An Opportunity to Ensure High-Quality Melanoma Care Through the Use of a Preoperative Treatment Algorithm

Abstract

As a proof of principle, an algorithm was developed to preoperatively verify that proposed melanoma treatments are concordant with established guidelines. These three pieces of information could be required during precertification, and nonconcordant treatment plans could prompt a peer-to-peer discussion. After additional pilot testing, the algorithm could offer a novel approach for quality improvement and provide a preoperative, prospective safeguard to ensure high-quality care for melanoma patients.

Melanoma patterns of care in Ontario: A call for a strategic alignment of multidisciplinary care

“…However, this trend corresponds with Australian data demonstrating that guideline‐concordant care for surgical margins in melanoma occurred in only 35% of patients . However, in a US study using algorithm based identification of guideline‐congruent care, 96% of patients received adequate care . Mitigating factors for such discrepancies are postulated to include patient declining treatment, triaging of patient referrals by age, inadequate knowledge of referring physicians concerning indications for and perceived benefit of specialist referral, resistance of physicians to follow recommended guidelines, and inadequate geographic supply of specialists.…”

“…of patients received adequate care. 28 Mitigating factors for such discrepancies are postulated to include patient declining treatment, triaging of patient referrals by age, inadequate knowledge of referring physicians concerning indications for and perceived benefit of specialist referral, resistance of physicians to follow recommended guidelines, and inadequate geographic supply of specialists.…”