皮肤科实证期刊阅读报告EBM-styleJournalReading.pptVIP

報告人： 陳清筠 Email: 137989@cch.org.tw 指導臨床教師：蔡妍筠 日期：102-4-25 Clinical Scenario （臨床情境） 一位43歲女性病患因罹患多毛症(hirsutism)多年至皮膚科門診求診，曾在報章報導看過多巴胺可有效治療多毛症，想進一步了解相關資訊。 Clinical Uncertainty → PICO 問題 Dopamine對毛囊生長是否有影響? 臨床個案的PICO Patient / Problem Hirsutism, female Intervention bromocriptine Comparison control Outcome hair shaft elongation, hair cycle stage and score Type of Question: Search Terms Strategy: （搜尋關鍵字與策略） 資料庫： Pubmed 搜尋日期： 102-4-10 搜尋關鍵字與隅策略： “ Hirsutism” AND “dopamine OR bromocriptine Best available evidence:（挑選可獲得之最佳研究證據） Citation/s: Dopamine is a novel, direct inducer of catagen in human scalp hair follicles in vitro Lead authors name : E.A. Langan 降階原因 : 個別的RCT異質性高，且結果不顯著 A consistent level 1 studies B consistent level 2 or 3 studies or extrapolations from level 1 studies C level 4 studies or extrapolations from level 2 or 3 studies D level 5 evidence or troublingly inconsistent or inconclusive studies of any level Extrapolations are where data is used in a situation that has potentially clinically important differences than the original study situation. Grades of Recommendation The Study: （研究效度）- 1 A consistent level 1 studies B consistent level 2 or 3 studies or extrapolations from level 1 studies C level 4 studies or extrapolations from level 2 or 3 studies D level 5 evidence or troublingly inconsistent or inconclusive studies of any level Grades of Recommendation The Study: （研究效度）- 2 Level of Evidence: Level 1b, Grade B (randomized study design, extrapolations) The Study: （研究效度）- 3本篇文獻的PICO (T) Patient / Problem Microdissected anagen VI HFs were obtained from redundant scalp skin, as a by-product of cosmetic surgery, with ethical approval and written informed consent. Intervention Microdissected HFs were cultured in a supplemented, serum-free culture medium for 7 days with the addition of dopamine, 10–1000 nmol L-1 or culture medium only. Comparison Microdissected HFs were cultured in a supplemented, serum-free culture medium for 7 da