Quality assessmentNo of patientsEffectQuality
No of studiesDesignRisk of biasInconsistencyIndirectnessImprecisionOther considerationsConcurrent
Time-to-maximum response (change in PASI; follow-up 4 weeks)
1
Ruzika 1998		observational studiesano serious risk of biasbno serious inconsistencyno serious indirectnessvery seriouscnoneCalcipotriol + betamethasone valerate

78		Based on PASI score over time maximum effect was not reached by 4 weeks of concurrent treatment in the randomised phase (following 2 weeks of calcipotriol treatment)⊕○○○
VERY LOW
Time-to-maximum response (change and % change in PASI; follow-up 8 weeks)
1
Kragballe 1998		observational studiesano serious risk of biasbno serious inconsistencyno serious indirectnessvery seriouscnoneCalcipotriol + betamethasone valerate

176		Based on change in PASI (and % change in PASI) maximum treatment effect had not been reached by 8 weeks⊕○○○
VERY LOW
Time-to-maximum response (change in PASI; follow-up 4 weeks)
1
Salmhofer 2000		observational studiesano serious risk of biasbno serious inconsistencyno serious indirectnessvery seriouscnoneCalcipotriol + diflucortolone valerate

63		Based on mean PASI, rapid improvement was seen over first 2 weeks but continued gradual improvement seen up to 4 weeks (maximum effect not reached)⊕○○○
VERY LOW
a

Although the data are taken from randomised trials the benefit of control data is not being utilised as considerations are being made based on single interventions without reference to the comparator arm

b

Unclear allocation concealment may have biased patient selection for this intervention

c

Interpreted from graphical representation

From: 8, Topical therapy

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Psoriasis: Assessment and Management of Psoriasis.
NICE Clinical Guidelines, No. 153.
National Clinical Guideline Centre (UK).
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