Table 2 Appraisal of study validity using the AOTA Evidence Based Project Scale[23]
From: The effectiveness of lasers in the treatment of onychomycosis: a systematic review
Study | NHMRC evidence level** | Sample size | Internal validity | Threats to internal validity | External validity | Threats to external validity |
|---|---|---|---|---|---|---|
Carney et al. [26] | IV | C | 2 | 20% attrition | b | Only DLSO mycosis of the hallux included |
Unblinded assessment | ||||||
Hees et al. [37] | III-3 | C | 1 | b | Only T Rubrum mycosis included | |
Hochman [28] | IV | C | 2 | Antifungal cream used post intervention. | b | Type of onychomycosis treated not classified |
Variable follow up periods | ||||||
Hollmig et al. [29] | II | B | 2 | Blinding procedures not stated | b | Type of onychomycosis treated not classified |
18% attrition | ||||||
Kalokasidis et al. [30] | IV | A | 3 | Short follow up period OSI results not fully reported | b | Mainly mild/DLSO mycosis treated |
No control group | ||||||
Kimura et al. [31] | III-3 | A | 3 | Variable no. of treatments (1–3) | b | Mainly DLSO mycosis treated |
Turbidity scoring not validated | ||||||
Landsman et al. [25] | II | B | 2 | Smaller control than treatment group | b | Majority cases mild to moderate mycosis |
Industry sponsorship/authorship | ||||||
Lim et al. [32] | IV | B | 2 | Blinding procedures for nail grading not clear. | b | Majority cases mild to moderate mycosis |
Not stated how many finger v. toe nails included | ||||||
Moon et al. [33] | IV | C | 2 | Limited details on nail scoring system validation | b | Mainly (DLSO) included |
Noguichi et al. [34] | IV | C | 2 | Limited detail on independence of nail score assessment | b | Severe nail disease or thick nails excluded - only mild/DLSO cases included |
Waibel et al. [35] | III-3 | B | 2 | No control/placebo group | b | Types of mycosis included not reported |
Limited detail on how nail clearance assessed and reported | ||||||
Zhang et al. [36] | III-3 | B | 3 | No control/placebo group | b | Types of mycosis included not reported |
Limited detail on how nail clearance assessed |