Surgical excision margins for primary cutaneous melanoma.

Background: Cutaneous melanoma accounts for 75% of skin cancer deaths. Standard treatment is surgical excision with a safety margin some distance from the borders of the primary tumour. The purpose of the safety margin is to remove both the complete primary tumour and any melanoma cells that might have spread into the surrounding skin.

US dermatology residents' satisfaction with training and mentoring: survey results from the 2005 and 2006 Las Vegas Dermatology Seminars.

Objective: To evaluate residents' satisfaction with dermatology training and mentorship.

Design: Written survey.

Setting: The Las Vegas Dermatology Seminar in 2005 and 2006.

Practicing evidence-based dermatology: a short guide.

Evidence-based medicine (EBM) is a paradigm for systematically collecting, evaluating, and applying the best information currently available to improve patient outcomes. Effective evidence-based practice requires defining an answerable, well-built question, systematically searching for the best current evidence, and appraising that evidence for validity. Essential components of EBM also require using our clinical expertise to integrate these data with our patients' characteristics, values, and circumstances; archiving the results of our EBM search; and evaluating the efficiency and effectiveness of the EBM process.

National appraisal of dermatology residency training: a Canadian study.

Objectives: To provide the first comprehensive assessment of dermatology residency training in Canada based on the residents' perspective; to examine and elucidate trends in current residents' envisioned career paths and aspirations.

Design: A national survey conducted in June 2004.

Participants: All Canadian dermatology residents.

Confidence intervals in procedural dermatology: an intuitive approach to interpreting data.

Background: Significant differences observed in therapeutic trials in procedural dermatology are typically denoted by p values of less than .05. Alternatively, significance can be conveyed by use of confidence intervals.

Dermatoepidemiology.

Dermatoepidemiology is an important emerging discipline in dermatology. This article reviews clinical and analytic epidemiology pertinent to reading, interpreting, and critically examining the literature, and presents an overview of evidence-based dermatology as a starting point for further study.

Power and sample size of therapeutic trials in procedural dermatology: how many patients are enough?

Background: Many new devices and therapeutic interventions are continually introduced in cutaneous surgery. The efficacy of these new techniques must be compared with that of preexisting standards so that patients can be appropriately counseled.

Objectives: The purpose of this article is to (1) review methods for estimating sample size and power, (2) estimate the range of sample sizes sufficient to ensure that true differences are not missed in clinical trials of new procedural dermatologic therapies, and (3) consider the reasons why the sample size may be too small in procedural dermatology trials and how this problem can be addressed.

Implementation of dermato-epidemiology curriculum at Case Western Reserve University dermatology program.

Dermato-epidemiology curriculum has been identified by the American Academy of Dermatology (AAD) as an important foundation for dermatology residency training. However, no one has yet reported implementation of dermato-epidemiology curriculum. To evaluate and relate our experience carrying out a dermato-epidemiology resident education initiative, based on recommendations by the AAD Epidemiology Committee.

The sensitivity of Medicare data for identifying incident cases of invasive melanoma (United States).

Background: The completeness of Medicare claims for identifying patients with melanoma for purposes of conducting population-based studies of melanoma is unknown.

Methods: Using a linked Surveillance, Epidemiology, and End Result (SEER) tumor registry-Medicare database, the sensitivity of Medicare claims for identifying 5372 patients age > or =65 years diagnosed with invasive melanoma between 1992 and 1996 was determined. Sensitivity was calculated as the proportion of incident cases of melanoma reported by SEER that was also captured by Medicare claim diagnostic codes.

Geographic and patient variation in receipt of surveillance procedures after local excision of cutaneous melanoma.

Little is known about variation in surveillance practices following the diagnosis of invasive melanoma. The objective of this study was to characterize geographic, patient, and tumor variation in the use of follow-up surveillance testing in patients with local or regional stage melanoma. A cohort of Medicare beneficiaries > or =65 y diagnosed with invasive melanoma during 1992 to 1996 living in a Surveillance, Epidemiology, and End Results registry area was studied.

The potential impact on melanoma mortality of reducing rates of suboptimal excision margins.

We estimated the potential benefit of reducing rates of inadequate excision margins in the treatment of localized invasive melanoma. A computer-simulated Markov decision analytic model was created to follow until death a hypothetical cohort of 55 y old Caucasians, newly diagnosed in a community setting with localized invasive melanoma. We considered two scenarios: usual care, and a hypothetical intervention.

Evaluating invasive cutaneous melanoma: is the initial biopsy representative of the final depth?

Background: An accurate initial biopsy of the deepest portion of the melanoma is vital to the management of patients with melanomas.

Objective: Our goal was to evaluate the accuracy of preliminary biopsies performed by a group of predominantly experienced dermatologists (n = 46/72).

Methods: A total of 145 cases of cutaneous melanoma were examined retrospectively.