What is the point of databases of reviews for dermatology if all they compile is “insufficient evidence”?

Abstract

Background The use of review databases for dermatology has been questioned because of the impression that these reviews frequently report finding insufficient evidence to guide therapeutic recommendations. Objective We sought to determine the number of review database entries most relevant to dermatology (addressing diseases with skin manifestations whereby a dermatologist may be the primary caregiver) and the percentage of these entries that report sufficient evidence to guide clinical decision making. Methods We conducted computerized searches and analysis of reviews in the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effectiveness. Database entries were categorized using the face value reports of the original reviewers as: (1) finding sufficient evidence to inform clinical decisions; (2) finding insufficient evidence; or (3) unable to classify with regard to degree of evidence found. Results Of all review database entries, 3% (54/1235 in Cochrane Database of Systematic Reviews and 65/2208 in the Database of Abstracts of Reviews of Effectiveness) were deemed relevant to dermatology. In all, 14 entries from the Database of Abstracts of Reviews of Effectiveness were in the process of being written and not available for further evaluation. Of the remaining entries, 40% (42/105) reported finding sufficient evidence. Of the 10 most common dermatologic diagnoses, 8 were addressed in 30% (31/105) of these reviews. Of entries addressing common dermatologic diagnoses, 32% (10/31) reported finding sufficient evidence. Conclusions Although few (3%) entries in review databases currently address dermatology topics, entries address many (8/10) of the top 10 dermatology diagnoses. Contrary to popular belief, a substantial number (40%) of such reviews report sufficient evidence to inform clinical decisions making.