In aesthetic medicine, new products, techniques, and “game-changing” claims appear almost daily. As injectors, it’s essential to know how to filter through the noise and lean on evidence-based medicine to guide our practice. Reviewing evidence doesn’t need to feel overwhelming—think of it as a structured process that helps you confidently decide what’s worth bringing into your treatment room.
Step 1: Frame the Question
Start by defining exactly what you want to learn. A simple way to do this is with the PICO framework:
- Population: Who are you treating?
- Intervention: What treatment or technique are you considering?
- Comparison: What are you measuring against (placebo, no treatment, another product)?
- Outcome: What result do you want to see?
💡 Example: In patients seeking midface rejuvenation (Population), does HA filler (Intervention) compared with no treatment (Comparison) improve perceived youthfulness and symmetry (Outcome)?
Step 2: Search & Select Evidence
Once you have your question, dig into the literature. Use databases like PubMed, Cochrane, and Embase for reliable results. Then apply inclusion and exclusion criteria—such as patient age, study design, or publication date—to filter out studies that don’t apply. Don’t forget to remove duplicates and skim abstracts to weed out irrelevant papers.
The five components that compromise a study – Abstract, Introduction Methods, Results, and Discussion. Skim the abstract and discussion of the article to decide if the research is relevant to your question.
Step 3: Critical Appraisal (a.k.a. Evidence “Dissection”)
This is where you evaluate whether a study truly holds weight. Ask yourself:
1. What is the design of the study & hierarchy of evidence Level
- Highest: Systematic reviews & meta-analyses
- Next: Randomized controlled trials (RCTs)
- Then: Cohort/case-control studies
- Lowest: Expert opinion
2. Validity & Bias
- Was the study randomized? Blinded? Large enough sample?
- Were variables controlled?
- Any funding or conflict-of-interest concerns?
3. Methodology
- Were outcomes clearly defined?
- Did they use validated scales (like GAIS, FACE-Q)?
- Was follow-up long enough to show meaningful results?
4. Results
- Look at effect size, confidence intervals, p-values.
- Are results clinically significant—not just statistically?
5. Applicability
- Can findings apply to your patients?
- Is it practical, safe, and in line with your clinic’s resources?
Step 4: Synthesize the Findings
Now, step back and look at the big picture:
- Do multiple RCTs agree with one another?
- Are the results consistent or conflicting?
- What themes, strengths, and gaps are emerging?
Systematic reviews and meta-analyses are especially valuable here because they combine results across studies, giving you a more precise overall answer.
Step 5: Draw Evidence-Based Conclusions
Finally, summarize the level of evidence: Is it strong, moderate, or weak? Consider whether benefits outweigh risks in your setting. And don’t overlook research gaps—these may highlight areas where future studies are needed or where caution should be exercised in practice.
Why This Matters for Injectors
In aesthetics, our patients trust us not only for our technique but also for our judgment. By grounding decisions in solid evidence, we safeguard patient outcomes, protect our professional reputation, and continue to elevate the standards of our field. Evidence is about making sure your practice is informed, safe, and truly patient-centered.
