Use of the hCONSORT Criteria as a Reporting Standard for Herbal Interventions for Common Dermatoses – A Systematic Review J. Ornelas, MD, MAS 1, E. Routt, MD 2, P. Kallis, BS, BA 3, H. Lev-Tov, MD, MAS 3 1. University of California, Davis Department of Dermatology 2. Ichan School of Medicine at Mount Sinai Department of Dermatology 3. University of Miami Miller School of Medicine Department of Dermatology and Cutaneous Surgery British Journal of Dermatology. DOI:10.1111/bjd.16256

Introduction (1) What’s already known? Complementary and alternative medicine (CAM) is popular with patients with skin disease 84.5% of patients with skin disease report using CAM in 2007 CAM interventions in dermatology are difficult to integrate into clinical practice Generally due to lack of quality data on efficacy and safety

Introduction (2) The CONSORT extension criteria on reporting herbal interventions (hCONSORT) aim to improve the quality of data reported for herbal interventions Adherence to these guidelines is not known

Methods Systematic review: search of Medline, Embase, Cochrane library for randomized controlled trials published 2009 – 2014 Narrowed to plant based interventions for acne, atopic dermatitis and psoriasis

Methods (2) Publications independently analysed by 2 authors to determine number of hCONSORT criteria met Analysis of variance used to examine differences in scores by each disease

Methods (3) See Table 1: Standards for reporting…

Results 27 publications met criteria for inclusion (see Prisma diagram, Figure 1)

Results (1) Only publications 4 reported at least 50% of hCONSORT criteria Highest score 8/14 criteria satisfied None of the publications satisfied a criteria in each category

Results (2) Mean score by disease Acne: 4.9 Eczema: 3.7 Psoriasis: 2.9 No association between number of criteria satisfied and year of publication, journal impact factor, sample size

[Please include Table 2: Summary of adherence…]

Discussion (1) What does this study add? This systematic review of the literature shows generally poor adherence to hCONSORT criteria Particularly concerning as the 3 disease states examined are most common chronic diagnoses encountered in clinical dermatology for which many CAM intervention exist

Discussion (2) Enforced adherence to hCONSORT criteria would improve quality of publications This would ease integration of CAM into clinical practice when appropriate

Discussion (3) Our review brought up important points for discussion: hCONSORT criteria could be refined to be more specific and easily applied Dosing rationale for approved allopathic medications in dermatology is sometimes arbitrary, possibly unfair standard Rationale for selected placebo may be assumed as obvious if it is standard of care for authors Differences in manufacturing standards in various countries Difficulty in reporting proprietary manufacturing techniques

Conclusions This study demonstrates a lack of adherence to hCONSORT guidelines in acne, eczema and psoriasis Future adherence to these guidelines will provide reliable data which will help to improve integration of CAM therapies, when appropriate

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