Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a Cochrane Clinical Answer that focuses on the above important clinical question.
Confidence in the evidence is high or moderate to high where GRADE has been performed and the intervention is more effective/beneficial than the comparison for key outcomes.
Population: Adolescents and adults with scalp psoriasis
Intervention: Topical corticosteroid ᵃ
Comparison: Topical vitamin D (calcipotriene) ᵃ
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Severity score (total sign score [TSS]) | See Notes ᵇ | GRADE assessment not performed for this outcome |
Clearance of symptoms (investigator assessed) | Favors intervention | Moderate |
Clearance of symptoms (patient assessed) | Favors intervention | GRADE assessment not performed for this outcome |
Response to treatment (investigator assessed) | Favors intervention | High |
Response to treatment (patient assessed) | Favours intervention | Moderate |
At least one adverse event | Occurs more commonly with topical vitamin D compared with topical corticosteroids (favors intervention) ᶜ | GRADE assessment not performed for this outcome |
At least one adverse event | No statistically significant difference ᵈ | GRADE assessment not performed for this outcome |
Withdrawals due to adverse events | Occurs more commonly with topical vitamin D compared with topical corticosteroids (favors intervention) | Moderate |
Disease‐free period, duration of response, quality of life | - | None of the studies identified by the review assessed these outcomes |
Note ᵃ This evidence table summarizes the findings for the comparison of topical corticosteroids versus topical vitamin D, which is the main comparison as stated in the Cochrane review Summary of Findings table. See the full Cochrane Clinical Answer (CCA) for information on other comparisons (topical corticosteroid versus placebo; topical corticosteroid plus vitamin D versus placebo; topical corticosteroid plus vitamin D versus topical vitamin D). ᵇ Results reported narratively (five RCTs; all trials reported a greater reduction in TSS with topical corticosteroids compared with topical vitamin D). ᶜ At least one adverse event occurred more commonly with topical vitamin D when compared with the following three corticosteroids: 1 mg/mL betamethasone valerate solution; 0.5 mg/g betamethasone dipropionate gel; and 0.05% clobetasol propionate shampoo. Results reported separately as subgroup analyses. ᵈ No statistically significant difference was found when comparing 0.05% clobetasol propionate solution with topical vitamin D; result reported as a subgroup analysis.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
- How do topical steroids affect outcomes in people with scalp psoriasis?
- How do topical steroids affect outcomes in people with scalp psoriasis?
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