Evidence map›Paper›PMID 34817543›Full record

Trial reportJAMA dermatology2022

Assessing the Potential for Patient-led Surveillance After Treatment of Localized Melanoma (MEL-SELF): A Pilot Randomized Clinical Trial.

Deonna M Ackermann, Mbathio Dieng, Ellie Medcalf, Marisa C Jenkins, Cathelijne H van Kemenade, Monika Janda, Robin M Turner, Anne E Cust, Rachael L Morton, Les Irwig and 16 more

Erratum issuedOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JAMA dermatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 24 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 5 pooled it
3.4field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 5 syntheses or guidelines pooled it, 49 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Trial
  7. Trial
  8. Survivorship care for melanoma patients: a scoping review.Journal of cancer survivorship : research and practice · 2026
    Review
  9. Article
  10. Article
  11. Review
  12. Article
  13. Review
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

26 authors at 9 institutions in 3 countries.

Deonna M AckermannSchool of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Mbathio DiengNational Health and Medical Research Council (NHMRC) Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia.
Ellie MedcalfSchool of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Marisa C JenkinsSchool of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Cathelijne H van KemenadeSchool of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Monika JandaCentre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia.
Robin M TurnerBiostatistics Centre, University of Otago, Dunedin, Otago, New Zealand.
Anne E CustSchool of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Rachael L MortonNational Health and Medical Research Council (NHMRC) Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia.
Les IrwigSchool of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Pascale GuiteraMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
H Peter SoyerDermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, Australia.
Victoria MarSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Jolyn K HerschSchool of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Donald LowCancer Voices New South Wales, Sydney, New South Wales, Australia.
Cynthia LowCancer Voices New South Wales, Sydney, New South Wales, Australia.
Robyn P M SawMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
Richard A ScolyerMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
Dorothy DrabarekSchool of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
David EspinozaNational Health and Medical Research Council (NHMRC) Clinical Trials Centre, The University of Sydney, Sydney, New South Wales, Australia.
Anthony AzziNewcastle Skin Check, Newcastle, New South Wales, Australia.
Alister M LilleymanNewcastle Skin Check, Newcastle, New South Wales, Australia.
Amelia K SmitSchool of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
Peter MurchieAcademic Primary Care Research Group, Division of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland, United Kingdom.
John F ThompsonMelanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia.
Katy J L BellSchool of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
University of Sydney · AUMelanoma Institute Australia · AUCancer Institute of New South Wales · AURoyal Prince Alfred Hospital · AUUniversity of Queensland · AUMonash University · AUNational Health and Medical Research Council · AUUniversity of Aberdeen · GBUniversity of Otago · NZ

Funding

Cancer Research UK 21685
6 · The paper itself

Abstract

importancePatient-led surveillance is a promising new model of follow-up care following excision of localized melanoma.

objectiveTo determine whether patient-led surveillance in patients with prior localized primary cutaneous melanoma is as safe, feasible, and acceptable as clinician-led surveillance. DESIGN, SETTING, AND

participantsThis was a pilot for a randomized clinical trial at 2 specialist-led clinics in metropolitan Sydney, Australia, and a primary care skin cancer clinic managed by general practitioners in metropolitan Newcastle, Australia. The participants were 100 patients who had been treated for localized melanoma, owned a smartphone, had a partner to assist with skin self-examination (SSE), and had been routinely attending scheduled follow-up visits. The study was conducted from November 1, 2018, to January 17, 2020, with analysis performed from September 1, 2020, to November 15, 2020.

interventionParticipants were randomized (1:1) to 6 months of patient-led surveillance (the intervention comprised usual care plus reminders to perform SSE, patient-performed dermoscopy, teledermatologist assessment, and fast-tracked unscheduled clinic visits) or clinician-led surveillance (the control was usual care). MAIN OUTCOMES AND MEASURES: The primary outcome was the proportion of eligible and contacted patients who were randomized. Secondary outcomes included patient-reported outcomes (eg, SSE knowledge, attitudes, and practices, psychological outcomes, other health care use) and clinical outcomes (eg, clinic visits, skin surgeries, subsequent new primary or recurrent melanoma).

resultsOf 326 patients who were eligible and contacted, 100 (31%) patients (mean [SD] age, 58.7 [12.0] years; 53 [53%] men) were randomized to patient-led (n = 49) or clinician-led (n = 51) surveillance. Data were available on patient-reported outcomes for 66 participants and on clinical outcomes for 100 participants. Compared with clinician-led surveillance, patient-led surveillance was associated with increased SSE frequency (odds ratio [OR], 3.5; 95% CI, 0.9 to 14.0) and thoroughness (OR, 2.2; 95% CI, 0.8 to 5.7), had no detectable adverse effect on psychological outcomes (fear of cancer recurrence subscale score; mean difference, -1.3; 95% CI, -3.1 to 0.5), and increased clinic visits (risk ratio [RR], 1.5; 95% CI, 1.1 to 2.1), skin lesion excisions (RR, 1.1; 95% CI, 0.6 to 2.0), and subsequent melanoma diagnoses and subsequent melanoma diagnoses (risk difference, 10%; 95% CI, -2% to 23%). New primary melanomas and 1 local recurrence were diagnosed in 8 (16%) of the participants in the intervention group, including 5 (10%) ahead of routinely scheduled visits; and in 3 (6%) of the participants in the control group, with none (0%) ahead of routinely scheduled visits (risk difference, 10%; 95% CI, 2% to 19%). CONCLUSIONS AND RELEVANCE: This pilot of a randomized clinical trial found that patient-led surveillance after treatment of localized melanoma appears to be safe, feasible, and acceptable. Experiences from this pilot study have prompted improvements to the trial processes for the larger trial of the same intervention.

trial registrationhttp://anzctr.org.au Identifier: ACTRN12616001716459.

Indexed as

MelanomaSkin NeoplasmsHumansMaleMiddle AgedNeoplasm Recurrence, LocalPilot ProjectsSelf-Examination

Identifiers

PMID34817543
PMCPMC8771298
OpenAlexW3214772895

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.