Mistaken Conclusions in a Nonmelanoma Skin Cancer Article Published in JAMA

Sobanko, Joseph F.; Ross, Steven T.

doi:10.1111/dsu.12469

Cited by 1 publication

(2 citation statements)

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“…Comorbidity assessment will likely become an important factor in individualizing treatment for all malignant diseases including skin cancer. It is well accepted that a single treatment approach should not be applied to all patients with skin cancer [ 28 ], and thus grading comorbidity severity in patients may help guide management. This pilot study shows that PRACE-27 was more likely to identify an ailment than the MI and better identified the higher grades.…”

Section: Commentmentioning

confidence: 99%

“…This pilot study shows that PRACE-27 was more likely to identify an ailment than the MI and better identified the higher grades. The ACE-27 is a validated tool that may be more applicable in the skin cancer population compared to other tools such as the Charlson Comorbidity Index (CCI), whose applicability to skin cancer populations has been challenged [ 28 ]. Utilizing a patient-reported questionnaire like the PRACE-27 during the physician encounter may ensure that important components of the relevant medical history are not omitted.…”

Section: Commentmentioning

confidence: 99%

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Comorbidity Assessment in Skin Cancer Patients: A Pilot Study Comparing Medical Interview with a Patient-Reported Questionnaire

Lee

Nijhawan

Nehal

et al. 2015

Journal of Skin Cancer

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Background. Comorbidities are conditions that occur simultaneously but independently of another disorder. Among skin cancer patients, comorbidities are common and may influence management. Objective. We compared comorbidity assessment by traditional medical interview (MI) and by standardized patient-reported questionnaire based on the Adult Comorbidity Evaluation-27 (ACE-27). Methods. Between September 2011 and October 2013, skin cancer patients underwent prospective comorbidity assessment by a Mohs surgeon (MI) and a radiation oncologist (using a standardized patient-reported questionnaire based on the ACE-27, the PRACE-27). Comorbidities were identified and graded according to the ACE-27 and compared for agreement. Results. Forty-four patients were evaluated. MI and PRACE-27 identified comorbidities in 79.5% and 88.6% (p = 0.12) of patients, respectively. Among 27 comorbid ailments, the MI identified 9.9% as being present, while the PRACE-27 identified 12.5%. When there were discordant observations, PRACE-27 was more likely than MI to identify the comorbidity (OR = 5.4, 95% CI = 2.4–14.4, p < 0.001). Overall comorbidity scores were moderate or severe in 43.2% (MI) versus 59.1% (PRACE-27) (p = 0.016). Limitations. Small sample size from a single institution. Conclusion. Comorbidities are common in skin cancer patients, and a standardized questionnaire may better identify and grade them. More accurate comorbidity assessments may help guide skin cancer management.

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Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%