Highlights from the November 4th issue, presented by Dr. John Fletcher, editor-in-chief, and Dr. Ken Flegel, senior editor for CMAJ. In this issue: families of children who have complex chronic medical conditions, prostate guidelines, longevity of guidelines, patients in clinical trials, periodic health exam, end-of-life care, and more. Full issue table of contents: http://www.cmaj.ca/content/186/16.toc