The Proportion Cured of Patients with Resected Stage II–III Cutaneous Melanoma in Sweden

Eriksson, Hanna; Utjés, Deborah; Bagge, Roger Olofsson; Gillgren, Peter; Isaksson, Karolin; Lapins, Jan; Schultz, Inkeri; Lyth, Johan; Andersson, Therése

doi:10.3390/cancers13102456

Cited by 6 publications

(2 citation statements)

References 31 publications

(39 reference statements)

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“…CM is an obvious candidate for screening programs, since its prognosis is excellent when it is diagnosed in an early stage of the disease [4][5][6]. Current evidence on the benefits of CM screening, summarized for the US Preventive Services Task Force in a recent systematic review covering 20 studies [7], is, however, inconsistent.…”

Section: Introductionmentioning

confidence: 99%

The level of agreement between self-assessments and expert assessments of melanocytic nevus counts: Findings from an evaluation of 4548 blinded double assessments

Gefeller,

Kaiser,

Brockmann

et al. 2024

Preprint

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Cutaneous melanoma (CM) is a candidate for screening programs, since its prognosis is excellent when diagnosed in an early disease stage. Targeted screening of those at high risk for developing CM, a cost-effective alternative to population-wide screening, requires valid procedures to identify the high-risk group. Self-assessment of the number of nevi has been suggested as a component of such procedures, but its validity has not yet been established. We analyzed the level of agreement between self-assessments and expert assessments of the number of melanocytic nevi in the area between the wrist and the shoulder of both arms based on 4548 study subjects in whom mutually blinded double counting of nevi was performed. Nevus counting followed the IARC protocol. Study subjects received written instructions, photographs, a mirror, and a “nevometer” to support self-assessment of nevi larger than 2 mm. Nevus counts were categorized based on the quintiles of the distribution into five levels defining a nevus score. Cohen’s weighted kappa-coefficient was estimated to measure the level of agreement. In the total sample, agreement between self-assessments and expert-assessments was moderate (raw agreement: 50.29%, weighted κ=0.596). Self-assessed nevus counts were higher than those determined by experts (mean differ-ence: 3.33 nevi). The level of agreement was independent of sociodemographic and cutaneous factors; however, participants’ eye color had a significant impact on the level of agreement. Our findings show that even with comprehensive guidance, only a moderate level of agreement between self-assessed and expert-assessed nevus counts can be achieved. Self-assessed nevus information does not appear to be reliable enough to be used in individual risk assessment to target screening activities.

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Section: Introductionmentioning

confidence: 99%

The level of agreement between self-assessments and expert assessments of melanocytic nevus counts: Findings from an evaluation of 4548 blinded double assessments

Gefeller,

Kaiser,

Brockmann

et al. 2024

Preprint

View full text Add to dashboard Cite

show abstract

“…CM is an obvious candidate for screening programs because its prognosis is excellent when it is diagnosed at an early stage of the disease [4][5][6]. Current evidence on the benefits of CM screening, summarized for the US Preventive Services Task Force in a recent systematic review covering 20 studies [7], is, however, inconsistent.…”

Section: Introductionmentioning

confidence: 99%

The Level of Agreement between Self-Assessments and Examiner Assessments of Melanocytic Nevus Counts: Findings from an Evaluation of 4548 Double Assessments

Gefeller,

Kaiser,

Brockmann

et al. 2024

Current Oncology

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Cutaneous melanoma (CM) is a candidate for screening programs because its prognosis is excellent when diagnosed at an early disease stage. Targeted screening of those at high risk for developing CM, a cost-effective alternative to population-wide screening, requires valid procedures to identify the high-risk group. Self-assessment of the number of nevi has been suggested as a component of such procedures, but its validity has not yet been established. We analyzed the level of agreement between self-assessments and examiner assessments of the number of melanocytic nevi in the area between the wrist and the shoulder of both arms based on 4548 study subjects in whom mutually blinded double counting of nevi was performed. Nevus counting followed the IARC protocol. Study subjects received written instructions, photographs, a mirror, and a “nevometer” to support self-assessment of nevi larger than 2 mm. Nevus counts were categorized based on the quintiles of the distribution into five levels, defining a nevus score. Cohen’s weighted kappa coefficient (κ) was estimated to measure the level of agreement. In the total sample, the agreement between self-assessments and examiner assessments was moderate (weighted κ = 0.596). Self-assessed nevus counts were higher than those determined by trained examiners (mean difference: 3.33 nevi). The level of agreement was independent of sociodemographic and cutaneous factors; however, participants’ eye color had a significant impact on the level of agreement. Our findings show that even with comprehensive guidance, only a moderate level of agreement between self-assessed and examiner-assessed nevus counts can be achieved. Self-assessed nevus information does not appear to be reliable enough to be used in individual risk assessment to target screening activities.

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Mixture and Non-mixture Cure Models for Health Technology Assessment: What You Need to Know

Latimer,

Rutherford

2024

PharmacoEconomics

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There is increasing interest in the use of cure modelling to inform health technology assessment (HTA) due to the development of new treatments that appear to offer the potential for cure in some patients. However, cure models are often not included in evidence dossiers submitted to HTA agencies, and they are relatively rarely relied upon to inform decision-making. This is likely due to a lack of understanding of how cure models work, what they assume, and how reliable they are. In this tutorial we explain why and when cure models may be useful for HTA, describe the key characteristics of mixture and non-mixture cure models, and demonstrate their use in a range of scenarios, providing Stata code. We highlight key issues that must be taken into account by analysts when fitting these models and by reviewers and decision-makers when interpreting their predictions. In particular, we note that flexible parametric non-mixture cure models have not been used in HTA, but they offer advantages that make them well suited to an HTA context when a cure assumption is valid but follow-up is limited. Supplementary Information The online version contains supplementary material available at 10.1007/s40273-024-01406-7.

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The Proportion Cured of Patients with Resected Stage II–III Cutaneous Melanoma in Sweden

Cited by 6 publications

References 31 publications

The level of agreement between self-assessments and expert assessments of melanocytic nevus counts: Findings from an evaluation of 4548 blinded double assessments

The level of agreement between self-assessments and expert assessments of melanocytic nevus counts: Findings from an evaluation of 4548 blinded double assessments

The Level of Agreement between Self-Assessments and Examiner Assessments of Melanocytic Nevus Counts: Findings from an Evaluation of 4548 Double Assessments

Mixture and Non-mixture Cure Models for Health Technology Assessment: What You Need to Know

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