Intended for healthcare professionals


PapersLocal treatments for cutaneous warts: systematic reviewCommentary: Systematic reviewers face challenges from varied study designs

BMJ 2002; 325 doi: (Published 31 August 2002) Cite this as: BMJ 2002;325:461

Is the practice of dermatology based on science or anecdotal opinion?

It is not clear to me why Prof. Rudolph is upset about the EBM
article on wart treatments. The systematic review article does not say
that his personal choice(s) of treatment of warts is quackery. It merely
states that medical studies performed on wart therapy are heterogenous and
inconclusive, and it certainly seems to me that there are many problems
with trial design and trial size in the area of wart therapy research. I
am not therefore not surprised that Prof.Pudolph concludes his animated
response by stating "I'm willing to bet my bottle of port, any
dermatologist anywhere who is going to alter their
therapeutic approach because of it, or be swayed by it." That may be true,
and if that attitude is reflective of the entire dermatology community,
then it would reflect poorly on the quality of scientific medicine
practiced by dermatologists -- if they prefer to practice anecdotal
medicine rather than perform well-designed clinical trials of much larger

Jeff Mann.

Competing interests: No competing interests

03 September 2002
Jeffrey Mann