Hadis Mohammed A, Zainal Siti A, Holder Michelle J, Carroll James D, Cooper Paul R, Milward Michael R, Palin William M
Biomaterials Unit, School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, St Chads Queensway, Birmingham, UK, B4 6NN.
Oral Biology, School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, St Chads Queensway, Birmingham, UK, B4 6NN.
Lasers Med Sci. 2016 May;31(4):789-809. doi: 10.1007/s10103-016-1914-y. Epub 2016 Mar 10.
Lasers and light-emitting diodes are used for a range of biomedical applications with many studies reporting their beneficial effects. However, three main concerns exist regarding much of the low-level light therapy (LLLT) or photobiomodulation literature; (1) incomplete, inaccurate and unverified irradiation parameters, (2) miscalculation of 'dose,' and (3) the misuse of appropriate light property terminology. The aim of this systematic review was to assess where, and to what extent, these inadequacies exist and to provide an overview of 'best practice' in light measurement methods and importance of correct light measurement. A review of recent relevant literature was performed in PubMed using the terms LLLT and photobiomodulation (March 2014-March 2015) to investigate the contemporary information available in LLLT and photobiomodulation literature in terms of reporting light properties and irradiation parameters. A total of 74 articles formed the basis of this systematic review. Although most articles reported beneficial effects following LLLT, the majority contained no information in terms of how light was measured (73%) and relied on manufacturer-stated values. For all papers reviewed, missing information for specific light parameters included wavelength (3%), light source type (8%), power (41%), pulse frequency (52%), beam area (40%), irradiance (43%), exposure time (16%), radiant energy (74%) and fluence (16%). Frequent use of incorrect terminology was also observed within the reviewed literature. A poor understanding of photophysics is evident as a significant number of papers neglected to report or misreported important radiometric data. These errors affect repeatability and reliability of studies shared between scientists, manufacturers and clinicians and could degrade efficacy of patient treatments. Researchers need a physicist or appropriately skilled engineer on the team, and manuscript reviewers should reject papers that do not report beam measurement methods and all ten key parameters: wavelength, power, irradiation time, beam area (at the skin or culture surface; this is not necessarily the same size as the aperture), radiant energy, radiant exposure, pulse parameters, number of treatments, interval between treatments and anatomical location. Inclusion of these parameters will improve the information available to compare and contrast study outcomes and improve repeatability, reliability of studies.
激光和发光二极管被用于一系列生物医学应用,许多研究报告了它们的有益效果。然而,关于许多低强度光疗法(LLLT)或光生物调节文献存在三个主要问题:(1)照射参数不完整、不准确且未经核实;(2)“剂量”计算错误;(3)对适当的光特性术语使用不当。本系统评价的目的是评估这些不足之处存在于何处以及程度如何,并概述光测量方法的“最佳实践”以及正确光测量的重要性。在PubMed中使用术语LLLT和光生物调节(2014年3月 - 2015年3月)对近期相关文献进行了综述,以研究LLLT和光生物调节文献中关于光特性和照射参数报告的当代信息。共有74篇文章构成了本系统评价的基础。尽管大多数文章报告了LLLT后的有益效果,但大多数文章没有关于光如何测量的信息(73%),而是依赖于制造商规定的值。对于所有综述的论文,特定光参数的缺失信息包括波长(3%)、光源类型(8%)、功率(41%)、脉冲频率(52%)、光束面积(40%)、辐照度(43%)、曝光时间(16%)、辐射能(74%)和能量密度(16%)。在所综述的文献中还经常观察到使用错误的术语。对光物理学的理解不足很明显,因为大量论文忽略报告或错误报告重要的辐射测量数据。这些错误影响了科学家、制造商和临床医生之间共享研究的可重复性和可靠性,并可能降低患者治疗的疗效。研究团队需要一名物理学家或具备适当技能的工程师,并且稿件评审人员应拒绝那些未报告光束测量方法以及所有十个关键参数的论文:波长、功率、照射时间、光束面积(在皮肤或培养表面;这不一定与孔径大小相同)、辐射能、辐射暴露、脉冲参数、治疗次数、治疗间隔和解剖位置。纳入这些参数将改善可用于比较和对比研究结果的信息,并提高研究的可重复性和可靠性。