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. 2018 Apr 18;2018(4):CD006545. doi: 10.1002/14651858.CD006545.pub3

Gong 2015.

Methods
  • Design: 3 arms

  • Country: China

  • Method of randomisation: 39 children with superficial infantile haemangiomas were randomised into 3 equal groups of 13 each: the first given topical timolol maleate together with oral propranolol, the second given only oral propranolol, and the third given only topical timolol maleate.

  • Blinding: double‐blind

  • Location: Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University

  • Length of follow up: 3 to 12 months

Participants
  • Diagnosis: children with superficial haemangiomas

  • Sex: 24 female, 15 male

  • Age: between 2 and 9 months

  • Inclusion criteria: children younger than 12 months with superficial haemangiomas with no previous treatment

  • Exclusion criteria: those with deep or mixed haemangiomas, bronchial asthma, pneumonia, sinus bradycardia or atrioventricular block (second degree and above), fever, and diarrhoea or respiratory infections

  • Number of randomised children: 39

Interventions Intervention A (number of children: 13): propranolol oral (regimen below) + timolol maleate topical (regimen below)
Intervention B (number of children: 13): propranolol oral: 10 mg tablet, at a 1.0 mg/kg dose orally once a day with food
Intervention C (number of children: 13): timolol maleate topical: 0.5% timolol maleate eye drops to the lesion twice daily (25 mg/5 mL) with medical cotton swabs
Outcomes Outcome A: the improvement in size after treatment was graded on a 4‐point scale as proposed by Achauer and colleagues: class I (poor) ‐ reduction in size of < 25%; class II (moderate) ‐ reduction in size of 25% to 50%; class III (good) ‐ reduction in size of 50% to 75%; and class IV (excellent) ‐ reduction in size of 75% to 100%. Classes I and II were considered ineffective treatment, and classes III and IV effective treatment.
Notes
  • Trial registration: not stated

  • Funder: not stated

  • Role of funder: not stated

  • A priori sample size estimation: not stated

  • Conducted: October 2012 to August 2013

  • Declared conflicts of interest: not reported

Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Quote: "a random sequence was generated using a computer program to assign patients in a 1:1:1 ratio to three groups of 13 patients each." Page 837
Comment: Authors reported information about adequate random sequence generation.
Allocation concealment (selection bias) Unclear risk There was insufficient information to classify this item as high or low.
Blinding of participants (Performance bias) Unclear risk It is highly probable that participants were aware of intervention group assigned, but it is unclear whether this had an impact or not on the trial results.
Blinding of personnel (performance bias) Unclear risk It is highly probable that researchers were aware of intervention group assigned, but it is unclear whether this had an impact or not on the trial results.
Blinding of outcome assessment (detection bias) 
 All outcomes Low risk Quote: "A panel of three surgeons who were unaware of which treatment the infant had been given and the response rates, assessed the outcomes." Page 837
Comment: Authors reported information about adequate blinding of outcome assessment.
Incomplete outcome data (attrition bias) 
 All outcomes Low risk No children were lost at follow‐up.
Selective reporting (reporting bias) Low risk Selective reporting of data was not detected.
Other bias Low risk No other biases were identified.