Empowering Primary Care Through Evidence

PEER is a primary care led evidence based medicine team focused on providing relevant evidence to family physicians and primary care providers.

Evidence Pertaining to a Healthy Primary Care Workforce

PEER reports on the recent changes and summarizes evidence pertaining to the importance of the primary care workforce.

Most Recent Tools for Practice

Tools for Practice #269 – Osteoarthritis pain getting you down? Duloxetine

Do Serotonin Norepinephrine Reuptake Inhibitors (SNRIs), specifically duloxetine, improve pain in patients with osteoarthritis?

Bottom Line: Duloxetine can meaningfully reduce osteoarthritis pain scores (by at least 30%) for ~60% of patients compared to ~40% on placebo. An average pain of ~6 (scale 0-10) will be reduced by ~2.5 points, compared to 1.7 on placebo. Duloxetine adverse effects lead to withdrawal in 12% of patients versus 6% on placebo.  Read More

Tools for Practice #268 – Is 45 really the new 50 in colorectal cancer screening?

Should we lower the age that average risk patients commence colorectal cancer screening from 50 to 45?

In developed countries, the incidence of colorectal cancer in persons under 50 years old has increased by 20-30% in the last 20 years. However, the absolute risk increase is only 1-4 per 100,000 persons. Screening average risk patients under age 50 should not be encouraged at this time. Read More

Tools for Practice #267 – Serology, Serology: How Accurate and Prevalent Art Thou?

What is the role of serology testing in the COVID-19 pandemic?

Bottom Line: IgM and IgG antibodies may reveal an individual's recent (after ~2 weeks) exposure to COVID-19. How long serology remains positive and whether antibodies confer immunity to subsequent infection is unknown. Many different tests exist, each with different accuracy. Current evidence does not support routine use of serology testing in COVID-19 management.    Read More

Tools for Practice #266 – Exercise-induced osteoarthritis: Running into problems?

Does running increase the risk of developing osteoarthritis?

Bottom Line: Based on low-quality observational data, running likely does not increase the risk of developing osteoarthritis, except possibly in elite athletes. Additionally, recreational running may be associated with lowering the risk of knee osteoarthritis. Exercise is one of the most effective treatments for reducing osteoarthritic pain. Read More

Tools for Practice #265 – “Does baby know best?”: Benefits and harms of baby-led weaning for transitioning to solid foods

What impact does baby-led weaning have on infant growth, iron intake, and choking?

Bottom Line: Transitioning infants to solid foods using a baby-led weaning approach (with parental education) results in up to 0.7kg less weight gain at 12 months than traditional spoon feeding. This is of unknown clinical significance. There is no difference in iron intake or choking episodes. Read More

PEER Values

When creating primary care education and programs, the PEER team focuses on minimizing bias, patient orientated outcomes, shared decision making, collaboration and most importantly simplicity.

Who is PEER?

Patients, Experience, Evidence and Research (PEER) was formed between a group of primary care providers who shared a common belief that evidence should be made accessible to all primary care providers.

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