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Show Notes
On today’s episode, we’ll go back to basics – how to read and digest a research article. We’ll cover the hierarchy of evidence and the need-to-knows for when you are reading and critiquing research.
Episode participants:
Radiance Wellness | radiance.well
Megan Ucich | the.skin.practitioner
Aayesha Patel | aaestheticsbyaayesha
Sarah Pertschuk | beautyinjectorsarah
Downloads:
- Radiance Wellness one-pager: Download Here
- Article review: How to critically appraise an article (Nature Clinical Practice)
Why Evidence Matters in Aesthetic Medicine
In aesthetic medicine, trends often move faster than the science. New techniques, products, and protocols frequently emerge through social media, online education, and peer discussions. While these sources can be valuable, relying on them alone risks drifting away from evidence-based practice. Returning to research helps ensure patient safety, professional credibility, and clinical consistency.
From Social Media to Science
Unlike other medical specialties, aesthetic medicine has a relatively small body of peer-reviewed research. This gap means clinicians often depend on anecdotal experience, influencer education, or industry-led content. While these perspectives can offer insight, they should always be based in scientific data. Research provides the foundation that allows clinicians to evaluate trends critically instead of adopting them blindly.
Start With the Right Question
Before diving into a research paper, it’s essential to define a clear clinical question. One commonly used approach is the PICO framework: Population, Intervention, Comparison, and Outcome. The PICO framework helps turn a vague clinical idea into a focused research question. For example, in adults with moderate acne scarring (Population), does microneedling with PRP (Intervention) compared to microneedling alone (Comparison) lead to greater improvement in scar severity and patient satisfaction (Outcome)? Defining these elements up front makes it easier to quickly judge whether a study is relevant before reading it in detail.
Understanding the Hierarchy of Evidence
Not all research offers the same level of credibility. At the top of the evidence hierarchy are systematic reviews and meta-analyses, which synthesize data from multiple high-quality studies. The gold standard of a design study is the randomized, blinded, controlled study. Randomization and blinding are two techniques used to prevent bias from affecting the outcome of the study. Randomization means patients are randomly assigned to a treatment group or a control group. Blinding means neither the patients nor the study staff know who is receiving the treatment and who is receiving the placebo or control. A list of weaker studies include: cohort studies, open label studies, single arm trials, case-control studies, and expert opinions. Recognizing where a study falls within this hierarchy provides a quick assessment of its strength.
Evaluating Sample Size and Relevance
A critical aspect of any study is its sample size and population. In aesthetic medicine, studies often include small groups and are in-vitro or animal vs human studies. While these findings can guide early understanding, they may not translate directly to real-world clinical practice. Clinicians should consider whether the study participants reflect their actual patient population in age, gender, ethnicity, and treatment history.
Bias, Funding, and Industry Involvement
Funding sources deserve thoughtful consideration but do not automatically discredit a study. Many large aesthetic trials are funded by pharmaceutical companies and evaluated under regulatory oversight. Transparency, study design, and reproducibility matter more than funding origin alone. Understanding potential bias allows clinicians to interpret results with appropriate caution.
Interpreting Statistical Significance
Understanding basic statistical concepts is essential when reviewing research. A p-value reflects the probability that results occurred by chance, with < 0.05 commonly considered statistically significant. This means that there is a less than 5% chance that this result would have occurred by chance alone and 95% or greater chance the result is due to the experimental treatment. A confidence interval (CI) shows the range in which the true effect is likely to fall, with narrower intervals indicating more precise results. However, statistical significance does not always equal clinical relevance. The study design should state what a clinically meaningful difference is, or the practitioner should decide what a clinically meaningful difference would be for their patients.
From Research to Clinical Practice
Even well-designed studies may not be immediately applicable in clinical settings. Aesthetic outcomes are often subjective, influenced by both clinician technique and patient perception. Integrating research into practice requires balancing evidence, clinical judgment, and individual patient goals. The study should have a section on safety where the side effects of the treatment are recorded. The best safety tables allow you to compare the incidence of a side effect seen in the treatment group to the incidence seen in the control group so you can clearly assess whether the treatment caused the side effect. Before deciding to introduce a treatment or procedure into your office, a risk/benefit ratio should be measured to make sure the risks don’t outweigh the beneficial effects of the treatment.
Recognizing Limitations and Future Directions
Quality research acknowledges its own limitations. Small sample sizes, short follow-up periods, and narrow study populations are common in aesthetics. These limitations don’t invalidate the research but highlight opportunities for future studies and continued learning.
Returning to the Practice of Medicine
Prioritizing evidence-based medicine elevates both patient trust and professional integrity. By critically evaluating research and thoughtfully applying findings, aesthetic providers reinforce their role as medical professionals committed to safety, education, and high-quality care.
