ArticleJournal of the American Academy of Dermatology2017
Variation among pathologists' treatment suggestions for melanocytic lesions: A survey of pathologists.
Article in Journal of the American Academy of Dermatology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- Molecular Biomarkers for Melanoma Screening, Diagnosis and Prognosis: Current State and Future Prospects.Frontiers in medicine · 2021Review
- Pathologists' agreement on treatment suggestions for melanocytic skin lesions.Journal of the American Academy of Dermatology · 2020Article
- Improving clinical diagnosis of early-stage cutaneous melanoma based on Raman spectroscopy.British journal of cancer · 2018Article
- Influence of variability in assessment of Breslow thickness, mitotic rate and ulceration among US pathologists interpreting invasive melanoma, for the purpose of AJCC staging.Journal of cutaneous pathology · 2018Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
backgroundThe extent of variability in treatment suggestions for melanocytic lesions made by pathologists is unknown.
objectiveWe investigated how often pathologists rendered suggestions, reasons for providing suggestions, and concordance with national guidelines.
methodsWe conducted a cross-sectional survey of pathologists. Data included physician characteristics, experience, and treatment recommendation practices.
resultsOf 301 pathologists, 207 (69%) from 10 states (California, Connecticut, Hawaii, Iowa, Kentucky, Louisiana, New Jersey, New Mexico, Utah, and Washington) enrolled. In all, 15% and 7% reported never and always including suggestions, respectively. Reasons for offering suggestions included improved care (79%), clarification (68%), and legal liability (39%). Reasons for not offering suggestions included referring physician preference (48%), lack of clinical information (44%), and expertise (29%). Training and caseload were associated with offering suggestions (P < .05). Physician suggestions were most consistent for mild/moderate dysplastic nevi and melanoma. For melanoma in situ, 18 (9%) and 32 (15%) pathologists made suggestions that undertreated or overtreated lesions based on National Comprehensive Cancer Network (NCCN) guidelines, respectively. For invasive melanoma, 14 (7%) pathologists made treatment suggestions that undertreated lesions based on NCCN guidelines. LIMITATIONS: Treatment suggestions were self-reported.
conclusionsPathologists made recommendations ranging in consistency. These findings may inform efforts to reduce treatment variability and optimize patterns of care delivery for patients.
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