Basal Cell Carcinoma, Non-melanoma Skin Cancer, Squamous Cell Carcinoma of Skin
Conditions
Keywords
Mohs surgery, Preoperative consultation
Brief summary
The purpose of this study is to determine whether separate- versus same-day preoperative consultation affects time to treatment (start to finish), utilization rate of Mohs, rate of case cancellations, cost, and patient satisfaction. The investigators hypothesize that patients with same-day preoperative consultation will have a shorter time between cancer diagnosis and removal but, only when coordination of care is needed, longer time between removal and consultation with other specialists, as compared to patients with separate-day consultation. The investigators anticipate that patients with same-day preoperative consultation will have a decrease in travel cost as compared to patients with separate-day consultation. The investigators expect that there will be no difference in various satisfaction matters between groups, with the exception of potentially greater convenience reported by patients in the same-day preoperative consultation group. Finally, the investigators hypothesize that there will be no difference between groups in regards to rates of surgery cancellation.
Detailed description
Procedure: Prospective trial which randomly assigns patients to either separate- or same-day preoperative consultation for Mohs surgery. A phone consultation will take place, which will assist in determining whether the patient is appropriate for enrollment into the study. If so, the patient will be randomized to either separate-day or same-day preoperative consultation. Materials: Patient survey Methods of data collection: The patient-specific data obtained from the medical record will include: Patient age, number of previous skin cancers, preoperative size, history of cutaneous surgery, employment status, and distance between home address and dermatology facility. Outcome measures that will be obtained from the medical record will include: Time between cancer diagnosis, removal and defect repair, rate of proceeding with Mohs as opposed to other treatment options, and rate of cancelling surgery (due to site discrepancy, anticoagulation issues). A survey will be used to assess patient satisfaction.
Interventions
OTHERSame-day preoperative consultation
Preoperative consultation occurs on the same day as Mohs surgery
Sponsors
Dartmouth-Hitchcock Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Patients will be considered for enrollment if they have been referred to a Mohs surgeon for consideration of Mohs surgery for non-melanoma skin cancer
Exclusion criteria
* Patients would be excluded if there is a lack of indication for Mohs * Significant comorbidities, or * In the case of a high-risk location or tumor size, for which in advance it is known that they will need consultation with other specialties
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Time to treatment | Eight weeks | Assess the total amount of time elapsed between skin cancer diagnosis and defect repair |
| Time to consultation with other specialties | Eight weeks | Assess the amount of time between cancer diagnosis and consultation with non-dermatologic specialties |
| Time to repair | Eight weeks | Assess the amount of time elapsed between cancer removal and defect repair |
| Patient satisfaction | Eight weeks | Administer a survey to assess patient's perception of convenience, level of comfort with the procedure, and self-evaluation of knowledge regarding the diagnosis and treatment |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Rate of case cancellation | Eight weeks | Assess the number of cases that are cancelled due to site discrepancy, anticoagulation or other medical issues in each arm |
| Travel cost | Eight weeks | Assess the total distance traveled by each patient coming and going to Mohs appointment(s) |
| Utilization rate of Mohs surgery | Eight weeks | Assess the percentage of patients who actually proceed with undergoing Mohs surgery in each arm |
Outcome results
None listed