Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 3 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 →Clin Otolaryngol
Artificial Intelligence in Facial Plastic Procedures
OBJECTIVES: We reviewed the prospects of Artificial Intelligence (AI) and its usage in facial plastic surgery. METHODS: Literature search was performed using PubMed, Medline, Google and Google Scholar search engines between 2000 and 2025 years. RESULTS: AI is poised to impact the threefold missions of patient care, education and research. It plays a role in aiding clinician decision-making, serving as virtual conversational agents for patient engagement, and forecasting surgical outcomes. Primary areas of AI exploration in the medical field include machine learning (ML), neural networks (NN) and natural language processing (NLP). ML models have demonstrated the ability to detect facial features such as larger nasofrontal and nasolabial angles, correlating with increased attractiveness post-cosmetic rhinoplasty. Efficient resource allocation can be achieved through ML models guiding the analysis of post-operative free flap viability in facial skin cancer reconstruction. During online patient consultations, AI virtual assistants (AIVA) utilising NLP comprehend human speech intent, responding through dialogue. Unsupervised ML in facial analysis software is currently employed for correctly diagnosing rare diseases by recognising dysmorphic craniofacial features in two-dimensional photographs. AI also finds application in assessing post-operative outcomes, as well as in surgical training and research. CONCLUSION: The use of AI in healthcare is on the rise, contributing to advancements in pre-operative assessments, predicting prognoses, managing patients and monitoring postoperative progress. Surgeons are encouraged to explore collaboration with data scientists to shape the evolution of AI, aiming to enhance surgical efficiency, improve patient outcomes and potentially alleviate the workload associated with repetitive administrative duties.
1 Jan 2026
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