Evidence-based Medicine Information Research Articles

Architectural design of national evidence based medicine information system based on electronic health record.

The global implementation of Electronic Health Records has significantly enhanced the quality of medical care and the overall delivery of public health services. The incorporation of Evidence-Based Medicine offers numerous benefits and enhances the efficacy of decision-making in areas such as prevention, prognosis, diagnosis, and therapeutic approaches. The objective of this paper is to propose an architectural design of an Evidence-Based Medicine information system based on the Electronic Health Record, taking into account the existing and future level of interoperability of health information systems in Greece. A study of the suggested evidence-based medicine architectures found in the existing literature was conducted. Moreover, the interoperability architecture of health information systems in Greece was analyzed. The architecture design reviewed by specialized personnel and their recommendations were incorporated into the final design of the proposed architecture. The proposed integrated architecture of an Evidence-Based Medicine system based on the Electronic Health Record integrates and utilizes citizens' health data while leveraging the existing knowledge available in the literature. Taking into consideration the recently established National Interoperability Framework, which aligns with the European Interoperability Framework, the proposed realistic architectural approach contributes to improving the quality of healthcare provided through the ability to make safe, timely and accurate decisions by physicians.

Making Science Computable Using Evidence-Based Medicine on Fast Healthcare Interoperability Resources: Standards Development Project.

Evidence-based medicine (EBM) has the potential to improve health outcomes, but EBM has not been widely integrated into the systems used for research or clinical decision-making. There has not been a scalable and reusable computer-readable standard for distributing research results and synthesized evidence among creators, implementers, and the ultimate users of that evidence. Evidence that is more rapidly updated, synthesized, disseminated, and implemented would improve both the delivery of EBM and evidence-based health care policy. This study aimed to introduce the EBM on Fast Healthcare Interoperability Resources (FHIR) project (EBMonFHIR), which is extending the methods and infrastructure of Health Level Seven (HL7) FHIR to provide an interoperability standard for the electronic exchange of health-related scientific knowledge. As an ongoing process, the project creates and refines FHIR resources to represent evidence from clinical studies and syntheses of those studies and develops tools to assist with the creation and visualization of FHIR resources. The EBMonFHIR project created FHIR resources (ie, ArtifactAssessment, Citation, Evidence, EvidenceReport, and EvidenceVariable) for representing evidence. The COVID-19 Knowledge Accelerator (COKA) project, now Health Evidence Knowledge Accelerator (HEvKA), took this work further and created FHIR resources that express EvidenceReport, Citation, and ArtifactAssessment concepts. The group is (1) continually refining FHIR resources to support the representation of EBM; (2) developing controlled terminology related to EBM (ie, study design, statistic type, statistical model, and risk of bias); and (3) developing tools to facilitate the visualization and data entry of EBM information into FHIR resources, including human-readable interfaces and JSON viewers. EBMonFHIR resources in conjunction with other FHIR resources can support relaying EBM components in a manner that is interoperable and consumable by downstream tools and health information technology systems to support the users of evidence.

A cross-sectional study evaluating the knowledge, attitude, and practice of evidence-based medicine among resident doctors of a health-care Institution of National Importance in India.

Evidence-based medicine (EBM) promotes the integration of updated- best evidence with patient preferences and medical expertise for clinical decision-making. Despite the availability of high-quality evidence such as systematic review and meta-analysis, some clinicians manage their patients based on past experiences and expert opinion. Thus, this study was proposed to assess the knowledge, attitude, and practice of EBM among resident doctors at a tertiary care hospital in India. This cross-sectional questionnaire-based study was conducted among senior residents and final-year postgraduates (PGs) who were independently involved in clinical decision-making. By convenience sampling method, the participants were recruited, and the validated EBM Questionnaire (EBMQ) was distributed online for assessing the knowledge, attitude, and practice of EBM. Descriptive statistics were represented as frequency and proportions. A total of 102 resident doctors participated with male preponderance (74.5%). Nearly, 96 (94.1%) participants were already practicing EBM and 21.6% had undergone EBM training. Textbooks (50%) were the most often referred sources for EBM information. Specific EBM databases such as MEDLINE and Cochrane were also utilized by 37.3% of participants. More than 70% of participants understood the terms such as a randomized controlled trial, case-control study, and P value. A higher proportion (80.4%) of participants showed a positive attitude about patient care improved by EBM. The majority of the resident doctors exhibited good knowledge and a positive attitude toward applying EBM in clinical decision-making. Periodic training through workshops or courses and integration of EBM with the PG curriculum would potentially enhance the EBM practice.

The perceived development needs for medicines information services in university hospital pharmacies: A mixed methods study

BackgroundReliable and evidence-based medicines information (MI) is critical for patient care. To guarantee this, in many countries, there are medicines information centers (MICs) which offer medicines information services (MISs). While there are no MICs in Finland, pharmacists in all five university hospital pharmacies provide MISs. A proposal for establishing five MICs has been made by the National Medicines Information Network. ObjectivesThe aim was to explore the current MISs and the perceptions of current and potential MI service providers of the need for the proposed national MICs. Barriers and facilitators for potential transition from the current MISs provided by the university hospital pharmacies to establishing national MICs, were examined. MethodsThis sequential explanatory mixed methods study was conducted nationally during September 2019–April 2020 as an online survey and semi-structured individual, pair and group theme interviews with hospital representatives. The survey questionnaire was sent to chief pharmacists and MI pharmacists in all five Finnish university hospital pharmacies (n = 5, census). The interviews (n = 13) were carried out with chief pharmacists, MI pharmacists, medication safety officers (pharmacists), chairs of the Medicines Advisory Board (physicians) and clinical pharmacologists (physicians) (participants n = 19). The data was analyzed using descriptive quantitative analysis and qualitative content analysis. ResultsAll invited representatives participated in the study. Offered MISs are quite similar but the human resources vary among the organizations. Answering MI questions was one of the core MISs. Most representatives considered a proposal of establishing five MICs to Finland positively. The expected benefits were related to achieving an official status to enhance MI, establishing the MICs within the university hospitals and close to where the MISs are needed, and fostering multiprofessional collaboration and collaboration between the MICs. Limited financial and human resources were seen the most critical challenges. ConclusionThe existing expertise of the pharmacists and the similarities in MISs provided by the university hospital pharmacies seem to provide a good basis and preconditions for expanding MI operations and forming MICs at the national level. By pooling current limited resources, synergies could be achieved and MISs, and potentially MICs developed. The establishment of MICs may enhance utilization of networking and multiprofessional collaboration in producing MISs at the national level.

Abdominal Wall Vascularized Composite Allotransplantation: A Scoping Review.

Abdominal wall vascularized composite allotransplantation (AW-VCA) is a novel reconstructive technique used for large abdominal wall defects in combination with intestinal transplantation (ITx) or multivisceral abdominal transplantation (MVTx). Since the introduction of this procedure, several studies have been published reporting their experience. This study aims to present a scoping review looking at all available evidence-based medicine information to understand the most current surgical techniques and clinical outcomes. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) extension for scoping reviews checklist. A comprehensive research strategy of several databases was conducted. A total of 31 studies were included in this review, which comprised animal, cadaveric, and human studies. In human studies, four surgical techniques with high flap survival rates and low complication rates were found. In cadaveric studies, it was shown that the use of iliofemoral cuff-based flaps provided adequate tissue perfusion to the abdominal wall graft. Also, the use of thoracolumbar nerves have been described to provide functionality to the AW-VCA and prevent long-term muscle atrophy. AW-VCA is a safe and efficient alternative for patients with large and complex abdominal wall defects. The future holds a promising evolution of a functional AW-VCA, though surgeons must face and overcome the challenge of distorted anatomy frequently present in this population. Forthcoming studies with a better level of evidence are required to evaluate functionality and differences between surgical techniques.

Understanding medical student evidence-based medicine information seeking in an authentic clinical simulation.

ObjectiveEvidence-based medicine practices of medical students in clinical scenarios are not well understood. Optimal foraging theory (OFT) is one framework that could be useful in breaking apart information-seeking patterns to determine effectiveness and efficiency of different methods of information seeking. The aims of this study were to use OFT to determine the number and type of resources used in information seeking when medical students answer a clinical question, to describe common information-seeking patterns, and identify patterns associated with higher quality answers to a clinical question.MethodsMedical students were observed via screen recordings while they sought evidence related to a clinical question and provided a written response for what they would do for that patient based on the evidence that they found.ResultsHalf (51%) of study participants used only 1 source before answering the clinical question. While the participants were able to successfully and efficiently navigate point-of-care tools and search engines, searching PubMed was not favored, with only half (48%) of PubMed searches being successful. There were no associations between information-seeking patterns and the quality of answers to the clinical question.ConclusionClinically experienced medical students most frequently relied on point-of-care tools alone or in combination with PubMed to answer a clinical question. OFT can be used as a framework to understand the information-seeking practices of medical students in clinical scenarios. This has implications for both teaching and assessment of evidence-based medicine in medical students.

OP128 Evaluating The NPS MedicineWise Medicines Information Phone Service

Introduction:The NPS MedicineWise pharmacist-delivered phone service, Medicines Line, aims to provide evidence-based medicines information to consumers. We evaluated outcomes of the Medicines Line, including common consumer inquiries and resultant decision-making, and explored consumer motivations for seeking medicines information.Methods:The evaluation involved conducting paper-based and telephone surveys of a sample of 200 Medicines Line callers, and semi-structured telephone interviews of a subset of twenty callers. Quantitative data were analyzed using SPSS software. Qualitative data were analyzed using content analysis.Results:Preliminary analysis found that the majority of callers thought the Medicines Line had improved their knowledge (ninety-six percent), confidence (eighty-two percent) and decision-making (eighty-nine percent). The most common reasons for calling the Medicines Line were inquiries about side effects or medicine compatibility. The medicines most commonly asked about were antidepressants (twenty percent), analgesics (thirteen percent) and antibiotics (nine percent). Questions about sertraline accounted for thirty-six percent of antidepressant inquiries. Interview themes regarding motivations for using the service included: trust; efficiency and convenience; specialized drug knowledge; and reporting adverse drug reactions to protect others from medicine-related harm. Medicines Line was perceived to be especially useful as an alternative to family physician or specialist consultations when consumers had a non-urgent inquiry about a medicine, and as a service to provide medicines information in remote communities.Conclusions:These results indicate that pharmacist-delivered medicines information telephone services are an effective and efficient way of handling medicines inquiries. Medicines information telephone services are effective in improving health literacy, by increasing callers’ knowledge and confidence to source evidence-based medicines information and improving their ability to make informed decisions about medicine use. This evaluation identified knowledge gaps in medicine side effects and antidepressant use. Identifying such knowledge gaps may be useful in informing future health professional education programs, community campaigns, and shared decision-making resources.

Introduction of a Mental Health Medicines Education Service

An introduction: Phoenix Pharmacy Department (PPD) provides hospital pharmacy services to the Phoenix Care Centre (PCC) and to Dublin North City Community Mental Health Services (DNCMHS). PCC is a 54 bed facility split into two psychiatric intensive care units (PICUs) and two rehabilitation units. PCC PICUs provide a tertiary referral service for a catchment area of 2,060,7191. Clinical pharmacists attend weekly multidisciplinary team (MDT) meetings, carrying out medicine reconciliation and optimisation. PPD recognise the problem that mental health (MH) service users (SUs) often do not seek out or fully engage with services2, 3. On this basis PPD identified an opportunity to enhance engagement and quality of care by introducing a medicines education service.Short description of practice change implementedPharmacist led medicines information sessions now held in PCCPre-discharge individual sessionsWeekly group sessionsNew community-based medicines information program in the Recovery Hub4Pharmacist delivering the medicines component of Eolas programme5Aim and theory of changeExpanding SU’s knowledge of medicinesImproving health literacy through supporting self careEmpowering SUs in their own recoveryTargeted population and stakeholdersPCC InpatientsOther health care professionals (HCPs).DNCMHS community SUs and their families/carersTimeline: Pharmacy Clinical Service to PCC (attending MDTs) set up in June 2014 and expansion of service to include medicines education service commenced in March 2016.Highlights: (innovation, impact and outcomes) Pharmacists are ideally placed to provide medicines education on both physical and mental health; thus bridging the gap between primary, secondary and tertiary services. Pharmacists can then advocate for SUs, and influence prescribing, based on SU experience and beliefs. Outcomes were measured through feedback forms and responses were very encouraging. The knowledge and time given by pharmacists was greatly appreciated.Comments on sustainability: Addition of two new clinical pharmacists in March 2016 enabled the provision of this service.Comments on transferability: Comprehensive clinical pharmacy services are transferrable but resources may limit widespread availability.Conclusions: (comprising key findings) Evidence-based medicines information is now routinely provided to SUs, both on demand, and proactively, by clinical pharmacists. SU’s/carers overall understanding of their medicines has been greatly enhanced.Discussions: Medicine education sessions, now available in both hospital and community settings, empower SUs and their families/carers. These sessions promote self care and improve health literacy6.Lessons learned: Medicines education sessions increased pharmacist-patient contact and increased pharmacist job satisfaction.The needs of this vulnerable MH service user group are similar to the needs of patients with any physical health issue and provision of information services should be comparable. Historically MH stigma has discriminated against MHSUs and created barriers against adequate treatment7. Our initiative is helping to overcome such barriers and optimise the quality of care. Feedback from SUs and other HCPs regarding the impact of direct contact with a clinical pharmacist has highlighted that this is a valuable service that needs to be available routinely throughout our national MH service.

Awareness and use of evidence-based medicine information among patients in Croatia: a nation-wide cross-sectional study.

AimTo determine the use of evidence-based medicine (EBM) information and the level of awareness and knowledge of EBM among patients in Croatia.MethodsA cross-sectional study was conducted among 987 patients in 10 family medicine practices in Croatia. Patients from both urban (n = 496) and rural (n = 482) areas were surveyed. A 27-item questionnaire was used to collect data about sources that patients searched for medical information, patient awareness and use of Cochrane systematic reviews and other EBM resources, and their demographic characteristics.ResultsHalf of the patients searched for medical information from sources other than physician. Internet was the most common place they searched for information. Very few patients indicated using EBM sources for medical information; one fifth of patients heard of EBM and 4% of the patients heard of the Cochrane Collaboration. Patients considered physician’s opinion as the most reliable source of medical information. A logistic regression model showed that educational level and urban vs rural residence were the predictors of awareness about EBM and systematic reviews (P < 0.001 for both).ConclusionOur finding that patients consider a physician’s opinion to be the most reliable source of health-related information could be used for promotion of high-quality health information among patients. More effort should be devoted to the education of patients in rural areas and those with less formal education. New avenues for knowledge translation and dissemination of high-quality health information among patients are necessary.

Pautas de chequeo, parte IV: STARD y CARE

Controlled clinical trials represent the design highlight in biomedical research. However, there are other methodological designs that provide relevant information for evidence-based medicine: studies of diagnostic test accuracy and case reports. As with other designs, they need to meet quality standards in their reporting, that is the reason for the design of STARD and CARE checklists, respectively. The STARD checklist began to develop in 1999, being published in 2003, it includes 25 items grouped into five domains (title / abstract / keywords, introduction, methods, results, discussion). The CARE checklist was made according to the Guidance for Developers of Health Research Reporting Guidelines, was published in 2013, it includes 13 items, without declared domains and is commonly used for all areas of medicine. As with other checklist, the use of STARD has been associated with an improvement in quality report of studies on diagnostic accuracy. In the case of CARE, it is necessary to assess over the years its impact on quality of case reports. This last article in the series describes both checklists for use by the authors of the REVISTA CHILENA DE CIRUGÍA, in order to achieve an improvement in their articles in a simple and efficient way.

Providing evidence-based medicines information about breastfeeding and pregnancy: a required skill for all pharmacists

Providing evidence-based medicines information about breastfeeding and pregnancy: a required skill for all pharmacists

No solution yet for combining two independent studies in the presence of heterogeneity.

No solution yet for combining two independent studies in the presence of heterogeneity.

Chapter 6: How to best practice evidence-based pharmacy with your available resources?

The aim is to help pharmacists working in different settings to identify, evaluate and use their own evidence-based sources for improving outcome of patient/client care. We describe strategies for assessing...

Хаотическая динамика параметров плазменного звена гемостаза при синдроме критической ишемии нижних конечностей

Active development of medical diagnostic base of instrumental studies demands the introduction of a new methodological support. Now it can be done on the basis of system analysis and synthesis of information to identify the significance of clinical diagnostic criteria for quasi-stationary states of the hemostatic system. Such a task is most successfully solved by the new trend of system analysis and synthesis, management and processing of information in evidence-based medicine: identification of quasi-attractors parameters of the human body state vector in terms of the theory of chaos and self-organization, and compartment-cluster theory of biological systems. According to classical statistics, the most effective treatment we observe in the third group patients, while the second group makes a significant impact too. As a result, the volume of quasi-attractors identify the best results in a change rX and xV obtained from the second group patients, in the third group the data are less evident. According to the data analysis of interattractors distances matrices showed the greatest increase in the distances (Zij) between the chaotic centers of the quasi-attractors in the third group, that shows a more effective conservative treatment in the third group than in group 1 and group 2.

Selling evidence over the counter: Do community pharmacists engage with evidence-based medicine?

Community pharmacy has been recently criticised for selling products which do not have a rational or robust evidence base. Available evidence suggests that pharmacists understand and are willing to embrace the concepts of evidence-based medicine (EBM), but it is not often utilised in the community pharmacy setting. Community pharmacists appear to rely more on consumer feedback and personal experience than clinical trial evidence when making over-the-counter recommendations, a practice at odds with the principles of EBM. Limiting factors for the uptake of EBM include a lack of resources and time, as well as a lack of skills in appraising scientific papers. Solutions may include improving pharmacists' awareness of existing EBM information resources, improving critical appraising training, and providing information tailored to the community pharmacy environment.

Usefulness of Cochrane Skin Group Reviews for Clinical Practice

Background and objectiveSystematic reviews are one of the most important sources of information for evidence-based medicine. However, there is a general impression that these reviews rarely report results that provide sufficient evidence to change clinical practice.The aim of this study was to determine the percentage of Cochrane Skin Group reviews reporting results with the potential to guide clinical decision-making. Material and methodsWe performed a bibliometric analysis of all the systematic reviews published by the Cochrane Skin Group up to 16 August, 2012. We retrieved 55 reviews, which were analyzed and graded independently by 2 investigators into 3 categories: 0 (insufficient evidence to support or reject the use of an intervention), 1 (insufficient evidence to support or reject the use of an intervention but sufficient evidence to support recommendations or suggestions), and 2 (sufficient evidence to support or reject the use of an intervention). ResultsOur analysis showed that 25.5% (14/55) of the studies did not provide sufficient evidence to support or reject the use of the interventions studied, 45.5% (25/25) provided sufficient but not strong evidence to support recommendations or suggestions, and 29.1% (16/55) provided strong evidence to support or reject the use of 1 or more of the interventions studied. ConclusionsMost of the systematic reviews published by the Cochrane Skin Group provide useful information to improve clinical practice. Clinicians should read these reviews and reconsider their current practice.

Feasibility and impact of an evidence-based electronic decision support system for diabetes care in family medicine: protocol for a cluster randomized controlled trial

BackgroundIn Belgium, the construction of the national electronic point-of-care information service, EBMPracticeNet, was initiated in 2011 to optimize quality of care by promoting evidence-based decision-making. The collaboration of the government, healthcare providers, Evidence-Based Medicine (EBM) partners, and vendors of Electronic Health Records (EHR) is unique to this project. All Belgian healthcare professionals get free access to an up-to-date database of validated Belgian and nearly 1,000 international guidelines, incorporated in a portal that also provides EBM information from sources other than guidelines, including computerized clinical decision support that is integrated in the EHRs.The EBMeDS system is the electronic evidence-based decision support system of EBMPracticeNet. The EBMeDS system covers all clinical areas of diseases and could play a crucial role in response to the emerging challenge posed by chronic conditions. Diabetes was chosen as the analysis topic of interest. The objective of this study is to assess the effectiveness of EBMeDS use in improving diabetes care. This objective will be enhanced by a formal process evaluation to provide crucial information on the feasibility of using the system in daily Belgian family medicine.MethodsThe study is a cluster-randomized trial with before/after measurements conducted in Belgian family medicine. Physicians’ practices will be randomly assigned to the intervention or control group in a 1:1 ratio, to receive either the EBMeDS reminders or to follow the usual care process. Randomization will be performed by a statistical consultant with an electronic random list generator, anonymously for the researchers. The follow-up period of the study will be 12 months with interim analysis points at 3, 6 and 9 months. Primary outcome is the one-year pre- to post-implementation change in HbA1c. Patients will not be informed about the intervention. Data analysts will be kept blinded to the allocation.DiscussionThe knowledge obtained in this study will be useful for further integration in other Belgian software packages. Users’ perceptions and process evaluation will provide information for improving the feasibility of the system.Trial registrationThe trial is registered with the ClinicalTrials.gov registry: NCT01830569.

EBMPracticeNet: A Bilingual National Electronic Point-Of-Care Project for Retrieval of Evidence-Based Clinical Guideline Information and Decision Support

BackgroundIn Belgium, the construction of a national electronic point-of-care information service, EBMPracticeNet, was initiated in 2011 to optimize quality of care by promoting evidence-based decision-making. The collaboration of the government, health care providers, evidence-based medicine (EBM) partners, and vendors of electronic health records (EHR) is unique to this project. All Belgian health care professionals get free access to an up-to-date database of validated Belgian and nearly 1000 international guidelines, incorporated in a portal that also provides EBM information from other sources than guidelines, including computerized clinical decision support that is integrated in the EHRs.ObjectiveThe objective of this paper was to describe the development strategy, the overall content, and the management of EBMPracticeNet which may be of relevance to other health organizations creating national or regional electronic point-of-care information services.MethodsSeveral candidate providers of comprehensive guideline solutions were evaluated and one database was selected. Translation of the guidelines to Dutch and French was done with translation software, post-editing by translators and medical proofreading. A strategy is determined to adapt the guideline content to the Belgian context. Acceptance of the computerized clinical decision support tool has been tested and a randomized controlled trial is planned to evaluate the effect on process and patient outcomes.ResultsCurrently, EBMPracticeNet is in "work in progress" state. Reference is made to the results of a pilot study and to further planned research including a randomized controlled trial.ConclusionsThe collaboration of government, health care providers, EBM partners, and vendors of EHRs is unique. The potential value of the project is great. The link between all the EHRs from different vendors and a national database held on a single platform that is controlled by all EBM organizations in Belgium are the strengths of EBMPracticeNet.

Developing a national medicines information strategy in Finland—A stakeholders’ perspective on the strengths, challenges and opportunities in medicines information

Purpose and settingThe Finnish Medicines Agency was mandated to develop a national medicines information strategy. The objectives of this study were to assess stakeholders’ views on strengths, challenges and opportunities in medicines information for the basis of the strategy. MethodsInterviews among stakeholder representatives (n=28) from patient organizations, universities, pharmacies, and professional associations in medicine, pharmacy and nursing were conducted in 2011. Interview memos were thematically content-analysed. The draft strategy was finalized through two public hearings and a public consultation. ResultsStakeholders highlighted the need to increase cooperation and coordination in medicines information. The existence of numerous quality- and evidence-based medicines information sources was identified as a strength; although the stakeholders were concerned about the fragmented and unequal access to them. The strengthening of the role of health care professionals in communicating about medicines was seen as an opportunity, but its realization requires improvements in basic and continuing education. Furthermore, the stakeholders emphasized the importance of uniform medicines information regardless of source. ConclusionsStakeholders identified multiple strengths, challenges and opportunities in medicines information that were fundamental to developing the national medicines information strategy. An inventory of stakeholder perspectives can be recommended as a tool to support decision-making in pharmaceutical policy.

Utilidad de las revisiones del Cochrane Skin Group para la práctica clínica

Background and objectiveSystematic reviews are one of the most important sources of information for evidence-based medicine. However, there is a general impression that these reviews rarely report results that provide sufficient evidence to change clinical practice.The aim of this study was to determine the percentage of Cochrane Skin Group reviews reporting results with the potential to guide clinical decision-making. Material and methodsWe performed a bibliometric analysis of all the systematic reviews published by the Cochrane Skin Group up to 16 August, 2012. We retrieved 55 reviews, which were analyzed and graded independently by 2 investigators into 3 categories: 0 (insufficient evidence to support or reject the use of an intervention), 1 (insufficient evidence to support or reject the use of an intervention but sufficient evidence to support recommendations or suggestions), and 2 (sufficient evidence to support or reject the use of an intervention). ResultsOur analysis showed that 25.5% (14/55) of the studies did not provide sufficient evidence to support or reject the use of the interventions studied, 45.5% (25/55) provided sufficient but not strong evidence to support recommendations or suggestions, and 29.1% (16/55) provided strong evidence to support or reject the use of 1 or more of the interventions studied. ConclusionsMost of the systematic reviews published by the Cochrane Skin Group provide useful information to improve clinical practice. Clinicians should read these reviews and reconsider their current practice.