Clinical inquiries from the family practice inquiries network

Clinical inquiries from the family practice inquiries network – Editorials

John Epling

Family physicians have many questions about appropriate diagnoses and treatments of their patients. These questions sometimes go unanswered because some of us do not have ready access to efficient resources to find answers, because the answers we find are not relevant to our practice, or because the urgencies of the day outweigh the need to search for an answer. (1) Even when these questions are answered, the resources used may not reflect current knowledge or best practice. To help resolve this problem, American Family Physician begins a new department entitled, “Clinical Inquiries from the Family Practice Inquiries Network.” This department joins other recently added departments and features containing content based on the most current and highest quality evidence.

The Family Practice Inquiries Network (FPIN) is a national, not-for-profit consortium of academic family medicine departments, family medicine residency programs, practicing family physicians, medical librarians, and other professionals. FPIN is dedicated to making information available to physicians at the point of care, and to generating new research-based evidence relevant to primary care. FPIN offers an online database of clinical answers that is accessible to paid subscribers (

Practicing physicians, like our readers, can submit questions about their patients to FPIN. The questions to be answered are selected by groups of practicing family physicians who vote through an online ballot. Questions are assigned to authors who search a set of selected, high-quality databases (see accompanying table) and answer the questions using the best evidence found in those databases. The evidence for each answer is summarized, appraised, and graded. The answer is put into a standard, easy-to-use format for quick reading. Each answer is peer reviewed.

If the selected databases do not provide sufficient information to answer a question, the question is referred to one of FPIN’s medical librarians, who conducts a systematic bibliographic search of MEDLINE and other sources to identify resources that the author can use to prepare an answer.

FPIN is working to create an online database that can provide answers to 80 percent of common questions within 60 seconds. The database of answers is available to FPIN subscribers and will be updated as necessary. The “Clinical Inquiries” articles in AFP will represent some of the most common questions. As with most content appearing in AFP, the “Clinical Inquiries” department is available online at

Readers of AFP who have questions about the “Clinical Inquiries” department can contact John Epling, M.D., associate editor for FPIN, by e-mail ( or through the FPIN’s Web site (http://www.

FPIN would be happy to involve you in the generation of questions and the question selection process. If you would like to submit a question to be answered or if you want to vote on submitted questions, you are welcome to send an e-mail to For membership information, send an e-mail to

AFP and FPIN hope this new department will assist you in providing high-quality care for your patients.

RELATED ARTICLE: Required databases for answering clinical inquiries.

Database, Web address

Agency for Healthcare Research and Quality, Clinical Guidelines and Evidence seports, American College of Physicians Journal Club, * Bandolier, Clinical Evidence from BMJ Publishing, * Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effectiveness (DARE), Evidence-Based Medicine, * InfoRetriever, * Institute for Clinical Systems Improvement (ICSI), National Guideline Clearinghouse,

U.S. Preventive Services Task Force (USPSTF), *–Subscription required to access database.


(1.) Ely JW, Osheroff JA, Ebell MH, Chambliss ML, Vinson DC, Stevermer JJ, Pifer EA. Obstacles to answering doctors’ questions about patient care with evidence: qualitative study. BMJ 2002; 324:710-3.

John Epling, M.D., is associate editor for the Family Practice Inquiries Network, and an assistant professor in the Department of Family Medicine at State University of New York-Upstate Medical University, Syracuse, N.Y.

Bernard Ewigman, M.D., M.S.P.H., is editor-in-chief for the Family Practice Inquiries Network and chairman of the Department of Family Medicine at the University of Chicago Medical Center, Chicago.

Mark H. Ebell, M.D., M.S., has a private practice in Athens, Ga., and is associate professor in the Department of Family Practice at Michigan State University College of Human Medicine, East Lansing. He is also deputy editor for evidence-based medicine for American Family Physician.

Address correspondence to John Epling, M.D., Department of Family Medicine, SUNY-Upstate Medical University, 475 Irving Ave., Suite 200, Syracuse, NY 13210 (e-mail:

COPYRIGHT 2003 American Academy of Family Physicians

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