Comorbidity Assessment in Skin Cancer Patients: A Pilot Study Comparing Medical Interview with a Patient-Reported Questionnaire

Background. Comorbidities are conditions that occur simultaneously but independently of another disorder. Among skin cancer patients, comorbidities are common and may influence management. Objective. We compared comorbidity assessment by traditional medical interview (MI) and by standardized patient...

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Main Authors: Erica H. Lee, Rajiv I. Nijhawan, Kishwer S. Nehal, Stephen W. Dusza, Amanda Levine, Amanda Hill, Christopher A. Barker
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Journal of Skin Cancer
Online Access:http://dx.doi.org/10.1155/2015/953479
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author Erica H. Lee
Rajiv I. Nijhawan
Kishwer S. Nehal
Stephen W. Dusza
Amanda Levine
Amanda Hill
Christopher A. Barker
author_facet Erica H. Lee
Rajiv I. Nijhawan
Kishwer S. Nehal
Stephen W. Dusza
Amanda Levine
Amanda Hill
Christopher A. Barker
author_sort Erica H. Lee
collection DOAJ
description Background. Comorbidities are conditions that occur simultaneously but independently of another disorder. Among skin cancer patients, comorbidities are common and may influence management. Objective. We compared comorbidity assessment by traditional medical interview (MI) and by standardized patient-reported questionnaire based on the Adult Comorbidity Evaluation-27 (ACE-27). Methods. Between September 2011 and October 2013, skin cancer patients underwent prospective comorbidity assessment by a Mohs surgeon (MI) and a radiation oncologist (using a standardized patient-reported questionnaire based on the ACE-27, the PRACE-27). Comorbidities were identified and graded according to the ACE-27 and compared for agreement. Results. Forty-four patients were evaluated. MI and PRACE-27 identified comorbidities in 79.5% and 88.6% (p=0.12) of patients, respectively. Among 27 comorbid ailments, the MI identified 9.9% as being present, while the PRACE-27 identified 12.5%. When there were discordant observations, PRACE-27 was more likely than MI to identify the comorbidity (OR=5.4, 95% CI = 2.4–14.4, p<0.001). Overall comorbidity scores were moderate or severe in 43.2% (MI) versus 59.1% (PRACE-27) (p=0.016). Limitations. Small sample size from a single institution. Conclusion. Comorbidities are common in skin cancer patients, and a standardized questionnaire may better identify and grade them. More accurate comorbidity assessments may help guide skin cancer management.
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spelling doaj-art-b64a1d1f695b4a35878f2b7b8d11365e2025-02-03T06:11:30ZengWileyJournal of Skin Cancer2090-29052090-29132015-01-01201510.1155/2015/953479953479Comorbidity Assessment in Skin Cancer Patients: A Pilot Study Comparing Medical Interview with a Patient-Reported QuestionnaireErica H. Lee0Rajiv I. Nijhawan1Kishwer S. Nehal2Stephen W. Dusza3Amanda Levine4Amanda Hill5Christopher A. Barker6Department of Medicine, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USADepartment of Medicine, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USADepartment of Medicine, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USADepartment of Medicine, Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10022, USADepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USADepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USADepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USABackground. Comorbidities are conditions that occur simultaneously but independently of another disorder. Among skin cancer patients, comorbidities are common and may influence management. Objective. We compared comorbidity assessment by traditional medical interview (MI) and by standardized patient-reported questionnaire based on the Adult Comorbidity Evaluation-27 (ACE-27). Methods. Between September 2011 and October 2013, skin cancer patients underwent prospective comorbidity assessment by a Mohs surgeon (MI) and a radiation oncologist (using a standardized patient-reported questionnaire based on the ACE-27, the PRACE-27). Comorbidities were identified and graded according to the ACE-27 and compared for agreement. Results. Forty-four patients were evaluated. MI and PRACE-27 identified comorbidities in 79.5% and 88.6% (p=0.12) of patients, respectively. Among 27 comorbid ailments, the MI identified 9.9% as being present, while the PRACE-27 identified 12.5%. When there were discordant observations, PRACE-27 was more likely than MI to identify the comorbidity (OR=5.4, 95% CI = 2.4–14.4, p<0.001). Overall comorbidity scores were moderate or severe in 43.2% (MI) versus 59.1% (PRACE-27) (p=0.016). Limitations. Small sample size from a single institution. Conclusion. Comorbidities are common in skin cancer patients, and a standardized questionnaire may better identify and grade them. More accurate comorbidity assessments may help guide skin cancer management.http://dx.doi.org/10.1155/2015/953479
spellingShingle Erica H. Lee
Rajiv I. Nijhawan
Kishwer S. Nehal
Stephen W. Dusza
Amanda Levine
Amanda Hill
Christopher A. Barker
Comorbidity Assessment in Skin Cancer Patients: A Pilot Study Comparing Medical Interview with a Patient-Reported Questionnaire
Journal of Skin Cancer
title Comorbidity Assessment in Skin Cancer Patients: A Pilot Study Comparing Medical Interview with a Patient-Reported Questionnaire
title_full Comorbidity Assessment in Skin Cancer Patients: A Pilot Study Comparing Medical Interview with a Patient-Reported Questionnaire
title_fullStr Comorbidity Assessment in Skin Cancer Patients: A Pilot Study Comparing Medical Interview with a Patient-Reported Questionnaire
title_full_unstemmed Comorbidity Assessment in Skin Cancer Patients: A Pilot Study Comparing Medical Interview with a Patient-Reported Questionnaire
title_short Comorbidity Assessment in Skin Cancer Patients: A Pilot Study Comparing Medical Interview with a Patient-Reported Questionnaire
title_sort comorbidity assessment in skin cancer patients a pilot study comparing medical interview with a patient reported questionnaire
url http://dx.doi.org/10.1155/2015/953479
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