2. Efficacy and safety of needle free jet injector assisted intralesional treatments in dermatology—a systematic review. 40 MATERIALS AND METHODS A literature search was conducted in April 2022 using Embase, MEDLINE ALL Ovid, Web of Science, and Cochrane Central Register of Controlled Trials databases, to identify relevant publications. This systematic review was registered in the PROSPERO (CRD42021258278) and followed the Preferred Reporting Items for the PRISMA 2020 checklist.15 Studies were included if they were human studies, written in English, published from inception to April 2022, randomized controlled trials (RCTs), controlled clinical trials (CCTs), prospective or retrospective cohort studies, and case series and included patients of all ages with dermatological indications eligible for intralesional treatment using needle-free jet injectors. Exclusion criteria included studies with fewer than 10 patients and intramuscular or subcutaneous drug delivery. Selection of the articles, standardized data extraction, and methodological quality assessment of the included studies were performed independently by two authors (V.B. and J.V.H.). Articles were screened based on title and abstract. The primary outcome measure was efficacy, and the secondary outcome measure was safety. For data extraction, we converted pressure settings, total injection volume, and drug concentration to psi, ml, and mg/ml, respectively. If possible, efficacy measures were simplified to percentages in terms of clinical response compared to baseline. Methodological quality was assessed using the Cochrane Collaborations risk-of-bias 2.0 tool (ROB 2.0) for RCTs and CCTs, and the Newcastle–Ottawa Scale (NOS) for cohort studies and case series.16–19 Final selection of the articles was based on screening of full texts. Discrepancies between reviewers were discussed and resolved by consensus and involved a third author (L.B.) if necessary. Illustrations of the methodological quality assessments were created using Robvis.17
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