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Each row is one question a systematic review asked: who, what, compared with what, and which outcome, with the effect it found and how certain that is. Words match anywhere in the field.
1,325 questions in 34 reviews · Oral medicine and oral cancer
current versionsNo studies 164 · 12.4%Ungraded 841 · 63.5%Very low 209 · 15.8%Low 72 · 5.4%Moderate 38 · 2.9%High 1 · 0.1%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
| Question | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Induction chemotherapy plus locoregional treatment (radiotherapy and/or surgery) vs Locoregional treatment (radiotherapy and/or surgery) alone Overall survival, induction cisplatin + 5-fluorouracil prior to concurrent chemoradiation (cisplatin) vs concurrent chemoradiation (cisplatin) · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy (2021) · Cochrane | HR 0.71 [0.37, 1.35] | 2 studies · 389 participants | Low |
Oral cytology (e.g. brush cytology, OralCDx brush biopsy) vs Surgical or punch biopsy with histological assessment Specificity · Adults (aged 16 years or over) presenting to primary or secondary care with clinically evident suspicious or innocuous… Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically… (2021) · Cochrane | Specificity 0.94 [0.88, 0.97] | 20 studies | Moderate |
Mouth self-examination (MSE) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative) Specificity for detection of oral cavity cancer/OPMD · Apparently healthy adults not reporting symptoms of OPMD or OSCC, attending an organised screening or surveillance… Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in… (2021) · Cochrane | Summary of findings 2 (no pooled analysis): specificity 1.00 (95% CI 1.00 to 1.00), 0.95 (95% CI 0.88 to 0.99), 0.44 (95% CI 0.20 to 0.70), and 0.54 (95% CI 0.37 to 0.69) across the 4 studies. Certainty VERY LOW. | 4 studies · 35059 participants | Very low |
Conventional oral examination (COE)/visual inspection vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative) Specificity for detection of oral cavity cancer/OPMD · Apparently healthy adults not reporting symptoms of OPMD or OSCC, attending an organised screening or surveillance… Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in… (2021) · Cochrane | Summary of findings 1 (no pooled analysis): for the 7 low-prevalence studies specificity ranged from 0.94 (95% CI 0.88 to 0.97) to 0.99 (95% CI 0.98 to 1.00); for the 3 higher-prevalence studies specificity ranged from… | 10 studies · 25568 participants | Low |
Combined index tests (e.g. vital staining plus light-based detection or cytology) vs Surgical or punch biopsy with histological assessment Sensitivity · Adults (aged 16 years or over) presenting to primary or secondary care with clinically evident suspicious or innocuous… Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically… (2021) · Cochrane | Sensitivity 0.78 [0.45, 0.94] | 9 studies | Very low |
Chemotherapy regimen A (+/- locoregional treatment) vs Chemotherapy regimen B (+/- locoregional treatment) Locoregional control, chemotherapy regimen A vs regimen B · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy (2021) · Cochrane | Locoregional control reported in 12 studies; not pooled. Olasz 2000 RR 0.50 (0.26 to 0.96); Prevost 2005 RR 1.48 (1.04 to 2.11); Molinari 1982 RR 0.35 (0.19 to 0.66). | 12 studies | Ungraded |
Concomitant (concurrent) chemoradiotherapy vs Radiotherapy alone (non-resectable tumours) Overall survival, concurrent chemoradiotherapy vs radiotherapy alone (pooled) · People receiving curative-intent treatment for oral cavity and oropharyngeal (squamous cell) cancer Interventions for the treatment of oral cavity and oropharyngeal cancer: chemotherapy (2021) · Cochrane | HR 0.74 [0.67, 0.83] | 24 studies · 2852 participants | Moderate |
Light-based detection and/or oral spectroscopy (e.g. ViziLite, VELscope, Microlux DL, Identafi 3000) vs Surgical or punch biopsy with histological assessment Sensitivity · Adults (aged 16 years or over) presenting to primary or secondary care with clinically evident suspicious or innocuous… Diagnostic tests for oral cancer and potentially malignant disorders in patients presenting with clinically… (2021) · Cochrane | Sensitivity 0.87 [0.78, 0.93] | 23 studies | Low |
COE with vital rinsing (toluidine blue/tolonium chloride) vs Conventional oral examination (COE) alone Sensitivity (COE alone arm) · OSCC or OPMD symptom-free individuals with tobacco habits Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in… (2021) · Cochrane | Sensitivity 0.50 [0.12, 0.88] | 1 study · 3895 participants | Moderate |
COE with vital rinsing (toluidine blue/tolonium chloride) vs Conventional oral examination (COE) alone Sensitivity (COE plus vital rinsing arm) · OSCC or OPMD symptom-free individuals with tobacco habits Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in… (2021) · Cochrane | Sensitivity 0.40 [0.05, 0.85] | 1 study · 4080 participants | Moderate |
Mouth self-examination (MSE) vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative) Sensitivity for detection of oral cavity cancer/OPMD · Apparently healthy adults not reporting symptoms of OPMD or OSCC, attending an organised screening or surveillance… Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in… (2021) · Cochrane | Summary of findings 2 (no pooled analysis): sensitivity 0.18 (95% CI 0.13 to 0.24), 0.09 (95% CI 0.04 to 0.15), 0.43 (95% CI 0.24 to 0.63), and 0.33 (95% CI 0.10 to 0.65) across the 4 studies. Prevalence 0.6% to 63.6%.… | 4 studies · 35059 participants | Very low |
Conventional oral examination (COE)/visual inspection vs Reference standard: examination and clinical evaluation by a physician/clinician with specialist knowledge or training (long-term follow-up accepted for those screened negative) Sensitivity for detection of oral cavity cancer/OPMD · Apparently healthy adults not reporting symptoms of OPMD or OSCC, attending an organised screening or surveillance… Clinical assessment for the detection of oral cavity cancer and potentially malignant disorders in… (2021) · Cochrane | Summary of findings 1 (no pooled analysis): for the 7 studies with low prevalence (<=10%) sensitivity ranged from 0.50 (95% CI 0.07 to 0.93) to 0.99 (95% CI 0.97 to 1.00); for the 3 higher-prevalence studies… | 10 studies · 25568 participants | Low |
Fluticasone propionate spray vs Betamethasone sodium phosphate mouthrinse Pain / clinical response (not analysable) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | Hegarty 2002: cross-over data not suitable for quantitative analysis | 1 study | Ungraded |
Topical triamcinolone acetonide vs Topical pimecrolimus Adverse effects · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment · end of treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | RR 0.21 [0.01, 4.10] | 1 study · 35 participants | Ungraded |
Clobetasol propionate plus miconazole (adjunctive antifungal) vs Clobetasol propionate plus placebo Candidosis (adverse effect) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | Lodi 2007: 5 cases of candidosis among 15 participants without antifungal vs 0 with adjunctive miconazole (low-certainty) | 1 study · 35 participants | Low |
Topical triamcinolone acetonide vs Topical tacrolimus Adverse effects · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment · 3-8 weeks Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | RR 0.47 [0.22, 0.99] | 2 studies · 58 participants | Low |
Topical triamcinolone acetonide vs Topical curcumin Pain (mean score) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | MD -0.64 [-1.19, -0.10] | 2 studies · 100 participants | Low |
Topical clobetasol propionate vs Topical ciclosporin Pain resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment · 3-8 weeks Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | RR 2.11 [0.76, 5.86] | 1 study · 39 participants | Very low |
Topical clobetasol propionate vs Topical tacrolimus Pain (mean VAS score) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment · end of treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | MD 0.08 [-0.33, 0.49] | 1 study · 68 participants | Ungraded |
Topical clobetasol propionate vs Topical tacrolimus Clinical resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment · 3-8 weeks Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | RR 0.61 [0.38, 0.99] | 2 studies · 52 participants | Very low |
Oral prednisone plus curcuminoids (adjunctive) vs Oral prednisone plus placebo Reduction in pain · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | Chainani-Wu 2007: no difference between adjunctive curcuminoids and placebo (recruitment stopped after interim analysis) | 1 study · 28 participants | Ungraded |
Topical triamcinolone acetonide vs Intralesional BCG-polysaccharide nucleic acid (BCG-PSN) Pain (mean score) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | MD 0.59 [-0.15, 1.33] | 1 study · 53 participants | Ungraded |
Topical betamethasone 0.1% gel vs Topical pimecrolimus 1% gel Pain and clinical response (not analysable) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | Ezzatt 2019 (betamethasone 0.1% gel vs pimecrolimus 1% gel): effectiveness data not reported in a way that allowed quantitative analysis | 1 study | Ungraded |
Systemic (oral) betamethasone vs Topical triamcinolone acetonide paste Clinical score · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | MD 1.13 [0.09, 2.17] | 1 study · 46 participants | Very low |
Topical triamcinolone acetonide vs Photodynamic therapy Clinical score · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | MD 1.52 [0.17, 2.87] | 1 study · 20 participants | Low |
Topical corticosteroid vs Placebo Clinical score · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment · end of treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | MD -0.38 [-0.89, 0.14] | 1 study · 32 participants | Low |
Topical triamcinolone acetonide vs Topical tacrolimus Clinical resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment · 3-8 weeks Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | RR 0.86 [0.55, 1.35] | 2 studies · 60 participants | Very low |
Intralesional betamethasone vs Intralesional triamcinolone acetonide Clinical resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | RR 1.40 [1.06, 1.83] | 1 study · 59 participants | Low |
Clobetasol propionate 0.025% microspheres vs Clobetasol propionate 0.025% ointment Clinical resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | RR 1.04 [0.80, 1.36] | 1 study · 45 participants | Ungraded |
Dexamethasone mouthwash plus nystatin vs Photodynamic therapy Clinical resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | Bakhtiari 2017 (dexamethasone mouthwash + nystatin vs photodynamic therapy): clinical resolution reported (Analysis 4.6); no clear difference (low to very low certainty collectively) | 1 study | Ungraded |
Topical clobetasol propionate vs Topical tacrolimus Adverse effects · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment · 3-8 weeks Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | RR 0.05 [0.00, 0.83] | 2 studies · 100 participants | Very low |
Mucoadhesive prednisolone tablet vs Triamcinolone acetonide paste Clinical response (not analysable) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | Ghabanchi 2009: data not suitable for quantitative analysis | 1 study | Ungraded |
Topical triamcinolone acetonide vs Topical ciclosporin Adverse effects · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment · end of treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | RR 0.15 [0.05, 0.49] | 1 study · 139 participants | Ungraded |
Intralesional betamethasone vs Intralesional triamcinolone acetonide Clinical score (14 days) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment · 14 days Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | MD 9.77 [0.81, 18.73] | 1 study · 59 participants | Very low |
Clobetasol propionate plus miconazole (adjunctive antifungal) vs Clobetasol propionate plus placebo Clinical score · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | Lodi 2007: no difference in percentage of oral mucosa affected between adjunctive antifungal and steroid-only groups | 1 study | Ungraded |
Triamcinolone plus systemic glucosamine sulphate (adjunctive) vs Triamcinolone alone Pain (mean score) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | Hesen 2017: no benefit of adjunctive systemic glucosamine sulphate for pain (low to very low certainty collectively) | 1 study | Ungraded |
Dexamethasone plus nystatin (adjunctive antifungal) vs Dexamethasone alone Clinical resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | Wei 2003: no difference in clinical resolution between dexamethasone with vs without nystatin (very low-certainty) | 1 study | Very low |
Dexamethasone ointment vs Amlexanox paste Pain resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | RR 0.75 [0.34, 1.66] | 1 study · 36 participants | Very low |
Topical triamcinolone acetonide vs Hyaluronic acid gel Pain (mean score) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | MD -0.12 [-0.65, 0.41] | 1 study · 40 participants | Ungraded |
Integrated Chinese and Western medicine (incl. oral prednisone) vs Western medicine (incl. oral prednisone) Clinical score · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | Xu 2002: benefit favouring integrated Chinese and Western medicine, just attained statistical significance (very low-certainty; high risk of bias) | 1 study | Very low |
Topical corticosteroid vs Placebo Clinical resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment · 8-9 weeks Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | RR 6.00 [0.76, 47.58] | 2 studies · 72 participants | Very low |
Topical triamcinolone acetonide vs Cryotherapy Pain (mean score, split-mouth) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | MD 1.48 [0.58, 2.38] | 1 study · 52 participants | Very low |
Topical triamcinolone acetonide vs Topical tacrolimus Pain resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment · 3-8 weeks Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | Summary of findings 2: 'No data for this outcome' (triamcinolone vs tacrolimus, pain resolution) | 0 studies | No studies |
Clobetasol propionate 0.025% microspheres vs Clobetasol propionate 0.025% ointment Pain (mean score) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | MD 1.83 [0.80, 2.86] | 1 study · 45 participants | Ungraded |
Topical clobetasol propionate vs Topical ciclosporin Clinical resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment · 3-8 weeks Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | RR 3.16 [1.00, 9.93] | 1 study · 39 participants | Very low |
Dexamethasone + nystatin + curcumin (adjunctive) vs Dexamethasone + nystatin + placebo Adverse effects · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | Amirchaghmaghi 2016: no adverse effects recorded in either group (low-certainty) | 1 study | Low |
Dexamethasone + nystatin + curcumin (adjunctive) vs Dexamethasone + nystatin + placebo Pain (mean score) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | Amirchaghmaghi 2016: no benefit of adjunctive curcumin for pain (low to very low certainty collectively) | 1 study | Ungraded |
Clobetasol propionate 0.05% ointment vs Clobetasol propionate 0.025% ointment Clinical score · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | MD 0.47 [-0.26, 1.20] | 1 study · 30 participants | Low |
Topical triamcinolone acetonide vs Topical ciclosporin Pain (mean VAS score) · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment · end of treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | MD -0.23 [-1.02, 0.56] | 1 study · 139 participants | Ungraded |
Clobetasol propionate 0.05% ointment vs Clobetasol propionate 0.025% ointment Clinical resolution · People with symptomatic, biopsy-confirmed oral lichen planus (OLP); not concurrently receiving other OLP treatment Interventions for treating oral lichen planus: corticosteroid therapies (2020) · Cochrane | RR 1.14 [0.56, 2.35] | 1 study · 30 participants | Very low |