RESUMO
Existen numerosas modalidades de tratamiento para el manejo de los carcinomas basocelulares (CBC), pero se desconoce la real eficacia y seguridad entre las alternativas quirúrgicas y no quirúrgicas disponibles. Este artículo resume la evidencia encontrada en la reciente revisión Cochrane de Thomson et al. y facilita la interpretación de sus resultados entre la comunidad científica iberolatinoamericana. La gran mayoría de la evidencia evaluada proviene de estudios individuales que impidieron la realización de una revisión sistemática cuantitativa. La escisión quirúrgica convencional continúa siendo la terapia más eficaz para el tratamiento de los CBC de bajo riesgo. La mayoría de estudios incluyeron tamaños de muestra pequeños y algunos tuvieron problemas con el cegamiento, lo que influiría en resultados subjetivos tales como el dolor o la cosmesis. Existe una falta de estandarización en relación con los desenlaces de recurrencia y de resultados cosméticos, lo que en conjunto afecta no solo la validez interna sino también la validez externa y la reproducibilidad de los estudios (AU)
Numerous surgical and nonsurgical modalities are available to treat basal cell carcinoma (BCC), but their true effectiveness and safety is unknown. This article summarizes the evidence presented in a recent Cochrane review and aims to facilitate the interpretation of the review's findings for the Spanish and Latin American scientific communities. Much of the evidence the reviewers found came from single studies, preventing meta-analysis. Conventional surgical excision continues to be the most effective treatment for low-risk BCC. Most studies had small sample sizes, and some had problems with blinding, limitations which will have affected the assessment of subjective outcomes, such as pain and cosmetic results. The authors identified a lack of standardization in relation to recurrences and cosmetic outcomes that threatens not only the internal validity of the studies but also their external validity and reproducibility (AU)
Assuntos
Humanos , Carcinoma Basocelular/terapia , Neoplasias Cutâneas/terapia , Revisões Sistemáticas como AssuntoRESUMO
Numerous surgical and nonsurgical modalities are available to treat basal cell carcinoma (BCC), but their true effectiveness and safety is unknown. This article summarizes the evidence presented in a recent Cochrane review and aims to facilitate the interpretation of the review's findings for the Spanish and Latin American scientific communities. Much of the evidence the reviewers found came from single studies, preventing meta-analysis. Conventional surgical excision continues to be the most effective treatment for low-risk BCC. Most studies had small sample sizes, and some had problems with blinding, limitations which will have affected the assessment of subjective outcomes, such as pain and cosmetic results. The authors identified a lack of standardization in relation to recurrences and cosmetic outcomes that threatens not only the internal validity of the studies but also their external validity and reproducibility (AU)
Existen numerosas modalidades de tratamiento para el manejo de los carcinomas basocelulares (CBC), pero se desconoce la real eficacia y seguridad entre las alternativas quirúrgicas y no quirúrgicas disponibles. Este artículo resume la evidencia encontrada en la reciente revisión Cochrane de Thomson et al. y facilita la interpretación de sus resultados entre la comunidad científica iberolatinoamericana. La gran mayoría de la evidencia evaluada proviene de estudios individuales que impidieron la realización de una revisión sistemática cuantitativa. La escisión quirúrgica convencional continúa siendo la terapia más eficaz para el tratamiento de los CBC de bajo riesgo. La mayoría de estudios incluyeron tamaños de muestra pequeños y algunos tuvieron problemas con el cegamiento, lo que influiría en resultados subjetivos tales como el dolor o la cosmesis. Existe una falta de estandarización en relación con los desenlaces de recurrencia y de resultados cosméticos, lo que en conjunto afecta no solo la validez interna sino también la validez externa y la reproducibilidad de los estudios (AU)
Assuntos
Humanos , Carcinoma Basocelular/terapia , Neoplasias Cutâneas/terapia , Revisões Sistemáticas como AssuntoRESUMO
Numerous surgical and nonsurgical modalities are available to treat basal cell carcinoma (BCC), but their true effectiveness and safety is unknown. This article summarizes the evidence presented in a recent Cochrane review and aims to facilitate the interpretation of the review's findings for the Spanish and Latin American scientific communities. Much of the evidence the reviewers found came from single studies, preventing meta-analysis. Conventional surgical excision continues to be the most effective treatment for low-risk BCC. Most studies had small sample sizes, and some had problems with blinding, limitations which will have affected the assessment of subjective outcomes, such as pain and cosmetic results. The authors identified a lack of standardization in relation to recurrences and cosmetic outcomes that threatens not only the internal validity of the studies but also their external validity and reproducibility.
Assuntos
Carcinoma Basocelular , Neoplasias Cutâneas , Humanos , Carcinoma Basocelular/cirurgia , Dor , Reprodutibilidade dos Testes , Neoplasias Cutâneas/cirurgiaRESUMO
BACKGROUND: In recent years, the need for international, objective, patient-reported outcomes measures has grown as international collaboration has increased. As most quality-of-life scales have been developed in English, there is a growing need to adapt them transculturally to obtain equivalence between the original instrument and the adapted scale. OBJECTIVES: To assess the construct and convergent-discriminant validity and responsiveness of the Colombian version of Skindex-29. METHODS: The cross-sectional and longitudinal validity and responsiveness were tested in both healthy and dermatology patients. Construct validity was tested through a confirmatory factor analysis. The convergent-discriminant validity was assessed by examining the Spearman correlation coefficient. Change sensitivity was tested by means of the standardized response mean. The effect size and the minimum detectable change were also assessed. RESULTS: A total of 265 participants were included; 21·1% were healthy individuals, and 78·9% patients had either inflammatory or noninflammatory skin diseases. Confirmatory factor analysis showed an adequate comparative fit index and Tucker-Lewis index adjustment for the root mean square error of approximation. Convergent validity showed moderate correlations between the emotions, functioning and physical function or physical role domains. Discriminant validity showed low correlations between overall domains for both scales. Sensitivity to change at the first and third month showed effect sizes in global Skindex scores of 0·92 and 0·82, respectively. CONCLUSIONS: The Colombian version of Skindex-29 is a valid and clinically sensitive instrument, which can be used for clinical practice and for research to measure the impact of skin diseases on the quality of life of dermatology patients.
