Melanoma detection by skin self-examination targeting at-risk women: A randomized controlled trial with telemedicine support for concerning moles

Abstract

Highlights At-risk women receiving online skin self-examination education initiated mole checks. Women receiving skin self-examination education sought health care when necessary. Provided education increased confidence in mole checking and did not affect anxiety. Women trained to do skin checks had fewer appointments for benign mole than controls. Detection of early melanomas was facilitated by skin self-examination education.

Dropout Rate in Digital Health Interventions for the Prevention of Skin Cancer: Systematic Review, Meta-analysis, and Metaregression

“…A total of 1566 studies were identified in the database search. After removing duplicates, the screening process, and complete reading of the records that met the eligibility criteria, 17 RCTs were finally included in the review [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50]. The complete process is shown in Figure 1.…”

“…The age of the participants ranged from 12.6 to 54.3 years. The digital strategies used in the included RCTs were web-based interventions in 8 studies [35,40,42,43,46,[48][49][50], 6 involved apps [36][37][38]44,45,47], 3 involved SMS [35,36,39], 2 involved video [34,41], and 1 involved a wearable device [47]. Conversely, the comparator groups involved no intervention in 11 studies [35,37,[43][44][45][46][47][48]50] and active controls in 6 studies [34,36,38,39,41,49].…”

“…The total number of dropouts for all arms of the included studies was 1120, with 681 (60.80%) in experimental interventions and 439 (39.20%) in controls. The reason for the dropout of participants was reported as loss during follow-up in 9 of the 17 RCTs [34,37,38,[40][41][42][43]47,49] and not answering the final questionnaire in 4 studies [39,44,45,50]; 2 studies did not report the reason for dropout [35,48]. The main characteristics of the studies are displayed in Table 2.…”

“…The meta-analysis of proportions included 22 arms (k) of study and 2610 subjects among whom there were 419 dropouts. An overall pooled dropout rate of 9.5% (95% CI, 5.0-17.5) was calculated (Figure 2; [34][35][36][38][39][40][41][42][43][44][45][46][47][48][49][50]). In the subgroup meta-analysis, digital strategies showed a higher dropout rate of 11.6% (95% CI 6.8-19.0) compared to 10.0% (95% CI 5.5-17.7) in the comparators.…”

“…A slight trend for a higher number of dropouts was observed in digital strategies with an OR of 1.16 (95% CI 0.98-1.36), but there were no significant differences between the experimental and control approaches (P=.39). The I 2 was 6% (95% CI 0-38) indicating a lack of heterogeneity between the studies analyzed for the overall and subgroup meta-analysis (Figure 3; [34][35][36][38][39][40][41][42][43][44][45][46][47][48][49][50]). We performed a meta-analysis of subgroups divided by the type of digital strategy and the comparison groups.…”