Evidensbaseret, ambulant dermatologisk behandling

The evidence base for routine therapeutic decisions in dermatological out-patients was studied in a random sample of the case-notes from 115 out-patients. The evidence base of therapy prescribed when the diagnosis was ascertained was studied in literature searches in MEDLINE® and EM-BASE®. Evidence was structured into primary evidence consisting of randomised controlled trials, and secondary evidence consisting of follow-up studies or applying trial results from clinical analogies, e.g. atopic and seborrheic dermatitis treatment. Randomised controlled trials could be found describing 38% (95% confidence interval: 30-47) of all treatments. Secondary evidence was found for 33% (24-41), while no evidence was found for 23% (16-31) of the given treatments. Approximately 75% of dermatological out-patient therapy is founded on scientific evidence spanning from randomised controlled trials to logical deduction about a given disease from an analogous clinical situation. The proportion of evidence based medicine in dermatological therapy therefore appears comparable to that of other fields of medicine.