The Top 20 Research Studies for Primary Care

What were the most important, practice-changing studies of 2021? Will my gazpacho recipe be a personal panacea?

The advice a physician gives you is based on many factors: what we have learned in school, what we have gleaned from experience, and what the continual stream of evidence as published in medical journals discovers. This is the first of 4 posts I’m going to write about what we learned in 2021. It is based on an article from American Family Physician, an important journal for docs like me. In this article the authors collected the highest rated POEMs of 2021. POEM here stands for patient-oriented evidence that matters. Basically, a panel of experts combs through tens of thousands of journal articles, selects the ones that are most relevant and likely to affect the actual care of patients in primary care, and presents them to doctors like me. This process is extremely valuable, as there is no way I’d have time to do what they did in 2021: the POEM folks reviewed over 20,000 journal articles, selected 260 that would really matter to primary docs practicing on the front lines, and then boiled each one down to the take-home points. I’m going to give you the take-home points from the 20 studies that were rated by physicians as the most likely to be relevant, valid, and potentially practice-changing for good patient care.

And for no good reason, at the end, I’ll share a gazpacho recipe that I’ve been obsessed with this summer. Fresh tomatoes, cucumbers, peppers, sweet onion… One of my biggest regrets in life was not ordering that second bowl of gazpacho in Madrid.

Back to the POEMs. These top 20 studies are best presented as answers to primary care questions. We need a little break from Covid (even though the top 5 most highly rated studies of 2021 were still about Covid - but if you’ve been reading my letter this year then you’ve already learned about them indirectly)!

Here are the questions for this first of 4 posts I’ll be doing:

• What is the likelihood that adults with prediabetes will develop actual diabetes over the next 7 years?

• What interventions are effective in managing chronic lower back pain?

• Which over-the-counter products are most effective in treating chronic constipation?

• Which dose of aspirin is best for people with atherosclerosis (like heart disease)?

• Will increasing the dose of medications for depression above the starting dose actually improve outcomes?

• Should we add the tomatoes to the blender with the olive oil from the start, or should we slowly drizzle the olive oil towards the end of the recipe?

Hopefully this 4 part series will save you (and me) the effort of reading 20,000 journal articles from 2021!