening for most women
- Small benefit to extended treatment with apixaban in selected patients with VTE
- Small but prolonged weight loss maintenance with orlistat
- Small changes to adult immunization recommendations
- Small changes to recommendations for adult immunizations (ACIP)
- Smaller benefit of statins without heart disease
- Small increase in cerebral palsy after antibiotics for preterm labor
- Small reduction in CV outcome after ischemic stroke with lower LDL target, but also harms; no change in all-cause mortality
- Small study shows steroids may benefit patients with severe CAP and high CRP levels
- Smartwatch app can detect atrial fibrillation in some patients, but its impact on health outcomes unclear
- Smoke-free legislation associated with better child and perinatal health
- Smokers who quit smoking become less anxious
- Smoking bans associated with reduced AMI incidence
- Smoking cessation: abrupt quitting more effective than a gradual approach
- Smoking cessation counseling for pregnant women lacks effectiveness
- Smoking cessation during pregnancy improves outcomes (SCOPE)
- Smoking cessation in pregnancy helps birthweight
- Smoking is bad for your health
- Smoking prevention counseling works in adolescents, cessation efforts don't
- Smoking status as vital sign prompts cessation advice
- Sniffing an alcohol wipe temporarily lessens nausea
- Soccer (football)-related knee injuries lessened with specific training
- Society of Hospital Medicine recommendations for safe opioid use for hospitalized patients
- Sodium oxybate improves symptoms of fibromyalgia
- Sodium phosphate preferred for bowel prep
- Sodium phosphate prep an option for colon cleansing
- Sodium polystyrene sulfonate linked to higher risk of hospitalization for adverse GI events
- SOFA in ICU, qSOFA in ED are best mortality predictors for patients with infection
- Some benefit to treating mild hypertension to prevent stroke, CV deaths, and overall mortality
- Some mothers still use a prone sleeping position for their infants
- Some new regimens slightly more effective for H. pylori eradication.
- Some older patients benefit from statin therapy
- Some patients report lasting negative effects from psych counseling
- Some support for the hygiene hypothesis: less asthma in nonmechanized farming environment
- Sometimes our word choices turn good news into bad news
- Soy, black cohosh may have some benefit for menopause sx
- Soy associated with less risk of breast cancer recurrence and death
- Soy supplements do not affect menopause or osteoporosis
- Soy supplements not beneficial in adults and children with poorly controlled asthma
- Specialized training decreases injuries in elite athletes
- Specific headache criteria useful for migraine diagnose, neuroimaging
- Speed bumps can aid in the diagnosis of acute appendicitis
- Spinal fusion does not significantly improve outcomes for patients with lumbar stenosis and grade I spondylolisthesis
- Spinal manipulation is as effective as other nonsurgical therapies for chronic low back pain
- Spinal manipulation more effective than exercise advice alone for back-related leg pain
- Spinal stenosis: physical therapy before surgery
- Spiral CT detects early lung cancer, but screening use is premature
- Spironolactone adds minimal benefit to treatment of patients with heart failure
- Spironolactone most effective add-on for patients with resistant hypertension (PATHWAY-2)
- Splint = cast for distal radial fracture in children
- Spontaneous labor and elective induction at full term have similar outcomes
- Spontaneous pushing in second-stage labor effective
- Spores of nontoxigenic C. difficile can prevent recurrent C. difficile infection
- Sputum purulence and CRP predict poor prognosis with COPD exacerbation
- SR: Carotid endarterectomy and stenting trade-offs in asymptomatic patients
- SR: ER geriatric consultations associated with decreased hospital admissions
- SR: generic activity advice approximately equal to structured exercise for sciatica
- SR: limited data on acupuncture for control of hot flashes in patients with cancer
- SR: limited data on rebleeding in elderly after subdural hematoma
- SR: Limited data show urate-lowering agents don't decrease CV events in patients with gout
- SR: limited evidence on marijuana to treat chronic noncancer pain
- SR: Limited evidence suggests no effective treatments for central poststroke pain
- SR: poor-quality data suggests stem cell joint injections are safe, but of unclear benefit
- SR: poor quality evidence on outcomes of lactate point-of-care testing in patients with suspected sepsis
- SR: Short courses of antibiotics as effective as longer courses for outpatient infections
- SR: Tai chi decreases the risk of falls in at-risk adults and elderly
- SSRIs associated with upper GI bleeding
- SSRIs effective for depression after 1 week
- SSRIs have no effect on the progression of dementia
- SSRI use during pregnancy may increase risk of speech/language disorders in offspring
- St. John's wort not effective for treatment of ADHD
- Stable ischemic heart disease diagnosis: clinical guideline
- Stable ischemic heart disease management: clinical guideline
- Stable TSH can be rechecked in 2 years
- Staff education insufficient to decrease use of restraints
- Staff training is ineffective in increasing patient self-management
- ST analysis during labor does not improve neonatal outcomes
- Standard-length needle may not reach shoulder bursa from posterior approach
- Standard of practice that encourages oral and subcutaneous opioids leads to decreased IV opioids
- Statin + fenofibrate no better than statin alone in T2DM (ACCORD)
- Statins are effective in the elderly, but data are limited for those without established vascular disease
- Statins associated with developing DM
- Statins but not fibrates associated with lower risk of pancreatitis
- Statins do not appear to impair cognition in elderly
- Statins effective for LDL 190 mg/dL or higher, regardless of risk level
- Statins for hyperlipidemia reduce all-cause mortality
- Statins ineffective for primary prevention in patients 75 years or older without diabetes
- Statins of modest benefit for low- to moderate-risk persons (NNT ~ 80)
- Statin therapy decreases cardiac events
- Statin therapy unlikely to be a risk factor for tendinopathy and tendon rupture
- Statin use is not associated with clinically important noncardiovascular benefits or harms
- Statin use may reduce risk of cataracts
- Stent retriever therapy added to tPA is effective for treatment of acute ischemic stroke
- Stent-retriever thrombectomy improves functional outcomes in acute stroke more than tPA alone
- Step-by-step approach to ruling out infant infection is accurate
- Sterile gloves not necessary for minor skin surgery
- Steroid + SABA similar to daily steroid for preventing exacerbations in mild asthma (SYGMA)
- Steroid disc injection of little benefit in treating chronic low back pain
- Steroid inhalers increase fracture risk in COPD
- Steroid injection does not improve response to exercise therapy for knee OA
- Steroid injection effective for trigger finger
- Steroid injection for carpal tunnel symptoms delays need for surgery
- Steroid injection for lateral epicondylitis worse than saline after 1 year
- Steroid injections for trochanteric pain = short-term benefit, long-term no better than usual care
- Steroid injections ineffective for knee osteoarthritis
- Steroid or saline injection ineffective for lumbar radiculopathy
- Steroids = placebo in community acquired pneumonia
- Steroids = placebo in preventing proteinuria in kids with HSP
- Steroids associated with increased risk of adverse outcomes in adults with IgA nephropathy
- Steroids at 34-36 weeks' and before term cesarean decrease respiratory distress syndrome
- Steroids beneficial, but antiviral agents are of uncertain value for Bell palsy
- Steroids beneficial as adjunctive treatment for community-acquired pneumonia
- Steroids better than montelukast in acute asthma exacerbations in children
- Steroids effective for hyperemesis gravidarum
- Steroids effective in acute Bell's palsy
- Steroids hasten sore throat sx resolution in adults
- Steroid treatment adds no benefit to antihistamines for acute hives
- STI counseling with HIV testing does not reduce subsequent STI acquisition
- Stigmatizing language in chart notes creates negative impressions
- Stillbirth risk increased after a previous stillbirth
- Stockings plus anticoagulation more effective to prevent post-op VTE, but anticoagulation increases bleeding
- STOPP/START decreases medication use but not falls or hospitalization in elderly residing in NH
- Stop using antipsychotics to treat or prevent delirium -- they are no better than placebo
- Strength training better than stretching for plantar fasciitis
- Strength training plus protein supplementation can delay or prevent frailty
- Stress-related disorder increases risk of subsequent autoimmune disease
- Strict blood sugar control increases ICU mortality (NICE-SUGAR)
- Stroke patients with imaging evidence of salvageable brain tissue benefit from late thrombectomy
- Structured discharge instructions reduce hospital use
- Structured exercise in pregnancy reduces cesarean delivery
- Studies of cognitive testing not helpful in identifying high-risk drivers
- Stuttering withdrawal of life support better for surviving family
- Subacromial decompression surgery for shoulder pain is not effective
- Subacute cough treatments: limited data, unclear benefits
- Subclavian central lines: fewer infections and clots, increased risk of pneumothorax
- Subclinical hypothyroidism associated with increased risk of CHD
- Sublingual allergen tablet reduces symptoms of grass allergy
- Sugar decreases pain signs in immunized infants
- Sugared drinks lead to greater increases in weight in kids than sugar-free (DRINK)
- Suggestions from the American Academy of Pediatrics on maternal and infant eating to avoid allergies
- Sulodexide given long-term may reduce recurrent VTE in patients with initial unprovoked VTE
- Summary of GOLD guideline for COPD
- Supervised exercise program no better than advice alone for rehab after ankle fracture
- Supplemental internet-delivered treatment for addiction improved treatment outcomes
- Supplemental MRI screening in women with very dense breasts reduces interval cancer rate but may cause overdiagnosis (DENSE)
- Supplemental oxygen ineffective for COPD with moderate hypoxemia
- Suppressive treatment results in zero HIV transmission in serodifferent couples reporting condomless sex
- Suppurative complications of sore throat uncommon and unpredictable
- Supraventricular premature complexes associated with increased risk of AF and CVD
- Surgery + PT similar to PT alone for adults with mensical tear and OA
- Surgery = no surgery for patients with subacromial shoulder pain (CSAW)
- Surgery = no surgery in acute patellar dislocation in kids
- Surgery and esomeprazole equally effective for chronic GERD
- Surgery and nonsurgical treatment of carpal tunnel give similar outcomes
- Surgery better than no surgery for spinal stenosis
- Surgery does not improve outcomes for partial medial meniscectomy
- Surgery effective for stenosis caused by spondylolisthesis (SPORT)
- Surgery effective in spinal stenosis not responsive to 3-6 month conservative Tx
- Surgery equal to nonsurgical treatment for displaced proximal humeral fractures
- Surgery for 2-part humeral fractures in older patients is no better than no surgery
- Surgery for clavicular fractures provides better outcomes but more harms than conservative treatment
- Surgery may be helpful for selected patients with scoliosis and back pain
- Surgery more effective than physiotherapy for urinary stress incontinence in women
- Surgery not effective for moderate/severe OA of knee
- Surgery not recommended for asymptomatic hyperparathyroidism
- Surgery of some benefit for lumbar spinal stenosis
- Surgery or lasers preferred to foam sclerotherapy for varicose veins
- Surgery superior to conservative treatment for first-time anterior shoulder dislocation
- Surgical intervention for adhesive small bowel obstruction associated with decreased risk of recurrence
- Surgical mask and N95 respirator similarly effective for preventing influenza
- Surveillance intervals for abdominal aortic aneurysms
- Surveillance useful for patients with Child-Pugh class B cirrhosis
- Survivors of childhood acute lymphoblastic leukemia at long-term increased cancer risk
- Survivors of out-of hospital cardiac arrest have lower memory scores
- Sustained effects of false-positive mammogram results
- Sustained modest reduction in daily salt intake: reduced BP, no adverse effect on lipids or hormones
- Sustained-release ropinirole improves advanced Parkinson's (EASE-PD)
- Switching to digital mammography for all is too costly
- Switching to oral abx after 10 days as effective as 6 weeks of IV abx for stable left-sided endocarditis
- Symptoms, nasal inspection poor at identifying allergic rhinitis
- Symptoms do not predict AOM in children
- Symptoms inaccurate in diagnosis of bladder outlet obstruction in men
- Symptoms not reliable in diagnosing colorectal cancer
- Symptoms poorly predict kids with serious respiratory illness
- Synbiotics improve short-term SCORAD scores in kids with atopic dermatitis
- Synovial WBC and percent PMNs best for septic arthritis diagnosis
- Systematic review: lung cancer screening with CT decreases mortality but with significant harms
- Systolic blood pressure at least 140 mm Hg best place to begin treatment
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