Diagnosis and Management of Infantile Hemangioma

Table 38. Strength of evidence for effectiveness of laser modalities
Outcome
Intervention
Longer pulse
PDL vs. other
laser types
and protocols
Study Design
Quality and Number
of Studies (N Total)
Improvement in IH
RCT: 1 fair 211 (52)
Cohort studies: 2
poor 215,216 (212)
Study
Limitations
Consistency Directness Precision
Reporting
Bias
Finding
Strength of Evidence Grade
Medium Inconsistent Direct Imprecise Undetected In 1 RCT, resolution outcomes
similar between laser types; greater
clearance in PDL +cooling arm in
one cohort study, 216 and more
children in PDL arm had complete
regression than in Nd:YAG in
another 215 ; typically more than 50%
of children receiving any laser had
at least 50% clearance.
PDL vs.
Observation
Improvement in IH
RCT: 1 good, 1
fair 210,212 (143)
Low SOE for no difference in
effects on size reduction between
longer pulse PDL and various other
lasers given few studies, medium
limitations, and inconsistent and
imprecise findings.
Low Consistent Direct Imprecise Suspected No significant difference in
measured volume or proportion of
clearance between groups in either
study when considering complete
and near complete clearance;
greater observer-ratings of
improvement for PDL arm vs.
observation in one study. 210
Low SOE for lack of difference
between PDL treatment and
observation in reducing lesion size
due to lack of precision, few
studies.
94