Hannah Verma

Background: Melanoma accounts for nearly 8000 skin cancer-related deaths annually in the USA. Its impact on survival across intersectional sociodemographic factors remains unclear. Objectives: To characterize relative survival rates (RSRs) in patients with melanoma stratified by various intersecting ­sociodemographic factors. Methods: In this retrospective cohort study, relative survival analysis was conducted on patients with acral lentiginous (ALM), nodular (NM), superficial spreading (SSM) and lentigo maligna melanoma (LMM). Relative survival is advantageous as it compares survival in patients with cancer with the expected survival of individuals without cancer with matched characteristics to minimize noncancer mortality differences. This study utilized the Surveillance, Epidemiology, and End Results (SEER) database, established on cancer registries covering ∼48% of the US population. Age-standardized 5-year RSRs and 95% log–log confidence intervals (CIs) were calculated for each melanoma subtype for subgroups stratified by intersections of age, race, sex, marital status and Breslow thickness. Results: All melanoma subtypes except LMM had significant survival reductions, with NM having the lowest RSR (73.5%, log–log CI 72.7–74.3). ALM impacted survival most in male patients, followed by older populations, with younger male patients having lower RSRs than older female patients but younger female patients having similar survival to their counterparts without cancer. Male patients of all races or ethnicities other than White had lower RSRs than White male patients at every Breslow stage, whereas female patients had similar RSRs across all races or ethnicities. In NM, younger male patients had lower RSRs than younger female patients, but this difference narrowed with age. Asian and Black patients with NM experienced the most impact on survival. Patients with NM and SSM who were married had higher SSRs than patients who were not married. With regard to SSM and LMM, many age groups had RSRs of 100%; younger patients had slight but significant survival reductions. In SSM, Asian male patients had a particularly low RSR (85.9%), while other race–sex subgroups had RSRs >94%, a pattern observed across all Breslow thicknesses. Conclusions: The impact of melanoma on survival is largest on older male patients with ALM of all races or ethnicities other than White; Asian, Black and older patients with NM; and Black female patients and Asian patients with SSM. White patients with all melanoma subtypes, older patients with SSM and LMM, and younger female patients with ALM and NM were the least affected. Our findings demonstrate the varying survival impact of melanoma on different subpopulations, underscoring the importance of investigating intersectional sociodemographic factors.

Background: Student-run clinics (SRCs) for dermatology hold potential to significantly advance skin-related health equity, and a comprehensive analysis of these clinics may inform strategies for optimizing program effectiveness. Objective: We aimed to perform a scoping review of the literature about dermatology SRCs across the United States. Methods: We conducted systematic literature searches of Ovid MEDLINE, Ovid Embase, and Scopus on March 1, 2023, and June 19, 2024. No date, language, or paper-type restrictions were included in the search strategy. A total of 229 references were uploaded to Covidence for screening by 2 independent reviewers (SK and LL), and 23 full-text documents were assessed for eligibility. After an additional 8 documents were identified through a gray literature search, a total of 31 studies were included in the final analysis. Inclusion criteria were as follows: (1) studies set in an SRC, which was operationally led by medical students and could render condition-relevant treatments to patients, with dermatology care; (2) published in English; (3) within the United States; (4) included characterization of any of the following: logistics, care, patients, or design; and (5) included all study or document types, including gray literature that was not peer reviewed (eg, conference abstracts, preprints, and letters to the editor). Exclusion criteria were (1) papers not published in English and (2) those with duplicated data or that were limited in scope or not generalizable. Data were extracted qualitatively using Microsoft Excel to categorize the studies by several domains, including clinic location, demographics, services offered, and barriers to care. Results: There are at least 19 dermatology SRCs across the United States. The most common conditions encountered included atopic dermatitis; acne; fungal infections; benign nevi; psoriasis; and neoplasms, such as basal cell carcinoma, squamous cell carcinoma, and melanoma. Key facilitators for the clinics included faculty oversight, attending physician participation for biopsy histopathology, and dedicated program coordinators. Major barriers included lack of follow-up, medication nonadherence, and patient no-shows. Conclusions: Dermatology SRCs serve a diverse patient population, many of whom are underrepresented in traditional dermatology settings. This scoping review provides insights to help build stronger program foundations that better address community dermatologic health needs.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). With the advent of immune checkpoint inhibitors (ICIs) for cancer treatment, patients use online forums to share experiences. As many as 60% of patients taking ICIs will develop cutaneous immune-related adverse events, which can be a good prognostic indicator for ICI treatment response. This paper explores patient sentiments in online reviews on drugs.com to ICIs, pembrolizumab and nivolumab, using Python with Selenium and manual review. There were statistically significant higher mean overall patient ratings in reviews mentioning dermatologic symptoms (DS) compared to those that did not (mean of 5.7/10 vs. 4.0/10, P=.007), and a trend towards higher sentiment scores as well (P=.074). Finally, DS-containing reviews more frequently reported positive cancer outcomes (P<.001).

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). With the advent of immune checkpoint inhibitors (ICIs) for cancer treatment, patients use online forums to share experiences. As many as 60% of patients taking ICIs will develop cutaneous immune-related adverse events, which can be a good prognostic indicator for ICI treatment response. This paper explores patient sentiments in online reviews on drugs.com to ICIs, pembrolizumab and nivolumab, using Python with Selenium and manual review. There were statistically significant higher mean overall patient ratings in reviews mentioning dermatologic symptoms (DS) compared to those that did not (mean of 5.7/10 vs. 4.0/10, P=.007), and a trend towards higher sentiment scores as well (P=.074). Finally, DS-containing reviews more frequently reported positive cancer outcomes (P<.001).

Objective:To determine whether the quality of the patient experience differs between video visits and in-person visits for primary care. Methods:Using patient satisfaction survey results from patients who had visits with the internal medicine faculty primary care practice at a large urban academic hospital in New York City from 2018 to 2022, we compared results regarding satisfaction with the clinic, physician, and ease of access to care between patients who attended a video visit and those who attended an in-person appointment. Logistic regression analyses were performed to determine if there was a statistically significant difference in patient experience. Results:In total, 9,862 participants were included in analysis. Mean age of respondents attending in-person visits was 59.0; mean age of respondents attending telemedicine visits was 56.0. There was no statistically significant difference in scores between the in-person and telemedicine groups for likelihood of recommending the practice to others, quality of time spent with the doctor, and how well the clinical team explained care. Patient satisfaction was significantly higher in the telemedicine group compared with the in-person group for ability to get an appointment when needed (4.48 ± 1.00 vs. 4.34 ± 1.04, p < 0.001), how helpful and courteous the person who assisted them was (4.64 ± 0.83 vs. 4.61 ± 0.79, p = 0.009), and ease of reaching the office through phone (4.55 ± 0.97 vs. 4.46 ± 0.96, p < 0.001). Conclusions:This analysis demonstrated parity in patient satisfaction for traditional in-person visits and telemedicine visits in primary care.

Introduction: Asthma is one of the most common chronic diseases worldwide. As a disease of the respiratory tract, the site of entry for the SARS-CoV-2 virus, there may be an important interplay bet... Graphical abstract