Minding the gap: Identifying gaps in skin disease research prioritization as reflected in the Cochrane Database of Systematic Reviews
Caroline Chen
Pro |
Presented at: Society for Investigative Dermatology 2025
Date: 2025-05-07 00:00:00
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Summary: Skin diseases rank among the leading causes of human disease, yet research prioritization for these conditions remains inadequately characterized. This study examines whether the representation of skin diseases in the Cochrane Database of Systematic Reviews (CDSR) aligns with their global disease burden as quantified by disability-adjusted life years (DALYs) in the most recent Global Burden of Disease (GBD) 2021 Study. In this bibliometric analysis, we evaluated 227 unique CDSR systematic reviews and protocols representing 15 skin disease categories as of November 2024. Representation was assessed relative to DALY metrics from GBD 2021, and linear regression analysis was performed to evaluate correlations between CDSR representation and DALY burden. Changes in CDSR representation from 2014 to 2024 were compared with changes in DALY burden from 2010 to 2021. We found that viral skin diseases were appropriately represented based on DALY metrics, while dermatitis, decubitus ulcer, melanoma, non-melanoma skin cancer, and the “other skin and subcutaneous diseases” category were overrepresented. Psoriasis, acne vulgaris, fungal and bacterial skin diseases, pruritus, leprosy, alopecia areata, urticaria, and scabies were underrepresented. From 2014 to 2024, 13 of 15 disease categories increased in CDSR representation, yet this growth poorly correlated with changes in DALY burden (R2 = 0.3953). Moreover, cumulative CDSR representation through 2024 showed a weak correlation with global DALY burden in 2021 (R2 = 0.0876). Overall, our findings reveal persistent misalignment between dermatologic research prioritization and global disease burden, with 14 of 15 skin disease categories showing disparities. Addressing these gaps will require increased investment in underrepresented, high-burden conditions and a more equitable allocation of research resources to improve evidence-based care and global health equity.