Diagnosis and Management of Infantile Hemangioma

Table 38. Strength of evidence for effectiveness of laser modalities (continued)
Intervention
PDL vs.
Observation
Outcome
Study Design
Quality and Number
of Studies (N Total)
Quality of life
RCT: 1 good, 1
fair 210,212 (143)
Study
Limitations
Consistency Directness Precision
Reporting
Bias
Finding
Strength of Evidence Grade
Medium Inconsistent Indirect Imprecise Undetected No significant differences in parent
ratings of QoL in one study; more
parents of children in PDL arm in
another considered appearance
improved than in observation arm.
Nd:YAG with
extended
cooling vs.
Nd:YAG with
standard
cooling
Nd:YAG vs.
CO2 laser vs.
Tracheostomy
Improvement in IH
Cohort studies: 1
fair 218 (290)
Speech
Cohort studies: 1
poor 214 (46)
Low SOE for lack of difference in
QoL with PDL compared with
observation due to lack of
consistency and precision, few
studies.
Medium Unknown Direct Imprecise NA Improved resolution with extended
cooling protocol vs. traditional.
Insufficient SOE given single study
with medium limitations.
High Unknown Indirect Imprecise NA 75% of children with tracheostomy
had delayed speech vs. 0 with no
tracheostomy in the laser treatment
era.
Insufficient SOE given small, single
study.
95