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POEM is Parent Oriented Evidence Medicine. This is equivalent to what clinicians call EBM or Evidence Based Medicine. In this section, I will write summaries from peer-reviewed medical journals. The topics that will be featured here should answer common clinical questions that primary care clinicians see in their offices or hospital.

In order to give the best pediatric care to children and their families, primary care clinicians should use the best scientific evidences coupled with the opinion and preferences of the parent. Clinicians should get the feelings and preferences of parents when recommending diagnostic tests and treatments. Better pediatric care is reached when parents are involved in the decision making process. The old practice of the clinician solely making the decision should be abandoned.

These are some of the journals that I regularly scan and read: PEDIATRICS, Journal Of Pediatrics, Archives of Diseases of Childhood, New England Journal of Medicine, British Medical Journal, Lancet, Contemporary Pediatrics, and European Journal of Pediatrics.

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11 August, Bangor, Maine. 

If your child has a heart murmur found during routine office visit and he is growing normally without any symptoms, a Chest X-ray and ECG (electrocardiogram) will hardly add information in what to do with the heart murmur. If your child’s clinician is concerned with the heart murmur, it is better to send your child for consultation with a pediatric cardiologist than spend money for a Chest X-ray and ECG. This is the conclusion of the ARCHIMEDES Towards evidence based medicine for pediatrician section at the Archives of Diseases of Childhood, July 2003, page 638.

[Comment: During the early years of my practice, I used to request for a Chest X-ray for my patients with heart murmur before referring them to a cardiologist. After several years of practice, and seeing many children with heart murmur, I stopped the getting a Chest X-ray. If I am not sure what the heart murmur is or if the parent are anxious about the murmur, I refer my patients to a pediatric cardiologist.]

Leo Leonidas, MD, FAAP, Assistant Clinical Professor in Pediatrics, Tufts University School of Medicine, Boston; Attending Pediatrician Eastern Maine Medical Center

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