The Cochrane Skin Group: a vanguard for developing and promoting evidence‐based dermatology (original) (raw)
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Global burden of skin disease as reflected in Cochrane Database of Systematic Reviews
JAMA dermatology, 2014
Research prioritization should be guided by impact of disease. To determine whether systematic reviews and protocol topics in Cochrane Database of Systematic Reviews (CDSR) reflect disease burden, measured by disability-adjusted life years (DALYs) from the Global Burden of Disease (GBD) 2010 project. Two investigators independently assessed 15 skin conditions in the CDSR for systematic review and protocol representation from November 1, 2013, to December 6, 2013. The 15 skin diseases were matched to their respective DALYs from GBD 2010. An official publication report of all reviews and protocols published by the Cochrane Skin Group (CSG) was also obtained to ensure that no titles were missed. There were no study participants other than the researchers, who worked with databases evaluating CDSR and GBD 2010 skin condition disability data. Relationship of CDSR topic coverage (systematic reviews and protocols) with percentage of total 2010 DALYs, 2010 DALY rank, and DALY percentage cha...
2021
Background: Clinical practice guidelines (CPGs) play a critical role in standardizing and improving treatment outcomes based on the available evidence. It is unclear how many CPGs are available globally to assist clinicians in the management of patients with skin disease. Objectives: To search for and identify CPGs for dermatological conditions with the highest burden globally. Methods: We adapted a list of 12 dermatological conditions with the highest burden from the Global Burden of Disease (GBD) study 2019. A systematic literature search was done to identify CPGs published between October 2014 to October 2019. The scoping review was conducted and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework. Results: A total of 226 CPGs were included. Melanoma had the greatest representation in the CPGs, followed by dermatitis and psoriasis. Skin cancers had a relatively high CPG representation but with lower GBD disease burden ranking. There was an uneven distribution by geographical region, with resource-poor settings being under-represented. The skin disease categories of the CPGs correlated weakly with the GBD disability-adjusted life-years metrics. Eighty-nine CPGs did not have funding disclosures and 34 CPGs were behind a paywall. Conclusions: The global production of dermatology CPGs showed wide variation in geographical representation, article accessibility and reporting of funding. The number of skin disease CPGs were not commensurate with its disease burden. Future work will critically appraise the methodology and quality of dermatology CPGs and lead to the production of an accessible online resource summarizing these findings.
The Growth of Clinical Trials and Systematic Reviews in Informing Dermatological Patient Care
Journal of Investigative Dermatology, 2012
Randomized controlled clinical trials remain the best method for minimizing bias when evaluating dermatological treatments. Many dermatologic clinical trials have suffered from small sample sizes, selective reporting of outcomes, publication bias, poor reporting, and heterogeneous outcomes that have hampered comparability-deficiencies that can be overcome by adopting good trial planning and reporting practice encouraged by this journal. Although a profusion of explanatory placebo-controlled studies have contributed little to decision making in the clinical setting, some comparative effectiveness trials such as the use of topical corticosteroids for pemphigoid may have played a pivotal role in improving the well-being of dermatological patients. Systematic reviews (SRs) of clinical trials strive to organize the entire body of evidence while minimizing bias so that policy makers and guideline developers can base their recommendations on the appropriate strength and level of evidence. In dermatology, SRs, such as those undertaken by the Cochrane Collaboration, have produced clear clinical messages despite conflicting individual studies, and also play a key role in identifying research gaps. Future challenges include optimizing the use of research resources, adopting methodological developments in health technology assessment, and prospective registration and complete reporting of all study results.
Global Burden of Skin Disease as Reflected inCochrane Database of Systematic Reviews
JAMA Dermatology, 2014
should be guided by impact of disease. OBJECTIVE To determine whether systematic reviews and protocol topics in Cochrane Database of Systematic Reviews (CDSR) reflect disease burden, measured by disability-adjusted life years (DALYs) from the Global Burden of Disease (GBD) 2010 project. DESIGN, SETTING, AND PARTICIPANTS Two investigators independently assessed 15 skin conditions in the CDSR for systematic review and protocol representation from November 1, 2013, to December 6, 2013. The 15 skin diseases were matched to their respective DALYs from GBD 2010. An official publication report of all reviews and protocols published by the Cochrane Skin Group (CSG) was also obtained to ensure that no titles were missed. There were no study participants other than the researchers, who worked with databases evaluating CDSR and GBD 2010 skin condition disability data. MAIN OUTCOMES AND MEASURES Relationship of CDSR topic coverage (systematic reviews and protocols) with percentage of total 2010 DALYs, 2010 DALY rank, and DALY percentage change from 1990 to 2010 for 15 skin conditions. RESULTS All 15 skin conditions were represented by at least 1 systematic review in CDSR; 69% of systematic reviews and 67% of protocols by the CSG covered the 15 skin conditions. Comparing the number of reviews/protocols and disability, dermatitis, melanoma, nonmelanoma skin cancer, viral skin diseases, and fungal skin diseases were well matched. Decubitus ulcer, psoriasis, and leprosy demonstrated review/protocol overrepresentation when matched with corresponding DALYs. In comparison, acne vulgaris, bacterial skin diseases, urticaria, pruritus, scabies, cellulitis, and alopecia areata were underrepresented in CDSR when matched with corresponding DALYs. CONCLUSIONS AND RELEVANCE Degree of representation in CDSR is partly correlated with DALY metrics. The number of published reviews/protocols was well matched with disability metrics for 5 of the 15 studied skin diseases, while 3 skin diseases were overrepresented, and 7 were underrepresented. Our results provide high-quality and transparent data to inform future prioritization decisions.
Journal of the European Academy of Dermatology and Venereology, 2020
is involved in performing clinical trials with many pharmaceutical industries including Novartis, Abbvie, Lilly, Regeneron, Sanofi, Boehringer, Leopharma, UCB, Pfizer, Amgen, Celgene that manufacture drugs used for the treatment of Accepted Article This article is protected by copyright. All rights reserved e.g. psoriasis and atopic dermatitis for which we get financial compensation paid to the department/hospital. The other authors declare that they have no competing interests.
Guidelines in dermatology—Quo vadis?: Facts and controversies
Clinics in Dermatology, 2010
Since their introduction in 1980s, medical guidelines have become a milestone in the modern medical practice and science. Being a key feature of modern evidence-based medicine, guidelines offer the opportunity for unification and standardization of diagnostic procedures, their use guarantees the equal access of patients to medical service, and they represent a scaffold for inexperienced physicians. The implementation of guidelines also can serve as a basis in malpractice issues and can contribute to the formation of national and international health care policies. In past decades, the process of development, update, and practical application of clinical guidelines has been seriously improved; however, certain limitations still exist, namely cost-effectiveness issues, editorial independence, applicability, accessibility, and external validity. This contribution discusses the advantages and the drawbacks in the use and the development of medical guidelines, emphasizing future perspectives and challenges in the development of clinical guidelines.
Current best evidence from dermatology literature
Indian Journal of Dermatology, Venereology and …, 2009
Comment: Many patients presenting in dermatology clinics have eczematous dermatitis affecting different body parts which does not qualify for the diagnosis of specific endogenous or exogenous eczema. In this group of patients, patch testing is a useful tool as shown in present study. ...
British Journal of Dermatology, 2009
This advice is aimed at the authors of British Association of Dermatologists (BAD) guidelines. The idea for developing a new topic for a BAD guideline usually comes from a member of the BAD, but could come from patient representatives or other organizations such as the Royal College of Physicians (RCP). The intention is that a guideline will be comprehensive and up-to-date, aimed at dermatologists and nurses working in clinical dermatological practice. Before proceeding, the topic must be agreed by the Therapy and Guidelines Subcommittee (T&G).
Journal of cutaneous pathology, 2018
Appropriate use criteria (AUC) provide physicians guidance in test selection, can affect health care delivery, reimbursement policy, and physician decision-making. The American Society of Dermatopathology (ASDP), with input from the American Academy of Dermatology (AAD) and the College of American Pathologists (CAP), sought to develop AUC in dermatopathology. The RAND/UCLA appropriateness methodology, which combines evidence-based medicine, clinical experience and expert judgment, was used to develop AUC in dermatopathology. With the number of ratings predetermined at 3, AUC were developed for 211 clinical scenarios (CS) involving 12 ancillary studies (AS). Consensus was reached for 188 (89%) CS, with 93 (44%) considered "usually appropriate", 52 (25%) "rarely appropriate", and 43 (20%) "uncertain appropriateness". The methodology requires a focus on appropriateness without comparison between tests and irrespective of cost. The ultimate decision of when...