New rating system for products and technologies launched by BAAPS and NAR
A new ratings system has been launched to helpconsumers identify the quality of researchbehind aesthetic products and treatments.
The British Association of Aesthetic Plastic Surgeons (BAAPS) unveiled the initiative, which it is launching in conjunction with The National Institute of Aesthetic Research (NIAR), at its annual scientific meeting. The “evidence pyramid” will be used to rate clinical evidence already used by medical journals and will comprise four tiers.
To reach the top tier of the pyramid, a device or procedure must have been studied for more than five years and have published more than 50 non-sponsored studies inmedical journals. At the other end of the spectrum, the fourth tier will include devices or procedures that have been studied for less than a year, have very few case studies to backup their claims and have all their information published through promotional channels rather than in scientific papers. These will be classified as “below surface” and will include products that make vague or unrealistic claims such as “boob job serum”. Former BAAPS president Mr RajivGrover who presented the initiative to the press playfully nicknamed this the “BS” level.
The pyramid is inspired by the way the surgical arenaevaluates – even early or experimental – data published inrespected outlets such as the Aesthetic Surgery Journal(ASJ) and Plastic and Reconstructive Surgery (PRS). Grover, who handed over leadership of the organisation to Mr Michael Cadier at the event at the QEII ConferenceCentre in London, said that such a system would help with misreporting in the mainstream media, which is often driven by manufacturers’ claims about their devices’ effects. Grover cited research from LexisNexis, which revealed that in 1991 there were only 45 articles in national newspapers dealing with cosmetic surgery compared to3,568 in 2013 – a rise of 7,900%. Yet, he explained, the amount of mainstream coverage achieved by just four ofthe most popular aesthetic devices was 24 times the number of clinical papers behind them (source: PubMed).However even the actual peer-reviewed data can besurprising if examined in detail, he said. The study’s evaluation of high-profile non-invasive liposuction technologies showed the number of patients studied varied wildly: from just two cases to a few hundred (only 16% involved more than 100and more than half involved less than 50), and all but onewere based on less than six months’ follow-up. Only one trialfollowed patients for five years (just two patients, however). In addition, more than a third (36%) of authors discloseda financial or conflict of interest – which means the devicecompany either made a payment, provided the equipment orthe author has a financial interest in the business.
Grover said, “It is, at its most basic, a call for commonsense and a reminder to ask questions. When was thetreatment launched? How many people were involved intrials and for how long were they followed? Where has the data been published or presented, and was it sponsored? Much of what is communicated will inevitably be ledby manufacturers, commercial providers or individualpractitioners, occasionally making grandiose claims. Inthe clinical world, there is widespread use of ‘tiers’ whichallow us to determine how much research backs findings,so we can make informed decisions based on evidence thatgoes further than skin deep. However, without a similarfilter, there are pitfalls for those who might be swayedby weak data, manipulated photos or paid-for celebrityendorsements. There urgently needs to be a traffic light orwarning system for new devices and techniques promotedto the public.”
The National Institute of Aesthetic Research, foundedlast year by BAAPS in conjunction with the HealingFoundation, will analyse the research and act as the “myth-buster” for the cosmetics sector. According to Preston-based consultant plastic surgeonand BAAPS trainee member Reza Nassab, who conductedthe studies titled ‘Evidence-Based Hype’ and ‘CosmeticSurgery in the Press’, “The evidence supporting many newdevices is of low level and the results are variable. The publicmay not be aware of all research findings and results –increased education is needed to ensure people understandtreatments may not be as effective as portrayed in theirmarketing materials. Organisations such as the BAAPSand the new National Institute for Aesthetic Research areideally placed to promote education in this area.”
