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Aim/background: Patient-reported outcome measurement instruments are important tools in understanding a breast reconstruction's impact on the patients' quality of life. A psychometric validation is essential before applying a patient-reported outcome measurement instrument in clinical practice and research. The BREAST-Q is a specific, validated questionnaire for breast surgery outcomes that has been translated from English to Danish. It consists of 167 items in 7 pre-operative scales and 15 post-operative scales. This validation study aims to validate the Danish BREAST-Q reconstruction module., Material and Methods: Eligible women were included from January 2019 to June 2020. Multiple-item scales with summated scores and more than 40 complete responses were eligible for psychometric validation, and psychometric analyses examined reliability and validity using Rasch Analyses and Classical Test Theory. Measurements included test for local response dependence, item fit, differential item functioning, and more. Clinical validity was assessed using known-groups hypotheses., Results: We obtained 115 and 201 complete responses pre-and postoperatively, respectively. We validated 120 items in four preoperative and nine postoperative scales. The Rasch analyses disclosed evidence of local response dependence in eight scales. Chronbach's α ranged 0.81-0.95 after adjustment. Item fit was evaluated using item-restscore correlations and showed good fit in 98 % of items. Differential Item Functioning was found in four items but had very little effect on the model. Clinical validity was supported by the know-group analyses., Discussion/conclusion: The Danish BREAST-Q reconstruction module has good acceptability, feasibility and validity, and adequate reliability. The results support the use in a Danish population., Competing Interests: Conflict of interests The authors have no conflict of interests., (Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction The use and consumption of "products", such as cosmetic procedures and confectionery, is on a rise in the Danish population. However, it has never been evaluated if the same tendency can be observed among the providers of these products. In view of the upcoming Christmas, we decided to investigate this delicate matter. Methods This study was a survey-based cross-sectional study examining demographics, professional backgrounds, as well as frequency and preferences regarding confectionery and cosmetic procedures among confectioners and plastic surgeons. Results A total of 90 persons answered the questionnaire. Results showed that consumption of confectionery was high among both confectioners and plastic surgeons, and that the use of cosmetic procedures was higher among both confectioners and plastic surgeons than among the background population. Both groups preferred to know the person who provided "the product" within their respective area. Conclusion Most plastic surgeons do not need to know their confectioner but would like to know their cosmetic procedure provider. So, if you, as part of the department management, or simply as a well-meaning colleague, want to treat your staff/colleagues, you can safely order cake from a random confectioner but not cosmetic procedures from a random surgeon! Funding none. Trial registration not relevant., (Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Introduction: The primary purpose of reconstructive and cosmetic breast surgery is to improve patients' quality of life, and patient-reported outcome measurements are important in outcome assessment of breast surgery. The BREAST-Q questionnaire measures changes in quality of life and patient satisfaction in patients undergoing breast surgery. The aim of this work was to translate and linguistically validate all BREAST-Q modules for use in Denmark., Methods: The Danish version of the BREAST-Q was developed through forward translation, back translation and cognitive debriefing following the guidelines from the MAPI Research Trust Foundation and approved by the developers. The aim was to achieve a conceptually equivalent Danish version using colloquial language rather than undertaking a simple literal translation., Results: A conceptually equivalent Danish version of all five BREAST-Q modules was achieved. The cognitive debriefing revealed good content validity. A cultural difference regarding the Satisfaction with Office Staff Scale was discovered., Conclusions: The BREAST-Q can now be used for patients undergoing breast surgery in Denmark to measure change in quality of life and patient satisfaction as part of the outcome assessment. The BREAST-Q may be used for both individual and group measurements in clinical and research settings alike. Data collection with BREAST-Q can provide valuable information for use in clinical counseling of women undergoing breast surgery. A psychometric validation of the Danish version of the BREAST-Q is currently underway., Funding: none., Trial Registration: not relevant., (Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.)

Introduction: The incidence of cutaneous melanoma is increasing in Denmark and worldwide. However, the prevalence of distant metastases at the time of diagnosis has decreased to 1%. We therefore questioned the value of routine preoperative chest X-ray (CXR) for staging asymptomatic melanoma patients and hypothesised that routine CXR is not justified., Methods: A retrospective study was conducted on patients undergoing wide local excision and sentinel lymph node biopsy for cutaneous melanoma in the period from 2010 to 2014., Results: A total of 603 patients were included. The mean time of follow-up was 34 months (range: 13-75 months). Of the 603 patients, 25 (4%) had a positive CXR and 578 (96%) had a negative CXR. Four (0.7%) patients had lung metastases of whom two had a true positive and two a false negative CXR, respectively. The sensitivity was 50%, specificity was 96%, the positive predictive value was 8%, and the negative predictive value was 100%., Conclusion: Our results suggest that CXR cannot be justified in the initial staging of cutaneous melanoma patients. The guideline for the treatment of melanoma in Denmark is under revision: The use of CXR has been omitted., Funding: This study received funding from the Department of Plastic Surgery, the Research Council at Herlev Gentofte Hospital and the Danish Cancer Society., Trial Registration: The Danish Regional Committee on Biomedical Research Ethics (r. no.: H-4-2014-127), the Danish Data Protection Agency (2012-58-0004, local record no.: HEH-2015-003, I-Suite no.: 03436) and the Danish Melan-oma Group.

Patient-reported outcome measurements (PROMs) are often questionnaires which provide and rate the patient's point of view in the measurement of subjective clinical phenomena such as pain or quality of life. In the first of two articles we describe five of the six developmental phases of a patient-reported outcome questionnaire. Adherence to good methodology throughout the process is of utmost importance to ensure reliable and valid results from studies using PROM. Patients from the target population should be involved in the process to obtain content and face validation, i.e. through focus groups.

Patient-reported outcome measurements (PROMs) are often questionnaires which provide and rate the patient's point of view in the measurement of subjective clinical phenomena such as pain or quality of life. In the second of two articles we describe field-testing, the psychometric theories Classical Test Theory and Item Response Theory, psychometric validation and the measurement properties of a PROM. The latter is based on the COSMIN (consensus-based standards for the selection of health measurement instruments) guidelines, which are developed to assist in development and evaluation of PROMs.

Progressive multifocal leukoencephalopathy (PML) is a rare demyelinating disease in the central nervous system. It is caused by reactivation of John Cunningham-virus and has a grave prognosis. PML occurs most frequently in HIV-patients, but can also be seen in patients with iatrogenic immunodeficiency. Here, we present a patient with multiple myeloma and cardiac amyloidosis who developed PML after receiving treatment with several chemotherapeutics. This case report underlines the importance of bearing PML in mind when immunocompromised patients develop diffuse neurological symptoms.