Search

Purpose: Surgical procedures for malignant and benign cutaneous diseases are commonly performed in the outpatient dermatology clinic. For patients, these procedures can be accompanied by significant uncertainty, angst, and feelings of unpreparedness. In some instances, this uncertainty may contribute to adverse events such as the development of deep venous thrombosis or pulmonary emboli due to unnecessarily held anticoagulants. Methods: We performed a prospective cohort study evaluating the impact of pre-surgical informative phone calls on patient satisfaction with their surgical experience. Surgical patients scheduled at our academic dermatology clinic for excision or Mohs surgery were randomly assigned to a “call”/intervention group or “non-call”/control group. Patients in the intervention group were called by their resident surgeon one evening prior to their procedure. The resident discussed a pre-written script of expectations and preparations for the surgical day and post-operative period, and allotted time for patients to ask questions. Patients from both groups were given identical five-point Likert scale surveys to complete on the day of their suture removal, which varied from 7-14 days after the procedure. Data analysis was performed using SPSS. Means and one-tail t-test for each question were calculated to compare the call group to the non-call group. Results: Patients in the call group reported higher rates of overall satisfaction, satisfaction with answers to questions, overall preparation, and overall rating of surgical experience while also reporting lower levels of fear and anxiety. Of these findings, differences in level of preparedness were statistically significant. Conclusions: The results suggest that presurgical phone calls to patients may improve patient education, help address their concerns and questions, improve their satisfaction with care, and can potentially limit adverse events.

BACKGROUND Clinical practice guidelines inform evidence-based decision making in the clinical setting; however, systematic reviews which inform these clinical practice guidelines may vary in terms of reporting and methodological quality, which affects confidence in summary effect estimates. OBJECTIVE Our objective was to appraise the methodological and reporting quality of the systematic reviews used in clinical practice guidelines for cutaneous melanoma and evaluate differences in these outcomes between Cochrane and non-Cochrane reviews. METHODS We conducted a cross-sectional analysis by searching PubMed for cutaneous melanoma guidelines published between the dates of January 1, 2015 and May, 21 2021. Next, we extracted systematic reviews composing these guidelines and appraised their reporting and methodological rigor using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and A MeaSurement Tool to Assess systematic Reviews (AMSTAR-2) checklists. Lastly, we compared these outcomes between Cochrane and non-Cochrane systematic reviews. All screening and data extraction occurred in a masked, duplicate fashion. RESULTS Of the systematic reviews appraised, the mean completion rate for the PRISMA checklist was 66.5% (SD=12.29) and 44.55% (SD=21.05) for AMSTAR-2. The majority of systematic reviews were of critically low methodological quality, with no systematic reviews being appraised as high quality. There was a statistically significant association between AMSTAR-2 and PRISMA checklists. Cochrane systematic reviews had higher PRISMA mean completion rates and higher methodological quality than non-Cochrane systematic reviews. CONCLUSIONS Systematic reviews supporting clinical practice guidelines focused on the management of cutaneous melanoma vary in reporting and methodological quality, with the majority of systematic reviews being of low quality. Increasing adherence to PRISMA and AMSTAR-2 checks will likely increase the quality of systematic reviews, thereby increasing the level of evidence supporting cutaneous melanoma clinical practice guidelines.