Welcome to the Podiatry Arena forums

You are currently viewing our podiatry forum as a guest which gives you limited access to view all podiatry discussions and access our other features. By joining our free global community of Podiatrists and other interested foot health care professionals you will have access to post podiatry topics (answer and ask questions), communicate privately with other members, upload content, view attachments, receive a weekly email update of new discussions, access other special features. Registered users do not get displayed the advertisements in posted messages. Registration is fast, simple and absolutely free so please, join our global Podiatry community today!

  1. Everything that you are ever going to want to know about running shoes: Running Shoes Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
  2. Have you considered the Critical Thinking and Skeptical Boot Camp, for taking it to the next level? See here for more.
    Dismiss Notice
  3. Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
    Dismiss Notice
Dismiss Notice
Have you considered the Clinical Biomechanics Boot Camp Online, for taking it to the next level? See here for more.
Dismiss Notice
Have you liked us on Facebook to get our updates? Please do. Click here for our Facebook page.
Dismiss Notice
Do you get the weekly newsletter that Podiatry Arena sends out to update everybody? If not, click here to organise this.

Clinical Study for Laser Treatment of Onycho

Discussion in 'General Issues and Discussion Forum' started by doc617, Jun 18, 2013.

  1. doc617

    doc617 Welcome New Poster


    Members do not see these Ads. Sign Up.
    As the world of podiatry becomes a larger and larger target for laser companies, what do you think would best prove the efficacy of using lasers to treat nail fungus?

    If a company were to put out a study that included the use of anti-fungal creams and sprays between treatment, do you believe it would discredit the study?

    Currently I have yet to see a very convincing study on this.
     
  2. Craig Payne

    Craig Payne Moderator

    Articles:
    6
    :welcome:

    I have no problem with industry done or funded research, as long as it stacks up to all the usual scrutiny (ie proper controls; blinding of subjects and assessors etc) and is published in a peer reviewed journal and all potential conflicts by authors are documented. For transparency purposes it is important that it was registered with one of the clinical trial registries.

    I regularly have a go at discrediting studies - who the authors are and who funded the study are usually near the bottom my list of things to be concerned about.


    You are right, there are yet no convicing studies on lasers and inychomycosis.
     
  3. Admin2

    Admin2 Administrator Staff Member

  4. doc617

    doc617 Welcome New Poster



    Thanks for the input Craig. I completely agree with you. One of the problems I have had with a number of the studies that have been peer reviewed is that their treatment protocol included the use of topicals and sprays in between treatments. To me, within a study to prove the efficacy of lasers, there should only be the laser that is used to create a credible study.
     
  5. If I were designing a study to test the laser, I should want two identical "laser machines" one fitted with a laser diode emitting light within the "therapeutic range" and one fitted with a diode emitting an identical colour/ shape beam but at a frequency which has been shown to be inert to fungus (in-vitro, at least). I'd want patients randomly allocated and testers blinded , trial registered etc as Craig has already noted. No other treatment in between.
     
  6. doc617

    doc617 Welcome New Poster

    Simon, much appreciated for your input as well. So you would like to focus on which laser wavelengths are actually able to eradicate fungus then? If that is the case, would you compare Q-Switched Nd:YAGs and long/short pulse Nd:YAGs, and diode lasers which are the available laser options right now. Or, would you also include other wavelengths including KTP, Alexandrite, Pulsed Dye or even ablative modalities as well?

    The reason I ask is that it is generally agreed that heat is needed in order to eradicate the fungus. And while it has not been scientifically proven it would be interesting to know whether any specific wavelength is actually attracted to the fungus itself.
     
  7. No, I would want to compare one which is thought to be efficacious with one which is known to be inert. Viz. a double blinded, placebo controlled trial. You would need to repeat for each of the available laser options which are claimed to be efficacious against an inert placebo that the patient nor practitioner cannot tell the difference between- hence a double blinded, placebo controlled trial. Once you've identified if/ which of them are better than placebo's, then you can start comparing them. But you need to show that they are better than placebo's on an individual basis first- unless your going to do a big, big, big study. I'm no expert on lasers, but I do understand research.
     
  8. doc617

    doc617 Welcome New Poster

    That is a very interesting way to go about a study and one that has not been performed yet. All trials I have seen only rate the efficacy in terms of treatment with a specific model, as verified with KOH, PAS and/or cultures.

    Thank you so much for your insight on this!
     
Loading...

Share This Page