Critical appraisal:Hedblad MA, Mallbris L 2012

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Critical Appraisal

Article being appraised

Hedblad MA, Mallbris L. Grenz ray treatment of lentigo maligna and early lentigo maligna melanoma. J Am Acad Dermatol 2012 Jul;67(1):60-8 Available from: http://www.ncbi.nlm.nih.gov/pubmed/22030019.


Applicable clinical question

Key Facts

Study Design

cohort study

Study aims:

To evaluate the efficacy and safety of ultra-soft x-ray/grenz-ray (GR) treatment in patients with Lentigo Maligna (LM) and early Lentigo Maligna Melanoma (LMM).

Number of Patients:

593

primary therapy, n = 350;

partial excision followed by GR, n = 71;

radical excision followed by GR as recurrence-prophylactic treatment, n = 172
Reported outcome(s):

Number of cases/number of cases with recurrence (C/R)

Results of outcome(s):

Number of cases [no. of deceased] / number of cases with recurrence (C/R) :

1. Ephelid:
- Primary Radiotherapy: 111 [11]/18
- Partial Excision: 16 [2]/1
- Recurrence prophylaxis: —

2. Lentigo:
- Primary Radiotherapy: 77 [16]/9
- Partial Excision: 10 [1]/2
- Recurrence prophylaxis: —

Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-2

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
Representative of eligible patients.
Comparison group
Representative of eligible patients
Comparability of groups on demographic characteristics and clinical features
Not comparable and not adjusted for differences
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

Meghna Kakani


Jutta's tick icon.png This appraisal has been completed.


Article
Hedblad MA, Mallbris L. Grenz ray treatment of lentigo maligna and early lentigo maligna melanoma. J Am Acad Dermatol 2012 Jul;67(1):60-8 Available from: http://www.ncbi.nlm.nih.gov/pubmed/22030019.
Assigned to
User:Meghna.kakani
Topic area
Guidelines:Melanoma
Clinical question
Form
Form:Critical appraisal


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