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Trials use different efficacy end points, have different study designs, involve different anatomic sites, and enroll different patient populations. In addition, because adherence in real\u2010world clinical practice differs from that observed in clinical trials, conclusions drawn from efficacy outcomes can be misleading. The objective of this review was to examine the efficacy end points used in studies of topical therapy for actinic keratosis, address other factors influencing efficacy outcomes in these studies, and discuss the possible influence of nonadherence on effectiveness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Review of the available literature on topical therapy for actinic keratosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The end points used to determine efficacy of therapies for actinic keratosis include a disparate group of outcomes, which can often make comparison between studies impossible.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Efficacy end points of clinical studies designed to assess the treatment of actinic keratosis should be standardized to facilitate between\u2010trial comparisons, and studies should focus on the end points that are most clinically relevant.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-4632.2012.05776.x","type":"journal-article","created":{"date-parts":[[2013,8,21]],"date-time":"2013-08-21T06:53:02Z","timestamp":1377067982000},"page":"1063-1070","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Understanding efficacy end\u2010points in studies of field\u2010directed therapy for actinic keratosis"],"prefix":"10.1111","volume":"52","author":[{"suffix":"Jr","given":"John E.","family":"Wolf","sequence":"first","affiliation":[{"name":"Department of Dermatology Baylor College of Medicine Houston TX USA USA"},{"name":"Department of Dermatology New York University Medical Center New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Darrell S.","family":"Rigel","sequence":"additional","affiliation":[{"name":"Department of Dermatology New York University Medical Center New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,8,21]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"36","article-title":"Treating AKs: what are your best options?","volume":"13","author":"Hubbs L","year":"2005","journal-title":"Skin Aging"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24284"},{"key":"e_1_2_7_4_1","first-page":"459","article-title":"Topical management of actinic keratosis and field cancerization","volume":"144","author":"Stockfleth E","year":"2009","journal-title":"G Ital Dermatol Venereol"},{"key":"e_1_2_7_5_1","first-page":"169","article-title":"Optimizing management of actinic keratosis and photodamaged skin: utilizing a stepwise approach","volume":"84","author":"Lee AD","year":"2009","journal-title":"Cutis"},{"key":"e_1_2_7_6_1","first-page":"1","article-title":"Actinic keratoses: sequelae and treatments. 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