Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 4 appraisals
Lasers in medical science
Efficacy and safety of recombinant human epidermal growth factor combined with fractional carbon dioxide laser for facial atrophic acne scars: a systematic review and meta-analysis of randomized trials
BACKGROUND: The combination of recombinant human epidermal growth factor (rhEGF) and fractional carbon dioxide (CO2) laser therapy is increasingly used in the treatment of facial atrophic acne scars. OBJECTIVE: This study aimed to systematically assess the efficacy and safety of rhEGF combined with fractional CO2 laser therapy for managing facial atrophic acne scars. METHODS: PubMed, Embase, the Cochrane Library, Web of Science, CNKI (China National Knowledge Infrastructure), Wanfang, SinoMed, and VIP were searched from inception to July 29, 2025. Parallel-group or split-face randomized controlled trials (RCTs) comparing fractional CO2 laser therapy + rhEGF with fractional CO2 laser therapy for treating atrophic acne scars were considered for inclusion. Risk of bias was assessed using the Cochrane Collaboration's risk-of-bias tool. The meta-analysis based on fixed or random effects models was carried out for Echelle d'Evaluation Clinique des Cicatrices d'acne (ECCA) scores, Vancouver Scar Scale (VSS) scores, transepidermal water loss (TEWL), etc. It was registered on PROSPERO (ID: CRD42024599311). RESULTS: Twelve RCTs involving 1,044 patients were included, and all trials were conducted in China. Follow-up durations across studies ranged from 1 week to 12 months. Compared with fractional CO₂ laser therapy alone, the combination therapy significantly reduced ECCA scores by a mean of 11.14 points (95% CI: -16.82 to -5.45, P = 0.0001) and VSS scores by a mean of 1.54 points (95% CI: -2.55 to -0.54, P = 0.003). The combination therapy demonstrated advantages in improving the durations of crust formation. The incidence of adverse events, particularly hyperpigmentation (RR = 0.41, 95% CI: 0.20 to 0.86; P = 0.02), was significantly lower in the combination therapy group. According to the GRADE assessment, the certainty of evidence ranged from very low to moderate for most outcomes. CONCLUSION: This study suggests that rhEGF combined with fractional CO₂ laser therapy may be beneficial for treating atrophic acne scars. However, because of the low to moderate certainty of evidence according to GRADE assessment, more robust, large-scale RCTs are needed to confirm these findings and define optimal treatment parameters.
23 May 2026
Read appraisal →Aesthetic surgery journal
Therapeutic Efficacy and Safety of Recombinant Botulinum Toxin Type A for Moderate to Severe Glabellar Lines: A Randomized, Controlled, Double-blind, Phase III Trial in Chinese Adults
BACKGROUND: Conventional botulinum toxin type A (BoNT/A) products include non-therapeutic accessory proteins vary in composition and manufacturing processes, which may contribute to differences in purity and biochemical characteristics. YY001 (Retoxin®) is a novel recombinant BoNT/A manufactured via E. coli expression to reduce impurities, improve purity, and minimize immunogenic risk. OBJECTIVES: To evaluate the efficacy, safety, and immunogenicity of YY001, a recombinant botulinum toxin type A (Chongqing Claruvis Pharmaceutical Co., Ltd., Chongqing, China), in the treatment of moderate-to-severe glabellar lines. METHODS: In this multicenter, randomized, double-blind, vehicle- and active-controlled Phase III trial, 529 adults aged 18-65 with moderate to severe glabellar lines were randomized 4:2:1 to receive a single 20 U injection of YY001, Botox®(Allergan Pharmaceuticals Ireland, Westport, Ireland), or vehicle. The primary endpoint was composite response rate (CRR) at Week 4, defined as a ≥2-grade improvement of glabellar line severity assessed by both investigator and participant. Secondary endpoints included onset time, duration, satisfaction, and safety. RESULTS: YY001 achieved a CRR of 86.7% at Week 4, significantly outperforming Botox® (66.7%, P < .0001) and vehicle (1.3%, P < .0001). It showed faster onset, longer median duration (97 days), and high participant satisfaction. Adverse events were mild and comparable across groups. Only one case of anti-drug antibody was observed; no neutralizing antibodies were detected. A 12-week follow-up and ethnically homogenous population may limit generalizability. CONCLUSIONS: YY001 demonstrated strong efficacy and a favorable safety profile than Botox®. Longer-term and multicenter studies are needed to assess durability, immunogenicity, and applicability across broader populations. LEVEL OF EVIDENCE: 1 (THERAPEUTIC): For image description, please refer to the figure legend and surrounding text.
19 May 2026
Read appraisal →Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery
Machine learning-powered decoding of facial complexity: a diamond-and-triangle geometry for frontal facial analysis
Facial configuration is far more complicated and variable than the representations offered by a couple of conventionally used mathematic laws, necessitating development of a comprehensive and interracially comparable system for frontal facial analysis. In this study, based on morphological analysis of 33 Caucasian and 33 Asian female faces with high perceived facial attractiveness (i.e. facial esthetic appeal in frontal views), validated by independent layperson ratings, in contrast with 'ordinary' faces of 67 Caucasian and 67 Asian females, a machine learning-powered model, building on a diamond-and-triangle geometric framework, was constructed to decode the esthetic-determining facial traits and quantify the probability of a face conforming to the generally accepted attractiveness. The SVM models demonstrated excellent efficacy in this task, based on the input of 21 facial proportion indices derived from the diamond-and-triangle geometry. By interpreting the contribution of input features to each model's diagnosis, the Asian and Caucasian faces shared prioritization of proportional coordination of facial height with mid-facial width and outer canthal distance in determining facial harmony, and exhibited ethnicity-specific variations in hierarchical importance of other proportion indices. The highly coordinated diamond-and-triangle geometric framework distinguished the attractive faces from the ordinary, with cross-ethnic similarities between Caucasian and Asian females. The machine learning-powered model, integrated with the diamond-and-triangle geometry, provides references for cross-ethnic facial analysis and customized treatment planning.
4 May 2026
Read appraisal →The Journal of dermatological treatment
Comparative efficacy and safety of platelet-rich plasma (PRP), injectable platelet-rich fibrin (i-PRF) and concentrated growth factors (CGF) for female pattern hair loss (FPHL): a prospective multicenter randomized clinical trial
BACKGROUND: Comparative studies among different autologous platelet concentrate types for FPHL remain lacking. METHODS: Patients with FPHL (Sinclair gradeII-III) were enrolled and randomized to receive 4 sessions of PRP, i-PRF or CGF treatment at 4-week intervals. The primary endpoint was the inter-group comparison of the non-vellus target area hair count (TAHC)-increase (%) at 24 weeks. Secondary endpoints included: within-group changes in TAHC from baseline; within-group changes in hair diameter (HD) from baseline and inter-group comparison of HD-increase (%) at 24 weeks; Growth factor concentrations were quantified to explore correlations with efficacy. RESULTS: Seventy-four patients completed the study. Post-treatment TAHC increased significantly from baseline in all groups (all p < 0.05). The TAHC-increase(%) was significantly greater in the CGF (27.11 ± 14.80%) and i-PRF (26.54 ± 11.46%) groups compared to the PRP group (14.53 ± 8.65%; p < 0.05), with no significant difference between CGF and i-PRF. Regarding HD increase, all three groups showed improvement, with no statistically significant differences observed among groups (p > 0.05). The i-PRF group showed the lowest adverse event rate. Vascular endothelial growth factor (VEGF) concentration demonstrated a significant positive correlation with the percentage increase in TAHC (r = 0.527, R2=0.278, p < 0.05). CONCLUSIONS: CGF and i-PRF demonstrated superior efficacy in increasing TAHC in FPHL patients. The i-PRF group had the lowest adverse event rate. VEGF levels may play a potential role in promoting hair growth.
2 May 2026
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