Diagnosis and Management of Infantile Hemangioma

Overview of the Literature .................................................................................................66
Detailed Analysis ...............................................................................................................67
Discussion .....................................................................................................................................78
State of the Literature...............................................................................................................78
Summary of Key Findings .......................................................................................................78
Key Findings From Contextual Questions .........................................................................78
Key Findings from Key (Comparative Effectiveness) Questions ......................................78
Findings in Relation to What is Already Known ...................................................................101
Applicability ..........................................................................................................................101
Implications for Clinical and Policy Decisionmaking ...........................................................102
Limitations of the Comparative Effectiveness Review Process ............................................103
Limitations of the Evidence Base ..........................................................................................104
Research Gaps and Areas for Future Research ......................................................................105
Conclusions .................................................................................................................................107
References ...................................................................................................................................108
Acronymes and Abbreviations Used in This Report ..............................................................122
Tables
Table A. Inclusion criteria .........................................................................................................ES-6
Table B. Summary of evidence in studies addressing imaging modalities ..............................ES-18
Table C. Summary of evidence in studies addressing pharmacologic interventions ...............ES-19
Table D. Sumary of evidence in studies addressing surgical interventions .............................ES-24
Table 1. Inclusion criteria ................................................................................................................9
Table 2. Strength of evidence grades and definitions ....................................................................13
Table 3. Characteristics of included studies addressing effectiveness and harms .........................20
Table 4. Posterior estimates of effect size .....................................................................................22
Table 5. Key resolution outcomes in studies comparing intravenous or intralesional and oral
corticosteroids ..........................................................................................................................27
Table 6. Key resolution outcomes in studies comparing intralesional and topical
corticosteroids ..........................................................................................................................28
Table 7. Key resolution outcomes in studies comparing methylprednisolone and prednisolone ..29
Table 8. Harms/adverse effects in comparative studies of steroids to treat IH ..............................30
Table 9. Adverse effects in case series of steroids to treat IH .......................................................32
Table 10. Key resolution outcomes in RCTs comparing propranolol and placebo or
observation ...............................................................................................................................39
Table 11. Resolution outcomes in studies comparing beta-blockers and steroids .........................43
Table 12. Resolution outcomes in studies comparing intralesional propranolol and
triamcinolone ...........................................................................................................................47
Table 13. Resolution outcomes in studies comparing propranolol with laser and propranolol
alone .........................................................................................................................................48
Table 14. Resolution outcomes in studies comparing propranolol and bleomycin .......................49
Table 15. Key outcomes in studies comparing propranolol and no propranolol ...........................50
Table 16. Resolution outcomes in studies comparing beta-blockers .............................................51
Table 17. Key resolution outcomes in studies comparing nadolol and propranolol ......................53
Table 18. Resolution outcomes in studies comparing forms of propranolol .................................54
Table 19. Key resolution outcomes in studies comparing timolol and observation or placebo ....55
Table 20. Resolution outcomes in studies comparing timolol and imiquimod..............................57
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