Understanding Evidence Levels: How ScarInsight Rates Treatments

Every treatment on ScarInsight carries an evidence badge. The badge is a shortcut, not a verdict — here's how I assign it and what to watch out for when reading research.

The four levels

Strong: multiple randomized controlled trials (RCTs) or systematic reviews consistently show the treatment helps a specific outcome. Moderate: clinical studies show promising results but the trial base is smaller or outcomes vary between studies. Emerging: early clinical trials, case series, or mechanistic work suggests potential, but high-quality comparative trials are lacking. Limited: case reports and laboratory rationale only — more clinical research is needed before drawing firm conclusions.

What I actually look at

I weight the evidence using four filters: study design (RCT > cohort > case series > case report), sample size (bigger is usually more reliable), replication (one positive trial is weaker than three), and outcome relevance (did they measure what matters to patients — scar volume, symptoms, recurrence — or a surrogate?). A treatment with one large RCT and two confirmatory studies earns a higher rating than a single pilot study.

Why the same treatment can look different across sources

Different review articles use different rating systems. One dermatology paper may call 5-FU 'effective' while another calls it 'emerging' — often because they include different studies or weight outcomes differently. I try to be transparent: every treatment page cites the sources I used.

How to use evidence levels in a decision

Start with the strong-evidence options when they're accessible and appropriate for your keloid. Layer in moderate-evidence adjuncts when the primary approach plateaus. Treat emerging-evidence options (like red light therapy for keloids) as complements, not replacements. Discuss the risk/benefit of any treatment — even strong-evidence ones — with your dermatologist.

When evidence conflicts with experience

If a strong-evidence treatment hasn't worked for you, that's useful information for your next step — not an argument against the evidence base in general. Keloid biology varies between people, which is why combination protocols and individualized care usually outperform monotherapy.