G. Michael Allan

University of Alberta | UAlberta · Department of Family Medicine

Objective: To refine the process for endorsement of guidelines and establish the expectations of the College of Family Physicians of Canada (CFPC) regarding the quality and relevance of clinical practice guidelines targeting family physicians and their patients. Composition of the committee: Initially, a group of 6 CFPC staff and selected Colleg...

Once-daily dosing of iron results in similar or slightly better hemoglobin (Hb) levels (about 3 g/L) than QOD or BIW dosing during a 3-month period. Daily dosing increases serum ferritin levels similarly or by up to 12 μg/L better. Intermittent dosing reduces adverse events (like abdominal pain) by up to 30% (absolute). (1) (PDF) Iron dosing freq...

Objective: To determine the proportion of patients with neuropathic pain who achieve a clinically meaningful improvement in their pain with the use of different pharmacologic and nonpharmacologic treatments. Data sources: MEDLINE, EMBASE, the Cochrane Library, and a gray literature search. Study selection: Randomized controlled trials that rep...

Objective: To summarize high-quality studies for 10 topics from 2020 that have strong relevance to primary care practice. Selecting the evidence: Study selection involved routine literature surveillance by a group of primary health care professionals. This included screening abstracts of high-impact journals and EvidenceAlerts, as well as search...

Objective: To determine the proportion of chronic low back pain patients who achieve a clinically meaningful response from different pharmacologic and nonpharmacologic treatments. Data sources: MEDLINE, EMBASE, Cochrane Library, and gray literature search. Study selection: Published randomized controlled trials (RCTs) that reported a responder...

In 2005, the Department of Family Medicine at the University of Alberta introduced an evidence-based practice curriculum into the 2-year Family Medicine Residency Program. The curriculum was based on best available evidence, had multiple components and was comprehensive in its approach. It prioritised preappraised summary evidence over in-depth evi...

Background: Skeletal muscle cramps are common and often occur in association with pregnancy, advanced age, exercise or motor neuron disorders (such as amyotrophic lateral sclerosis). Typically, such cramps have no obvious underlying pathology, and so are termed idiopathic. Magnesium supplements are marketed for the prophylaxis of cramps but the ef...

Muscle cramps are common and can occur in a wide range of settings. Older adults and pregnant women commonly complain of leg cramps while they are resting, athletes can cramp when they are pushing the limits of their endurance, and some people develop muscle cramps as a symptom of other medical conditions. One potential treatment that is already be...

Objective: To determine the effect of mask use on viral respiratory infection risk. Data sources: MEDLINE and the Cochrane Library. Study selection: Randomized controlled trials (RCTs) included in at least 1 published systematic review comparing the use of masks with a control group, either in community or health care settings, on the risk of...

Objective: To determine how many patients with chronic osteoarthritis pain respond to various non-surgical treatments. Data sources: PubMed and the Cochrane Library. Study selection: Published systematic reviews of randomized controlled trials (RCTs) that included meta-analysis of responder outcomes for at least 1 of the following intervention...

Purpose: Without supporting evidence, clinicians commonly recommend that warfarin be taken in the evening. We conducted a randomized controlled trial to evaluate the effect of administration time (morning vs evening) on the stability of warfarin's anticoagulant effect. Methods: A total of 236 primary care physicians serving 54 western Canadian c...

Objective: To determine the stability of warfarin anticoagulation using a nationally representative sample of Canadian primary care patients and providers. Design: Prospective cohort study. Setting: Primary care practices associated with the Canadian Primary Care Sentinel Surveillance Network. Participants: Adult warfarin users with 7 or mor...

Objective: To use the best available evidence and principles of shared, informed decision making to develop a clinical practice guideline for a simplified approach to managing opioid use disorder (OUD) in primary care. Methods: Eleven health care and allied health professionals representing various practice settings, professions, and locations c...

Objective: To summarize the best available evidence regarding various topics related to primary care management of opioid use disorder (OUD). Data sources: MEDLINE, Cochrane Library, Google, and the references of included studies and relevant guidelines. Study selection: Published systematic reviews and newer randomized controlled trials from...

Objectif: Résumer des études de qualité supérieure sur 10 sujets en 2018 qui sont étroitement en rapport avec la pratique des soins primaires. QUALITÉ DES DONNÉES: Pour choisir les études, un groupe de professionnels des soins de santé primaires a exercé une surveillance systématique des publications scientifiques, notamment par un examen des résum...

Objective: To summarize high-quality studies for 10 topics from 2018 that have strong relevance to primary care practice. Quality of evidence: Study selection involved routine literature surveillance by a group of primary care health professionals. This included screening abstracts of important journals and Evidence Alerts, as well as searching...

Objective To develop key performance indicators that evaluate the effectiveness of a prescription medication system. Methods A modified RAND/UCLA appropriateness method was used to develop key performance indicators (KPIs) for a prescription medication system. A broad list of potential KPIs was compiled. A multidisciplinary group composed of 21 ex...

The seven key performance indicators that were highly ranked by 70 percent of respondents. (DOCX)

Example response from the first rating exercise. (DOCX)

Objective: To identify the most commonly presenting conditions in primary care globally, and to compare common reasons for visits (RFVs) as reported by clinicians and patients, as well as among countries of different economic classifications. Data sources: Twelve scientific databases were searched up to January 2016, and a dual independent revie...

Objective: To summarize 10 high-quality studies from 2017 that have strong relevance to primary care practice. Quality of evidence: Study selection involved routine literature surveillance by a group of primary care health professionals. This included screening abstracts of important journals and Evidence Alerts, as well as searching the America...

Objective: To develop a clinical practice guideline for a simplified approach to medical cannabinoid use in primary care; the focus was on primary care application, with a strong emphasis on best available evidence and a promotion of shared, informed decision making. Methods: The Evidence Review Group performed a detailed systematic review of 4...

Objective: To determine the effects of medical cannabinoids on pain, spasticity, and nausea and vomiting, and to identify adverse events. Data sources: MEDLINE, the Cochrane Database, and the references of included studies were searched. Study selection: Systematic reviews with 2 or more randomized controlled trials (RCTs) that focused on medi...

Background Almost half a million breast reduction surgeries are performed internationally each year, yet it is unclear how this type of surgery impacts breastfeeding. This is particularly important given the benefits of breastfeeding. Objectives To determine if breast reduction surgery impacts breastfeeding success and whether different surgical t...

Selected additional data of the studies. (DOCX)

Reasons for not attempting to breastfeed and reasons for not breastfeeding successfully. (DOCX)

Risk of bias calculation. (DOCX)

Breastfeeding success and sensitivity analysis of women that attempted to breastfeed. (DOCX)

Breast reduction technique characteristics. (DOCX)

Background: Eight out of 10 major antihypertensive trials in older adults attempted to achieve a target systolic blood pressure (BP) less than 160 mmHg. Collectively these trials demonstrated benefit for treatment, as compared to no treatment, for an older adult with BP greater than 160 mmHg. However an even lower BP target of less than 140 mmHg i...

Background While journals and reporting guidelines recommend the presentation of confidence intervals, many authors adhere strictly to statistically significant testing. Our objective was to determine what proportions of not statistically significant (NSS) cardiovascular trials include potentially clinically meaningful effects in primary outcomes a...

Clinical Question: In patients at higher risk of contracting HIV, can daily antiviral therapy prevent infection? Bottom-line: Tenofovir/emtricitabine (PrEP) once daily reduces the risk of HIV by ~50%, preventing infection for ~1 in 50 per year. A year of therapy costs ~$12,000 and ~1 in 34 develop nausea/vomiting due to the drug Tools for Practic...

Background: Warfarin is an oral anticoagulant medication that disrupts the liver's production of clotting factors. While this medication is highly effective for the prevention of thromboembolic events, it also has a narrow therapeutic range and a vulnerability to interactions with other drugs and vitamin K-containing foods. Warfarin is commonly in...

In our experience, complaints of ankle swelling are more common in summer, typically from patients with no obvious cardiovascular disease. Surprisingly, this observation has never been reported. To objectively establish this phenomenon, we sought evidence of seasonality in the public’s Internet searches for ankle swelling. Our data, obtained from G...

Over the past decade, a large body of observational evidence has suggested an association between lower vitamin D status (25-hydroxyvitamin D) and multiple acute and chronic disorders, including cancer, multiple sclerosis, depression and respiratory tract infections. This evidence has fostered the hypothesis that increasing vitamin D intake may tre...

Background and objectives: Our objective was to determine the relationship between critical thinking skills and objective measures of academic success in a family medicine residency program. Methods: This prospective observational cohort study was set in a large Canadian family medicine residency program. Intervention was the California Critical...

Objective: To develop clinical practice guidelines for a simplified approach to primary prevention of cardiovascular disease (CVD), concentrating on CVD risk estimation and lipid management for primary care clinicians and their teams; we sought increased contribution from primary care professionals with little or no conflict of interest and focused...

Objective: To develop clinical practice guidelines for a simplified approach to primary prevention of cardiovascular disease (CVD), concentrating on CVD risk estimation and lipid management for primary care clinicians and their teams; we sought increased contribution from primary care professionals with little or no conflict of interest and focuse...

Background: Risk estimates for the same patient can vary substantially among cardiovascular risk calculators and the reasons are not fully explained. We compared the relative risk increases for consistent risk factors changes across different cardiovascular risk calculators. Methods: Five clinicians independently selected 16 calculators providin...

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of a less aggressive (higher) blood pressure target compared to the conventional blood pressure target of < 140/90 mmHg in hypertensive adults 65 years of age or older.

Bottom-Line: Many trials are old, most are short and/or small, and the results are inconsistent. Benzodiazepines appear, at best, equivalent to antipsychotics in reducing agitation in the short-term, but superior to placebo. If used, they should be stopped as soon as possible due to potential harms. Evidence: • Eight randomized controlled trials (R...

To determine which screening tests family medicine residents order as part of preventive health care. A cross-sectional survey. Alberta and Ontario. First- and second-year family medicine residents at the University of Alberta in Edmonton, the University of Calgary in Alberta, and McMaster University in Hamilton, Ont, during the 2011 to 2012 academ...