Diagnosis and Management of Infantile Hemangioma

Table 39. Strength of evidence for harms of laser modalities (continued)
Intervention
Nd:YAG
Cryotherapy
vs.
Observation
Outcome
Study Design
Quality and Number of
Studies (N Total)
Pigmentation changes
Cohort studies: 1 good 215
(50)
Scarring
Cohort studies: 1 good, 2
poor 214,215,218 (386)
Case series: 3
poor 231,232,234 (954)
Bleeding
Case series: 2 poor 232,234
(794)
Scarring
Comparative study with
treated/untreated IH per
child: 1 poor 220 (13)
Study
Limitations
Consistency Directness Precision
Reporting
Bias
Finding
Strength of Evidence Grade
Low Unknown Direct Imprecise NA 2/25 children receiving Nd:YAG
in one study had scarring.
Insufficient SOE due to few
occurrences of the outcome
reported.
Medium Consistent Direct Precise NA Most studies reported scarring in
≤5% of children.
Low SOE for association of
scarring with Nd:YAG treatment
due to few occurrences of the
outcome reported.
High Unknown Direct Precise Undetected Bleeding noted in 13/794
children.
Insufficient SOE due to few
occurrences of the outcome
reported in studies.
High Unknown Direct Imprecise NA Scarring in 4 of 17 IH treated with
cryotherapy.
Insufficient SOE due to single,
small study.
99