Assessing the Potential for Patient-led Surveillance After Treatment of Localized Melanoma (MEL-SELF)

Abstract

IMPORTANCEPatient-led surveillance is a promising new model of follow-up care following excision of localized melanoma.OBJECTIVE To 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 PARTICIPANTS This 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.

Exploring the Integration of Environmental Impacts in the Cost Analysis of the Pilot MEL-SELF Trial of Patient-Led Melanoma Surveillance

“…The aim of the current study was to: (1) describe an approach to include environmental impacts in a cost analysis; and (2) demonstrate this approach by estimating selected environmental impacts alongside traditional health system and other costs using the example of the pilot MEL-SELF randomised controlled trial (RCT) of patient-led melanoma surveillance [ 13 ].…”

JAMA Dermatology—The Year in Review, 2021

“…2 A third article achieving a high Altmetric score reported results of the MEL-SELF randomized clinical trial, which examined patient-led (and smartphone-assisted) skin selfexaminations and dermoscopy vs clinician-led routine surveillance for melanoma. 5 The results of this pilot study indicate that patient-led surveillance after treatment of localized melanoma may be safe, feasible, and acceptable to patients, providing key foundational evidence in support of larger studies needed to inform melanoma surveillance guidelines. Several additional JAMA Dermatology publications this year examined melanoma treatments, re-evaluated what outcomes should be the priority for melanoma research, and questioned central dogma, including the role of UV exposure in melanoma pathogenesis in persons with skin of color.…”

Lessons for Oncology From the COVID-19 Pandemic

“…Technologies such as connected devices (wearables and nonwearables) can passively or actively collect information from patients to transmit to providers 14 . Online platforms and mobile applications can help collect patient-reported outcome measures (PROMs) and guide patients through disease surveillance and symptom monitoring 15–17 . Tools such as artificial intelligence (AI)–powered chat bots can increase opportunities for conversational, bidirectional information exchange to provide information to patients and assist with triaging patients to the correct resources and clinical staff 18 …”