Critically appraise studies based on injectable treatments.

Assessment: Critique of 3 studies

In this assessment the task is to critically appraise studies based on injectable treatments.

In this assessment you will critique three research papers, all of which assess the efficacy of treatments but which use different methodologies and study designs. You will need to read each paper thoroughly and consider whether the approach of each manuscript is scientifically sound.

The three research papers can be accessed in the reading list (Assignment 2 essential reading) and are also listed below:

Essential Reading Section Notes

Custis, T. et al. (2010) Comparison of treatment of melomental fold rhytides with cross‐linked hyaluronic acid combined with onabotulinumtoxina and cross‐linked hyaluronic acid alone Dermatologic surgery 36, 1852-1858 This article compares the efficacy of intradermal cross‐linked hyaluronic acid (HA) and onabotulinumtoxinA combination therapy with the efficacy of cross‐linked HA monotherapy in patients with melomental fold rhytides.

Carruthers, A., Carruthers, J., Monheit, G. D., Davis, P. G., and Tardie, G. (2010) Multicenter, randomized, parallel‐group study of the safety and effectiveness of onabotulinumtoxinA and hyaluronic acid dermal fillers (24‐mg/ml smooth, cohesive gel) alone and in combination for lower facial rejuvenation Dermatologic surgery 36, 2121-2134 This article evaluates safety and effectiveness and compares combination treatment with onabotulinumtoxinA and a 24‐mg/mL smooth, cohesive HA gel filler with either treatment alone for rejuvenation of the perioral area and lower face in female subjects.

Bae, G. Y., Na, J. I., Park, K. C., and Cho, S. B. (2020) Nonsurgical correction of drooping mouth corners using monophasic hyaluronic acid and incobotulinumtoxinA Journal of Cosmetic Dermatology 19(2), 338-345 This article describes validation of a nonsurgical therapeutic approach for correcting a “saddened” appearance characterized by drooping mouth corners, oral commissures, and/or marionette lines.

Compare and contrast the findings of the papers and also the different study methods.

Describe the methods and findings of the three papers in isolation.

Compare and contrast the methodologies and the consensus findings across the papers and discuss possible reasons for the differences.

Recommended Reading Section Notes

Sundaram, H. et al. and Global Aesthetics Consensus Group (2016) Global Aesthetics Consensus: hyaluronic acid fillers and botulinum toxin type A—recommendations for combined treatment and optimizing outcomes in diverse patient populations Plastic and Reconstructive Surgery 137(5), 1410-1423. This article considers strategies for combined treatments, and how patient diversity influences treatment planning and outcomes.

Carruthers, J. D., Glogau, R. G., and Blitzer, A. (2008) Advances in Facial Rejuvenation: Botulinum Toxin Type A, Hyaluronic Acid Dermal Fillers, and Combination Therapies– Consensus Recommendations Plastic and reconstructive surgery 121(5), 5S-30S. This article reviews the properties and uses of botulinum toxin type A (BoNTA) and hyaluronic acid fillers and updates consensus recommendations for facial rejuvenation using these two types of products.

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