Medicine and Health Sciences Commons^™

Does Routine Use Of Medical Cannabis (Marijuana) Decrease The Intensity Of Chronic Neuropathic Pain In Adults?, Ben Arpin

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM was to investigate the question, “Does routine use of medical cannabis (marijuana) decrease the intensity of neuropathic chronic pain in adults?

STUDY DESIGN: systematic review of 3 English language primary studies, published between 2005 and 2009.

DATA SOURCES: Three Randomized Controlled Trials (RTC’s) published on or after 2005 were selected based on their relevance to the proposed question via PubMed. All three RTC’s compared cannabis use vs. placebo for chronic neuropathic pain, with two RTC’s focusing on HIV neuropathic pain and the third focusing on MS.

OUTCOMES MEASURED: The outcomes measured in these …

Does Nebulized Hypertonic Saline Solution Decrease Hospital Admission Rates When Compared To Nebulized Normal Saline In Children Less Than Or Equal To 24 Months Old With Bronchiolitis?, Korie Alecxih

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not nebulized hypertonic saline solution reduces hospital admission rates when compared to nebulized normal saline solution in children less than or equal to 24 months of age diagnosed with acute bronchiolitis in the emergency department setting.

STUDY DESIGN: Systematic review of three randomized, double-blind, placebo controlled trials in the English language all published in 2014.

DATA SOURCES: Data sources obtained for this review were articles published in peerreviewed journals found using PubMed Database.

OUTCOMES MEASURED: The outcome measured was hospital admission rate. Hospital admission rate is calculated …

Is Viscosupplementation Effective In Reducing Osteoarthritis Knee Pain?, Amalia Antonoplos

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not viscosupplementation is effective in reducing osteoarthritis knee pain

STUDY DESIGN: Review of three randomized, double blind, placebo control trials between 2009- 2010

DATA SOURCES: Three randomized, double blind, placebo control trials were found via PubMed and NCBI

OUTCOMES MEASURED: Each randomized control trial measured knee pain and/or patient satisfaction following their intervention (placebo or hyaluronic acid) in patients with knee osteoarthritis, which was measured via WOMAC pain scale and patient global assessment forms.

RESULTS: (P<0.05) for change in pain at 14-26 weeks after injection (NNT=6- 8 for Chevalier et al and 4 for Kul-Panza & Berker). Patient satisfaction was higher in the experimental groups as compared to the control with conclusions of NNT between 11 and 20 for Chevalier et al and Kul-Panza & Berker respectively. Chavelier et al found adverse events such as arthralgias and joint effusion in <10% of their study population (NNH=39). No dichotomous data was presented in Diacoglu et al; however an ANOVA was deemed statistically significant (p<0.01).

CONCLUSION: Review of these articles concludes that the use of hyaluronic …

Is Laser Therapy An Effective Alternative Treatment For Women With Fibromyalgia?, Michelle B. Astrove

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not, “Is the use of laser therapy an effective alternative treatment for women with fibromyalgia?”

STUDY DESIGN: Review of three English language primary studies, published between 2002 and 2013.

DATA SOURCES: Three randomized controlled trials (RCTs) were found using Cochrane Systematic Reviews. These studies analyzed the effectiveness of laser therapy in women with fibromyalgia.

OUTCOMES MEASURED: Main outcomes measured were improvement in pain, number of tender points, muscular spasm, skinfold tenderness, sleep disturbance, fatigue and morning stiffness measured by an ordinal likert scale, Pain and FM impact …

Is Narrowband Uvb Phototherapy In Combination With Nonsteroidal Topical Medications More Effective At Repigmentation Of Vitiligo Lesions When Compared To Narrowband Uvb Therapy Alone In Healthy Men And Women Between The Ages Of 11 And 69?, Cassandra Baier

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not narrowband UVB (NB-UVB) phototherapy in combination with nonsteroidal topical medications is more effective at repigmentation of vitiligo lesions when compared to NB-UVB therapy alone in healthy men and women between the ages of 11 and 69.

STUDY DESIGN: Review of three peer-reviewed randomized controlled trials written in English, two of which were published in 2014, and one in 2011.

DATA SOURCES: Studies were selected based on the method of study, the randomized- control structure of the studies, and the relevance to the clinical question, and all …

Is Topical Phenytoin Effective In Healing Diabetic Foot Ulcers In Patients Over Age 18?, Jordan Byrd

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not topical phenytoin is effective in healing diabetic foot ulcers in patients over age 18.

STUDY DESIGN: Systematic review of three randomized controlled trials, published in 2011, 2013 and 2014.

DATA SOURCES: Three randomized controlled trials comparing the effectiveness of topical phenytoin to placebo in healing diabetic foot ulcers. Data sources found using PubMed and Google Scholar.

OUTCOMES MEASURED: Greater than 50% reduction in ulcer area measured via graph paper tracings and area reduction calculations, discontinuation of slough and discharge from ulcers via blind observer decision, complete …

Are Statins An Effective Treatment In Men With Erectile Dysfunction?, Kelsey Caton

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not HMG-CoA Inhibitors (Statins) are an effective treatment for erectile dysfunction (ED).

STUDY DESIGN: Systematic review of three English language randomized controlled trials published between 2011-2013.

DATA SOURCES: Three randomized controlled trials published in peer-reviewed journals comparing the effects of statins on erectile function found using the PubMed database.

OUTCOMES MEASURED: The outcomes measured included erectile function, assessed using the International Index of Erectile Dysfunction Questionnaire (IIEF) in all three studies and Nocturnal Penile Tumescence (NPT) in one study, and male ED-quality of life using the MED-QoL …

Is Acupuncture, Including Electroacupuncture, Effective In Treating Pain In Plantar Fasciitis?, Alicia Campiglia

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether the use of acupuncture, including electroacupuncture, is effective in treating pain in patients with plantar fasciitis.

STUDY DESIGN: Review of 3 RCTs published between 2011-current, all in the English language.

DATA SOURCES: Three RCTs analyzed the effectiveness of acupuncture therapy compared to a control group using alternate analgesic therapies. All studies were found using EBSCOhost and PubMed and were selected based on relevance to the proposed clinical question.

OUTCOMES MEASURED: Each of the 3 articles analyzed the effectiveness of treating pain with acupuncture treatment in patients diagnosed with …

Is Glyceryl Trinitrate An Effective Treatment For Reducing Visibility Of Anal Fissures In Patients Without Heart Disease Compared To Placebo?, Christopher Deneault

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not topical glyceryl trinitrate is an effective treatment for reducing visibility of anal fissures in patients without heart disease compared to placebo.

STUDY DESIGN: Evidence based review of three randomized controlled trials published in 1999, 2001, and 2007.

DATA SOURCES: Three randomized controlled trials each evaluating the effectiveness of topical glyceryl trinitrate in the treatment of anal fissure, published in the English language, and containing exclusion criteria disqualifying participants with a history of heart disease.

OUTCOMES MEASURED: Healing was measured via visibility of fissure through examination and structured …

Is Acupuncture Effective In Reducing The Pain Intensity Due To Primary Dysmenorrhea?, Allison Eichenlaub

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: the objective of this selective EBM review is to determine whether or not acupuncture is effective in reducing the pain intensity due to primary dysmenorrhea in women ages 15 to 35.

STUDY DESIGN: Review of three randomized control trials (RCTs) written in English, one of which was published in 2011 and two in 2013.

DATA SOURCES: Three non-blind randomized control trials published in peer reviewed journals found via PubMed.

OUTCOME MEASURED: Pain intensity due to primary dysmenorrhea was measured using visual analog scale (VAS), Cox Menstrual Symptom Scale (CMSS), and Cox Retrospective Symptom Scale (RSS COX2 – average …

Is Enbrel (Etanercept) Safe And Effective In Treating Patients With Sciatic Nerve Pain Resulting From Lumbar Disc Herniation Or Spinal Stenosis?, Abigail Lee Ferry

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Enbrel (etanercept) is safe and effective in treating patients with sciatic nerve pain resulting from lumbar disc herniation or spinal stenosis.

STUDY DESIGN: Review of three English language primary randomized controlled trials from 2012- 2013.

DATA SOURCES: One triple-blind, placebo-controlled randomized clinical trial, one double-blind, placebo-controlled randomized clinical trial, and one prospective randomized clinical trial were found using PubMed. These studies compared treatment with etanercept to treatment with saline and steroids (dexamethasone or methylprednisolone).

OUTCOMES MEASURED: Clinical outcomes of leg and back pain were measured using …

What Is The Efficacy Of Peppermint Oil In Reducing The Symptoms And Improving The Quality Of Life In Patients With Irritable Bowel Syndrome (Ibs)?, Danielle Farnell

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not peppermint oil reduces the symptoms and improves the quality of life in patients with irritable bowel syndrome (IBS).

STUDY DESIGN: Review of three randomized, double-blind, placebo controlled clinical trials were used in this review. The articles were found on PubMed, and selected based on outcomes measured and relevance to the objective.

OUTCOMES MEASURED: The outcomes measured were based on Quality of life and Reduction in Symptoms. Quality of life was measured using the Persian translation of the SF-6 form for assessment of quality of life before …

Is Aprepitant Effective In Preventing Postoperative Nausea And Vomiting?, Rebeccah M. Gomberg

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not aprepitant is effective in preventing postoperative nausea and vomiting.

STUDY DESIGN: Review of three English language primary randomized controlled trials from 2012-2014.

DATA SOURCES: Three double-blind, randomized controlled trials comparing oral aprepitant with placebo. All articles were found using PubMed.

OUTCOMES MEASURED: The three studies measured nausea severity using a verbal rating system and number of episodes of nausea and vomiting recorded by a blinded study investigator.

RESULTS: Vallejo et al found that 29.7% of the patients in the placebo group vomited compared to 9.3% of …

Is Botulinum Toxin A Safe And Effective For The Treatment Of Trigeminal Neuralgia In Adults?, Bryan Frank

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this evidence based medicine review is to determine whether or not Botulinum Toxin A is safe and effective for the treatment of trigeminal neuralgia in adults.

STUDY DESIGN: Three double blind, randomized controlled trials were reviewed and selected based on their relevance to the clinical question and their inclusion of patient oriented outcomes (POEMS).

DATA SOURCES: Each study was obtained by searching NCBI and PubMed database.

OUTCOMES MEASURED: The outcomes were measured using the Visual Analog Scale (VAS), Quality of Life (QoL), Patient Global Impression of Change Scale (PGIC), Last Observation Carried Forward (LOCF), and detected …

Is A Vitamin Supplement Effective In Treatment Of Recurrent Aphthous Ulcers?, Annalyse Grayson

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this EBM review is to determine whether or not a daily vitamin supplement is effective treatment for recurrent aphthous ulcers.

STUDY DESIGN: A review of 3 randomized control trials. All three trials are in English between 2009-2014.

DATA SOURCES: 3 randomized double blind placebo-controlled parallel-arm single center trials were found using PubMed.

OUTCOMES MEASURED: Each of the RCTs measured the efficacy of treatment for RAU in patients with aphthous ulcer outbreaks for at least a year or at least one to three outbreaks a month. This was performed by subjects of the study reporting on efficacy …

Is Desvenlafaxine Effective For Reducing Hot Flashes In Postmenopausal Females?, Maria Graziano

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective Evidence Based Medicine (EBM) review is to determine whether or not Desvenlafaxine is effective in reducing daily hot flashes in postmenopausal females.

STUDY DESIGN: Review of three primary randomized controlled trials (RCTs) published after the year 2000 in the English language.

DATA SOURCES: Three double-blind, randomized controlled trials were found using PubMed and EBSCOhost Web. All trials selected compared treatment with Desvenlafaxine to a visually matched placebo.

OUTCOMES MEASURED: Patients completed daily diary cards on which they recorded the number and severity of daily hot flashes from the screening period through the 12 weeks …

Does Temporal Lobe Resection Cure Seizures In Epileptics?, Alyssa Hall

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this systematic review is to determine whether or not temporal lobe resection cures seizures in epileptics.

Study Design: Systematic review of three English language, peer-reviewed randomized controlled trials, published between 2001 and 2012

Data Sources: Two randomized controlled trials comparing temporal lobe resection surgery to antiepileptic drugs in the treatment of epileptic seizures, and one randomized controlled trial comparing 3.5 cm temporal lobe resection to 2.5 cm temporal lobe resection in the treatment of epileptic seizures. Studies were obtained by the author through the PubMed database.

Outcomes Measured: Primary outcome measured by the three studies was …

Is Safinamide Effective As An Add-On Medication In Treating Parkinson's Disease Motor Symptoms?, Erin E. Kilonsky

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this systematic review is to determine whether or not “Is safinamide effective as an add-on medication in treating Parkinson's disease motor symptoms?”

Study Design: Review of three randomized, controlled studies published in peer reviewed journals in English between 2012-2014.

Data Sources: The three randomized, double-blind clinical trials were found via PubMed and EBSCOhost Web. Articles were selected based on relevance, the date of publication, and whether or not they included patient outcomes.

Outcomes Measured: Among other measures, each trial measured improvement in motor symptoms using the Unified Parkinson’s Disease Rating Scale (UPDRS) Part III (motor) scores, …

Does Music Therapy Reduce Anxiety Levels In End-Stage Renal Disease Patients Undergoing Hemodialysis?, Andrew C. Konopacki

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not music therapy reduces anxiety levels in end-stage renal disease patients undergoing hemodialysis.

STUDY DESIGN: Systematic Review of two randomized controlled trials and one crossover study published in English in 2008, 2012 and 2013, respectively.

DATA SOURCES: Two non-blind randomized controlled trials and one cross-over study were found via PubMed and EBSCOhost databases.

OUTCOMES MEASURED: Subjective Anxiety Levels were measured in ESRD patients undergoing hemodialysis pre and posttest via patient self-reporting. An anxiety level survey graded on a scale of 1-10 was used in the study by …

Is Laser Therapy Effective At Relieving Pain In Adult Patients With Recurrent Aphthous Stomatitis?, Kevin Jackson

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not laser therapy is effective at relieving pain in adult patients with recurrent aphthous stomatitis.

STUDY DESIGN: Systematic review of three randomized controlled trials published in 2009, 2009, and 2013.

DATA SOURCES: Three randomized controlled trials were obtained using PubMed.

OUTCOMES MEASURED: The symptom of pain was measured for improvement by patient survey of visual analog pain scales.

RESULTS: Prasad et al. (2013), Tezel et al. (2009), and Zand et al. (2009) all demonstrated improvement in a majority of the subjects’ pain relief from treatment with laser …

How Effective Is Acupuncture In Treating Cancer-Related Fatigue In Adult Cancer Patients?, Anita Elizabeth Kurian

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not acupuncture is an effective course of treatment for improving cancer-related fatigue in adult cancer patients.

DESIGN: Review of three English language primary randomized controlled studies published from 2006-2012.

DATA SOURCES: Three randomized controlled trials studying the effects of acupuncture therapy on cancer-related fatigue were found using PubMed and Cochrane databases.

OUTCOMES MEASURED: Each of the three trials assessed the efficacy and clinical improvement of cancer-related fatigue after acupuncture therapy. Results were measured on the Functional Assessment of Chronic-Illness Therapy-Fatigue Subscale (FACIT-F) or the Multidimensional Fatigue Inventory …

Does Hyperbaric Oxygen Therapy Relieve Post-Concussion Symptoms And Improve Quality Of Life?, Kevin (Sung Min) Lee

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not hyperbaric oxygen therapy relieves post-concussion symptoms and improve quality of life.

Study Design: Review of three randomized controlled trials published in English in peer review journals.

Data Sources: Three randomized controlled trials which evaluated the therapeutic benefits of hyperbaric oxygen therapy compared to control group that did not receive any treatment. All studies were found in PubMed database.

Outcomes Measured: All three studies analyzed the effect of hyperbaric oxygen therapy on quality of life. Rivermead Postconcussion Symptoms Questionnaire (RPQ) and EQ-VAS questionnaire were used to measure …

Does Ivabradine Improve Quality Of Life In Cardiovascular Disease Patients?, Daniel E. Lynch

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this review is to determine whether ivabradine therapy can improve the quality of life in cardiovascular disease patients.

Study Design: The studies included in this review are one randomized control study and two double blind randomized control studies from 2008, 2010, and 2012.

Data Source: The three studies in this review were obtained by performing a PubMed search using the keywords “ivabradine” and random control trial.” All articles were published in English and in peer-reviewed journals.

Outcomes Measured: The three studies ascertained whether there was a decrease in hospitalization events within coronary artery disease and heart …

Is Vitamin D Supplementation Effective At Reducing Idiopathic Musculoskeletal (Mss) Pain?, Darra O. Markland

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine “Is Vitamin D supplementation effective at reducing idiopathic musculoskeletal (MSS) pain?”

Study Design: Review of primary studies published between the years 2012-2014.

Data Sources: One double blind randomized controlled trial (RCT), one semi-crossover RCT, and one before and after observational study. These were found using Cochrane Review and PubMed databases.

Outcomes Measured: Clinical outcomes were measured in these studies utilizing the Visual Analogue Scale for Pain, the 5-point Likert Pain Scale, the Standard Nordic Questionnaires and numerical grading of pain level, and number of pain sites before and after …

Is Acupuncture An Effective Treatment For Women With Chronic Migraine?, Elham Oumer

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not acupuncture is effective in treating chronic migraine in women between the ages of 18-65.

STUDY DESIGN: Review of two randomized controlled trials and one prospective controlled trial published in English language between 2009 and 2014.

DATA SOURCES: Two PCTs and one prospective CT published in peer reviewed journals, searched through PubMed, EBSCOhost.

OUTCOMES MEASURED: The outcome measured included improvement in quality of life, reduction in intensity and number of headache days. This were measured using 50% responders analysis, self reporting by participants, short form 36 (SF-36) …

Is Polidocanol Foam Sclerotherapy Effective In Treating Varicose Veins As Compared To Conventional Treatments?, Sachi Patel

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not Polidocanol foam sclerotherapy is effective in treating varicose veins as compared to conventional treatments.

STUDY DESIGN: Review of three randomized controlled trials. All three studies are published in English between 2008 – 2012.

DATA SOURCES: Three randomized control trials were found using PubMED and Medline. The sources were selected based on the outcomes measured and how the studies and outcomes mattered to patients (POEMS).

OUTCOMES MEASURED: The patients’ assessment for quality of life analyzed by logistic regression model, Chronic Venous Insufficiency Questionnaire (CVIQ), EQ-5D model, Visual …

Does Physical Activity, When Combined With Androgen Deprivation Therapy, Yield A Better Quality Of Life In Prostate Cancer Survivors?, Nicholas J. Ridolfi

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not physical activity, when combined with androgen deprivation therapy, yields a better quality of life in survivors of prostate cancer.

STUDY DESIGN: Three randomized, controlled trials (RCTs) were found using the PubMed and Cochrane databases. The studies compared regular physical activity in men undergoing androgen deprivation therapy for prostate cancer.

OUTCOMES MEASURED: The outcomes measured were self-reported quality of life surveys at different time intervals.

RESULTS: Two out of the three studies demonstrated statistically significant improvement in reported quality of life during the exercise programs. The third …

Do Botulinum Toxin Injections Improve The Freezing Of Gait (Fog) Episodes Experienced By Parkinson’S Disease (Pd) Patients?, Caroline R. Poole

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not botulinum toxin injections improve the freezing of gait (FOG) episodes experienced by patients diagnosed with Parkinson’s disease (PD).

STUDY DESIGN: This review is based on three randomized controlled trials published in 2004, 2005, and 2007. All of the studies compared the efficacy as well as safety of using botulin toxin injections to treat FOG episodes experienced by PD patients.

DATA SOURCES: All articles used were published in English, in peer-reviewed journals, and were found using PubMed searches.

OUTCOMES MEASURED: For all studies, the safety and efficacy …

Is The Addition Of Vitamin D In Treatment For Asthma Effective In Children Less Than 18 Years Old?, Danielle M. Read

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the addition of vitamin D in treatment for asthma is effective in children less than 18 years old.

STUDY DESIGN: Review of three English language, randomized, controlled, double blind studies after 1999.

DATA SOURCES: Randomized, controlled double blind studies comparing the addition of vitamin D with an inhaled corticosteroid in treatment of asthma with a control group of inhaled corticosteroid alone. All articles were found in PubMed.

OUTCOMES MEASURED: Each study assessed the number of asthma exacerbations or symptoms in the control group and in the …

Is Pancrelipase Delayed Release Capsule (Creon) Safe For Use In Patients’ ≥7 Years Old Who Suffer From Pancreatic Insufficiency Due To Cystic Fibrosis?, Iman Shamloul

PCOM Physician Assistant Studies Student Scholarship

Objective: The objective of this selective EBM review is to determine whether or not Pancrelipase Delayed Release Capsule (Creon) is safe for use in patients’ ≥7 years old who suffer from pancreatic insufficiency due to cystic fibrosis.

Study Design: Systemic review of 3 English language primary studies, published between 2000-2010.

Data Sources: Two double blind randomized controlled trials (RCTs) as well as an open label phase study with a double blind phase comparing the safety of Pancrelipase Delayed Release Capsule (Creon) in treating pancreatic insufficiency in those suffering from Cystic Fibrosis. These studies were found using Cochrane Systematic Reviews and …