Canadian Medical Association

peoples feet lined up to social distancing floor markers

For over 20 years, a team of clinicians, including experts in family medicine, pharmacology, hospital medicine, and women’s health systematically reviews English-language medical journals to identify original research most likely to change and improve primary care practice. The result is POEMs, or patient-oriented evidence that matters, by Essential Evidence Plus.

Published by John Wiley & Sons, Inc., the selected research studies must report at least one patient-oriented outcome, be free of methodologic bias, and if applied in practice, prompt the adoption of a new practice or the ceasing an old one shown to be ineffective or harmful.

How POEMs are rated

Through the CMA Joule subscription, CMA members can rate the daily POEM and receive CPD credit by using a validated questionnaire. This is called the Information Assessment Method. A POEM is rated according to clinical relevance, cognitive impact, use of the information in practice and expected benefit for the patient. Dr. Roland Grad (MD, MSc, McGill University, Montreal, Quebec, Canada) and Dr. Mark H. Ebell (MD, MS, University of Georgia, Athens, Georgia) analyze ratings and report on the most clin­ically relevant POEMs as rated by CMA members in an annual series published in American Family Physician. The recent publication on the top POEMs from 2020 marks the 10th installment.

Driven in part by CMA member feedback, the Wiley team launched COVID-19 research briefs in April 2020 to meet physicians’ desire for timely updates on the rapidly evolving pandemic. By the end of 2020, 54 out of 306 POEMs they published addressed the epidemiology, diagnosis, treatment, and prognosis of patients with COVID-19.

The four highest-rated POEMs overall, and 5 of the top 20 highest-rated POEMs for clinical relevance, were on COVID-19 prevention:

Handwashing Reduces Transmission of Respiratory Infections

Clinical question: Can advice to wash hands frequently reduce the transmission of respiratory infections?

Bottom line: A brief online handwashing intervention reduced respiratory infections.

SR Shows Consistent Benefit of Quarantine Measures to Reduce the Spread of An Epidemic

Clinical question: Do quarantine measures reduce the spread of infection during a pandemic?

Bottom line: High-quality evidence shows that quarantine measures, particularly in conjunction with other public health measures, are consistently effective for reducing the spread of an epidemic.

Stay-at-Home and Social Distancing Policies Are Effective at Reducing the Spread of SARS-CoV-2

Clinical question: Do stay-at-home orders or social distancing policies reduce the spread of COVID-19?

Bottom line: Retrospective data suggest that the implementation of stay-at-home and social distancing policies in US counties slowed the spread of COVID-19.

Not All Face Coverings Offer Similar Degrees of Protection

Clinical question: How effective are the different types of face masks for preventing the spread of COVID-19?

Bottom line: Based on laser testing, N95 masks transmitted less than 0.1% of respiratory droplets of COVID-19.

44% of Secondary Infections of SARS-CoV2 Occur When the Index Case Is Presymptomatic

Clinical question: How common is the presymptomatic transmission of the COVID-19 virus?

Bottom line: This analysis of the temporal pattern of viral shedding of COVID-19 finds that a high proportion of secondary cases were infected when the index case was presymptomatic.

CMA members have access to POEMs and the journal American Family Physician via ClinicalKey, a tool included with their membership.

Do you have a question on COVID-19 or another clinical topic? Contact the Ask a Librarian team to request a literature search.

This material is for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. The opinions stated by the authors are made in a personal capacity and do not necessarily reflect those of the Canadian Medical Association and its subsidiaries including CMA Joule. 

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