- Meniere's disease
Essential Evidence Topics, 28-Jun-2021
Overall Bottom Line: The diagnosis of Meniere's disease requires more than one episode of vertigo, hearing loss documented by audiometry, and tinnitus. None of the commonly used therapies (diuretics, antihistamines) has been shown to work better than pl - Neck mass
Essential Evidence Topics, 12-Jun-2021
Overall Bottom Line: A neck mass in an adult should be considered cancer until ruled out. Initial evaluation of a neck mass begins with the determination of whether it is congenital, infectious/inflammatory, or possibly neoplastic ( and ). If neoplasm - Optic neuritis
Essential Evidence Topics, 8-Apr-2021
Overall Bottom Line: Suspect optic neuritis in a young patient (especially a white female) with visual loss, pain with eye movements, and loss of color vision. Obtain a brain and orbits MRI with gadolinium to assess for areas of demyelination. If the - Otitis externa
Essential Evidence Topics, 26-Jul-2019
Overall Bottom Line: Acute otitis externa is of bacterial origin in 90% or more of cases and fungal in 2-10%. Chronic otitis externa, unless the result of inadequately treated acute disease, commonly originates from a local allergic response or a systemic - Otitis media (acute)
Essential Evidence Topics, 31-Mar-2022
Overall Bottom Line: Three criteria are needed for the diagnosis of acute otitis media (AOM). They include: (1) acute onset of fever or ear pain, (2) middle ear fluid as demonstrated by exam or diagnostic testing, and (3) signs of middle ear inflammation - Otitis media (chronic serous)
Essential Evidence Topics, 16-Feb-2021
Overall Bottom Line: Chronic serous otitis media (CSOM) is diagnosed via pneumatic otoscopy. The main goal of diagnosis and treatment is to identify children at risk for language delay, learning problems, or significant hearing loss. Drug therapy is n - Otosclerosis
Essential Evidence Topics, 20-Oct-2021
Overall Bottom Line: Suspect otosclerosis in a patient between the ages of 15 years and 45 years who presents with gradual onset of hearing loss. Family history is usually positive. Audiologic evaluation is necessary to determine the extent and type of - Presbycusis
Essential Evidence Topics, 2-Aug-2021
Overall Bottom Line: The USPSTF concluded that the current evidence is insufficient to recommend screening for hearing loss in asymptomatic adults aged 50 years and older. This does not apply to adults seeking care for hearing problems. Patients who rep - Retinal detachment
Essential Evidence Topics, 30-Jan-2022
Overall Bottom Line: A patient with flashes, floaters, or a curtain/veil over their vision should be referred urgently to an ophthalmologist. Rhegmatogenous retinal detachment (RD) is the most common type and is due to a full-thickness break in the reti - Retinal vein occlusion
Essential Evidence Topics, 28-Jun-2021
Overall Bottom Line: When clinically suspected, perform a complete eye exam with attention to slit-lamp and dilated fundus examination; refer to retinal specialist for optical coherence tomography and fluorescein angiography. Consider systemic workup fo - Retinitis pigmentosa
Essential Evidence Topics, 22-Mar-2021
Overall Bottom Line: Patients may be asymptomatic, but may complain of nyctalopia (night blindness) and clumsiness at night. Ophthalmologic examination reveals visual field constriction, optic nerve pallor, retinal vascular attenuation, and peripheral r - Retinoblastoma
Essential Evidence Topics, 22-Mar-2021
Overall Bottom Line: Retinoblastoma is a childhood intraocular cancer caused by the defect or absence of a tumor suppressor gene; retinoblastoma may be familial or sporadic. Children with a family history should undergo ophthalmic screening from birth u - Retinopathy of prematurity
Essential Evidence Topics, 5-Apr-2021
Overall Bottom Line: Retinopathy of prematurity (ROP) is a vascular retinopathy that develops only in premature infants with outcomes anywhere from normal vision to blindness. Incidence decreases with increasing birth weight and gestational age. Infants w - Sialadenitis
Essential Evidence Topics, 19-Jul-2021
Overall Bottom Line: Sialadenitis is clinically diagnosed by the sudden onset of an indurated, warm, erythematous swelling of a salivary gland. Maintenance of adequate hydration and broad-spectrum oral antimicrobial therapy are initial therapy for patie - Sialolithiasis
Essential Evidence Topics, 17-Apr-2021
Overall Bottom Line: Patients who present with unilateral salivary gland swelling and/or pain should be carefully examined; the diagnosis can often be confirmed clinically by the presence of visible or palpable stones. If unable to confirm submandibular - Sinusitis (adult, acute)
Essential Evidence Topics, 28-Sep-2020
Overall Bottom Line: Bacterial rhinosinusitis is more likely in patients with preceding cold, unilateral tender maxillary sinuses, maxillary toothache, and purulent nasal discharge. It is also more likely in patients with more severe symptoms, and possibl - Sinusitis (child)
Essential Evidence Topics, 14-Jan-2022
Overall Bottom Line: In a child with a cold, consider rhinosinusitis when symptoms last beyond 10 days or when they are more severe than usual or worsen after several days of improvement. Suspect a complication if orbital or meningeal or neurological symp - Strabismus and amblyopia
Essential Evidence Topics, 19-Jan-2021
Overall Bottom Line: Consistent screening is recommended in the neonatal period, at 6 months, and at 3 years. Amblyopia is a clinical diagnosis; if suspected, the patient should be referred for confirmation of the diagnosis by an ophthalmologist. Afte - Tear duct problems
Essential Evidence Topics, 13-Aug-2019
Overall Bottom Line: Congenital nasolacrimal duct obstruction is diagnosed by a persistent overflow of tears (epiphoria) in infants aged between 3 and 12 weeks. Watchful waiting or lacrimal duct massage is recommended as initial therapy for the patients - Tinnitus
Essential Evidence Topics, 1-Feb-2021
Overall Bottom Line: Avoidance of loud noises and ototoxic agents may aid in the prevention of tinnitus. Evaluation of tinnitus should include a thorough history and physical examination to identify any reversible causes. All patients should undergo a
Essential Evidence is a powerful, one-stop, state-of-the-art reference that includes best-evidence answers to your most important clinical questions concerning symptoms, diseases, and treatment. Its concise, highly structured content is tightly integrated and hyperlinked to thousands of calculators, articles, and evidence summaries within Essential Evidence Plus to make searching for answers quick and seamless. Each topic has a “strength of evidence” rating for every recommendation, a “Bottom-line” summary that introduces each section, and a broad array of helpful algorithms.
