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For the past 24 years, a team of six clinicians has systematically reviewed more than 100 medical journals to find the research most likely to change and improve primary care practice. The team includes experts in family medicine, pharmacology, hospital medicine, and women's health. 1,2
The goal of this process is to identify POEMs (patient-oriented evidence that matters). A POEM must report at least one patient-oriented outcome, such as improvement in symptoms, morbidity, or mortality. It should also be free of important methodologic bias, making the results valid and trustworthy. Finally, if applied in practice, the results would change what some physicians do by adopting a new practice or discontinuing an old one shown to be ineffective or harmful. Of more than 20,000 research studies published in 2022 in the journals reviewed by the POEMs team, 253 met criteria for validity, relevance, and practice change. These POEMs are emailed daily to subscribers of Essential Evidence Plus (Wiley-Blackwell, Inc.).
The Canadian Medical Association purchases a POEMs subscription, and thousands of its members receive the daily POEM. These physicians can rate each one using a validated questionnaire. 3 This process is called the Information Assessment Method (https://www.mcgill.ca/iam). POEM ratings address the domains of clinical relevance, cognitive impact, use in practice, and expected health benefits. In 2022, each of the 253 daily POEMs were rated by an average of 1,087 physicians. New for 2022, readers of the daily POEM saw an “overuse alert” for POEMs that align with a Choosing Wisely recommendation. 4
In this article, the 12th installment of our annual series (https://www.aafp.org/pubs/afp/content/top-poems.html), we summarize the 20 most clinically relevant POEMs of 2022 as determined by Canadian Medical Association members. Although some of the most highly rated POEMs addressed COVID-19, rapid changes in management as the pandemic has evolved make many of them less relevant in 2023. Therefore, we briefly summarize these COVID-19 POEMs, as well as highly rated practice guidelines, separately. The full POEMs discussed in this review are available at https://www.aafp.org/pubs/afp/content/top-poems/2022.html.
Preventive Health Care
The first two POEMs relate to preventive medicine (Table 1). 5,6 Many patients take statins to reduce cardiovascular events. But how large is the benefit? A meta-analysis identified 19 studies that randomized 132,763 patients to statin therapy or placebo. 5