Usefulness of cochrane intervention reviews for the practicing dermatologic surgeon

Background: The Cochrane Collaboration produces systematic, evidence-based reviews of clinically relevant topics in medicine, including those relevant to dermatologic surgery. Objective: To assess the utility of Cochrane reviews for practicing dermatologic surgeons. Methods: Search of the Cochrane Database of Systematic Reviews on February 20, 2012 for topics relevant to dermatologic surgery. Assessment of clinical recommendations with regard to their likelihood to affect medical decision-making in clinical dermatologic surgery. Results: Fifteen Cochrane reviews met the search criteria; three offered positive conclusions regarding the comparative effectiveness of different therapies for the same indications. Conclusions: Cochrane reviews offer outstandingly complete evidence-based summaries of their topics. As such, the methodology of Cochrane reviews is a model for reviews in dermatologic surgery. Because of the dearth of high-level evidence in dermatologic surgery, the ability of Cochrane reviews to provide specific recommendations remains limited. Furthermore, dermatologic surgery may be inherently difficult to study because of the rapid evolution of procedures, intraprocedure complexity and variation, difficulties inherent in randomizing patients to interventions, and intersurgeon skill variation. That being said, the dermatologic surgery literature continues to improve and grow, and investigators are now broaching the special challenges associated with research in this area.