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Same-day Versus Separate-day Preoperative Consultation for Mohs Surgery

Not Applicable
Withdrawn
Conditions
Non-melanoma Skin Cancer
Basal Cell Carcinoma
Squamous Cell Carcinoma of Skin
Interventions
Other: Same-day preoperative consultation
Registration Number
NCT02321982
Lead Sponsor
Dartmouth-Hitchcock Medical Center
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.

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
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

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Same-day preoperative consultationSame-day preoperative consultationPatients referred for Mohs surgery for non-melanoma skin cancer will have a preoperative consultation on the day same day as the procedure.
Primary Outcome Measures
NameTimeMethod
Time to repairEight weeks

Assess the amount of time elapsed between cancer removal and defect repair

Time to treatmentEight weeks

Assess the total amount of time elapsed between skin cancer diagnosis and defect repair

Time to consultation with other specialtiesEight weeks

Assess the amount of time between cancer diagnosis and consultation with non-dermatologic specialties

Patient satisfactionEight 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 Outcome Measures
NameTimeMethod
Utilization rate of Mohs surgeryEight weeks

Assess the percentage of patients who actually proceed with undergoing Mohs surgery in each arm

Rate of case cancellationEight weeks

Assess the number of cases that are cancelled due to site discrepancy, anticoagulation or other medical issues in each arm

Travel costEight weeks

Assess the total distance traveled by each patient coming and going to Mohs appointment(s)

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