Physician-Centered Outcomes for Skin Cancer Treatment: A Single-Day Modified Delphi Process to Assess the Importance of Themes in Skin Cancer Management

Anthony M. Rossi, Joseph Sobanko, Naomi Lawrence, Jeremy Bordeaux, Todd Cartee, Eric S. Armbrecht, Anit Behera, Christian L. Baum, Murad Alam, Ian A. Maher

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


BACKGROUNDSuccess in skin cancer treatment is determined through outcome measurement. Patients and physicians may prioritize different outcomes of care, and identification of such may enhance patient-centered care.OBJECTIVETo identify gaps between patient and physician attitudes toward skin cancer outcomes.MATERIALS AND METHODSA single-day, 21-patient, modified, in-person Delphi process to solicit and rate the importance of skin cancer-related outcomes was conducted. Twelve masked dermatologic surgeons rated patient-generated outcomes in a 2-round modified Delphi process. Each item was rated on a 1 to 9 scale (1, least important; 9, most important) using the Qualtrics web platform (Qualtrics, Provo, UT). Results of the physician ratings were compared with the patient ratings.RESULTSA list of 53 skin cancer treatment-related themes and outcomes was generated. Eight items were ranked by physicians as "very high" (>80% importance), 5 as "high" (>70% importance), 19 as intermediate, and 21 as low. The physician and patient panels' ratings were concordant for 56% of items, whereas 7 outcome items showed a 2-category discordance.CONCLUSIONPhysicians and patients were concordant regarding skin cancer treatment on multiple spheres. Areas of discordance include patient fear of unknown future risk, recurrence, or empowering patients to make treatment choices, and may be areas of continued improvement for delivery of patient-centered care.

Original languageEnglish (US)
Pages (from-to)869-874
Number of pages6
JournalDermatologic Surgery
Issue number7
StatePublished - Jul 1 2019

Bibliographical note

Funding Information:
Supported by an institutional research contract from the Patient-Centered Outcome Research Initiative. This research was funded in part through the PCORI ASDS Grant and the NIH/NCI Cancer Center Support Grant P30 CA008748. The authors have indicated no significant interest with commercial supporters.

Publisher Copyright:
© 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.


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