Critical appraisal:Altamura D, Avramidis M, Menzies SW 2008

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Article
Altamura D, Avramidis M, Menzies SW. Assessment of the optimal interval for and sensitivity of short-term sequential digital dermoscopy monitoring for the diagnosis of melanoma. Arch Dermatol 2008 Apr;144(4):502-6 Available from: http://www.ncbi.nlm.nih.gov/pubmed/18427044.
Assigned to
User:Lyndal.alchin
Topic area
Guidelines:Melanoma
Clinical question
Form
Form:Critical appraisal
Study design
cohort study

Section below only relevant for Cancer Council Project Officer

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Critical Appraisal

Article being appraised

Altamura D, Avramidis M, Menzies SW. Assessment of the optimal interval for and sensitivity of short-term sequential digital dermoscopy monitoring for the diagnosis of melanoma. Arch Dermatol 2008 Apr;144(4):502-6 Available from: http://www.ncbi.nlm.nih.gov/pubmed/18427044.


Applicable clinical question

Key Facts

Study Design

cohort study

Study aims:

To determine whether 6 weeks could replace 3 months for short-term sequential digital dermoscopy imaging (ST-SDDI) of suspicious melanocytic lesions and determine the proportion of melanomas missed.

Number of Patients:

1859

Reported outcome(s):

Proportion of changed melanomas

Results of outcome(s):

Eighty-one melanomas were detected using ST-SDDI (Breslow thickness: median, in situ; maximum, 0.8 mm). Of 39 melanomas detected using ST-SDDI in the 6-week monitored lesions, 27 (69%) were detected at 6 weeks and 12 (31%) at 3 months. The OR for melanoma for a lesion changing at 6 weeks was 19 (95% confidence interval [CI], 10-35), and the overall OR for melanoma for a lesion changing during the short-term monitoring period (6 weeks to 4.5 months) was 47 (95% CI, 23-94).
For lesions remaining unchanged at 3 months, 99.2% (1118
of 1127 lesions) were shown to be benign as defined by an unremarkable further follow-up. Seventy-five percent (15 of 20) of the lentigo maligna melanomas, 93% (40 of 43) of other in situ melanomas, and 96% (26 of 27) of the invasive melanomas were detected using ST-SDDI.

Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-3

Risk of bias
High risk of bias Comments: Please replace this text and include any additional comments in regards to your risk of bias rating

Risk of bias assessment: cohort study

Subject selection
"New technology" group
Highly selected or not described
Comparison group
Highly selected or not described
Comparability of groups on demographic characteristics and clinical features
Not comparable but adjusted analysis used
Measurement of outcomes
Outcome measures blind to technology used
No, but objective measures used
Same method of measurement used across comparison groups
Yes
Completeness of follow-up
Was follow-up complete and were all patients included in the analysis?
Yes (follow-up >95%) or survival analysis using all patients
Result of appraisal

Jutta's tick icon.png Included




Completed by

Lyndal Alchin