Level of Evidence for Using Lasers and Light Procedures for Treating Melasma Using the GRADE Working Group Recommendation [38-40]

Levels of evidence for aesthetic procedures

Level of evidence

Quality of evidence and definitions

A: High

Further research is very unlikely to change our confidence in the estimate of effect Several high quality studies with consistent results

B: Moderate

Further research is likely to have an important impact on our confidence in the

estimate of effect and may change the estimate

One high quality study or several studies with limitations

C: Low

Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate One or more studies with limitations

D: Very low

Any estimate of effect is very uncertain

Expert opinion with

No direct research experience

One or more studies with very severe limitations

GRADE Working Group [38], Guyatt et al. [39]

Reference

Procedures

Quality of evidence (A-D)

[5-7]

Full ablative lasering

D (very low)

[11, 13, 14]

Fractional lasers

B (moderate)

[2-4]

QS Nd:YAG laser

C (low)

[18-22, 28]

QS Nd:YAG laser toning

A (high)

[26, 27, 29]

Intense pulsed light

C (low)

[33, 34]

Pulsed dye laser

C (low)

[37, 38]

Copper bromide laser

C (low)

 
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