RESUMEN
BACKGROUND: Randomized controlled trials are the gold standard for comparing safety and effectiveness of surgical interventions. Reporting guidelines are available for conveying the results of such trials. OBJECTIVE: To assess adherence to standard reporting guidelines among randomized controlled trials in dermatologic surgery. MATERIALS AND METHODS: Systematic review. Data source was randomized controlled trials in the journal Dermatologic Surgery, per PubMed search, 1995 to 2014. Studies were appraised for the number of the 37 CONSORT 2010 Checklist criteria reported in each. Analysis included comparison of reporting across 4 consecutive periods. RESULTS: Three hundred sixty-three studies were eligible. The mean number of items reported per study increased monotonically from 14.5 in 1995 to 1999 to 16.2 in 2002 to 2004, 17.7 in 2005 to 2009, and 18.0 in 2010 to 2014 (p < .0001). A limitation was that study procedures may have been performed without being reported. CONCLUSION: Completeness of reporting in randomized controlled trials in dermatologic surgery has improved significantly during the preceding 2 decades. Some elements are still reported at lower rates.
Asunto(s)
Procedimientos Quirúrgicos Dermatologicos , Adhesión a Directriz , Ensayos Clínicos Controlados Aleatorios como Asunto , Informe de Investigación/normas , HumanosRESUMEN
BACKGROUND: Dermatologic surgery is a fruitful research area that has spawned numerous randomized control trials (RCTs). OBJECTIVE: To assess the quality of reporting of randomization, blinding, sample size, and power analysis in RCTs published in the journal Dermatologic Surgery. MATERIALS AND METHODS: Randomized control trials published in Dermatologic Surgery between 1995 and 2012 were assessed regarding the quality of trial reporting. Data extraction performed independently by 2 data extractors. RESULTS: Dramatic increases in the numbers of RCTs in dermatologic surgery were noted in successive 5-year periods, from 39 in 1995 to 1999 to 66 in 2000 to 2004 and 131 in 2005 to 2009. The median Jadad score for articles from 1995 to 1999 was 1 and was 2 for articles since 2000. Subjects per study were 20 during 1995 to 1999, 25.5 from 2000 to 2004, and over 30 since 2005. Power analysis with sample size determination was reported in 0 articles during 1995 to 1999; greater than 13% of articles since 2005. Alpha level was specified for 37% of RCTs from 1995 to 1999 and 64% to 70% since 2005. CONCLUSION: During the last 20 years, the number of RCTs in Dermatologic Surgery has grown rapidly, almost doubling every 5 years, because the number of subjects per study has also increased and the quality of reporting has significantly improved.
Asunto(s)
Bibliometría , Procedimientos Quirúrgicos Dermatologicos , Publicaciones Periódicas como Asunto/normas , Edición/normas , Proyectos de Investigación , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Tamaño de la MuestraRESUMEN
BACKGROUND: Floaters are dislodged pieces of tumor tissue than can obscure Mohs micrographic surgery (MMS) frozen sections and confound their interpretation. OBJECTIVE: To understand the common causes of floaters and identify management strategies. METHODS: An initial virtual consensus conference of Mohs surgeons based on a 60-item questionnaire. Data were validated in interviews with randomly selected Mohs surgeons. RESULTS: Based on retrospective reporting of 230 surgeon-years and 170,404 cases of MMS by 26 surgeons, the mean rate of floaters per tumor treated was 1.8%, and the rate of floaters per tissue block was 0.70%. Not wiping blades between cuts when a stage is separated into subunits can predispose to floaters. There was also strong consensus that basal cell carcinomas, ulcerated tumors, and tissue from the first stage were more likely to yield floaters. There is little consensus on how to manage floaters, with possibilities including taking additional sections, taking an additional stage, or simply noting the floater. CONCLUSION: Floaters are not rare and can complicate MMS margin assessment. There is significant expert consensus regarding the causes of floaters and the tissue features that may predispose to them. Floaters may be prevented by minimizing their likely causes. There is less consensus on what to do with a floater.
