Skip to main content
SSO 2024 Annual Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Recorded for On-Demand Viewing
Recorded for On-Demand Viewing
Back

Melanoma

E319: The impact of a Regional Communities of Practice to improve quality of melanoma care: setting guidelines for preoperative diagnostic imaging in early stage melanoma

    ePoster Abstract Author(s)

  • Rebecca Lau, BMSc (she/her/hers)

    Medical student
    Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, The Ottawa Hospital
    Ottawa, Ontario, Canada

    • Submitter(s)

  • Rebecca Lau, BMSc (she/her/hers)

    Medical student
    Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, The Ottawa Hospital
    Ottawa, Ontario, Canada

    • Author(s)

  • KA

    Katherine Aw, BMSc

    Medical student
    Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, The Ottawa Hospital
    Ottawa, Ontario, Canada

  • BW

    Boaz Wong, BMSc

    Medical Student
    Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, The Ottawa Hospital
    Ottawa, Ontario, Canada

  • KR

    Karine Riad, MD

    Resident
    Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, The Ottawa Hospital, Ontario, Canada

  • Alex Lee, MD

    Resident
    Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, The Ottawa Hospital
    Ottawa, Ontario, Canada

  • HL

    Heidi Li, MD

    Resident
    Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, The Ottawa Hospital
    Ottawa, Ontario, Canada

  • EG

    Elysia Grose, MD

    Resident
    Faculty of Medicine, University of Ottawa; Ottawa Hospital Research Institute, The Ottawa Hospital, Ontario, Canada

  • OB

    Olivier Brandts-Longtin, BSc

    Medical student
    Faculty of Medicine, University of Ottawa
    Ottawa, Ontario, Canada

  • AA

    Ahmad Abed, MD

    Resident
    Ottawa Hospital Research Institute, The Ottawa Hospital, United States

  • JS

    James Stevenson, MD

    Resident
    Ottawa Hospital Research Institute, The Ottawa Hospital, United States

  • RS

    Rahat Sheikh, BSc

    Medical student
    Ottawa Hospital Research Institute, The Ottawa Hospital, United States

  • RC

    Richard Chen, BSc

    Student
    Ottawa Hospital Research Institute, The Ottawa Hospital, Canada

  • CG

    Clara Goulet, n/a

    Student
    Ottawa Hospital Research Institute, The Ottawa Hospital, United States

  • SJ

    Stephanie Johnson-Obaseki, MD, MSc

    Physician
    Department of Head and Neck Surgery, University of Ottawa; Ottawa Hospital Research Institute, The Ottawa Hospital
    Ottawa, Ontario, Canada

  • Carolyn Nessim, MD, MSc

    Physician
    Division of General Surgery, Department of Surgery, University of Ottawa; Ottawa Hospital Research Institute, The Ottawa Hospital
    Ottawa, Ontario, Canada

Introduction: We aim to assess whether the proportion of patients with ≤ T3b melanoma receiving inappropriate preoperative diagnostic workup imaging decreased after the implementation and dissemination of the Communities of Practice guidelines.

Methods: Retrospectively collected data of patients with biopsy-proven primary melanoma who underwent wide local excision and sentinel lymph node biopsy surgery were included for analysis. Patients with biopsy dates before and after May 24, 2018, were grouped into the pre- and post-guideline cohorts, respectively. Frequency, type, and positivity rate of preoperative imaging were collected and analyzed. Patient baseline demographics and tumour histological characteristics were collected for multivariate analysis. 

Results: A total of 642 patients were included for analysis [pre-guideline (n=338) and post-guideline (n=304)]. Patients in the post-guideline cohort had significantly lower rates of pre-operative imaging when compared with the pre-guideline cohort (p< 0.0001).  This reduction in imaging remained significant when regrouping the post-guideline cohort as 1-, 3-, and 5- months of dissemination after initial guideline announcement. On multivariable analysis, guideline dissemination was associated with lower odds of receiving preoperative imaging [odds ratio, 0.23 (95% confidence interval, 0.13-0.39), p< 0.0001], while Breslow thickness [1.75 (1.15-2.71), p=0.0091] and microsatellitosis [9.15 (2.58-33.37), p=0.0006] were associated with receiving preoperative imaging.    

Conclusions: Here we report a reduction in inappropriate pre-operative imaging following CoP guideline dissemination. Our findings support the importance of quality improvement initiatives such as a CoP to advance melanoma care.    

Learning Objectives:

  • Upon completion, participants will be able to describe the role and impact of quality improvement initiatives on melanoma care and healthcare resource management.
  • Upon completion, participants will be able to demonstrate an understanding of regional guidelines for pre-operative imaging in early-stage cutaneous melanoma
  • Upon completion, participants will be able to list factors that influence pre-operative diagnostic imaging in early-stage cutaneous melanoma.