Alexander Witkowski, Abel D Jarell, Kelli L Ahmed, Jennifer J Siegel, Brooke H Russell, Jason H Rogers, Matthew S Goldberg, Neil F Fernandes, Joanna Ludzik, Aaron S Farberg
{"title":"皮肤科医生使用基因表达谱诊断测试指导患者管理的临床影响研究。","authors":"Alexander Witkowski, Abel D Jarell, Kelli L Ahmed, Jennifer J Siegel, Brooke H Russell, Jason H Rogers, Matthew S Goldberg, Neil F Fernandes, Joanna Ludzik, Aaron S Farberg","doi":"10.2217/mmt-2023-0002","DOIUrl":null,"url":null,"abstract":"<p><p><b>Aim:</b> Cutaneous melanocytic neoplasms with diagnostic and/or clinical ambiguity pose patient management challenges. <b>Methods:</b> Six randomized case scenarios with diagnostic/clinical uncertainty were described with/without a benign or malignant diagnostic gene expression profile (GEP) result. <b>Results:</b> Clinical impact was assessed by reporting the mean increase/decrease of management changes normalized to baseline (n = 32 dermatologists). Benign GEP results prompted clinicians to decrease surgical margins (84.2%). Malignant GEP results escalated surgical excision recommendations (100%). A majority (72.2%) reduced and nearly all (98.9%) increased follow-up frequency for benign or malignant GEP results, respectively. There was an overall increase in management plan confidence with GEP results. <b>Conclusion:</b> Diagnostic GEP tests help guide clinical decision-making in a variety of diagnostically ambiguous or clinicopathologically discordant scenarios.</p>","PeriodicalId":44562,"journal":{"name":"Melanoma Management","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131342/pdf/","citationCount":"0","resultStr":"{\"title\":\"A clinical impact study of dermatologists' use of diagnostic gene expression profile testing to guide patient management.\",\"authors\":\"Alexander Witkowski, Abel D Jarell, Kelli L Ahmed, Jennifer J Siegel, Brooke H Russell, Jason H Rogers, Matthew S Goldberg, Neil F Fernandes, Joanna Ludzik, Aaron S Farberg\",\"doi\":\"10.2217/mmt-2023-0002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Aim:</b> Cutaneous melanocytic neoplasms with diagnostic and/or clinical ambiguity pose patient management challenges. <b>Methods:</b> Six randomized case scenarios with diagnostic/clinical uncertainty were described with/without a benign or malignant diagnostic gene expression profile (GEP) result. <b>Results:</b> Clinical impact was assessed by reporting the mean increase/decrease of management changes normalized to baseline (n = 32 dermatologists). Benign GEP results prompted clinicians to decrease surgical margins (84.2%). Malignant GEP results escalated surgical excision recommendations (100%). A majority (72.2%) reduced and nearly all (98.9%) increased follow-up frequency for benign or malignant GEP results, respectively. There was an overall increase in management plan confidence with GEP results. <b>Conclusion:</b> Diagnostic GEP tests help guide clinical decision-making in a variety of diagnostically ambiguous or clinicopathologically discordant scenarios.</p>\",\"PeriodicalId\":44562,\"journal\":{\"name\":\"Melanoma Management\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2024-05-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11131342/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Melanoma Management\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2217/mmt-2023-0002\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Melanoma Management","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2217/mmt-2023-0002","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"ONCOLOGY","Score":null,"Total":0}
A clinical impact study of dermatologists' use of diagnostic gene expression profile testing to guide patient management.
Aim: Cutaneous melanocytic neoplasms with diagnostic and/or clinical ambiguity pose patient management challenges. Methods: Six randomized case scenarios with diagnostic/clinical uncertainty were described with/without a benign or malignant diagnostic gene expression profile (GEP) result. Results: Clinical impact was assessed by reporting the mean increase/decrease of management changes normalized to baseline (n = 32 dermatologists). Benign GEP results prompted clinicians to decrease surgical margins (84.2%). Malignant GEP results escalated surgical excision recommendations (100%). A majority (72.2%) reduced and nearly all (98.9%) increased follow-up frequency for benign or malignant GEP results, respectively. There was an overall increase in management plan confidence with GEP results. Conclusion: Diagnostic GEP tests help guide clinical decision-making in a variety of diagnostically ambiguous or clinicopathologically discordant scenarios.
期刊介绍：
Skin cancer is on the rise. According to the World Health Organization, 132,000 melanoma skin cancers occur globally each year. While early-stage melanoma is usually relatively easy to treat, once disease spreads prognosis worsens considerably. Therefore, research into combating advanced-stage melanoma is a high priority. New and emerging therapies, such as monoclonal antibodies, B-RAF and KIT inhibitors, antiangiogenic agents and novel chemotherapy approaches hold promise for prolonging survival, but the search for a cure is ongoing. Melanoma Management publishes high-quality peer-reviewed articles on all aspects of melanoma, from prevention to diagnosis and from treatment of early-stage disease to late-stage melanoma and metastasis. The journal presents the latest research findings in melanoma research and treatment, together with authoritative reviews, cutting-edge editorials and perspectives that highlight hot topics and controversy in the field. Independent drug evaluations assess newly approved medications and their role in clinical practice. Key topics covered include: Risk factors, prevention and sun safety education Diagnosis, staging and grading Surgical excision of melanoma lesions Sentinel lymph node biopsy Biological therapies, including immunotherapy and vaccination Novel chemotherapy options Treatment of metastasis Prevention of recurrence Patient care and quality of life.
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