Statistics

 array:23 [
  "pii" => "S0365059624000291"
  "issn" => "03650596"
  "doi" => "10.1016/j.abd.2023.09.004"
  "estado" => "S300"
  "fechaPublicacion" => "2024-07-01"
  "aid" => "915"
  "copyright" => "Sociedade Brasileira de Dermatologia"
  "copyrightAnyo" => "2024"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "fla"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "pt" => array:18 [
      "pii" => "S2666275224000341"
      "issn" => "26662752"
      "doi" => "10.1016/j.abdp.2024.03.002"
      "estado" => "S300"
      "fechaPublicacion" => "2024-07-01"
      "aid" => "915"
      "copyright" => "Sociedade Brasileira de Dermatologia"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "fla"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:1 [
        "total" => 0
      ]
      "pt" => array:12 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Artigo original</span>"
        "titulo" => "As interven&#231;&#245;es comportamentais s&#227;o a melhor escolha para pacientes com dermatite at&#243;pica&#63; Metan&#225;lise de seis ensaios controlados randomizados"
        "tienePdf" => "pt"
        "tieneTextoCompleto" => "pt"
        "tieneResumen" => "pt"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "503"
            "paginaFinal" => "512"
          ]
        ]
        "contieneResumen" => array:1 [
          "pt" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "pt" => true
        ]
        "contienePdf" => array:1 [
          "pt" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0015"
            "etiqueta" => "Figura 3"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr3.jpeg"
                "Alto" => 1632
                "Ancho" => 2925
                "Tamanyo" => 260574
              ]
            ]
            "descripcion" => array:1 [
              "pt" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Metan&#225;lise do tamanho do efeito de interven&#231;&#245;es psicol&#243;gicas para aliviar a gravidade do eczema&#46; IC&#44; intervalo de confian&#231;a&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Wenying Zhong, Wei Li, Guangsheng Wu"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "Wenying"
                "apellidos" => "Zhong"
              ]
              1 => array:2 [
                "nombre" => "Wei"
                "apellidos" => "Li"
              ]
              2 => array:2 [
                "nombre" => "Guangsheng"
                "apellidos" => "Wu"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "pt"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S0365059624000291"
          "doi" => "10.1016/j.abd.2023.09.004"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059624000291?idApp=UINPBA00008Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224000341?idApp=UINPBA00008Z"
      "url" => "/26662752/0000009900000004/v1_202406100414/S2666275224000341/v1_202406100414/pt/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "S0365059624000370"
    "issn" => "03650596"
    "doi" => "10.1016/j.abd.2023.07.005"
    "estado" => "S300"
    "fechaPublicacion" => "2024-07-01"
    "aid" => "923"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
      "titulo" => "Assessment by the Scheimpflug imaging system of corneal clarity and anterior segment properties in rosacea patients"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "513"
          "paginaFinal" => "519"
        ]
      ]
      "contieneResumen" => array:1 [
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Erman Bozali, Duygu Yal&#305;nba&#351; Yeter, Mustafa Tosun, An&#305;l Selim Apa"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Erman"
              "apellidos" => "Bozali"
            ]
            1 => array:2 [
              "nombre" => "Duygu Yal&#305;nba&#351;"
              "apellidos" => "Yeter"
            ]
            2 => array:2 [
              "nombre" => "Mustafa"
              "apellidos" => "Tosun"
            ]
            3 => array:2 [
              "nombre" => "An&#305;l Selim"
              "apellidos" => "Apa"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S2666275224000420"
        "doi" => "10.1016/j.abdp.2024.03.010"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224000420?idApp=UINPBA00008Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059624000370?idApp=UINPBA00008Z"
    "url" => "/03650596/0000009900000004/v2_202407191005/S0365059624000370/v2_202407191005/en/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S0365059624000345"
    "issn" => "03650596"
    "doi" => "10.1016/j.abd.2023.07.004"
    "estado" => "S300"
    "fechaPublicacion" => "2024-07-01"
    "aid" => "920"
    "copyright" => "Sociedade Brasileira de Dermatologia"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "fla"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Continuing Medical Education</span>"
      "titulo" => "Tattoos&#58; risks and complications&#44; clinical and histopathological approach"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "491"
          "paginaFinal" => "502"
        ]
      ]
      "contieneResumen" => array:1 [
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0030"
          "etiqueta" => "Figure 6"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr6.jpeg"
              "Alto" => 1223
              "Ancho" => 3341
              "Tamanyo" => 887343
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0030"
              "detalle" => "Figure "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Sclerodermiform&#47;morphea-like pattern&#46;</span> The epidermis appears unaltered in thickness&#46; In the dermis&#44; fibrosis with effacement of cutaneous appendages is observed&#44; associated with deposition of black ink pigment&#44; &#40;Hematoxylin &#38; eosin&#44; &#91;A&#93; &#215;100&#44; &#91;B&#93; &#215;400&#41;&#46; Photographic archive of the Dermatopathology Laboratory&#44; Dermatology Section&#44; University of Antioquia&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "David Chalarca-Ca&#241;as, Mario A&#46; Caviedes-Cleves, Luis A&#46; Correa-Londo&#241;o, Juan Pablo Ospina-G&#243;mez, Margarita M&#46; Vel&#225;squez-Lopera"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "David"
              "apellidos" => "Chalarca-Ca&#241;as"
            ]
            1 => array:2 [
              "nombre" => "Mario A&#46;"
              "apellidos" => "Caviedes-Cleves"
            ]
            2 => array:2 [
              "nombre" => "Luis A&#46;"
              "apellidos" => "Correa-Londo&#241;o"
            ]
            3 => array:2 [
              "nombre" => "Juan Pablo"
              "apellidos" => "Ospina-G&#243;mez"
            ]
            4 => array:2 [
              "nombre" => "Margarita M&#46;"
              "apellidos" => "Vel&#225;squez-Lopera"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "pt" => array:9 [
        "pii" => "S2666275224000407"
        "doi" => "10.1016/j.abdp.2024.03.008"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "pt"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224000407?idApp=UINPBA00008Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059624000345?idApp=UINPBA00008Z"
    "url" => "/03650596/0000009900000004/v2_202407191005/S0365059624000345/v2_202407191005/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>"
    "titulo" => "Are behavioral interventions a better choice for atopic dermatitis patients&#63; A meta-analysis of 6 randomized controlled trials"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "503"
        "paginaFinal" => "512"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Wenying Zhong, Wei Li, Guangsheng Wu"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "Wenying"
            "apellidos" => "Zhong"
            "email" => array:1 [
              0 => "sczjhzzwy@126.com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Wei"
            "apellidos" => "Li"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Guangsheng"
            "apellidos" => "Wu"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:2 [
          0 => array:3 [
            "entidad" => "Department of Dermatology&#44; The Affiliated Hospital of Hangzhou Normal University&#44; Hangzhou&#44; China"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Department of Pediatrics&#44; The Affiliated Hospital of Hangzhou Normal University&#44; Hangzhou&#44; China"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig0025"
        "etiqueta" => "Figure 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr5.jpeg"
            "Alto" => 1490
            "Ancho" => 2925
            "Tamanyo" => 183650
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0025"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Meta-analysis of effect size of psychological interventions for reducing scratching severity&#46; CI&#44; Confidence Interval&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Atopic dermatitis is one of the most common chronic and relapsing inflammatory skin disorders worldwide&#44; with a prevalence of 10&#37;&#8210;20&#37; in children and 2&#37;&#8210;8&#37; in adults&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;3</span></a> The clinical presentations of atopic dermatitis include disturbed epidermal differentiation and diminished skin barrier function&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Atopic dermatitis is a potential contributor to cause debilitating symptoms&#44; and it significantly reduces the patient&#8217;s quality of life&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Due to the heterogeneity in age&#44; ethnicity&#44; and lifestyle factors of patients&#44; the etiology of atopic dermatitis has not been fully clarified&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7&#8211;9</span></a> Currently&#44; topical application of emollients and anti-inflammation agents is still the basic strategy for treating atopic dermatitis&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;11</span></a> The topical therapy is not effective for the treatment among a considerable proportion of moderate-to-severe patients&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> which may cause a series of psychological consequences&#44; such as sleep disturbance&#44; anxiety&#44; depression&#44; and financial strain&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> Meanwhile&#44; psychological factors have also been shown to aggravate skin symptoms&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> Therefore&#44; psychological interventions are considered an indispensable element of multidisciplinary management strategy for atopic dermatitis&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">14&#44;15</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Up to now&#44; several original studies<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#8211;18</span></a> have investigated the therapeutic effects of various psychological intervention strategies on atopic dermatitis&#46; Meanwhile&#44; some meta-analyses<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;20</span></a> have also systematically evaluated the role of psychological and educational interventions in treating atopic dermatitis&#46; However&#44; the results of previously published studies of psychological interventions for atopic dermatitis are conflicting&#46; It&#8217;s noted that the therapeutic effects of psychological interventions may change according to the variations of types of psychological interventions&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#44;22</span></a> However&#44; different psychological interventions were combined as an individual interventional strategy in the previous meta-analyses&#44;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;20</span></a> which may cause conflicting findings&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">As an indispensable part of psychological interventions&#44; behavioral therapy refers to the application of modern theories of learning and conditioning in the treatment of behavior disorders&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> Currently&#44; many behavioral techniques have been used in clinical practice&#44; such as cognitive behavioral therapy&#44; habit-reversal therapy&#44; and dialectical behavior therapy&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> Of these available behavioral techniques&#44; habit-reversal therapy<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> and cognitive behavioral therapy<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">25&#44;26</span></a> have been used successfully in dermatology&#46; Habit-reversal therapy was initially described by Azrin and Nunn as a competing response produced by tightening muscles with antagonists&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> Habit-reversal therapy consists of multiple components&#44; but competing response training and awareness training represent its most effective techniques&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> While&#44; cognitive behavioral therapy is a combination of cognitive and behavioral approaches&#44; which can help the patient recognize his distorted thoughts and ineffective behaviors&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Several studies<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24&#44;26</span></a> have explored the potential of habit-reversal therapy and cognitive behavioral therapy in managing atopic dermatitis&#46; Bewley has reported that atopic dermatitis patients who received three weeks of habit-reversal therapy had significantly better atopic dermatitis scores than those of the topical treatments alone&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> Goyonlo et al&#46; suggested that cognitive behavioral therapy helped dermatitis patients improve clinical severity scores&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> To our knowledge&#44; there has been no relevant meta-analysis evaluating the effects of behavioral interventions on atopic dermatitis&#46; Therefore&#44; the authors conducted the present meta-analysis to assess the effects of separate behavioral interventions on health outcomes in atopic dermatitis patients&#46; The authors aimed to provide a definitive evidence-based recommendation for behavioral interventions in atopic dermatitis patients&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Study design</span><p id="par0030" class="elsevierStylePara elsevierViewall">This systematic review and meta-analysis was carried out following the structure recommended by the Cochrane Handbook&#44;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> and was reported in strict accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis &#40;PRISMA&#41; checklist&#44;<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> thus strongly ensuring the transparency and reliability of conducting the current meta-analysis&#46; All these fulfill the requirement of registering a formal protocol in a public platform&#44; therefore the authors did not further register a protocol for this meta-analysis&#46; This study did not require ethical approval and the patient&#8217;s informed consent&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Selection criteria</span><p id="par0035" class="elsevierStylePara elsevierViewall">Two independent reviewers strictly followed the criteria to select studies from the retrieved records&#46; When there was disagreement about the literature retrieval&#44; the authors resolved it by consulting a third reviewer&#46; Three steps were designed for study selection&#58; &#40;a&#41; Removal of duplicate studies based on EndNote software&#59; &#40;b&#41; Initial eligibility assessment based on the titles and abstracts screening&#59; and &#40;c&#41; Final eligibility assessment based on full-text evaluation&#46;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Inclusion criteria</span><p id="par0040" class="elsevierStylePara elsevierViewall">Eligibility of each study was evaluated using the PICOS acronym&#44; including patients&#44; intervention&#44; comparison&#44; outcome&#44; and study design&#58; &#40;a&#41; Patients were diagnosed with atopic dermatitis by a physician with recognized criteria &#40;<span class="elsevierStyleItalic">P acronym</span>&#41;&#59; &#40;b&#41; Patients in the experimental group were instructed to receive behavioral interventions in addition to usual medical care for atopic dermatitis &#40;<span class="elsevierStyleItalic">I acronym</span>&#41;&#59; &#40;c&#41; Patients in the control group received usual medical care alone &#40;<span class="elsevierStyleItalic">C acronym</span>&#41;&#59; &#40;d&#41; At least one of eczema severity&#44; itching intensity&#44; and scratching severity was reported effectively &#40;<span class="elsevierStyleItalic">O acronym</span>&#41;&#59; and &#40;e&#41; Patients were randomly assigned into different groups &#40;<span class="elsevierStyleItalic">S acronym</span>&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Exclusion criteria</span><p id="par0045" class="elsevierStylePara elsevierViewall">Studies were excluded from the following criteria&#58; &#40;a&#41; Behavioral interventions were designed as one part of the psychological protocol rather than separate intervention&#59; &#40;b&#41; Data about correlation coefficient &#40;<span class="elsevierStyleItalic">r</span>&#41; were not available&#59; &#40;c&#41; Ineligible study design was used&#44; such as quasi-randomized studies&#44; observational studies&#44; and animal studies&#59; and &#40;d&#41; Duplicate studies with overlapped samples&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Information sources</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors systematically searched three common English databases&#44; including PubMed&#44; EMBASE&#44; and the Cochrane Central Registry for Controlled Trials &#40;CENTRAL&#41;&#44; for retrieving relevant Randomized Controlled Trials &#40;RCT&#41; regarding the application of behavioral interventions in atopic dermatitis patients from their inception until February 2022&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Search strategy</span><p id="par0055" class="elsevierStylePara elsevierViewall">The search strategy was developed using subject terms and free words as follows&#58; &#8220;atopic dermatitis&#8221;&#44; &#8220;habit-reversal&#8221;&#44; &#8220;behavior therapy&#8221;&#44; &#8220;behavior modification&#8221;&#44; &#8220;behavior change&#8221;&#44; and &#8220;behavior treatment&#8221;&#46; Two independent reviewers conducted the search and updated weekly to avoid missing potentially eligible studies&#46; The authors also identified additional relevant studies through screening references of included studies and topic-related meta-analysis&#46; The authors did not restrict the publication status in literature retrieval&#46; Detailed search strategies of target databases were reported in Table S1&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Data extraction</span><p id="par0060" class="elsevierStylePara elsevierViewall">Two independent reviewers extracted the essential information from eligible studies using a pre-designed standard sheet&#46; The following information was extracted&#58; authors&#44; year of publication&#44; country&#44; sample size&#44; percentage of female patients&#44; the mean age of patients&#44; duration of atopic dermatitis&#44; details of grouping&#44; duration of intervention&#44; the number of sessions&#44; follow-up duration&#44; detailed outcomes of interest&#44; and information for quality assessment&#46; The authors also contacted authors to obtain more information if necessary&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Assessment of outcome</span><p id="par0065" class="elsevierStylePara elsevierViewall">This meta-analysis evaluated three outcomes&#44; including eczema severity&#44; itching intensity&#44; and scratching severity&#46; Eczema severity was measured using the Scoring the Severity of Atopic Dermatitis &#40;SCORAD&#41;&#44; the Modified SCORAD&#44; the AD Assessment Measure &#40;ADAM&#41;&#44; or the authors&#8217; original scoring methods&#44; and itching and scratching intensity was measured using a subjective Likert-type scale&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Risk of bias assessment</span><p id="par0070" class="elsevierStylePara elsevierViewall">Quality assessment was conducted by two independent reviewers using the Cochrane risk of bias assessment tool&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a> In this assessment tool&#44; seven items were involved&#44; including random sequence generation &#40;selection bias&#41;&#44; allocation concealment &#40;selection bias&#41;&#44; blinding of participants and personnel &#40;performance bias&#41;&#44; blinding of outcome assessment &#40;detection bias&#41;&#44; incomplete outcome data &#40;attrition bias&#41;&#44; selective reporting bias &#40;reporting bias&#41;&#44; and other bias&#46; Each item would be classified as &#8220;low&#8221;&#44; &#8220;unclear&#8221;&#44; or &#8220;high&#8221; risk based on the actual information reported in studies&#46; Finally&#44; the overall quality of each study was appraised as either &#8220;low&#8221;&#44; &#8220;moderate&#8221;&#44; or &#8220;high&#8221; level&#46; Specifically&#44; the overall methodological quality was appraised as &#8220;high&#8221; if all items were classified as &#8220;low&#8221; risk&#44; &#8220;low&#8221; if at least one of the seven items was classified as &#8220;high&#8221; risk&#44; or &#8220;moderate&#8221; if at least one of the seven items was classified as &#8220;unclear&#8221; risk but no one was classified as &#8220;high&#8221; risk&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Statistical analysis</span><p id="par0075" class="elsevierStylePara elsevierViewall">In this meta-analysis&#44; the authors used Stata 14&#46;0 software &#40;State Corporation&#44; Lake Way&#44; Texas&#44; USA&#41; to calculate the effect size&#44; which was expressed as a correlation coefficient &#40;<span class="elsevierStyleItalic">r</span>&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a> Statistical heterogeneity across studies was tested using Cochrane <span class="elsevierStyleItalic">Q</span><a class="elsevierStyleCrossRefs" href="#bib0170"><span class="elsevierStyleSup">34&#44;35</span></a> and I<span class="elsevierStyleSup">2</span> statistic&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a> Studies were considered homogeneous if p&#8239;&#62;&#8239;0&#46;1 and I<span class="elsevierStyleSup">2</span> &#60; 50&#37;&#59; Otherwise&#44; they were regarded as heterogeneous&#46; The authors selected the random-effects model for all statistical analyses regardless of the level of statistical heterogeneity because this model incorporated the variance resulting from differences between studies and within studies into estimates calculation&#46;<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a> The authors calculated the corresponding <span class="elsevierStyleItalic">r</span> value according to the data reported in the included studies using an online calculator&#44; namely the &#8220;Practical Meta-Analysis Effect Size Calculator&#8221;&#44; which was designed by Wilson et al&#46; to facilitate the computation of effect sizes for meta-analysis&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a> The authors performed a sensitivity analysis to examine the robustness of results for eczema severity through the leave-one-out method&#46; Finally&#44; publication bias examination for meta-analysis of eczema severity was conducted using the Egger linear regression and Begg rank relationship methods although the cumulative number of eligible studies does not exceed 10&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">38</span></a></p></span></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Results</span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Literature search</span><p id="par0080" class="elsevierStylePara elsevierViewall">The authors retrieved 237 records from electronic databases using pre-designed search strategies&#46; After removing 36 duplicate records&#44; 201 unique studies were retained for initial eligibility evaluation&#46; The authors excluded a total of 194 ineligible studies after screening the titles and abstracts due to being unrelated to the topic &#40;n&#8239;&#61;&#8239;183&#41;&#44; registered study protocol &#40;n&#8239;&#61;&#8239;8&#41;&#44; and meta-analysis &#40;n&#8239;&#61;&#8239;3&#41;&#46; Then&#44; the authors retrieved the full texts of the remaining seven studies for further eligibility evaluation&#46; After excluding two ineligible studies due to ineligible topics&#44; five studies<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">39&#8211;43</span></a> were considered for meeting the selection criteria&#46; Moreover&#44; the authors identified another eligible study<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">44</span></a> from a previous meta-analysis&#46; Finally&#44; six RCTs<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">39&#8211;44</span></a> involving seven reports were included in this meta-analysis because the study by Ehlers et al&#46;<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">44</span></a> compared the effectiveness of 4 group treatments for atopic dermatitis&#46; The detailed process of selecting the study is indicated in <a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Study characteristics</span><p id="par0085" class="elsevierStylePara elsevierViewall">Detailed basic characteristics of the included studies are presented in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; A total of 246 patients were included in the current study&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">39&#8211;44</span></a> Five studies<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">39&#8211;44</span></a> enrolled adult patients&#44; and pediatric patients were included in only one study&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">40</span></a> Among six included studies&#44; three studies<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">40&#8211;42</span></a> designed habit reversal behavioral therapy&#44; and another three<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">39&#44;43&#44;44</span></a> designed cognitive behavioral therapy for treating atopic dermatitis&#46; Three studies<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">40&#44;42&#44;44</span></a> assigned physician to evaluate outcomes&#59; two studies<a class="elsevierStyleCrossRefs" href="#bib0205"><span class="elsevierStyleSup">41&#44;43</span></a> measured outcomes with the Scoring Atopic Dermatitis &#40;SCORAD&#41;&#59; and one study<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">39</span></a> used Atopic Dermatitis Assessment Measure &#40;ADAM&#41; to evaluate outcomes&#46; The effect sizes of included studies regarding target outcomes of interest are presented in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Risk of bias</span><p id="par0090" class="elsevierStylePara elsevierViewall">Only one study <a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">41</span></a> specifically introduced the method of generating random sequences and performing allocation&#46; All studies <a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">39&#8211;44</span></a> were rated as having an unclear risk for blinding participants and personnel&#44; and one study <a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">44</span></a> was rated as high risk for blinding of outcome assessment&#46; All studies <a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">39&#8211;44</span></a> were rated as low risk for attrition bias and reporting bias but high risk for other biases due to extremely insufficient sample size&#46; Detailed results of the quality assessment are presented in <a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Meta-analysis results</span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Eczema severity</span><p id="par0095" class="elsevierStylePara elsevierViewall">All included studies&#44;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">39&#8211;44</span></a> involving seven reports with 246 patients&#44; evaluated the effect of behavioral interventions on eczema severity&#46; Heterogeneity examination indicated that all studies were homogeneous for analysis of eczema severity &#40;I<span class="elsevierStyleSup">2</span>&#8239;&#61;&#8239;0&#37;&#44; p&#8239;&#61;&#8239;0&#46;890&#41;&#46; Meta-analysis indicated that&#44; compared to traditional medical care&#44; behavioral interventions relieved eczema severity more effectively &#40;effect size &#91;95&#37; CI&#93;&#58; &#8722;0&#46;39 &#91;&#8722;0&#46;50&#44; &#8722;0&#46;28&#93;&#59; z&#8239;&#61;&#8239;&#8722;7&#46;003&#44; p&#8239;&#60;&#8239;0&#46;001&#41;&#46; The forest plot is depicted in <a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Itching intensity</span><p id="par0100" class="elsevierStylePara elsevierViewall">Among six included studies&#44; two studies<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">40&#44;44</span></a> involving three reports evaluated the effect of behavioral interventions on itching intensity&#46; All studies were considered homogeneous for this analysis &#40;I<span class="elsevierStyleSup">2</span> &#61; 0&#37;&#44; p&#8239;&#61;&#8239;0&#46;842&#41;&#46; Meta-analysis suggested behavioral interventions were comparable with traditional medical care in terms of itching intensity&#44; with a small effect size of &#8722;0&#46;02 &#40;95&#37; CI &#8722;0&#46;19 to 0&#46;16&#59; z &#61; &#8722;0&#46;202&#44; p&#8239;&#61;&#8239;0&#46;840&#41;&#46; The forest plot is depicted in <a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Scratching severity</span><p id="par0105" class="elsevierStylePara elsevierViewall">Four studies involving five reports<a class="elsevierStyleCrossRefs" href="#bib0200"><span class="elsevierStyleSup">40&#8211;42&#44;44</span></a> evaluated the effect of behavioral interventions on scratching severity&#46; Heterogeneity examination did not detect substantial statistical heterogeneity across studies for this analysis of scratching severity &#40;I<span class="elsevierStyleSup">2</span>&#8239;&#61;&#8239;34&#46;2&#37;&#44; p&#8239;&#61;&#8239;0&#46;194&#41;&#46; Results of the meta-analysis suggested that behavioral interventions were associated with decreased scratching severity compared with usual medical care&#44; with an effect size of -0&#46;19 &#40;95&#37; CI &#8722;0&#46;35 to &#8722;0&#46;03&#59; <span class="elsevierStyleItalic">z</span>&#8239;&#61;&#8239;&#8722;2&#46;377&#44; p&#8239;&#61;&#8239;0&#46;017&#41;&#46; The forest plot is depicted in <a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#46;</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Subgroup analysis</span><p id="par0110" class="elsevierStylePara elsevierViewall">As introduced above&#44; two types of behavioral interventions were identified in this meta-analysis&#44; including habit-reversal behavioral therapy and cognitive-behavioral therapy&#46; We&#44; therefore&#44; conducted a subgroup analysis according to the types of interventions&#46; Results from subgroup analysis suggested that both habit-reversal behavioral therapy and cognitive-behavioral therapy effectively relieved eczema severity&#44; but only habit-reversal behavioral therapy significantly reduced scratching severity&#46; Detailed results of subgroup analyses are presented in Figure S1&#46;</p></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Sensitivity analysis</span><p id="par0115" class="elsevierStylePara elsevierViewall">To analyze eczema severity&#44; the authors used the leave-one-out method to examine the robustness of the synthesized size of the effect&#46; As presented in Figure S2&#44; the synthesized size of the effect was not significantly changed after removing any one study at one time&#44; indicating the robustness and credibility of the synthesized effect size in the current study&#46;</p></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Publication bias</span><p id="par0120" class="elsevierStylePara elsevierViewall">The publication bias of studies included for analysis of eczema severity was evaluated using Egger&#8217;s test and Begg&#8217;s test&#46; As shown in Figure S3&#44; a symmetrical funnel plot was generated for Egger&#8217;s test &#40;<span class="elsevierStyleItalic">z</span> &#61; &#8722;0&#46;15&#44; p&#8239;&#61;&#8239;0&#46;881&#41; and Begg&#8217;s test &#40;<span class="elsevierStyleItalic">t</span> &#61; &#8722;0&#46;19&#44; p&#8239;&#61;&#8239;0&#46;853&#41;&#44; suggesting the absence of publication bias&#46;</p></span></span></span><span id="sec0120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Discussion</span><p id="par0125" class="elsevierStylePara elsevierViewall">Although psychological interventions have been clinically recognized as effective&#44; their benefits for treating atopic dermatitis are still controversial&#46; This meta-analysis included 6 RCTs for data analysis&#46; Results suggest that behavioral interventions are more effective than usual medical care in relieving eczema and scratching severity&#46; Furthermore&#44; habit-reversal behavioral therapy is a more efficacious intervention for treating atopic dermatitis because separate analysis further demonstrates its benefits in relieving eczema and scratching severity&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Currently&#44; two published meta-analyses<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;20</span></a> evaluated the effects of psychological and educational interventions on atopic dermatitis&#46; Chida et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> included eight studies in their meta-analysis&#44; and they identified eight types of intervention&#58; aromatherapy&#44; autogenic training&#44; brief dynamic psychotherapy&#44; cognitive-behavioral therapy&#44; dermatological education combined with cognitive-behavioral therapy&#44; habit reversal behavioral therapy&#44; stress management program&#44; and structured educational programs&#46; After calculating synthesized sizes of effect&#44; they found that the role of psychological interventions in treating atopic dermatitis was premature&#44; although it had a significant ameliorating effect on eczema severity&#44; itching intensity&#44; and scratching in atopic dermatitis patients&#46; In 2017&#44; Hashimoto et al&#46; conducted another meta-analysis to investigate the effect of psychological and educational interventions on atopic dermatitis&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> Pooled results from 3 RCTs suggested no significant difference in eczema severity between the two groups&#46; The effects of different psychological and educational interventions were different&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">21&#44;22</span></a> However&#44; previously published two meta-analyses just incorporated different types of interventions into an individual regimen&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">In this meta-analysis&#44; the authors specifically investigated the pure effects of behavioral interventions on health outcomes in atopic dermatitis patients compared with previous meta-analyses&#46; Meanwhile&#44; the authors evaluated the effects of habit-reversal behavioral therapy and cognitive-behavioral therapy in treating atopic dermatitis&#44; providing definitive evidence-based recommendations for clinical decision-making&#46; More importantly&#44; in this meta-analysis&#44; the authors evaluated the role of behavioral interventions in treating atopic dermatitis by calculating the magnitude of therapeutic effect based on the correlation coefficient&#46; Finally&#44; the authors evaluated statistical heterogeneity across studies for the individual outcome&#46; The authors calculated all synthesized sizes of effect with the random-effects model which simultaneously considered variations between studies and within studies&#46; Therefore&#44; the meta-analysis generated relatively conservative effect sizes&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">However&#44; the present meta-analysis remains to have some limitations&#46; First and foremost&#44; only six eligible studies with extremely insufficient sample sizes were included in this meta-analysis&#46; Therefore&#44; the current results should be cautiously interpreted due to inadequate statistical power&#46; Second&#44; patients enrolled in original studies were recruited from diverse backgrounds&#44; including clinic-based and population-based backgrounds&#44; which may introduce bias to the present findings&#46; Third&#44; five studies enrolled adult patients except for one study&#44; in which pediatric patients were included&#46; However&#44; the authors performed a sensitivity analysis to examine the robustness of synthesized effects using the leave-one-out method&#46; Sensitivity analysis indicated that behavioral interventions might be more effective for pediatric patients&#44; but the pooled result did not change statistically&#46; Fourth&#44; the authors did not conduct a subgroup analysis to eliminate the effect of variations in the duration of disease&#44; duration of treatment&#44; number of sessions&#44; duration of follow-up&#44; and outcome assessment method due to the insufficient number of eligible studies&#46; Fifth&#44; as stated in the subsection of the study design&#44; the authors did not register the used protocol in any public platform&#46; However&#44; the authors conducted this meta-analysis to ensure transparency and reliability in strict accordance with the Cochrane Handbook and PRISMA statements&#46; Sixth&#44; one study compared behavioral intervention combined with educational strategy to educational strategy alone&#59; however&#44; the authors also included it in the final analysis&#44; which may introduce bias for the pooled results due to variations in control&#46; Notably&#44; sensitivity analysis based on the leave-one-out strategy suggested that the inclusion of this study did not significantly affect the reliability of the pooled results&#46; Finally&#44; although the examination for the analysis of eczema severity did not show publication bias risk&#44; the authors must recognize that the cumulative number of eligible studies did not meet the minimum criteria of conducting a publication bias examination&#44; it is therefore difficult to eliminate the risk of obtaining false negative results&#46;</p></span><span id="sec0125" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Conclusion</span><p id="par0145" class="elsevierStylePara elsevierViewall">In conclusion&#44; based on the currently available evidence&#44; the present meta-analysis indicates that behavioral interventions may be effective for relieving eczema severity and scratching severity&#46; In addition&#44; habit-reversal behavioral therapy may be more effective for the treatment of atopic dermatitis&#46; However&#44; the authors must recognize that the result for scratching severity is not accurate due to the small number of patients and the lower CI limits of almost null value&#46; More importantly&#44; the authors evaluated all outcomes only from a statistically significant perspective rather than from a clinical relevance&#46; Therefore&#44; the present findings should be further validated from a clinically relevant perspective in future studies&#46;</p></span><span id="sec0130" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Financial support</span><p id="par0150" class="elsevierStylePara elsevierViewall">This paper was supported by The <span class="elsevierStyleGrantSponsor" id="gs0005">Hangzhou Biomedical and health industry development support special project Research Fund</span> &#40;<span class="elsevierStyleGrantNumber" refid="gs0005">2021WJCY294</span>&#41;&#46; The funding bodies had no role in the design of the study and collection&#44; analysis&#44; and interpretation of data and in writing the manuscript&#46;</p></span><span id="sec0135" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0175">Authors&#8217; contributions</span><p id="par0155" class="elsevierStylePara elsevierViewall">Wenying Zhong&#58; The study concept and design&#59; Writing of the manuscript or critical review of important intellectual content&#59; Data collection&#44; analysis&#44; and interpretation&#59; Effective participation in the research guidance&#59; Intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; Critical review of the literature&#59; Final approval of the final version of the manuscript&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Wei Li&#58; Data collection&#44; or analysis and interpretation of data&#59; statistical analysis&#59; Data collection&#44; analysis&#44; and interpretation&#59; Intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Guangsheng Wu&#58; Data collection&#44; or analysis and interpretation of data&#59; Statistical analysis&#59; data collection&#44; analysis&#44; and interpretation&#59; Intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#46;</p></span><span id="sec0140" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0180">Conflicts of interest</span><p id="par0170" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:11 [
        0 => array:3 [
          "identificador" => "xres2206310"
          "titulo" => "Abstract"
          "secciones" => array:6 [
            0 => array:2 [
              "identificador" => "abst0005"
              "titulo" => "Background"
            ]
            1 => array:2 [
              "identificador" => "abst0010"
              "titulo" => "Objectives"
            ]
            2 => array:2 [
              "identificador" => "abst0015"
              "titulo" => "Methods"
            ]
            3 => array:2 [
              "identificador" => "abst0020"
              "titulo" => "Results"
            ]
            4 => array:2 [
              "identificador" => "abst0025"
              "titulo" => "Study limitations"
            ]
            5 => array:2 [
              "identificador" => "abst0030"
              "titulo" => "Conclusions"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1850932"
          "titulo" => "Keywords"
        ]
        2 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        3 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Methods"
          "secciones" => array:8 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Study design"
            ]
            1 => array:3 [
              "identificador" => "sec0020"
              "titulo" => "Selection criteria"
              "secciones" => array:2 [
                0 => array:2 [
                  "identificador" => "sec0025"
                  "titulo" => "Inclusion criteria"
                ]
                1 => array:2 [
                  "identificador" => "sec0030"
                  "titulo" => "Exclusion criteria"
                ]
              ]
            ]
            2 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Information sources"
            ]
            3 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Search strategy"
            ]
            4 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Data extraction"
            ]
            5 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Assessment of outcome"
            ]
            6 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Risk of bias assessment"
            ]
            7 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Statistical analysis"
            ]
          ]
        ]
        4 => array:3 [
          "identificador" => "sec0065"
          "titulo" => "Results"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0070"
              "titulo" => "Literature search"
            ]
            1 => array:2 [
              "identificador" => "sec0075"
              "titulo" => "Study characteristics"
            ]
            2 => array:2 [
              "identificador" => "sec0080"
              "titulo" => "Risk of bias"
            ]
            3 => array:3 [
              "identificador" => "sec0085"
              "titulo" => "Meta-analysis results"
              "secciones" => array:6 [
                0 => array:2 [
                  "identificador" => "sec0090"
                  "titulo" => "Eczema severity"
                ]
                1 => array:2 [
                  "identificador" => "sec0095"
                  "titulo" => "Itching intensity"
                ]
                2 => array:2 [
                  "identificador" => "sec0100"
                  "titulo" => "Scratching severity"
                ]
                3 => array:2 [
                  "identificador" => "sec0105"
                  "titulo" => "Subgroup analysis"
                ]
                4 => array:2 [
                  "identificador" => "sec0110"
                  "titulo" => "Sensitivity analysis"
                ]
                5 => array:2 [
                  "identificador" => "sec0115"
                  "titulo" => "Publication bias"
                ]
              ]
            ]
          ]
        ]
        5 => array:2 [
          "identificador" => "sec0120"
          "titulo" => "Discussion"
        ]
        6 => array:2 [
          "identificador" => "sec0125"
          "titulo" => "Conclusion"
        ]
        7 => array:2 [
          "identificador" => "sec0130"
          "titulo" => "Financial support"
        ]
        8 => array:2 [
          "identificador" => "sec0135"
          "titulo" => "Authors&#8217; contributions"
        ]
        9 => array:2 [
          "identificador" => "sec0140"
          "titulo" => "Conflicts of interest"
        ]
        10 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2023-06-03"
    "fechaAceptado" => "2023-09-21"
    "PalabrasClave" => array:1 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1850932"
          "palabras" => array:4 [
            0 => "Behavioral therapy"
            1 => "Cognitive behavioral therapy"
            2 => "Dermatitis&#44; atopic"
            3 => "Meta-analysis"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:1 [
      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">The treatment for atopic dermatitis &#40;AD&#41; has been the focus of clinical research&#44; and behavioral intervention is considered an indispensable treatment method&#46; To our knowledge&#44; no relevant meta-analysis has evaluated the effects of behavioral interventions on atopic dermatitis&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objectives</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">To evaluate the effects of behavioral interventions on atopic dermatitis&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Methods</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">The authors searched PubMed&#44; EMBASE&#44; and Cochrane CENTRAL to retrieve relevant RCTs &#40;up to Feb 2022&#41;&#46; The search strategy involved a combination of related keywords&#46; The Cochrane Q and I<span class="elsevierStyleSup">2</span> statistics were used to assess heterogeneity&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Six RCTs involving seven reports with 246 patients were included&#46; The results suggested that behavioral interventions could relieve eczema severity &#40;correlation coefficient &#91;<span class="elsevierStyleItalic">r</span> &#61; &#8722;0&#46;39&#93;&#59; p&#8239;&#60;&#8239;0&#46;001&#41; and scratching severity significantly &#40;<span class="elsevierStyleItalic">r</span> &#61; &#8722;0&#46;19&#59; p&#8239;&#61;&#8239;0&#46;017&#41;&#44; while not affect itching intensity &#40;<span class="elsevierStyleItalic">r</span> &#61; &#8722;0&#46;02&#59; p&#8239;&#61;&#8239;0&#46;840&#41;&#46; A sensitivity analysis confirmed the robustness of the results&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Study limitations</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">An important limitation of this study was the insufficient number of RCTs and the limited sample size&#46; In addition&#44; the study lacked a control group receiving a type of intervention other than the experimental protocol&#46; Another limitation was the short duration of follow-up&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conclusions</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">This study suggests that behavioral interventions could be effective in treating atopic dermatitis by reducing eczema and scratching severity&#46; Additionally&#44; habit-reversal behavioral therapy may be more effective for treating atopic dermatitis&#46;</p></span>"
        "secciones" => array:6 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Background"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objectives"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Methods"
          ]
          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Results"
          ]
          4 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Study limitations"
          ]
          5 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Conclusions"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Study conducted at the Affiliated Hospital of Hangzhou Normal University&#44; Hangzhou&#44; Zhejiang&#44; China&#46;</p>"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0180" class="elsevierStylePara elsevierViewall">The following is Supplementary data to this article&#58;<elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary material"
            "identificador" => "sec0150"
          ]
        ]
      ]
    ]
    "multimedia" => array:8 [
      0 => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2548
            "Ancho" => 2508
            "Tamanyo" => 436898
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Flow chart of the process of selecting study&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1173
            "Ancho" => 1675
            "Tamanyo" => 214795
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Risk of bias assessment of included studies&#46; In this figure&#44; Q1 to Q7 represents random sequence generation&#44; allocation concealment&#44; blinding of participants and personnel&#44; blinding of outcome assessment&#44; incomplete outcome data&#44; selective reporting outcome&#44; and other bias&#44; respectively&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1632
            "Ancho" => 2925
            "Tamanyo" => 253476
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0015"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Meta-analysis of effect size of psychological interventions for relieving eczema severity&#46; CI&#44; Confidence Interval&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "fig0020"
        "etiqueta" => "Figure 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 1255
            "Ancho" => 2925
            "Tamanyo" => 140312
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0020"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Meta-analysis of effect size of psychological interventions for reducing itching intensity&#46; CI&#44; Confidence Interval&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "fig0025"
        "etiqueta" => "Figure 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr5.jpeg"
            "Alto" => 1490
            "Ancho" => 2925
            "Tamanyo" => 183650
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0025"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Meta-analysis of effect size of psychological interventions for reducing scratching severity&#46; CI&#44; Confidence Interval&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0030"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">UMC&#44; Usual Medical Care&#59; DE&#44; Dermatological Education&#59; BT&#44; Behavioral Therapy&#59; ADAM&#44; Atopic Dermatitis Assessment Measure&#59; SCORAD&#44; Scoring Atopic Dermatitis&#59; N&#46;R&#46;&#44; Not Reported&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Country&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Setting&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Design&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sample size&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mean age&#44; years&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Percent female&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Duration of disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Duration of treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Number of sessions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Follow-up&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Outcome assessment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ehlers&#44; et al&#46;&#44; 1995</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Germany</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Clinic-based</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">UMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 weeks</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 weeks</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Physician&#8217;s evaluation</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DE&#8239;&#43;&#8239;BT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habib&#44; et al&#46;&#44; 1999</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Australia</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Population-based</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">UMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">33&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 weeks</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 weeks</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ADAM</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">36&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">78&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Melin&#44; et al&#46;&#44; 1986</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sweden</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Clinic-based</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">UMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46;5</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">n&#46;r&#46;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#46;R&#46;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 weeks</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 weeks</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Physician&#8217;s evaluation</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Noren&#44; et al&#46;&#44; 1989</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sweden</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Clinic-based</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">UMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&#46;8</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">64&#37;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#46;R&#46;</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 weeks</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 weeks</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Physician&#8217;s evaluation</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Schut&#44; et al&#46;&#44; 2013</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Germany</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Population-based</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">UMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#46;R&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 weeks</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 weeks</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SCORAD</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#46;R&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Noren&#44; et al&#46;&#44; 2018</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sweden</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Population-based</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">UMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 weeks</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 weeks</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SCORAD</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BT&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3599849.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The basic characteristics of the included studies&#46;</p>"
        ]
      ]
      6 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0035"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">UMC&#44; Usual Medical Care&#59; DE&#44; Dermatological Education&#59; BT&#44; Behavioral Therapy&#59; N&#46;R&#46;&#44; Not Reported&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Study&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Comparison&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Eczema severity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Itching intensity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Scratching severity&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ehlers&#44; et al&#46;&#44; 1995a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BT vs&#46; UMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;348 &#40;&#8722;0&#46;575 to &#8722;0&#46;071&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;039 &#40;&#8722;0&#46;239 to 0&#46;312&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;094 &#40;&#8722;0&#46;361 to 0&#46;187&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ehlers&#44; et al&#46;&#44; 1995b&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DE&#8239;&#43;&#8239;BT vs&#46; DE&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;328 &#40;&#8722;0&#46;546 to &#8722;0&#46;069&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;073 &#40;&#8722;0&#46;326 to 0&#46;189&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;109 &#40;&#8722;0&#46;358 to 0&#46;154&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Habib&#44; et al&#46;&#44; 1999&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BT vs&#46; UMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;499 &#40;&#8722;0&#46;790 to &#8722;0&#46;024&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#46;R&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#46;R&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Melin&#44; et al&#46;&#44; 1986&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BT vs&#46; UMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;426 &#40;&#8722;0&#46;761 to 0&#46;088&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;&#8722;0&#46;496 to 0&#46;496&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;574 &#40;&#8722;0&#46;833 to &#8722;0&#46;109&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Noren&#44; et al&#46;&#44; 1989&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BT vs&#46; UMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;346 &#40;&#8722;0&#46;581 to &#8722;0&#46;058&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#46;R&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;248 &#40;&#8722;0&#46;505 to 0&#46;049&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Schut&#44; et al&#46;&#44; 2013&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BT vs&#46; UMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;272 &#40;&#8722;0&#46;586 to 0&#46;113&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#46;R&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#46;R&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Noren&#44; et al&#46;&#44; 2018&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BT vs&#46; UMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;518 &#40;&#8722;0&#46;721 to &#8722;0&#46;233&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">N&#46;R&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;059 &#40;&#8722;0&#46;354 to 0&#46;246&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3599848.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Effect size of included studies regarding each outcome&#46;</p>"
        ]
      ]
      7 => array:5 [
        "identificador" => "upi0005"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc1.docx"
          "ficheroTamanyo" => 662370
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:44 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of atopic dermatitis in Europe"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "E&#46; Kowalska-Ol&#281;dzka"
                            1 => "M&#46; Czarnecka"
                            2 => "A&#46; Baran"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/21556660.2019.1619570"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Drug Assess"
                        "fecha" => "2019"
                        "volumen" => "8"
                        "paginaInicial" => "126"
                        "paginaFinal" => "128"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31232396"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of atopic dermatitis in adults&#58; results from an international survey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Barbarot"
                            1 => "S&#46; Auziere"
                            2 => "A&#46; Gadkari"
                            3 => "G&#46; Girolomoni"
                            4 => "L&#46; Puig"
                            5 => "E&#46;L&#46; Simpson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/all.13401"
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy"
                        "fecha" => "2018"
                        "volumen" => "73"
                        "paginaInicial" => "1284"
                        "paginaFinal" => "1293"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29319189"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The prevalence of atopic dermatitis in adults&#58; systematic review on population studies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46;M&#46; Mathiesen"
                            1 => "S&#46;F&#46; Thomsen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Dermatol Online J"
                        "fecha" => "2019"
                        "volumen" => "25"
                        "paginaInicial" => "13030"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Carboxamide derivatives are potential therapeutic AHR ligands for restoring IL-4 mediated repression of epidermal differentiation proteins"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "G&#46; Rikken"
                            1 => "N&#46;J&#46;M&#46; van den Brink"
                            2 => "I&#46;M&#46;J&#46;J&#46; van Vlijmen-Willems"
                            3 => "P&#46;E&#46;J&#46; van Erp"
                            4 => "L&#46; Pettersson"
                            5 => "J&#46;P&#46;H&#46; Smits"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/ijms23031773"
                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Mol Sci"
                        "fecha" => "2022"
                        "volumen" => "23"
                        "paginaInicial" => "1773"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35163694"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Advances in atopic dermatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Plant"
                            1 => "M&#46;R&#46; Ardern-Jones"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7861/clinmed.2021-0280"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Med &#40;Lond&#41;"
                        "fecha" => "2021"
                        "volumen" => "21"
                        "paginaInicial" => "177"
                        "paginaFinal" => "181"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34001568"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines on management of atopic dermatitis in India&#58; an evidence-based review and an expert consensus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Rajagopalan"
                            1 => "A&#46; De"
                            2 => "K&#46; Godse"
                            3 => "D&#46;S&#46; Krupa Shankar"
                            4 => "V&#46; Zawar"
                            5 => "N&#46; Sharma"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4103/ijd.IJD_683_18"
                      "Revista" => array:6 [
                        "tituloSerie" => "Indian J Dermatol"
                        "fecha" => "2019"
                        "volumen" => "64"
                        "paginaInicial" => "166"
                        "paginaFinal" => "181"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31148854"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reframing racial and ethnic disparities in atopic dermatitis in black and latinx populations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "E&#46;A&#46; Croce"
                            1 => "M&#46;L&#46; Levy"
                            2 => "A&#46;S&#46; Adamson"
                            3 => "E&#46;C&#46; Matsui"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaci.2021.09.015"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2021"
                        "volumen" => "148"
                        "paginaInicial" => "1104"
                        "paginaFinal" => "1111"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Subtypes of atopic dermatitis&#58; from phenotype to endotype"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "Y&#46; Tokura"
                            1 => "S&#46; Hayano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.alit.2021.07.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergol Int"
                        "fecha" => "2022"
                        "volumen" => "71"
                        "paginaInicial" => "14"
                        "paginaFinal" => "24"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34344611"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The molecular features of normal and atopic dermatitis skin in infants&#44; children&#44; adolescents&#44; and adults"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "Y&#46; Renert-Yuval"
                            1 => "E&#46; Del Duca"
                            2 => "A&#46;B&#46; Pavel"
                            3 => "M&#46; Fang"
                            4 => "R&#46; Lefferdink"
                            5 => "J&#46; Wu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaci.2021.01.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2021"
                        "volumen" => "148"
                        "paginaInicial" => "148"
                        "paginaFinal" => "163"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33453290"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atopic eczema"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;J&#46; Brown"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.7861/clinmedicine.16-1-66"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Med &#40;Lond&#41;"
                        "fecha" => "2016"
                        "volumen" => "16"
                        "paginaInicial" => "66"
                        "paginaFinal" => "69"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26833520"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Update on atopic dermatitis&#58; diagnosis&#44; severity assessment&#44; and treatment selection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;B&#46; Fishbein"
                            1 => "J&#46;I&#46; Silverberg"
                            2 => "E&#46;J&#46; Wilson"
                            3 => "P&#46;Y&#46; Ong"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaip.2019.06.044"
                      "Revista" => array:4 [
                        "tituloSerie" => "J Allergy Clin Immunol Pract"
                        "fecha" => "2020"
                        "paginaInicial" => "91"
                        "paginaFinal" => "101"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Depression&#44; anxiety&#44; and dermatologic quality of life in adolescents with atopic dermatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;J&#46; Slattery"
                            1 => "M&#46;J&#46; Essex"
                            2 => "E&#46;M&#46; Paletz"
                            3 => "E&#46;R&#46; Vanness"
                            4 => "M&#46; Infante"
                            5 => "G&#46;M&#46; Rogers"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaci.2011.05.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2011"
                        "volumen" => "128"
                        "paginaInicial" => "668"
                        "paginaFinal" => "671"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21684588"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mental stress in atopic dermatitis--neuronal plasticity and the cholinergic system are affected in atopic dermatitis and in response to acute experimental mental stress in a randomized controlled pilot study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46;M&#46; Peters"
                            1 => "A&#46; Michenko"
                            2 => "J&#46; Kupfer"
                            3 => "W&#46; Kummer"
                            4 => "S&#46; Wiegand"
                            5 => "V&#46; Niemeier"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0113552"
                      "Revista" => array:3 [
                        "tituloSerie" => "PLoS One"
                        "fecha" => "2014"
                        "volumen" => "9"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermatology for the internist&#58; optimal diagnosis and management of atopic dermatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Narla"
                            1 => "J&#46;I&#46; Silverberg"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/07853890.2021.2004322"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Med"
                        "fecha" => "2021"
                        "volumen" => "53"
                        "paginaInicial" => "2165"
                        "paginaFinal" => "2177"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34787024"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Atopic dermatitis&#58; the updated practice parameter and beyond"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Boguniewicz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2500/aap.2014.35.3798"
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy Asthma Proc"
                        "fecha" => "2014"
                        "volumen" => "35"
                        "paginaInicial" => "429"
                        "paginaFinal" => "434"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25584909"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anxiety level and severity of skin condition predicts outcome of psychotherapy in atopic dermatitis patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Linnet"
                            1 => "G&#46;B&#46; Jemec"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1046/j.1365-4362.2001.01272.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Dermatol"
                        "fecha" => "2001"
                        "volumen" => "40"
                        "paginaInicial" => "632"
                        "paginaFinal" => "636"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11737422"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluation of a parental training program for the management of childhood atopic dermatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Staab"
                            1 => "U&#46; von Rueden"
                            2 => "R&#46; Kehrt"
                            3 => "M&#46; Erhart"
                            4 => "K&#46; Wenninger"
                            5 => "P&#46; Kamtsiuris"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1034/j.1399-3038.2002.01005.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Allergy Immunol"
                        "fecha" => "2002"
                        "volumen" => "13"
                        "paginaInicial" => "84"
                        "paginaFinal" => "90"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12000479"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Age related&#44; structured educational programmes for the management of atopic dermatitis in children and adolescents&#58; multicentre&#44; randomised controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Staab"
                            1 => "T&#46;L&#46; Diepgen"
                            2 => "M&#46; Fartasch"
                            3 => "J&#46; Kupfer"
                            4 => "T&#46; Lob-Corzilius"
                            5 => "J&#46; Ring"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.332.7547.933"
                      "Revista" => array:6 [
                        "tituloSerie" => "Bmj"
                        "fecha" => "2006"
                        "volumen" => "332"
                        "paginaInicial" => "933"
                        "paginaFinal" => "938"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16627509"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effects of psychological intervention on atopic dermatitis&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Y&#46; Chida"
                            1 => "A&#46; Steptoe"
                            2 => "N&#46; Hirakawa"
                            3 => "N&#46; Sudo"
                            4 => "C&#46; Kubo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000101940"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int Arch Allergy Immunol"
                        "fecha" => "2007"
                        "volumen" => "144"
                        "paginaInicial" => "1"
                        "paginaFinal" => "9"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17449959"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Psychological and educational interventions for atopic dermatitis in adults&#58; a systematic review and meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46; Hashimoto"
                            1 => "Y&#46; Ogawa"
                            2 => "N&#46; Takeshima"
                            3 => "T&#46;A&#46; Furukawa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1017/bec.2017.4"
                      "Revista" => array:5 [
                        "tituloSerie" => "Behaviour Change"
                        "fecha" => "2017"
                        "volumen" => "34"
                        "paginaInicial" => "48"
                        "paginaFinal" => "65"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Psychological interventions for personal stigma of patients with schizophrenia&#58; a systematic review and network meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "H&#46; Luo"
                            1 => "Y&#46; Li"
                            2 => "B&#46;X&#46; Yang"
                            3 => "J&#46; Chen"
                            4 => "P&#46; Zhao"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jpsychires.2022.02.010"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Psychiatr Res"
                        "fecha" => "2022"
                        "volumen" => "148"
                        "paginaInicial" => "348"
                        "paginaFinal" => "356"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35202995"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparative effectiveness of multiple psychological interventions for psychological crisis in people affected by coronavirus disease 2019&#58; a bayesian network meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "Y&#46; Yang"
                            1 => "S&#46; Sun"
                            2 => "S&#46; Hu"
                            3 => "C&#46; Tang"
                            4 => "Y&#46; Zhang"
                            5 => "H&#46; Lin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3389/fpsyg.2021.577187"
                      "Revista" => array:3 [
                        "tituloSerie" => "Front Psychol"
                        "fecha" => "2021"
                        "volumen" => "12"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Using values in cognitive and behavioral therapy&#58; a bridge back to philosophy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46; Martin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jep.13872"
                      "Revista" => array:4 [
                        "tituloSerie" => "J Eval Clin Pract"
                        "fecha" => "2023"
                        "paginaInicial" => "1189"
                        "paginaFinal" => "1195"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Habit reversal therapy quickly and significantly contributes to the management of children with atopic eczema"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46; Bewley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/bjd.16260"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2018"
                        "volumen" => "178"
                        "paginaInicial" => "584"
                        "paginaFinal" => "585"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29595231"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Stress and skin&#58; an overview of mind body therapies as a treatment strategy in dermatology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Graubard"
                            1 => "A&#46; Perez-Sanchez"
                            2 => "R&#46; Katta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5826/dpc.1104a91"
                      "Revista" => array:3 [
                        "tituloSerie" => "Dermatol Pract Concept"
                        "fecha" => "2021"
                        "volumen" => "11"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cognitive behavioral therapy as an adjuvant therapy in acne excori&#233;e&#58; a randomized controlled clinical trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "V&#46; Mashayekhi Goyonlo"
                            1 => "M&#46;S&#46; Sardabi"
                            2 => "A&#46;M&#46; Tavalaei"
                            3 => "Z&#46; Khoshnevisan"
                            4 => "M&#46; Razmara"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/09546634.2020.1776207"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dermatolog Treat"
                        "fecha" => "2022"
                        "volumen" => "33"
                        "paginaInicial" => "782"
                        "paginaFinal" => "788"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32502358"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Habit-reversal&#58; a method of eliminating nervous habits and tics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46;H&#46; Azrin"
                            1 => "R&#46;G&#46; Nunn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0005-7967(73)90119-8"
                      "Revista" => array:6 [
                        "tituloSerie" => "Behav Res Ther"
                        "fecha" => "1973"
                        "volumen" => "11"
                        "paginaInicial" => "619"
                        "paginaFinal" => "628"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4777653"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Habit reversal with muscle tics&#58; replication and component analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46;G&#46; Miltenberger"
                            1 => "R&#46;W&#46; Fuqua"
                            2 => "T&#46; McKinley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0005-7894(85)80054-X"
                      "Revista" => array:5 [
                        "tituloSerie" => "Behavior Therapy"
                        "fecha" => "1985"
                        "volumen" => "16"
                        "paginaInicial" => "39"
                        "paginaFinal" => "50"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cognitive-behavioral therapy for depression using mind over mood&#58; CBT skill use and differential symptom alleviation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46;L&#46; Hawley"
                            1 => "C&#46;A&#46; Padesky"
                            2 => "S&#46;D&#46; Hollon"
                            3 => "E&#46; Mancuso"
                            4 => "J&#46;M&#46; Laposa"
                            5 => "K&#46; Brozina"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.beth.2016.09.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Behav Ther"
                        "fecha" => "2017"
                        "volumen" => "48"
                        "paginaInicial" => "29"
                        "paginaFinal" => "44"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28077219"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cochrane handbook for systematic reviews of interventions version 6&#46;2 &#40;updated February 2021&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;P&#46;T&#46; Higgins"
                            1 => "J&#46; Thomas"
                            2 => "J&#46; Chandler"
                            3 => "M&#46; Cumpston"
                            4 => "T&#46; Li"
                            5 => "M&#46;J&#46; Page"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Libro" => array:2 [
                        "titulo" => "Cochrane"
                        "fecha" => "2021"
                      ]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [
                        "link" => "www&#46;training&#46;cochrane&#46;org&#47;handbook"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cochrane Handbook for Systematic Reviews of Interventions version 6&#46;2 &#40;updated February 2021&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;P&#46;T&#46; Higgins"
                            1 => "J&#46; Thomas"
                            2 => "J&#46; Chandler"
                            3 => "M&#46; Cumpston"
                            4 => "T&#46; Li"
                            5 => "M&#46;J&#46; Page"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:2 [
                        "titulo" => "Cochrane"
                        "fecha" => "2021"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The cochrane collaboration&#8217;s tool for assessing risk of bias in randomised trials"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;P&#46;T&#46; Higgins"
                            1 => "D&#46;G&#46; Altman"
                            2 => "P&#46;C&#46; G&#248;tzsche"
                            3 => "P&#46; J&#252;ni"
                            4 => "D&#46; Moher"
                            5 => "A&#46;D&#46; Oxman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.d5928"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2011"
                        "volumen" => "343"
                        "paginaInicial" => "d5928"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22008217"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "r equivalent&#58; a simple effect size indicator"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Rosenthal"
                            1 => "D&#46;B&#46; Rubin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1037/1082-989X.8.4.492"
                      "Revista" => array:6 [
                        "tituloSerie" => "Psychol Methods"
                        "fecha" => "2003"
                        "volumen" => "8"
                        "paginaInicial" => "492"
                        "paginaFinal" => "496"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14664684"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantifying heterogeneity in a meta-analysis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;P&#46; Higgins"
                            1 => "S&#46;G&#46; Thompson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/sim.1186"
                      "Revista" => array:6 [
                        "tituloSerie" => "Stat Med"
                        "fecha" => "2002"
                        "volumen" => "21"
                        "paginaInicial" => "1539"
                        "paginaFinal" => "1558"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12111919"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Quantifying&#44; displaying and accounting for heterogeneity in the meta-analysis of RCTs using standard and generalised Q statistics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Bowden"
                            1 => "J&#46;F&#46; Tierney"
                            2 => "A&#46;J&#46; Copas"
                            3 => "S&#46; Burdett"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1471-2288-11-41"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Med Res Methodol"
                        "fecha" => "2011"
                        "volumen" => "11"
                        "paginaInicial" => "41"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21473747"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Measuring inconsistency in meta-analyses"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;P&#46; Higgins"
                            1 => "S&#46;G&#46; Thompson"
                            2 => "J&#46;J&#46; Deeks"
                            3 => "D&#46;G&#46; Altman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1136/bmj.327.7414.557"
                      "Revista" => array:6 [
                        "tituloSerie" => "BMJ"
                        "fecha" => "2003"
                        "volumen" => "327"
                        "paginaInicial" => "557"
                        "paginaFinal" => "560"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12958120"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "B&#46;W&#46; D&#46; Practical Meta-Analysis Effect Size Calculator"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "W&#46;L&#46; Mark"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "WWW" => array:2 [
                        "link" => "https&#58;&#47;&#47;www&#46;campbellcollaboration&#46;org&#47;escalc&#47;html&#47;EffectSizeCalculator-Home&#46;php"
                        "fecha" => "2001"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Practical considerations on detection of publication bias"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Palma Perez"
                            1 => "M&#46; Delgado Rodriguez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1157/13101085"
                      "Revista" => array:6 [
                        "tituloSerie" => "Gac Sanit"
                        "fecha" => "2006"
                        "volumen" => "20 Suppl 3"
                        "paginaInicial" => "10"
                        "paginaFinal" => "16"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17433196"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Stress management for atopic dermatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Habib"
                            1 => "S&#46; Morrissey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1375/bech.16.4.226"
                      "Revista" => array:5 [
                        "tituloSerie" => "Behaviour change"
                        "fecha" => "1999"
                        "volumen" => "16"
                        "paginaInicial" => "226"
                        "paginaFinal" => "236"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Behavioural treatment of scratching in patients with atopic dermatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "L&#46; Melin"
                            1 => "T&#46; Frederiksen"
                            2 => "P&#46; Noren"
                            3 => "B&#46;G&#46; Swebilius"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.1986.tb06241.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "1986"
                        "volumen" => "115"
                        "paginaInicial" => "467"
                        "paginaFinal" => "474"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3778815"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The positive effects of habit reversal treatment of scratching in children with atopic dermatitis&#58; a randomized controlled study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46; Nor&#233;n"
                            1 => "L&#46; Hagstr&#246;mer"
                            2 => "M&#46; Alimohammadi"
                            3 => "L&#46; Melin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/bjd.16009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2018"
                        "volumen" => "178"
                        "paginaInicial" => "665"
                        "paginaFinal" => "673"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28940213"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "42"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effect of combined topical steroids and habit-reversal treatment in patients with atopic dermatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46; Nor&#233;n"
                            1 => "L&#46; Melin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.1989.tb01430.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "1989"
                        "volumen" => "121"
                        "paginaInicial" => "359"
                        "paginaFinal" => "366"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2679856"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "43"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Psychophysiological effects of stress management in patients with atopic dermatitis&#58; a randomized controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "C&#46; Schut"
                            1 => "U&#46; Weik"
                            2 => "N&#46; Tews"
                            3 => "U&#46; Gieler"
                            4 => "R&#46; Deinzer"
                            5 => "J&#46; Kupfer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2340/00015555-1415"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Derm Venereol"
                        "fecha" => "2013"
                        "volumen" => "93"
                        "paginaInicial" => "57"
                        "paginaFinal" => "61"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22983681"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "44"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of atopic dermatitis&#58; a comparison of psychological and dermatological approaches to relapse prevention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Ehlers"
                            1 => "U&#46; Stangier"
                            2 => "U&#46; Gieler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1037//0022-006x.63.4.624"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Consult Clin Psychol"
                        "fecha" => "1995"
                        "volumen" => "63"
                        "paginaInicial" => "624"
                        "paginaFinal" => "635"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7673540"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/03650596/0000009900000004/v2_202407191005/S0365059624000291/v2_202407191005/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "89516"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Article"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/03650596/0000009900000004/v2_202407191005/S0365059624000291/v2_202407191005/en/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059624000291?idApp=UINPBA00008Z"
]